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Mike MacKinnon (MM): Welcome to We Can Answer That. I'm your host, Mike MacKinnon. Each week, I sit down with a ²ÝÝ®ÎÛÊÓƵµ¼º½ expert to ask five questions contributed by our audience and to shed light on topics that matter to you. If there's one thing the COVID-19 pandemic has shown us, it's the importance of scientific research. After all, we can't fight a deadly disease if we don't understand how it works. In this episode, we're talking with Dr. Paul Kubes, a professor in the Cumming School of Medicine. The ²ÝÝ®ÎÛÊÓƵµ¼º½ is home to one of Canada's few biosafety level three labs. The lab's been inactive for a few years, but Paul and his team are getting it up and running again so we can study COVID-19 without having to rely on other locations to do it for us. Paul, thanks for joining us.

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Paul Kubes (PK): My pleasure.

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MM: First, can you tell us what a biosafety level three lab is?

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PK: Okay. So we have many labs at the ²ÝÝ®ÎÛÊÓƵµ¼º½. Many of them study pathogens that could potentially kill people, but most of those pathogens are level two pathogens. In other words, they don't spread through the air and you can't really get them by breathing in these pathogens. And so level two is still requires certain protective gear and making sure that you don't get infected, but level three takes it a notch higher. And what I mean by that is that now we have a couple of things we need to consider. One, the pathogen you're working with cannot leave that lab. It has to stay within the lab. And so the issue here is how do we seal the room so that nothing can get out and viruses are tiny. So we have to be very careful about making sure that everything is sealed and completely incapable of having a barrier breach. So that's the first thing that has to be done. And at the same time, you need to get things in and out of the facility. So you need doorways, you need autoclaves to clean all the equipment that goes in and out. So it's a bit tricky to build one of these and it takes some real effort from engineers and various other folks to ensure that we get it right. In the end, they do all kinds of testing to make sure that nothing's sneaks out from inside the lab. So that's the first thing, we want to protect all the other folks in the university. We don't want this virus getting out of the level three. The second thing is we then need to protect the people inside the level three. So if I'm going to be working with COVID for example, and it's all around me, I need to make sure that I'm protected. And so in a level three, there are certain precautions that are taken that we wouldn't have to do in a level two. And that includes things like up a PAPR, which is a special hood battery operated masks, so that it filters the air so that I don't breathe in any of the potential pathogen. And in addition to that, we double mask, sorry, we double glove. We do various other things to ensure that we don't get sick either. So that's the essence of a level three facility.

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MM: So we're reopening the lab primarily to study COVID-19, but what other types of diseases were studied there before it closed? And what kinds of diseases could be studied there in the future, aside from COVID?

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PK: Yeah, so, that's a great question. Most of these level three facilities are geared towards a single pathogen. And so in the first instance, we hope to study SARS-CoV-2 exclusively. However, the investment we have made, it would be a real shame now to close it up, should we end up with a cure for COVID-19. And so we've been planning to do other things. And the pathogens that we were hoping to study are tuberculosis. So TB, there are numerous patients that are now resistant to antibiotics against TB. And so, as the tuberculosis gets more and more resistant, we need to find new ways of treating it. And so tuberculosis is first on our list of other pathogens we want to study. Certainly there are other viruses. SARS itself, the original SARS, MERS, which is another form of these types of viruses. So there are numerous viruses that we could really begin to study in a level three facility like this.

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MM: Now what about you personally, once the lab is up and running again, what's the first thing you're going to study?

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PK: So I had this dream many months ago of what I wanted to do. What we're able to do outside of the level three lab is take a microscope and go inside the lungs and visualize what's happening in the lungs. So we can see what's happening inside the sacs, the alveoli, we can see what's happening in the bloodstream. It's almost like, I don't know if you remember the amazing journey where they took a submarine into the human body and they were able to visualize all the different components of the immune system. We can do that, not with a submarine, but with our microscope. And so we're really keen on getting that microscope moved into the level three. And once it's in there, we'll be able to take a mouse for example, or a hamster infected with SARS-CoV-2, and then visualize what that virus is doing. We happen to have a fluorescent form of the virus. So we actually will know which cells are infected and then be able to see how is the immune system behaving in response to those infected cells? Is it becoming hyper activated? And so now you get all kinds of immunity you don't need, or is it ignoring the infected cells? And that's why there's a problem. So being able to go inside and visualizing and seeing what's happening in the body will be very unique. It will give us new insights. We won't be guessing at what might be happening inside a patient. I think we'll now see firsthand what's happening.

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MM: The science behind COVID-19 seems to be changing almost daily. So how can people know what's reliable information and what isn't?

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PK: So, Mike, let me tell you, I'm in that same boat. I mean, you read things every day and every day you wonder, is this real? Is it not real? How do I make ends meet of all the information that's coming at us? And I think part of that is that normally what happens is that I do my research. I write up a paper, it gets submitted to people in the field, review it, it's all done anonymously. I get a letter back from the editor saying you've got a year to make revisions, send us back a new copy and we'll have another look at it. That's the normal process. Okay? Now what happens with COVID is hurry, hurry, hurry. Everybody's in a hurry. Everybody needs to publish yesterday. So the reviews often are quite quick. The papers are written up in a way that's as quick as possible, not enough patients, not enough experiments. And we're bombarded with information as quickly as possible. And often this leads to incomplete information. I don't want to say misinformation, but I think it's incomplete information. And in addition to that, after I published my paper normally, others will look at it. They'll say, look. We should really look at this. They look at it and either they verify the findings, in which case it becomes the foundation of knowledge that we move on from. Nowadays, something comes out, and no one has time to really look at it, respond, verify it. It's just in mainstream media and everybody's looking at it. And so it's really tough to know what do I trust? What is it that I should believe and what shouldn't I believe? And so as a parent, what I trust is what Alberta Health Services tells me, what Dr. Hinshaw says, I believe those sources, I'm less reluctant to believe the sensational story found on some network and leave it at some network. And I'm more hesitant about that. The other problem that's happened is that now we have this new system called bio archives where people can put their papers on the net as if they were published and they've not even been peer reviewed. So I could put a paper on that my wife has three heads and it would get into mainstream media and no one's ever reviewed that. And I can guarantee you, my wife does not have three heads. So I think we're in a time where things are slipping through the cracks and we don't have the same level of surveillance of the literature and making sure it's correct. So I think that it's really tough for the community to know what to believe, what not to believe. And I continue to go back to our health agency, the Alberta Health Services, and I continue to go back to Health Canada and say, those are what we should be listening to at this stage. They've got lots of really good advisors, lots of people who really peruse the literature and understand what's going on.

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MM: So you've kind of alluded to this already, but more generally speaking, how has this pandemic changed scientific research?

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PK: Well, so as I just said, things have become very quick, very expedited and not always for the better. I will say that there's another thing that's changed dramatically. And we're seeing in the hospitals, as far as patients are concerned, and we're seeing it in science, and we're seeing it with all the foundations. COVID has taken over everything. And by that, I mean that, for example, the cystic fibrosis foundation this year had to completely call off their awards for grants to study cystic fibrosis. They just weren't able to raise enough money. And so now all that important cystic fibrosis research is not being done because it can't be funded. So a very important disease, devastating to kids that are diagnosed with cystic fibrosis, it's no longer being researched. Many scientists have pivoted because it is a lung disease and have started studying COVID. And so I think that it's changed science in a way that's not always good. I think that the money is flowing more into COVID research and less into some of these other important diseases. We see that with patients as well, more and more patients are hesitant about coming in, even though they're sick, they don't have COVID, but do I really want to go to the hospital right now? We see that with patients, we're seeing it with science and we're seeing it with all the journals that are publishing science. They are certainly focusing on COVID and looking for new, exciting COVID stories. So I think that the important work that is being done in other areas, we still need to keep in mind that there's many devastating diseases, and we need to continue to fund that research.

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MM: It certainly seems like COVID is the only disease out there right now. Do you anticipate when the pandemic is over that things will kind of go back to normal or how does that look in the future?

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PK: I think that I would say that about three months ago, it was nothing but COVID. In fact, our labs couldn't be open unless we were studying COVID. So that is changing already. And more and more scientists are able to return to their daily lives. I've been in every day, we're studying all kinds of different things, not just COVID and all of that work can now progress. And so I think that we're returning to normal in the laboratories. And I think that people are starting to go back to what they were studying and what they were doing. And importantly, doing the work that may lead to cures in various diseases. And I will tell you that one thing that has always amazed me is it's almost never the person who is studying a particular disease that finds the cure. It's people studying other areas of research that contribute in a major way to finding the cure for COVID. And so it may be someone studying a very different virus that will find how that virus gets into cells, apply it to COVID and find out, wow, this works. And so we have to let that other research continue, because I think it contributes in a very meaningful way to all research, including COVID research.

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MM: This has been We Can Answer That. We've been talking to Dr. Paul Kubes, professor in the Cumming School of Medicine about ²ÝÝ®ÎÛÊÓƵµ¼º½'s biosafety level three lab, and how we can use it to understand more about COVID-19. You can subscribe to We Can Answer That on Apple, Google, or Spotify, or by visiting ucalgary.ca/podcasts. Follow our social channels to see which one of our experts will be featured in our next episode and to send us questions you'd like them to answer. We Can Answer That is a production of the ²ÝÝ®ÎÛÊÓƵµ¼º½. Thanks to Paul for his time today, and thanks to you for listening.

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