by Catriona Nguyen-Roberston
RSV Science Communication Officer

This article follows a presentation on 21^st April 2021 as part of the Midsumma Festival Queers in Science Lecture Series delivered by Professor Michael Toole AM (Burnet Institute) and Professor Deborah Williamson (The Peter Doherty Institute for Infection and Immunity). This series was supported by Queers in Science, Museums Victoria, the Royal Society of Victoria and the Inspiring Victoria Program.

Professors Deborah (Deb) Williamson and Michael Toole were overseas when they first news of the novel coronavirus in Wuhan – in both cases, via the New York Times. Deb was concerned that it was on the front page rather than further in, but returned her attentions to her holiday with her daughter in Los Angeles. Michael was in Egypt celebrating Coptic Christmas with his partner and also felt a sense of dread but filed it away.

By the time Michael stopped at Beirut Airport en route back to Melbourne and checked the news again at the end of January, the WHO had declared a global public health emergency. From 54 cases in Wuhan to 10,000 worldwide, he knew it would be bad.

They were both in for a crazy, hectic year.

Michael cut short his long-service leave. Having been working since he graduated from Monash Medical School for exactly 50 years, he had been ready for retirement mid-2020, but his boss suggested that he might postpone to September – of an unspecified year.

Michael completed his Medical Residency in Chiang Mai, Thailand, then was appointed Director of the Ban Nam Yao Refugee Health Program in Thailand, where he saw 200 patients a day and had to learn three languages on top of English and Thai to provide adequate care. His next assignments were as Senior Health Adviser for a Somalian Refugee Health Unit, then Oxfam. He coordinated public health responses as a Medical Epidemiologist in the International Health Unit of the US Centres for Disease Control and Prevention (CDC), before returning to Australia as Head of Burnet Institute’s Centre for International Health. With extensive experience in international health, Michael was no stranger to dealing with pandemics.

After returning to Melbourne in early 2020, Michael was assigned as Technical Advisor to the newly established Knowledge Hub for COVID-19 (Know-C19 Hub) at Burnet Institute. One of his tasks was to produce a biweekly global update report incorporating public health responses, current scientific understanding, data and models, and a global analysis. He was particularly interested in assessing how other countries were going about easing restrictions and learning from what they were doing right.

When the second wave rippled through Victoria, Michael strongly advocated for mask wearing, decentralised testing hubs and hotel quarantine. South Korea was an exemplar country for digital contract tracing efforts – they had a decentralised system whereby local governments conducting drive-in testing and pioneered the use of QR codes at retail land hospitality venues. Michael was involved in a pilot program with Yarra Council to demonstrate the effectiveness of decentralised community-based responses, and also advocated for better contact tracing – and now we can’t imagine not scanning into places with a QR code.

As he reflects on the global response to the pandemic, Michael believes that it was a failure in most high and upper middle income countries (and even lower income countries, such as Brazil, Mexico, Indonesia and India). In many of these cases, governments ignored public health advice to their country’s detriment, and in others, there were blind spots (e.g. migrant workers being ignored in Singapore, leading to the highest infection rates per capita in Asia). The rare success stories are mostly in the Indo-Pacific region, including Australia and New Zealand – coincidentally, both countries where Deborah has worked.

Deb Williamson was appointed the Director of Microbiology at the Royal Melbourne Hospital in 2019. She had grand plans for the year ahead, but they were thrown out the window. Deb’s passion for microbiology and infectious disease was ignited during her medical and science degrees at the University of Glasgow. She then moved to London for physician’s training at St Mary’s Hospital, where she constantly walked past the room in which Alexander Fleming discovered penicillin. She undertook clinical microbiology training in Auckland and then was recruited as the Deputy Director of the Public Health Lab at the Doherty Institute for Infection and Immunity. After being promoted to Director of Microbiology, her year turned into a fluctuation between scraggy hair, fighting for toilet paper, and a rollercoaster of successes and challenges in the lab.

Early in the pandemic, it became very clear that testing would be a fundamental part of the response. Deb turned to her pathology training to navigate the many challenges with laboratory testing: swab and reagent shortages, timely reporting, regulatory frameworks, etc. Deb’s group was one of the first to consider using saliva testing for COVID-19. Compared to the (uncomfortable) nasopharyngeal swabs, saliva testing was not as sensitive, but has now become an integral part of hotel quarantine testing. (Out in the community, however, we still have to deal with jabs up the nose.)

Deb also helped develop a lateral flow antibody (serological) test, which uses blood from a finger prick to assess whether a person has antibodies against the SARS-CoV-2 virus. Antibodies are proteins produced by the immune system that are specifically shaped to target certain viruses, and their presence indicates exposure or immunity. Towards the end of the second COVID-19 wave in Victoria, they also tested rapid antigen tests, which detect viral protein from patient samples and could show results within 15 minutes. While standard testing remained the best way to track infection, this work offered hope during a time we needed it.

Being on the front lines, not only did Michael and Deb have to navigate the changing situation and constant influx of information, but also the media. Michael was not prepared for the media storm – since April 2020, he has had 520 media engagements with news outlets around the world. Similarly, every study on COVID testing published by Deb’s team has been picked up by the media and she sometimes felt ambushed.

Deb and Michael were both grateful to be doing meaningful work every day. For Michael, daily walks along the beach across the road with his puppy got him through lockdown. But he hasn’t seen partner since he returned to Melbourne in January 2020, as he stayed to work in Cairo. Deb, thankfully, has been surrounded by family – her children and partner – who helped keep her sane, well-fed, and entertained with memes.

These two incredible individuals were at the forefront, solving many of the challenges thrown at us by the pandemic. It has been a tough couple of years, but we are thankful for their efforts and for sharing their experiences.