I wrote a podcast episode about clinical trials, and look forward to recording it. In the meantime, a new idea.
Bacterial communities on surfaces create biofilms with capsule, produced in varying amounts by different species under different conditions. The nature of the capsule produced may also vary. What if one could predict the infectivity of COVID-19 by looking at which lung mucosal communities produce which and how much capsule? Capsule, for nonspecialists, is jellylike gooey polymer produced by many bacteria, and bacteria vary in when and what kind and how much is produced.
It is not far-fetched to assume that gut communities, which impact or are affected by a lot of risk factors for severe COVID-19 symptoms, affect lung communities or vice versa (gut-lung axis) and that these in turn will impact the amount and composition of capsule produced. Which in turn may affect viral infectivity and symptom development. Is anyone looking at this? Would administering a probiotic to the lungs actually help prevent severe symptoms? Which strain to use?
Things to consider.
One thing that puzzles me: why did people focus on swabbing the back of the nasal cavity, which is a difficult and unpleasant task and unlikely to be carried out properly by untrained people (especially when one does this to oneself)? Why can’t you just cough sputum or swab the throat?
For that matter, why can’t particulates from the lungs be exhaled (or coughed, perhaps more than once) into a collection device (like one of the air filters in aerial microbiology, or this thing) and tested? Why can’t such devices be used in public spaces to monitor air quality, or used in hospital ventilators to monitor patient progress? I will bet anyone a bottle of hand sanitizer that this will be more effective. Tests that are easier to do are less likely to be screwed up.
If one captures DNA as well as RNA and uses whole metagenome sequencing methods, one can profile many different viruses and other aerial organisms. It might even be possible to identify if other microbes (bacteria, fungi, archaea, other viruses) are contributing either to symptoms or lack of such in patients, and coughing into a filter is less intrusive than a nasal swab.