GoKawiilWhen the COVID-19 pandemic began sweeping across the world in February 2020, Linda Guamán, a microbiologist at the University UTE in Quito, was ready to serve her country. Ecuador announced its first case on 29 February, and the disease spread quickly. Guayaquil, the nation’s largest city, was hit particularly hard. Hospitals, funeral homes and mortuaries were overwhelmed, with bodies reportedly being abandoned in the streets. Guamán, whose research focused on synthetic biology and metabolic engineering, knew that the country would not have enough testing capacity — and she wanted to help.
“It was clear to me that I should use all the knowledge that I had gained. I joke about this, but I was kind of happy in the sense that this is what I’d been reading about for my whole career. This is what I’d trained for,” she says.
However, within months, that excitement turned to anguish as she became embroiled in a political controversy over the purchase of COVID-19 tests. In an ordeal that lasted several years, she would be arrested, face a trial with the possibility of a prison sentence of up to 13 years and be forced to wear an ankle tag to monitor her movements.
Guamán recounts how she received a call in April 2020 from Ximena Abarca, a public-health scientist and former vice-minister of health, inviting her to work on Quito’s COVID-19 testing strategy. The city had purchased around 100,000 rapid point-of-care tests from a company overseas, and even before Guamán accepted Abarca’s offer, there were stories in the press about the tests being overpriced. “My mum said, ‘You’re going to get into trouble if you take this job.’ But to me it seemed pretty clear. I didn’t participate in the purchase of the tests — I’m just going to work as hard as I can,” Guamán recalls.
In January 2021, the police contacted her. And in March, she was accused of misappropriating public funds, alongside Abarca, Jorge Yunda — a physician, and Quito’s mayor at the time — and 11 others, mainly scientists and health workers. At first, Guamán did not realize the gravity of the situation.
“I just thought, this is absurd. It makes no sense and it’s all going to end really soon,” she says.
The investigation focused on why the Municipality of Quito chose to use loop-mediated isothermal amplification (LAMP) tests rather than the more widespread polymerase chain reaction (PCR) tests. LAMP tests are similar to PCR tests but are faster and simpler to use, because they don’t require repeated cycles of heating and cooling. Michael Mina, an epidemiologist and immunologist who was based at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts, at the time and gave evidence through a video link at the trial, tells Nature he felt it was his duty as a scientist to explain how testing for the virus worked.
“At the time, there was tremendous confusion about the science of testing,” he says. “Linda was not confused,” he adds. She saw LAMP as “a very powerful and inexpensive approach to COVID-19 testing” that her country could use at a time when PCR reagents were in short supply across the globe. “LAMP was an alternative to PCR that was exceptionally high quality, and available,” Mina says.
Testing alternatives
Mina, who went on to help lead the US government’s Home Test to Treat Program, points to an erroneous view at the time that PCR was the only test that could be relied on. He says that LAMP, and then antigen tests, each had their own applications in different circumstances. “In some ways, PCR turned out to be one of the most limited technologies for the needs of the pandemic,” he adds. “It was too sensitive to reliably use as an indicator of whether someone was infectious and required isolation. It was also technically challenging for many labs, and reagents were expensive and scarce. LAMP was a great alternative.”
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