Op-Ed: We are losing ground on every other disease while fighting COVID-19
With 48 hours notice, we froze all our lab samples. We packed boxes of tissue and cell samples into liquid nitrogen tanks and terminated more than 20 experiments aimed at fighting deadly viruses. We put away so many samples in the deep freezer, set at minus-80 degrees, that its alarm sounded, imploring us to shut the door. The only research activity allowed to continue is that addressing the root cause of our new normal: COVID-19
We suspended laboratory work aimed at ending congenital cytomegalovirus, the most common infectious cause of birth defects and brain damage, which affects one in 150 live births each year, and leaves tens of thousands of children with lifelong neurologic impairments. We halted experiments aimed at eliminating pediatric HIV, at a time when over 400 children a day contract this lifelong infection for which there is no cure.
Like thousands of academic researchers across the U.S. and the world, we took extraordinary steps to pause research operations to help limit the extent of this pandemic — both to prevent infections among our research team and to protect support staff such as animal caretakers and laboratory safety personnel. We did so to achieve the only defense we have against the new coronavirus: limiting human interaction.
The only research activity allowed to continue is that addressing the root cause of our new normal: COVID-19, caused by the virus SARS-CoV2, a virus no one knew existed until four months before.
In January, scientists, public health officials and journalists were warning that the coronavirus was set to explode out of China. Few listened.
While taking these steps to close down academic research operations was necessary, it also means we are losing ground. We are losing ground in the fight against Alzheimer’s disease, obesity, preexisting global epidemics such as malaria, HIV and tuberculosis — and the next global pandemic virus. Clinical trials of new therapies for major killers such as cancer, heart disease and diabetes are on hold. Basic research on new cellular mechanisms that has led to game-changing breakthrough therapies, such as cancer immunotherapy and gene editing, is shuttered.
Meanwhile, the next generation of researchers are not making progress toward the time-sensitive achievements required for a successful career, such as completing their doctoral theses, publishing their first manuscripts or obtaining preliminary data that can land a research grant. These young scientists are losing ground on building foundations for independent research programs and will be tethered even longer to senior research mentors who achieved success prior to the COVID-19 pandemic.
It is unclear how long research on non-COVID-19 diseases can be kept on pause without serious consequences on cures for other conditions for generations to come.
Those of us in academic medicine who have some expertise in virology, immunology, vaccine and drug development are responding to the “call to arms.” We are doing all we can to make a sudden shift — to build research capacity to study a virus we never expected to take on. We did so even before specific funding streams became available, which is now starting to happen.
We quickly launched much-needed controlled trials of novel therapies for COVID-19. We are writing grant proposals that could pave the way for therapies that keep infected individuals out of the ICU and for vaccines that would end the need for social distancing. If we could write our way out of this pandemic, academic medical center researchers would have already achieved that goal.
When we emerge from the COVID-19 fog, we will confront big gaps in biomedical research productivity and funding because of our sole focus on one disease. In particular, junior researchers who are only breaking into their fields will face immense challenges in securing independent funding for their research.
Their challenges will be compounded by academic institutions facing intense economic hardships, and thus, academic scientists and physician-researchers may become even rarer. Biomedical research, and especially programs of junior investigators, will need to be stimulated via federal funding, as they were after the Great Recession by the American Recovery and Reinvestment Act, a 2009 federal stimulus package.
However, the pandemic response is strengthening our capacity to respond quickly and nimbly to new medical threats. That capacity can be repurposed and redeployed when the next emerging infection rears its head.
We can and should take immediate steps to ensure we see the next threat coming our way much sooner, so we don’t again find ourselves locking down years’ worth of research in a freezer, with only 48 hours warning.
Research funding must be more heavily geared toward communicable disease prevention, public health data science, and implementation strategies for diagnostics and tracing the contacts of those diagnosed with infection. We must develop teams and resources that can be rapidly deployed for countermeasures for emerging infections.
We should never again be caught so off guard by the kind of pathogen many had predicted we would face.
Twenty years ago, I was inspired to pursue a career in vaccinology after observing the impact of the AIDS epidemic in Sub-Saharan Africa, where I saw hospital wards full of patients wasting away from opportunistic infections and infants born with HIV who had slim odds of making it to age 5.
Perhaps many of the children whose lives have been so severely disrupted by COVID-19 will be motivated to pursue a career as a vaccinologist, immunologist, or an emerging-virus hunter. If we take steps now, they will be better equipped to meet the challenges of the next historic, life-altering pandemic.
Sallie Permar is a physician and an associate dean and professor of pediatrics, immunology, and molecular genetics and microbiology at Duke University School of Medicine.
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