By Judith S. Currier, MD
Trust in scientific research and in our medical experts has shown us the way out of public health crises in the past, and it will do so again.
How did science become a pawn in the discourse over our national response to the COVID-19 pandemic?
This is not how it should be — certainly not at a time when our country is in the midst of a health crisis, and trust in science and in medical experts is critical to help us to establish a plan to prevent and treat the consequences of the virus. There have been distortion and denial from those who assert that the threat of SARS-CoV-2, the virus that causes COVID-19, is exaggerated and our response has been excessive. How, in the face of more than 206,000
American dead from this disease — six times the number of deaths from influenza in 2018-2019 — is it possible to minimize or deny the impact of the pandemic and reject common-sense strategies like universal masking and physical distancing that clearly have been shown to be effective in other countries?
Health care providers treating patients critically ill with COVID-19 know better. Caregivers on the front lines see the terrible cost of this pandemic every day and recognize its toll, not only in death and devastated lives, but also in economic upheaval for families and businesses. We understand the urgency of reopening and rebooting our economy, as well as the overwhelming desire of people to resume normal lives and once again be together with family and friends in public spaces without restrictions. We want that, too. But we also know that without a solid foundation of rigorous, evidence-based science to guide our decision-making about prevention and treatment, we will find ourselves back where we started. We have already seen that story unfolding in states and countries that have opted to reopen too soon or too quickly.
In the months since the start of the pandemic, we have made significant progress in the treatment of severe COVID-19 disease in the hospital setting, but many challenges remain. It is through studies for the prevention and treatment of early disease conducted in the laboratory, in the field and in carefully constructed clinical trials that we will find our way out of this pandemic. I know from my experience as an HIV researcher that, at a time when thousands were dying and desperate for a cure, claims about certain drugs based on anecdotes or uncontrolled studies proliferated. But the progress we made toward finding effective treatment was the result of rigorous clinical trials coupled with direct engagement and input from the populations most affected by the disease. People with HIV now live healthy, normal lives as a result of research that has led to the availability of safe, well-tolerated and effective evidence-based treatment. The development of evidence-based prevention and treatment strategies utilizing science and research is also the formula that is necessary to meet the challenges of COVID-19.
There currently are more than 5,000 COVID-19 clinical studies in progress in the U.S. and around the world. Many of these trials have appropriately focused on hospitalized patients; however, there is now a national effort, under the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) Partnership, in collaboration with the AIDS Clinical Trials Group, to evaluate the safety and effectiveness of promising new agents to treat adults who have COVID-19 but have not been hospitalized. Finding effective therapies to treat COVID-19 early is vital to help us prevent transmission, hospitalization and advanced illness. The ACTIV partnership is designed to help us rapidly evaluate the most promising treatments to radically alter the current pandemic landscape. Along with other studies around the world, this research has the potential to save lives and reduce the suffering and disability caused by COVID-19, but only if communities trust the scientific process and volunteer to participate in these clinical trials. Misinformation about science and research breeds mistrust and threatens to undermine progress.
Science is not stagnant, and recommendations in response to the pandemic evolve based on new information. When this began, SARS-CoV-2 was a new virus about which we knew nothing. Early on it was thought that wearing a mask did little to hinder spread of the disease, but through scientific advances, we now know better. This does not mean that the science was wrong and, so, can’t be trusted; it means that we acquired new knowledge, which has informed evidence-based recommendations. This should not erode public trust; it should enhance it.
Quality, high-impact research does not happen overnight. Even at the incredible speed with which vaccine trials are moving, an effective vaccine will be months away. That is why it remains essential that we take evidence-based measures like wearing a mask while in public and maintaining physical distancing as we wait for science to do its job.
This pandemic will be with us for many more months. Trust in scientific research and in our medical experts has shown us the way out of public health crises in the past, and it will do so again with this pandemic. Instead of attacking each other, we must come together to attack our common enemy, this virus that has killed so many of us, wreaked havoc on our economy and torn at the social fabric of our country. The scientific community and countless research volunteers have transformed the way we prevent and treat diseases like HIV, hepatitis C and cancer. We can do the same for COVID-19.
Dr. Judith S. Currier is chief of the UCLA Division of Infectious Diseases and chair of the AIDS Clinical Trials Group.