Dr. John L. Wallace, Tribune News Service
Good science takes time. This has always been clear to those of us doing health research — less so to the general public. In the pursuit of treatments for COVID-19, we need to manage expectations about what’s not just possible, but also desirable.
Finding a vaccine is difficult work, but it’s not like finding a needle in a haystack. Scientists start from a place of knowledge. Researchers around the world are already working on more than 150 possible vaccines, with 22 in human trials. There are also thousands of previously developed pharmaceuticals in testing. A vaccine for COVID-19 is quite likely to arrive faster than any before it. Yet despite all that, we need to remember that it will take many months, likely years. And, frankly, it should. Why so long? Because we need time to do it right, no matter what incentives, resources and pressures are applied. Ensuring safety is especially critical for older people, who are more susceptible to COVID-19 and other health issues. But it matters to us all.
A COVID-19 vaccine will be administered rapidly to billions of people with a vast range of genetic, health and environmental circumstances. Testing these populations and subpopulations will require immense planning and coordination. It can’t all be done in parallel; some new results will necessitate new investigations. As Merck’s CEO Ken Frazier noted recently in an interview, “we don’t want to rush the vaccine before we’ve done rigorous science. We’ve seen in the recent past with the swine flu, for example, that that vaccine did more harm than good. We don’t have a great history of introducing vaccines quickly in the middle of a pandemic. We want to keep that in mind.”
Good science takes time.
Meanwhile, people and governments have already shown that they’re willing to take shortcuts. Individuals have begged, borrowed and stolen in pursuit of personal protection equipment, medicine and other household essentials, from hand sanitizer to toilet paper. Governments have bid up prices, invoked emergency powers and practically hijacked shipments of gear to supply their citizens. They’ve spent billions for access to medicines that don’t exist yet.
With so much hanging in the balance, people are trafficking in information instead. It’s tempting to simplify, to overclaim, to speak beyond one’s expertise. There has been a surge in unreviewed research. Early publication makes data and lines of inquiry available to other researchers faster, but it also facilitates misinformation, premature reporting and social-media speculation. In January, a “preprint” describing a study on COVID-19’s origins circulated on Twitter and was covered by news media before attracting scientific criticism and a separate research paper devoted to debunking its findings.
Even the medical journals — bastions of peer-reviewed science and notoriously picky in what they publish — have come under fire for publishing studies that needed to be walked back. The Lancet and the New England Journal of Medicine, august journals with nearly 400 years of history between them, both recently found themselves issuing coronavirus retractions on the same day. The New York Times reported that the peer-review process favoured by these and other journals has been condensed from months to days.
Social scientists have also been rushing to publish amid the pandemic, to their peril. Again, many of their COVID-19 papers are being rushed into print — written and reviewed on timelines more appropriate for daily journalism than the intended permanence of scientific literature.
“I was recently asked to review three such papers for a scientific journal,” University of Chicago professor Anthony Fowler wrote recently in an opinion piece for Bloomberg. “Although an editor might normally give me six weeks to complete one review, I was asked to complete three reviews in just one week.”
And these are the pitfalls for well-intentioned claims. I try not to think about ones with less pure motives. But they do exist.
It’s also important to distinguish between the science itself and the organisational obstacles that new research needs to navigate. The irony there is that there are more legitimate ways than ever to streamline science through collaboration. Artificial intelligence. Tailored drug discovery. Digital tools like cloud storage, teleconferencing and Slack. Endless avenues for creating, analysing and sharing big data. These are all in our favour when it comes to beating COVID-19.
But when it comes to the actual research and trials, speed cannot be the driving priority. My own company is conducting drug trials right now. Not for COVID-19, but for pain treatment. Of course, we want to take our treatment to market with all due speed. But our trials can’t be rushed without creating unacceptable risks.
And neither can a COVID-19 vaccine, even though a global pandemic feels like it should be different. We all want a vaccine as quickly as possible, and we should be everything prudent to make it happen. But it has to work, and it has to be safe, for as many people as possible. No matter what it’s for, good science takes time.