COVID-19 rates are at an all-time high. With no singular containment strategy underway in the U.S., it has become more critical than ever to understand who has previously been infected by the virus, whether or not they displayed symptoms. Traditional serology tests can detect the presence of antibodies in the blood, indicating that the body has responded to an infection in the past, but antibodies appear to wane over time. Moreover, recent studies show that some people never mount a detectable antibody response and are instead able to fight off the infection with other immune cells, T cells, before antibodies even appear. Having different tests to help detect recent or past infection is critical to gaining a more accurate understanding of immunity on a population-wide scale.

As part of our ongoing effort with Microsoft to build the TCR-Antigen Map and develop novel, more accurate diagnostics to diagnose many different diseases, we’ve analyzed over 1,500 SARS-CoV-2 samples to date in the ImmuneCODE study. Our most recent study published on the preprint server medRxiv shows that Adaptive’s T-cell test under development outperformed commercial EUA approved antibody testing as an indicator of past SARS-CoV-2 infection, with 99.8% specificity. These data support the launch of T-Detect™ COVID, which will be available later this fall. The study also found that T-cell response differed and was considerably higher in individuals with greater disease severity, whereas there was no correlation between disease severity and antibody levels in these recovered patients. Taken together, these data add to the growing body of evidence that T cells are critical in understanding our immunity to the novel coronavirus.

Vo’, Italy – One Town’s Mission to Contain the Pandemic

On February 21, 78-year-old Adriano Trevisan was the first person in Italy to die of pneumonia due to COVID-19. He was from a small town in northern Italy called Vo’, a one-hour drive west of Venice. Two days following his death, the entire municipality of Vo’ was placed under a strict lockdown and almost immediately, an aggressive testing campaign was initiated. At the beginning and end of a 14-day lockdown, 2,900 residents – 97% of Vo’s population – were tested using PCR to confirm the presence of the virus. More than 40% of those who tested positive showed no symptoms, and this study was one of the first showing that these asymptomatic cases were key to the undetected spread of the virus. Those who tested positive were either quarantined at home or, in severe cases, hospitalized. All residents were encouraged to limit their movement outside of their homes. By March 23, the spread of the illness had stopped and there were no new infections. These data were published in Nature and were widely cited because they provided real world evidence for how the pandemic could be controlled through proper testing and quarantine of affected individuals.

A Breakthrough in Detecting Past SARS-CoV-2 Infection and a Potential Key to Immunity

Vo’ is one of the only locations in the world where previous SARS-CoV-2 infection status is “known” for an entire population. It is thus ideal for understanding how to measure past infection. Two months after the initial lockdown, Adaptive collaborated with University of Padua and Ospedale San Raffaele in Milan in a follow-up study of 2,290 residents, including 70 people who had tested positive with PCR testing on initial analysis. Study participants underwent antibody testing with a EUA approved commercial test (IgG) and T-cell testing with Adaptive’s T-Detect. T-Detect identified 97% of past infections, while antibody testing identified only 77%. Additionally, the T-cell response was higher in symptomatic versus asymptomatic subjects, demonstrating a relationship between disease severity and the amount of detectable T cells, whereas antibody levels did not correlate with disease severity in this recovery period.

Notably, of the 2,200 people who originally tested negative for the virus using PCR¬, 45 tested positive for virus-specific T cells with T-Detect. About half of them had reported symptoms, either before or after PCR testing, or had household exposure. Therefore, T-Detect may also identify past infections that had been missed by prior PCR testing.

Assessing Protection from Future Infection

As infection rates continue to soar, T-cell testing can help us understand the true prevalence of COVID-19 in our communities as well as the degree to which our population is protected from future infection. At the individual level, the availability of a T-cell based clinical test could be useful for people who suspect they may have had COVID-19, but were either unable to get tested or had a negative PCR test at the time of their illness, and who want to know for sure whether they had the disease.

While there is still much to be learned about immunity to and protection from this virus, emerging data show that antibody protection may be transient, and T cells could be the key to durability of protection. Such insights will be critical as we progress toward lasting solutions for the COVID-19 pandemic, including the race toward a vaccine.

Learn more about T-Detect

The coronavirus pandemic has thrust testing into the spotlight, highlighted by long lines to get tested across the country.  We know that accurate, sensitive, and timely diagnosis is paramount in fighting and containing this virus. The same can be said for many diseases; having the right test goes beyond COVID-19.

Today, in parallel with our efforts to bring forth a novel T-cell-based test for COVID-19 to market soon, another major focus at Adaptive and for those in the oncology community is the ability to test for “minimal residual disease,” or MRD. MRD refers to the small number of cancer cells that can stay in the body during and after treatment. Often, these cells are present at such low levels that they do not cause any physical signs or symptoms. However, they may be a signal that cancer is returning, and their absence can be a signal that the disease is under control.

As one of the strongest predictors of patient outcomes in blood cancer, it is no surprise that more and more oncology and hematology treatment developers are integrating MRD tests into their clinical trials. In fact, we recently entered into a collaboration with GlaxoSmithKline (GSK) to use our clonoSEQ® Assay – the first and only FDA-cleared in vitro diagnostic for MRD monitoring in patients with chronic lymphocytic leukemia (CLL), multiple myeloma (MM), and B-cell acute lymphoblastic leukemia (ALL) – across GSK’s hematology and oncology portfolio. This adds to a number of partnerships already established with AbbVie, Amgen and Genentech which incorporate clonoSEQ into their blood cancer clinical trials.

Not only is the use of MRD testing growing in clinical trials, but it is also becoming more routine in the post-approval patient journey. MRD status can help patients and doctors understand how the body is responding to treatment and make timely course-corrections as needed. Especially today, as novel therapies drive better response, MRD testing is increasingly important to assess the depth and durability of that response, so clinicians are prepared to intervene quickly and patients have the opportunity to make choices and plan.

As MRD testing continues to become more commonplace, we’ve recently launched a study with the primary goal of understanding why and how MRD testing is used in patients with ALL, CLL, MM and Non-Hodgkin’s Lymphoma (NHL) to identify trends and best practices for the broader oncology community. As part of our new WATCH registry, we will be following patients’ MRD data and treatment changes for up to three years to understand how MRD testing with clonoSEQ is used, what decisions physicians are making based on MRD results, and qualitatively, the correlation between MRD and patient outcomes.

Knowing MRD status – with a test that, given sufficient sample input, can detect one cancer cell among a million cells – gives patients and doctors the confidence and empowerment they need to stay in the driver’s seat of their disease. In the coming weeks, there will be a lot of new data shared about innovation in both testing and treatment at the American Society of Hematology meeting. I look forward to sharing some thoughts around those advances soon.

Testing is a backbone of treatment. As oncology treatments continue to advance and become more personalized, and the options continue to widen, so too should our focus on diagnostics to ensure physicians have the best information to make the best decisions for their patients.

In light of the COVID-19 pandemic, understanding the role of the immune system has become critical in deciphering how this highly contagious virus affects people across the globe of all ages, ethnic backgrounds, and social backgrounds, with widely varying responses. This has unequivocally brought the role of the immune system to the forefront of research and the public discussion, making Adaptive’s immune medicine platform more relevant than ever. We are seeing that with this virus, as with many other pathogens, the T cell provides a key link to understanding exposure and immunity when it comes to COVID-19. Now we have the ability to use T cells to detect SARS-CoV-2 and leverage this capability to measure and monitor a more comprehensive immune response to vaccines in development.

Critical role of the T cell in the immune response to SARS-CoV-2
We and others are learning a great deal about the critical role T cells play in the immune response to SARS-CoV-2. Specifically, exposure to the novel coronavirus can induce virus-specific T-cell responses without inducing antibodies and can be detected up to 100 days after symptom onset, the maximum time period currently available to assess response,¹ as shown in this diagram below.

Much of what we are learning about T cells is consistent with what we see in the immune response to other viruses, but the combination of global scientific focus and the number of people infected with the virus in such a short period of time has led to an understanding of the variability of individual responses on a greater scale. In the setting of COVID-19, we are seeing:

• T-cell responses arise earlier than antibodies and last through clearance into convalescence. ²
• T cells play a critical role in supporting the development of antibodies by B cells and can serve as the first signs of an immune response to SARS-CoV-2 infection. ³
• The majority of COVID-19 patients generate a T-cell response comprised of both CD8+ T cells, or “killer” T cells which destroy virus-infected cells, and CD4+ “helper” T cells, which help other immune cells, including B cells which produce antibodies. ⁵
• CD8+ & CD4+ T cells were observed in convalescent patients with mild and severe COVID-19 disease. ⁶

Solving a big data problem to study the T cell – the critical missing link in immunity

What makes the task seem daunting is that T cells have been historically notoriously hard to study. Our bodies have hundreds of millions of different T cells in order to be prepared to respond to millions of different types of threats. Most researchers have continued to rely on techniques to either measure the immune response solely based on antibody levels, or sometimes measuring T cells using techniques that are expensive, bespoke and low throughput.

At Adaptive, we set out to solve this problem several years ago. Our platform enables us to identify the specific T cells that map to any disease quantitatively at unprecedented scale, speed and precision. Soon after the pandemic hit, our team at Adaptive Biotechnologies, along with our partners at Microsoft, worked quickly to map the T-cell response to SARS-CoV-2 across the population to make these data freely available via ImmuneCODE, which we believe to be the largest database for the T-cell immune response to this virus.

To date, we have analyzed over 1,400 de-identified patient samples. From these samples, we have identified over 135,000 T-cell receptors (TCRs) that map not only to the spike protein but to 10 other specific parts of the virus which we have shown to be most likely to induce an immune response. It is our hope that these data will help researchers around the world in their quest for solutions to this pandemic.

In addition to making these data publicly available, we have developed two applications: a T-cell based diagnostic, and a T-cell monitoring tool for vaccine developers.

Benefits of using T cells to detect SARS-CoV-2

Using a set of identified “shared” TCRs that are seen across multiple infected individuals, we identified a T-cell signature that can be used for diagnostic purposes. Data from Adaptive Biotechnologies and from others to date show that the properties of T cells, outlined above, could make a test that detects virus-specific T cells a more effective way to assess SARS-CoV-2 exposure before antibodies arise and after they wane.

Comparing T-cell signature with antibody serology

To demonstrate this, we recently conducted a head-to-head study in a real-world setting comparing our test under development with two leading serology tests in 100 patients, ranging from active infection through convalescence. The tests were set at 99.8% specificity to minimize false positives. In this study, 94% of patients were detected as positive by Adaptive’s T-cell test under development vs. 90% (IgG and IgM) and 87% (IgG only) for the serology tests, respectively.1

What we are learning about immune response to this virus from our own studies and other research highlight three reasons that may explain the higher sensitivity of a T-cell test:

1. Patients could be tested after the T-cell response begins but prior to seroconversion. Two of the participants who originally enrolled in our ImmuneRACE study as “exposed” subjects became acutely infected prior to sample collection tested positive for T cells but not for antibodies.
2. Some patients may effectively fight the virus with T cells alone and never seroconvert. One T-cell positive patient in our 100 sample cohort was asymptomatic with two positive PCR tests, but tested negative by both antibody tests. Other researchers have also reported infections that lead to T-cell response but no detectable antibody response.⁴
3. Antibodies wane over time. In our data, we have seen persistence of T cells for most patients as far out as we have measured (~100 days). Other studies have demonstrated that, in contrast, antibodies seem to wane over time although we have not yet observed this in our own data. Literature shows in another coronavirus infection, SARS-CoV-1, that virus specific T cells have been routinely detected in studies in the years following the initial SARS outbreak, including at least a decade after initial infection, while antibodies waned quickly. ^10,11

These results, together with a growing body of evidence indicating T cells can be present in the absence of antibodies, suggest the potential utility of Adaptive’s T-cell based approach to detect immune response to SARS-CoV-2 earlier, and in less severe cases, than tests that detect antibody response.

Regulatory submission

Detection of recent or past infection is our first application, and we are currently working with the FDA to generate and package the data required to submit for Emergency Use Authorization (EUA). We anticipate that the data we continue to generate will expand the clinical applications for our T-cell based testing approach to potentially include assessing pre-existing immunity based on cross-reactive T cells, post infection immunity, and immunity from a vaccine, which may need to be monitored for possible boosters over time.

The need to study T cells when measuring and monitoring immune response to vaccines

As we learn more about the role T cells play in immunity, vaccine developers are recognizing the need to measure the T-cell response in addition to the antibody response to their vaccines. The same qualities that make a T-cell test ideal for diagnostic purposes also underscore its utility for measuring immune response to vaccines. We recently launched immunoSEQ® T-MAP™ COVID as a tool to offer vaccine developers a way to integrate our map of SARS-CoV-2-specific T cells into their vaccine trials.

This is the first molecular T-cell monitoring tool for SARS-CoV-2 that accurately, quantitatively, and reproducibly measures the T-cell immune response to vaccines and tracks the persistence of that response over time. We are providing data that map those TCRs to SARS-CoV-2 antigens, a capability that may significantly improve the ability to measure the immune response to vaccines in development. Importantly, we can do this from a simple blood sample that does not require any special storage or handling.

Speed and samples are needed to learn more

Globally, we are all moving quickly to learn more about the virus and find solutions that will help us turn the corner in this fight. We believe that T cells are key to understanding exposure and immunity – one of the many important pieces of this very big puzzle. Our focus remains clear. We will continue to map T cells at scale, track their immune response to vaccines in development, and track their persistence over time, working together in this collective cause to help end this pandemic. If you are interested in contributing to this important effort: Institutions or collaborators interested in contributing blood samples can direct inquiries to COVID19ImmuneResponse@adaptivebiotech.com, and our ImmuneRACE study is still recruiting – visit www.ImmuneRACE.com for more information.

1. Snyder, et al MedRxiv preprint, 2020
2. Funk, et al. Frontiers in Pharmacology, 2020​
3. Sekine, et al. BioRxiv preprint, 2020 ​
4. Gallais, et al. MedRxiv preprint, 2020​
5. Grifoni, et al. Cell, 2020​
6. Peng, et al. BioRxiv preprint, 2020​
7. Paolo, et al. Pediatric Allergy & Immunology, 2020​
8. Subbarao, et al. Immunity, 2020​
9. Channappanavar, et al. Immunol Res, 2014​
10. Tang et al, J Immunol, 2011
11. Ng et al, Vaccine, 2016

Earlier in my career, in the late 90s and early 2000s, I had the opportunity to work in the “global e-business” groups at two large pharmaceutical companies. At that time, e-business was a new noun – a word widely used across industries but with so many different and emerging meanings. In healthcare, e-business was the start of a new era of data collection and information delivery across the industry.

Nine months ago, my peers and I marveled at how far we’ve come in 20 years with the convergence of biotech and tech, the genomic revolution, the way in which data is helping segment patient populations for more targeted therapies, and the emergence of machine learning to advance research and discovery in healthcare. “E-business” is no longer a noun used anywhere, but it is very much part of everything we do in business and in healthcare.

We are now in the midst of another transformation of the use of big data in healthcare. Collaborative efforts throughout the industry, often propelled by technology like AI, have accelerated our ability to obtain information about the biology of the SARS-CoV-2 virus and how people across the globe are responding to it. This is fundamentally altering the way therapeutics and vaccines are researched and developed – in record time – so that patients can get the care they need.

At Adaptive, we are focused on how people across the globe are responding to the virus. By decoding the adaptive immune response at the individual and population level, we aim to make sense of the interaction between the virus and the human body from exposure to infection to recovery. This is a very hard but solvable big data problem if you have the right technology and the right minds behind it.

In 2018, Microsoft and Adaptive forged a partnership to bring together MSFT’s machine learning, AI and cloud computing to our immune medicine platform – accelerating our ability to map the trillions of T-cell receptors to the millions of clinically-relevant disease antigens to which they bind. As my colleague, and partner, Peter Lee at Microsoft, once said, “the adaptive immune system presents an extremely large but beautiful machine learning problem.”

Why? Because our immune cells have evolved to be massively diverse and dynamic to protect us from millions of different signals of disease that our bodies encounter every day. And each person’s immune system is different, which is why people are reacting so differently to this novel coronavirus. Every single person presents the virus a little bit differently to their own immune system, and we have evolved this way as humans to ensure that no virus or germ can completely eradicate the human race.

Since the immune system sees SARS-CoV-2 just like it would any other virus, we were able to quickly mobilize our platform to map the T cell response across thousands of people from around the world. All of the T cell response data that we’ve collected so far is being made freely available to the scientific and public health communities to help accelerate solutions.

At the same time that we have been generating and releasing this T cell mapping data, researchers around the world have been publishing studies showing that antibodies don’t tell the whole story about the immune response to the virus. We now have the ability to broaden the definition of immune response to include the T cell response at scale to inform more accurate and effective diagnostics, therapeutics and vaccines.

The pandemic has spurred many novel partnerships and innovations to expedite and make drug discovery more efficient, breaking down barriers as we band together as an industry to advance solutions as fast as technology can glean new data. Take for instance, the global COVID R&D Alliance that is bringing together 20 of the most experienced life science and drug development companies – like Schrödinger, Amgen, Pfizer and others – to identify, study, and accelerate promising treatments for COVID-19. Recently, Google Cloud joined this alliance, donating over 16 million hours of high-computing technology to advance solutions.

Thanks to AI and other novel technologies, today we can harness data to crack the code of disease and the immune response to disease in ways unimaginable, until now. As data continues to emerge at an unprecedented rate about the SARS-CoV-2 virus and the immune response, it’s clear that there is no one-size-fits-all approach. Only by blending the best minds with the best of science and tech can we continue to make a true difference in how this and future pandemics are defeated.

Countless people and organizations around the world – from those on the front lines, to those in the lab, to those in the home office – are in a race. Not in a race against each other, but in a race to find solutions to better detect, treat, and contain COVID-19 and ultimately, allow society to reopen safely.

This week, Adaptive Biotechnologies and Microsoft launched ImmuneRACE, a virtual clinical study to decode patients’ immune response to COVID-19. If you are currently fighting, have recently recovered or have been exposed to the virus, your immune system holds important clues about how to detect and fight this disease. By capturing these important lessons learned, we can potentially develop new diagnostics and therapeutics that leverage our bodies’ natural immune response.

Right now, the world needs more reliable testing for COVID-19. Currently there are two types of tests. The first is a PCR test that looks at the virus itself through a nasal swab, and the second is a serology-based blood test that looks at the presence of antibodies in your immune system. But there is potentially a third type of test that looks at a different component of the immune system.

Specifically, the test that we are developing will measure the presence of T cells in the immune system, which identify the disease early on and multiply to combat the infection. By creating a diagnostic that looks at the T cells, we hope to be able to:

• Detect the virus in patients that have mild symptoms or are asymptomatic
• Determine who may have more severe symptoms and require hospitalization vs. being able to recover at home
• Determine if people have or have had the disease, even if antibodies are not present

We are hopeful that this data will be used to help contain the spread of COVID-19, ensure the care matches people’s needs, and ultimately help to reopen society.

Fortunately, the approach we are taking is not new to Adaptive or Microsoft. We partnered more than two years ago to map the immune response of T cells to many diseases, including infectious diseases like Lyme disease, autoimmune diseases and cancers. This effort is an extension of that existing partnership where we are now applying our combined expertise to address COVID-19 and fulfill the need for more reliable testing.

While many people are feeling powerless during this uncertain time, those who have been affected by COVID-19 have an opportunity to make a real difference in the lives of others. If you have or had COVID-19, your immune system has a critical story to tell us about how to beat the virus. We want to learn from you, so together, we can overcome this pandemic.

COVID-19 will likely become part of our lives for the foreseeable future. For that reason, we need many different solutions – preventative, diagnostic and therapeutic – to contain and manage this disease at a global scale for years to come. That’s why we are also making data from ImmuneRACE freely available to public health officials, academia, and the biopharma industry to help accelerate other solutions.

We’re looking forward to seeing and applying the results of our ImmuneRACE Study to inform faster vaccine development, better therapeutic development and more reliable testing. Thank you to everyone who has joined and will join our race and others. It’s going to be the collective efforts of all of us that will lead us toward the finish line.

As the COVID-19 pandemic continues to impact us all personally and professionally, the amount of scientific brainpower that is being dedicated to solving this crisis has been unprecedented. Over the last several weeks, researchers and companies around the world have been racing to develop a variety of potential solutions, from existing therapeutics to new diagnostics and treatments.

At Adaptive, we recently announced an expanded partnership with Amgen to develop a potential antibody therapy to prevent or treat COVID-19. I’m here to answer some frequently asked questions about the work we’re doing together to address this pandemic.

What are Adaptive and Amgen doing to fight COVID-19?

Through this partnership, we are identifying certain antibodies, called neutralizing antibodies, from the blood of patients who are actively fighting or have recently recovered from COVID-19 and then using those to develop a therapeutic. We are analyzing the immune response to COVID-19 from the blood of some recovered patients to find the best antibodies that could neutralize the virus.

Once we have found the best antibody candidates using our high-throughput screening platform, Amgen will then select, develop and manufacture the strongest antibodies into a therapeutic. If successful, the therapeutic would be used for treating patients fighting the disease, as well as preventing infection in those with heightened exposure, such as healthcare workers.

What is the rationale behind antibody therapy?

We have seen some early successes transfusing convalescent plasma from people who have recovered from the virus to treat those who are fighting severe cases of the disease. However, it isn’t a scalable or sustainable solution to the worldwide problem.

Building on the philosophy behind this approach, we want to leverage what worked in the immune response from survivors and infuse the best of those antibodies into people currently fighting the virus. Adaptive’s technology enables us to find the right antibodies and Amgen’s technology enables a scalable solution – the best of both worlds.

What are neutralizing antibodies, and why are you focused on those vs. other types of antibodies?

Neutralizing antibodies are a special set of antibodies that happen to interfere with the biological function of an invading virus. What makes these antibodies particularly special, and why just one or a few of these antibodies could be packaged into a treatment, is their ability to fight the virus all on their own.

How is Adaptive and Amgen’s approach different from others working on antibody therapies?

While others are working on an antibody solution, there are two distinguishing features about our platform which makes the combined Adaptive/Amgen approach unique.

First, our platform lets the immune system reveal the best antibodies against the virus without restricting our search to a pre-identified target. In contrast, some groups are using biological insights about this virus combined with comparative genomics of related viruses to select targets such as an epitope on the spike protein. This is an excellent hypothesis and lets you reduce your search space massively and move fast and we hope it will work in many patients.

Second, we have the scale and speed to assess a much broader pool of possible antibodies against a wider range of targets. Our platform allows us to look at the full sequence of all of the activated antibodies in patients currently fighting the virus. We then funnel them down through a series of techniques to find those that neutralize most efficaciously. I’ll give you a basketball analogy, since we’re all yearning for some sports: We’re scouting for the “Michael Jordan” of antibodies. With Adaptive’s platform, we can scout more candidates than any other team, at one time, to find the “MVP” of antibodies to neutralize this virus. FYI, I grew up in Chicago. This may also dictate whether we develop a single antibody therapy or a cocktail of antibodies, and when along the treatment continuum neutralizing antibodies specific to COVID-19 might matter most.

Why are you confident this approach will work?

Most RNA viruses, such as influenza and Ebola, mutate quickly. For this reason, single antibody therapies have only had mild success, as you are effectively trying to hit a moving target. However, SARS-CoV-2 is an RNA virus that mutates more slowly than other RNA viruses. While it does mutate and there is expected to be an increasing number of strains, they are more genetically related to each other. This relative stability lends itself well to a neutralizing antibody therapy, since the virus will be largely the same in most people, and therefore able to be treated with a single antibody therapy.

How do neutralizing antibodies fit with other solutions being developed for COVID-19?

Based on everything we know about this coronavirus, we expect that it will, at some point, transition from being pandemic to endemic. This means there would be an ongoing need for a therapeutic over potentially many years, and most certainly for the foreseeable future.

Ideally, a global vaccine and other effective treatments, including more reliable testing options, will be available in the near future.

In reality, it may take a while to get a vaccine that works broadly and can be administered across the whole world. Even after a vaccine is found, we can expect periodic outbreaks that further the need for therapies as part of the long-term solution paradigm for this virus. In addition, we know that it’s unlikely one treatment solution will work for everyone, especially as we learn more about who is at higher risk for having a harder recovery.

How does this partnership differ with what Adaptive is doing with Microsoft?

Adaptive is harnessing its immune medicine platform to pursue two separate but synergistic applications to combat COVID-19. Using the same immune medicine platform that we are working with to deliver antibody candidates to Amgen, we are also working with Microsoft to decode the T cell response to COVID-19.

What gives you hope?

At Adaptive, we have long believed the immune system holds the key to diagnosing and treating almost all diseases. It’s really encouraging to see so much research and focus in this moment on the immune response to COVID-19.

Additionally, I have never seen more companies set aside their “bottom line” to collectively solve a global crisis. We are incredibly proud and inspired to be in the fight with all those who have committed their brainpower, expertise and resources to defeating COVID-19. It’s not a matter of who gets there first, just that we – all of us – bring the world much-needed solutions for this pandemic and future threats.