Biobanks and the Next Pandemic


America needs to attack the next pandemic before it infects and kills millions of people.

Biobanks are repositories of biological specimens and health information.

Biobanks will help prevent or attenuate the impact of future pandemics.

How?

Analysis and statistical modeling of biobank data can predict who
  1. is likely to not become infected
  2. will become mildly ill
  3. may require hospitalization or intensive care unit admission

A well-designed biobank will provide leading indicators. Metrics like pandemic fatality rates can be calculated on specific population segments.

Biobanks let researchers discover what pre-existing health conditions or environmental factors make some people more vulnerable. With corresponding diagnostics and therapies for these populations, researchers can optimize for the highest quantifiable impact on the health of many.

Background

The term “biobank” is used for a variety of repositories. Many banks have a small number of doctor-collected biological specimens—say during a cancerous tumor treatment.

The tissue is stored in the physician researcher's freezer. Usually it's a single sample from the patient. Sometimes blood is also drawn.

Often there's limited patient previous history. And little or no follow-up collection of tissue, blood, or health information kept in an organized, retrievable manner. And the info isn't shared with other researchers or the broader community through manuscripts or at scientific meetings.

A Better Design

A well-designed biobank can change the pandemic game. This should be set up to collect biological samples and corresponding personal, community, and public health data on the participants who contribute.

We should also create biobanks that are set up for future research without a specific hypothesis in mind. Because, future uses and applications mayn't be obvious at the inception stage.

This way, qualified researchers can use this to ask critical questions—like how to attack a pandemic before it spreads like the California wildfires.

The salient characteristics are:

  • Biological samples, such as blood, urine, stool, and/or biopsied tissue are collected from the same individual over the course of time. Ergo, there's a longitudinal record of the individual. And the changes that occur in that person over time.
  • The biological samples are processed and stored in a consistent and rigorous way. Multiple biological molecules, not just DNA, but also RNA, proteins, lipids, metabolites, and small molecules are preserved. And not degraded.
  • Detailed personal health information is collected through surveys and electronic health records. In the past, research excluded minority groups, different socioeconomic classes, and harder-to-reach rural populations. Any conclusions drawn from just a middle class Caucasian population will be of limited value for future research and discovery.
  • Environmental information is collected to know whether participants have been exposed to pollution from wildfires, extreme temperature events, or other environmental phenomena.
  • A large number of participants are enrolled so that statistics can be performed on any findings. The UK Biobank consists of 500,000 people in Great Britain.
  • The NIH-sponsored, All of Us Biobank aims to enroll one million. The large sample size will help researchers pinpoint the causes of diseases—both common and rare.
  • The Colorado Longitudinal Study focuses by recruiting only from the state of Colorado. Now, researchers can study neighborhood health in addition to community and public health. Neighborhood environments shape residents' physical and mental health.

Even sub-optimal biobanks have been useful:

  • Genetic analysis of the UK Biobank participants revealed links between insulin resistance and coronary artery disease.
  • The Framingham Heart Study is one of the longest, most important epidemiological studies in medical history. In the 1960s, the study showed cigarette smoking's role in the heart disease development. And helped fuel the era's anti-smoking campaigns. And the seminal research defining cardiovascular disease risk (CVD) factors. This shaped public CVD prevention guidelines.
  • George Washington University is setting up a COVID-19 specimen bank to accelerate research. They will collect samples from COVID positive patients from day 1-11 and then at 10 weeks, 6 months, and one year later.