By: Christopher Sirota, CPCU
All eyes have been on the scientific community to produce solutions to combat COVID-19, but how has the pandemic affected that community and research on other diseases?
According to a December 2020 article in The Atlantic, there is mixed news in this respect: the pandemic has reportedly altered the ability of many scientists to conduct research in general and it has potentially altered the amount of research afforded to other diseases in the near term.
Concerns about the scientific community's enormous shift in focus were actually noted as early in the pandemic as April 2020, such as by The New York Times which explained that some laboratory lockdowns gave many scientists little choice but to work on COVID-19.
First, Some Good News
Respiratory Virus Research
Not surprisingly, The Atlantic notes that, overall, the scientific community will likely be better prepared for the next pandemic. For example, according to the article, scientists should be able to more quickly identify the most common means of viral transmission and be able to develop a vaccine faster based on what has been learned so far during the current pandemic. In addition, per the article, there is a seemingly renewed respect for respiratory viruses such as other coronaviruses, rhinoviruses, adenoviruses, bocaviruses, and the respiratory syncytial virus all which typically can cause cold-like symptoms and have historically garnered little funding; now, they may have a better chance to be studied, in part, because the next pandemic is also reportedly expected to be a respiratory virus.
Chronic Illness Research
Another area of research that may benefit from the current pandemic could be research related to chronic illnesses such as myalgic encephalomyelitis, fibromyalgia, mast stem cell activation syndrome, and dysautonomia. Per The Atlantic, some of these illnesses have historically occurred after certain infections but have not been well understood or researched; during the current pandemic there have been a significant number of cases reported by so-called "long hauler" patients who have survived COVID-19 but reportedly continue to face various symptoms (also known as "Long COVID") that may be similar to such post-infection illnesses, thus some experts have reportedly expressed hope that more interest and research will result.
Collaboration with Social Epidemiologists
The Office of Disease Prevention and Health Promotion provides background information about social and environmental determinants of health, such as air pollution, water quality, extreme heat, economic stability, education, health and health care, and community context. The Atlantic further explains that since germ theory became accepted in the 1800's, biomedical scientists have generally focused more on combatting microbes, and less on the potential health effects of one's social and environmental living conditions, reportedly resulting in an ongoing low interest in collaborating with social scientists; now, however, there is apparently hope that the unequal conditions reportedly revealed by COVID-19 demographic data may reinvigorate such collaboration to help better understand how a person's living situation, poverty and privilege can affect health outcomes.
Now, Some Potentially Bad News for Other Diseases
The Atlantic points out that when the pandemic started in 2020, the majority of the scientific community generally stopped their current research to focus on COVID-19. One survey of 2500 researchers in the U.S., Canada and Europe, reportedly indicated that over 30% of them halted their research to work on COVID-19, including non-biomedical scientists. To provide an order of magnitude, The Atlantic notes the following comparison of research output by topic based on the number of scientific papers (as of December 2020):
The pandemic also reportedly halted billions of dollars of non-COVID-19 clinical trials further pushing some scientists into researching only COVID-19. Funding for COVID-19 research also reportedly appeared to attract many researchers, such as over a reported $3 billion to the National Institutes of Health from Congress and $350 million from the Bill and Melinda Gates Foundation. One expert reportedly opined that such a flip towards a single virus did not occur during Zika or Ebola outbreaks, and that the focus on COVID-19 research has slowed to a crawl research for tuberculosis, which annually causes about 1.5 million fatalities, about the same number as COVID-19-related deaths in 2020.
A related article from the University of Pittsburgh explains additional potential effects as follows:
Normally, trainees work in a lab investigating a particular field of biology or medicine, such as cancer or neurodegeneration. Each trainee studies a single, specific topic and publishes his or her research as scientific papers. The rapid pivot to COVID research means many labs—and trainees—that were once studying other topics are now focused on SARS-CoV-2, which means fewer young scientists are now being trained to tackle other health threats. This loss of knowledge and expertise could leave us less prepared for the next health crisis or outbreak.
Lastly, Some Not So Great Trends
Usually, scientists submit their research papers for peer review before publication, however, there reportedly has been a less common approach to quickly disseminate work called a preprint which does not require such a review; the pandemic apparently flipped some of the community's attitude towards preprints, in part, for the perceived importance of sharing information fast: The Atlantic notes that preprints in one repository called medRxiv increased from about 1,000 at the beginning of 2020, to 12,000 in October 2020.
Unfortunately, the lack of peer review plus attention from the global press seem to have reportedly contributed to some reporting of specious analysis about COVID-19. Per the article, one preprint by non-epidemiologists incorrectly concluded that a tuberculosis vaccine used in a region was associated with lower COVID-19 mortality in that region; the preprint's "ecological fallacy" was reported by over 70 news providers. In another example from the article, non-epidemiologists applied a modeling technique for determining geologic ranges of animals or vector-borne pathogens to estimate the range of the COVID-19 virus, but it was inappropriate for that use; the preprint's reported inaccurate conclusion that the pandemic would not spread to tropical regions such as Brazil were reported by over 50 news providers, and subsequently proved false by the increase in COVID-19 cases reported in those regions.
The Atlantic also points out that during the pandemic many women researchers often have to carry a heavier burden in their family situations, reportedly taking a toll on their ability to publish research: for example, the number of preprints in medRxiv from women as first authors reportedly dropped by over 40% in the spring of 2020 compared to the same period in 2019; also, the number of published COVID-19 papers in a single journal with woman scientists as first authors reportedly dropped by 19% compared with the percentage of women authors in papers published in 2019. According to The Atlantic, a slow down in research output can alter a scientist's career. And perhaps as a result "[m]ale scientists were quoted four times as frequently as female scientists in American news stories about the pandemic."
The pandemic may be directly hindering women scientists' ability to conduct research, but it has reportedly been the choice of government and scientific institution leaders—not the disease—to indirectly hinder the participation of women scientists in decision-making bodies created to combat COVID-19. The Atlantic highlights a BMJ study which revealed that when many governments around the world rushed to create groups to address COVID-19, they did so in a way that sourced leadership positions from ministries and institutions mostly occupied by men, resulting in men leading "more than 80 percent of national COVID‑19 task forces in 87 countries." The study explains some possible consequences as follows:
While current evidence suggests direct COVID-19 severity and mortality is higher for men, women are disproportionately burdened by compounded social and economic impacts. Decision-making bodies which are neither inclusive nor diverse can easily overlook the reality that COVID-19 acts as a multiplier of pre-existing gender-based inequities. Many governments established COVID-19 response measures which disregarded women’s higher levels of income loss, expanded and unpaid family care responsibilities, and gendered poverty rates. Ignorance of these implications exacerbates (life - time) poverty and hunger. Response measures often do not account for women’s increased exposure to domestic and sexual violence or their loss of access to essential health services.