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#Covid19ResearchVoices: Why clinical research is more important now than ever

Covid-19 Research Voices: Chris Green

Published: 19 June 2020

Dr Chris Green, a consultant in Infectious Diseases, explains how a wide range of research studies are needed to answer the many different questions raised in the fight against COVID-19. His blog is part of the COVID-19 Research Voices series.

The outbreak of a novel disease, COVID-19, has highlighted the importance of having invested in an integrated research infrastructure to protect the health of a nation.

The UK has a rich community of world-class clinicians and research scientists. This community has immediately pulled together and cooperated across hospitals throughout the UK, in order to develop the science for an effective, evidence-based, response to the threat of COVID-19. Urgent public health research studies were set up in record-breaking time, on the background of a much diminished workforce that was largely deployed to front-line clinical duty.

There are too many of these valuable studies to mention individually, but the impact of this work has already saved many lives. After the 2009 influenza pandemic, several 'hibernating' studies were prepared for the next population-wide threat and were re-activated as early as January 2020. These have helped to fully characterise the threat and develop the disease models needed to support policy decisions and the allocation of healthcare resources.

It is perhaps obvious that the first step has been to fully understand the challenge and make preparations for what is likely to follow. For example, the ISARIC study aims to answer a number of urgent questions about COVID-19, such as how long people are infectious and what is the best way to diagnose it?

The next round has been to explore our existing arsenal of drugs and other therapies for what may help in this wave of disease. In other words, the repurposing of devices and drugs that have pre-clinical data or clinical data from related viral infections such as MERS and SARS in multi-site, tested in randomised-controlled clinical trials across the country. Examples include the RECOVERY trial, which aims to identify treatments that may benefit adults and children hospitalised with confirmed COVID-19 and the West Midlands-led recovery-RS study (Respiratory Support) which compares the effectiveness of three ventilation methods.

But there is much more underway and needed still. Now, in our hospitals, rapidly accelerated clinical trials are testing a plethora of novel antiviral drugs and immune modulators, targeting different components of the immune response. This will prepare us for treating patients admitted with severe COVID-19 disease in the future. This is notwithstanding the parallel and unprecedented drive to protect the wider public who have so stoically played their part with social isolation.

For them, we press on with vaccine development, track-and-trace methods of transmission interruption and in understanding the individual and inter-personal protective properties of anti-COVID-19 antibody. To put it simply, there has never been a more important time for research.

NIHR has been, and remains, the primary research framework for supporting the NHS and in answering the urgent public health questions to best protect our loved ones. Speaking personally as a front-line Infectious Diseases physician, a university academic and as Clinical Research Specialty Lead for the NIHR Clinical Research Network West Midlands, I remain continually humbled and encouraged by the sustained efforts of so many to this pandemic and in the difficult circumstances that we find ourselves in.

Read more blogs in our Covid-19 Research Voices series.

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