MedGenome, a genomics and clinical data-driven diagnostics and drug discovery research company, recently received $15 million funding from IFC. In an interview with BusinessLine , Ruchira Shukla, South Asia Regional Lead for Disruptive Technology Investments at IFC, and Sam Santosh, Chairman and Founder of MedGenome, share their perspective about the work the company is carrying out, especially in the area of Covid virus and research on the vaccine. Excerpts:

IFC has invested in a variety of start-ups. So, how does MedGenome fit into your portfolio?

Ruchira: We are sector-agnostic. We have invested in Byju’s, 1mg, Lenskart, BigBasket etc. MedGenome is India’s leading genomic diagnostics business, and we are very proud of this investment, and I think it is very pertinent at this time, particularly as the world is seeing the worst-ever healthcare crisis that it has ever faced. And if anything, this crisis has underlined for us the importance of smart, personalised effective health tech solutions for the world at large, particularly for emerging markets, where IFC has a strong focus and World Bank has strong operations.

So, in the emerging marketing realm, we have been looking at various business models in the genomic space, and actually have been tracking MedGenome’s performance for the last five years. They have built a unique database of South Asian samples and genomic data.

They are now launching new tests for infectious diseases. So, across the board, they have been pushing the boundaries. And with Covid-19, they have been instrumental in expanding the country’s Covid testing capacity, as well as helping us understand the complexities of this pandemic by doing genetic surveillance to figure out virus variants, and how that impacts the susceptibility to this disease by various patients.

Experts say the third wave of Covid is around the corner. But being a genomics and drug discovery company, what kind of work have you done on Covid so far?

Sam: We were right at the forefront fighting this pandemic, both here in India and globally. From February last year, we started focussing on genetic variants that would affect the response of patients to Covid. We have seen some patients reacting badly, while a few others got away with a couple of weeks of downtime, or in the worst case, hospitalisation.

So, we quickly wanted to see what are the genetic variants that are driving that. So, we put out our first paper in March 2020 itself. We looked at 300,000 genomes that are sequenced genomes and examined their genetic variants.

The Y shaped receptors on the cell surface are more prevalent in the lung and that is how the virus gets in. We examined the structure of these two receptors and we looked at the spiked protein on top of the virus (the orange balls with spikes on top).

So, what we found out was that for some the two receptors are so different that the spike protein just doesn’t get in and, hence, are completely immune to the virus. There are those, where the spike really ties into the antibody to these two receptors, and they are the ones who get seriously affected because their infection will be hard on them, while a majority on the neutral place, those who get the infection but it doesn’t really kill them.

Since the data was useful we did not want to wait for a peer review, and we put the first version of the preprint server (repositories) so that everybody could access it. Later it took one year to follow up on that and actually create the antibodies in the lab and draw the structure...what we theoretically predicted is actually right, so that we did and, as you know, that takes time so the structure of the antibodies could really work on the virus which we published two months back on peer review in Nature.

So, what do the research papers say? For example, are Indians more susceptible to the virus?

Sam: As of now, I don’t think that there is anything that actually makes Indians more susceptible. In fact, another paper we published last month clearly shows that in general the susceptibility of Indians is lesser because we have been exposed to many other kinds of infection. It could be because of the climate, our environment, etc.

So, you might ask why is it that we continue to see a rise in cases. That could be because the government may have miscalculated a bit when the first wave went down and did not rush the vaccine and, second, the density of the population. Wearing masks is just one part, but if you look at individual houses, there are a number of people there.

So, what happens is that when the virus spreads fast, it obviously creates more variants. So, it is a vicious cycle, where the variants lead to different types of infections, and there is a possibility of people who have already been infected getting infected again.

Ruchira: I would also jump in and say, and let us be a little empathetic to the country. A large majority of people are uneducated; they probably don’t understand these protocols, plus they live in situations where there are no choices Social distancing is a luxury, especially for the poor in India. They have to go to work, otherwise they can’t earn a living.

What is the uppermost in the minds of the people is how long will the epidemic last. Will it turn out to be an endemic at some point in time?

Sam: So, we have been affected by viruses even earlier. This will obviously be a part of our life. We will learn to control it quickly. I think in the next two years we should be able to get it under control all over the world. But, obviously, the virus will mutate and there will be other variants.

We have to live with it and need to be careful about how we take care of ourselves and our environment. As of now, the vaccination that we have been given is good enough. It is as good as it gets. I don’t think anybody could have come up with a better thing For the time being, yes, and now that we have that sort of as good as it gets. I mean you know this, I don’t think anybody could have come up with a better thing in a short time.

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