Intended for healthcare professionals

Rapid response to:

Letters Waste in covid-19 research

Covid-19: research methods must be flexible in a crisis

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2668 (Published 06 July 2020) Cite this as: BMJ 2020;370:m2668

Rapid Response:

COVID-19 Pandemic, the quest for urgent information and soulutions and the paradox: making haste slowly to avoid ‘COVID-19 Research Waste’; time for strategic ‘COVID-19 Research Retreat for a Decad’

The ‘Unprecedented Rapidly Dynamically Transmuting Specifics’ of the ‘SARS-CoV-2’ and the ‘COVID-19’ constitute the ‘Increasingly Dominant Impetus’ for the equally ‘Rapidly Emerging Avalanche of COVID-19 Research Outputs’ in the ‘COVID-19 Pandemic Era’! The ‘Intense Research Pressure’ in response to the ‘COVID-19 Pandemic Trying Times’ begets the ‘COVID-19 Research Outpourings’ reported as ‘COVID-19 Research Waste’ [1-5]!! Some ‘Communications’ downplay ‘COVID-19 Research Waste’ and suggest the need for less STRINGENT ADHERENCE to ‘Robust Research Standards’ [6-9]!! Another recent ‘Communication’ highlights the ‘Intricate Dyadic Intertwined Interface between Suggested Calibrated Research Standards and Preprints’ to forestall ‘Scientists’ UNDERMINING ‘Science-Research Dyad’ in a ‘COVID-19 Pandemic Era’ already witnessing ‘Politics’ similarly UNDERMINING the same ‘Science-Research Dyad’ [10]!! Given the ‘COVID-19 Pandemic Situational Realities’ and the ‘Evolving Compromised COVID-19 Research Quality’, the ‘Composite COVID-19 Research Overview’ is an imperative! There should be a ‘Forensic Research Audit’ situate with ‘Robust Research Governance Pillars’ and ‘Stiff Data Governance Principles’ to evolve a ‘Strategic COVID-19 Research Retreat for a Decad’: A critical ‘Review-Audit’ of ‘COVID-19 Research’ focusing on ’Ten Research Domains’ covering the ‘COVID-19 Pandemic Facets’!! This is a ‘Clarion Call’ for ‘Research on Research’: Systematic Reviews, Meta-Analyses, Prospective Meta-Analyses etc on ‘COVID-19 Research’ spanning the ‘Decad Domains’!! The ‘COVID-19 Research Retreat’ affords the World the ‘Unique Opportunity to Withdraw and have a Systematic-Systemic Forensic Overview and Reworking’ of ‘COVID-19 Research Output’ juxtaposed with the reported ‘COVID-19 Research Waste’ for ‘Programmatically Repositioning’ the ‘COVID-19 Research’ in proper ‘Situational Perspectives!!!

1. CORONAVIRUS (SARS-CoV-2): The ‘Novel Coronavirus Specifics’/ ‘Information in a Flux’ necessitate further ‘Information Search’ for the True Origin, Appropriate Nomenclature, Natural Biological or Artificial Agent/ ‘Conspiracy Theories’ re: Bioweapon-Economic Terrorism, True State of Human Immunity, Genetic-Genomic Diversity-Serotypes, Viral Recombination Capacity, Aerosolization-Airborne and Transmission Modes, Incubation Period, Disease Severity Determinants! Others: Coronavirus in several Body Fluids (Saliva, Faeces, Urine, Breastmilk etc) and Transmission Implications, Reproduction Rate (R Value)/ Implications, Lethality and Transmissibility, Epidemic Curve Patterns-Metrics etc [11-15]!!

2. CORONAVIRUS DISEASE 2019 (COVID-19): The ‘COVID-19 Specifics’/ ‘Information in a Flux’: Appropriate Nomenclature, Susceptibility and Vulnerability/ Socio-Demographics, Body Systems Afflictions/ Presentations, Increasingly Emerging Clinical Syndromes (MicroCLOTS, MIS-C, Cytokine Storm Syndrome, Post-Traumatic Stress Disorder, Chronic Fatigue Syndrome, ‘Long COVID’, ‘COVID Party’ etc)! Transmission Issues: Modes, Pre-Symptomatic and Asymptomatic, International Spread and Community Spread, Silent Spreaders/ Super Spreaders, etc. Also, Reinfection and Reactivation, Immunity and Convalescent Plasma-Serum/ Antibody Therapy, Disease Severity and Antibodies Levels, Duration and Immunity/ Protection! Other Issues: Analytics, Diagnostics, Therapeutics and Holistics etc [15-24]!!

3. COVID-19 PANDEMIC: The ‘COVID-19’ as a ‘Case’, ‘Outbreaks’, then ‘PHEIC’/ 30th January 2020 and WHO-declared ‘Pandemic’/ 11th March 2020! Further ‘Issues’: ‘Information Search’ to undergird ‘Lessons Learnt’ for the future; It was expected that ‘Previous Epidemics-Pandemics/ Lessons Learnt’ should have prevented the World caught off-guard re: ‘Unprecedented COVID-19 Pandemic Ravaging Devastations’ [15,25]!!

4. COVID-19 PANDEMIC PHARMACEUTICAL INTERVENTIONS: ‘Novel Coronavirus’/ ‘Information in a Flux’ re: Analytics, Biomarkers and Metabolomics/ Exposomics and Testing-Tracing-Tracking and Sensitivity/ Specificity Issues! Also, Diagnostics and Antibodies/ Types and Duration re: Duration and Individual/ Herd Immunity/ Antibodies Coverage Levels Required!! Other ‘Issues’/ Therapeutics: Anti-COVID-19 Drugs in ‘Randomized Controlled Trials’-Monoclonal Antibodies-Immunoglobulins Therapy!! Vaccinology/ Candidate Vaccines in different Phases of Clinical Trials and Specifics re: Production Precursor Diversity, Doses/ Single or Boosters Required, Side Effects, Response Time, Induced Antibodies Types, Levels for Individual/ Herd Immunity, T Cell Immunity-Response-Duration-Protection, True Protection/ Reinfection and Reactivation, Production, Distribution, Supply Chain Issues, Inverse Equity Hypothesis/Access Inequalities, Single or Multiple Vaccines etc [22-24]!! Also, ‘Critical Care Gadgets-Ventilators-CPAPs-PPEs etc’!!!

5. COVID-19 PANDEMIC NON-PHARMACEUTICAL INTERVENTIONS: These are the ‘Interventions that Work’ but suffer ‘Interventional Inequity’ concerning ‘Research, Developments and Investments’! The ’Non-Pharmaceutical Interventions (NPIs)’/ ‘Information in a Flux’ and the relevant Prescriptions-Epidemic Curve Metrics-Epidemiological Metrics for Social Distancing, Self-Isolation, Mass Gatherings Restrictions, Face Masks Specifics, ALL Shutdowns-Easing Lockdowns-‘Stratified Lockdown’ and Universal-Specific Precautionary Measures. The ‘Global Precautionary Measures’: Appropriate Hand-washing Techniques-Proper Hand Sanitizer Use, Frequent Disinfectant Spraying-Soaked Cloth Cleaning of Surfaces Frequently Touched, Avoiding Touching Eyes, Nose and Mouth, ‘NPIs-compliance’-Impact etc [26-34]!

6. COVID-19 PANDEMIC AND SOCIAL-STRUCTURAL DISPARITIES: The ‘COVID-19 Pandemic’/ ‘Social-Structural Disparities’ in various ‘Human Existential-Developmental Spheres’ needing the ‘True Situational Realities’; ‘Issues’ of ‘COVID-19 Racial Disparities’, ‘Racism in Medicine’, ‘Other Social-Structural Disparities’ require ‘Updated Accurate Information’ [35-38]!!

7. COVID-19 INFODEMIC: The ‘COVID-19 Infodemic’/ Another ‘Global Pandemic’ the World is grappling with in the ‘COVID-19 Pandemic Era’! Further ‘COVID-19 Pandemic Accurate Information-seeking Interventions’ are urgently necessitated as imperatives; As ‘Nature Abhors Vacuum’, ‘New and Accurate COVID-19 Information’ MUST be rapidly ‘Sourced and Infused’ to replace any/ every vacated ‘Component’ of the ‘COVID-19 Infodemic’ [38,39]!!

8. COVID-19 RESEARCH: The ‘COVID-19 Research’, an ‘Avalanche of Research Outpourings’ to the ‘Unprecedented Rapidly Dynamically Transmuting COVID-19 Pandemic Specifics’, is now itself the subject/ target of urgently needed ‘Research Interventions’! While some ‘Communications’ [1-5] have regarded the ‘COVID-19 Research’ as ‘COVID-19 Research Waste’, other ‘Communications’ [6-9] call for ‘Differentially Calibrating Strict/ Robust Research Governance Pillars and Data Governance Principles’ to accommodate the ‘Sub-Optimal Research Outputs’!!

9. COVID-19 PANDEMIC AND WHO: The ‘ROLE’ of the WHO right from the beginning of the ‘Novel Infection’ up until this moment has been variously ‘Scrutinized/ Criticized’, and perhaps also ‘Politicized’, and need ‘Further Accurate Information-seeking Interventions’ to appropriately ‘SITUATE/ RE-SITUATE’ the ‘Global Health Body’ in this ‘COVID-19 Pandemic Trying Times’ [15]! The ‘Pandemic Declaration Timeliness’, ‘Interventional Pronouncements’, ‘Certain Issues/ Seeming Uncertainties’, ‘Some Flip-Flop Stance’ etc need ‘Further Research’ for ‘Integrity/ Performance Reaffirmation’!!

10. COVID PHENOMENON: The ‘COVID-19 Pandemic’ has been described as a ‘COVID Phenomenon’40! The ‘Unprecedented Pandemic’ has both ‘Devastating Effects’ [41-43] and ‘Beneficial Outcomes’ [44-46]!! These various ‘COVID-19 Pandemic Effects’ need further ‘Research Interventions’ to properly document their ‘Situational Realities’ and others yet to be identified for a ‘Comprehensive Cost-Benefit Balance’ [47,48]!! The real impact of the ‘Pandemic’ on ‘Non-COVID-19 Conditions’ needs further attention as part of the ‘Total Cost-Benefit Balance’!!!

This ‘Communication’, as a ‘Tantalizing Teaser’, is a ‘Contribution’ to the enlarging extant ‘COVID-19 Research Waste Conversations’ and seeks to focus attention to the ‘Ten Domains-Stated Specifics’ requiring ‘Further Information-seeking Interventions’ by conducting ‘New COVID-19 Research’ that meet ‘Best Practices and Standards in Research’! This, hopefully, should contribute to minimizing and possibly eclipsing the bothersome ‘Other Global Pandemics’: ‘COVID-19 Research Waste’ and ‘COVID-19 Infodemic’!!

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Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria.
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria.
UNICEF-Trained BFHI Master Trainer,
ICDC-Trained in Code Implementation,
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria.
*No Competing Interests.

Competing interests: No competing interests

21 July 2020
CHARLES OSAYANDE EREGIE
MEDICAL DOCTOR
Professor of Child Health and Neonatology, University of Benin and Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria. Also, UNICEF-Trained BFHI Master Trainer and ICDC-Trained in Code Implementaion. Also a Technical Expert/ Consultant on FMOH-UNICEF-NAFDAC Project on Code Implementation in Nigeria
Institute of Child Health, College of Medical Sciences, University of Benin, Benin City, Nigeria.