VII- TEST, TEST, TEST: Discovering Zlatan

Tedros Adhanom Ghebreyesus, who sounds as a striker playing for  Olympiacos, is the president of the World Health Organization (WHO). The man, born and schooled in Ethiopia, earning a doctorate in England, has been a bit busy in the office lately. On March 16th 2020, in Geneva, somewhat fed up with giving so many recommendations and explanations, with a tired face, said: “We have a very simple message for all countries: test, test, test.

Simple, brief tips are the best —and probably most effective— for complex problems.

—I’m not getting on with my boyfriend.

—Then tell him to go to hell, my dear.

When Luis Aragonés began to coach the Spanish national team, the biggest problem was Spain’s historic absence of trophies. Faced with such a setback for a country that consumes more football than water, Don Luis arrived at the 2008 European Championships insisting that to be champions, you had to “win, win and win, and win again.” Don Luis’ simple advice worked on some players who had the qualities to execute it. Cesc almost fainted before taking the decisive penalty kick against eternal foes Italy in the quarter-finals, and Torres almost did a Salinas* when one on one with the Germany goalkeeper Lehmann in the final. Almost but not quite. Cesc converted the penalty and Torres held his nerve to score the goal that won the European Championships in Vienna.

Don Tedros’ task seems more complicated than winning that European Championships. Furthermore, unlike Luis Aragonés, Tedros has to lead a team of 194 sovereign countries.

Why is it difficult to apply Don Tedros’ “test, test, test”?

The most effective diagnostic method, the RT-PCR, is complex, expensive, and requires sophisticated machines. South Korea and Germany —countries in the top 10 in R&D investment— have had the muscle and the nous to do thousands of RT-PCRs a day, very efficiently isolating those infected and those who were in contact with them.

Now, ask Malawi, Democratic Republic of the Congo, or Nicaragua to do thousands of RT-PCRs a day. It’s impossible. In the case of Spain, progressively, although more slowly than desired, more RT-PCRs have been done to detect SARS-CoV-2. There are research centres and universities that are helping in this task because, at the peak of infections, the infrastructure of our public health system was not enough.

In any case, in Spain and in the rest of the countries, it would be convenient to carry out diagnostic tests in a non-centralized way, so that a test could be performed anywhere without the need for specialized machines and people. It is like a football club that only tests players at its facilities. It is not entirely efficient. The more scouts you have everywhere, the better to find good players. In March 2001, Leo Beenhakker discovered Zlatan Ibrahimovic whilst he was on a training camp at Spain’s La Manga with his Swedish club Malmö and took him to Ajax without hesitation.

These tests to detect the virus without the need for a sophisticated machine did not exist. But science accelerated and, by applying previous knowledge, those tests now exist. They need time to pass controls, gather permits, and be mass-produced, but we’ll hear from them soon. The one that will probably be available first, due to its sensitivity to detect the virus, is one based on CRISPR technology, a topic in which I have been working for years to edit genomes of model organisms 6. In this way, if you wish, enjoying a beer on a terrace with a view of the Mar Menor, you could detect a SARS-CoV-2 or an Ibrahimovic.

*Julio Salinas missed a clear opportunity to score against Italy in the quarter-finals at the 1994 World Cup in USA. He was one on one with Pagliuca, the Italy goalkeeper, but failed to take his chance.

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