During an outbreak, the scientific community has an obligation to learn more in order to shape the public health response and for proper evaluation of new interventions being tested
There is a general understanding that pandemic preparedness requires not only the involvement of the health sector but the whole society. However, until there is scientific intrusion in the decisions at each level, the preparedness and responses will be partial. This increases the scientific responsibility manifold with a commitment to fast track information and solutions that will ultimately influence life sustenance. During an outbreak, there is a moral obligation to learn more, as quickly as possible, in order to shape the public health response and for proper scientific evaluation of new interventions being tested. Such an approach improves preparedness for future outbreaks.
This requires carefully-designed and ethically-conducted scientific research and release of correct scientific information. Evaluation of diagnostics through rapid methods, probable treatments through suggested drugs and vaccines require clinical trials and regulatory control. Research for suggesting preventive measures and social behaviour including epidemiological, social science and implementation studies can play a critical role in reducing morbidity and mortality.
The world is looking at national and world health systems for an emergency response to this pandemic and at the same time expecting the scientific fraternity to come up with a scientific preparedness plan in the form of prevention, management and treatment. There is no paucity of expertise and technology available to carry out crisis-related research. Using the available infrastructure and management framework, the resources can be rapidly mobilised to come up with rapid solutions.
Science for response coordination: Preparing for and deploying emergency responses will require coordination not only of scientific research activities but for associated policy and administrative decisions, too. A coordinated scientific response is the key to collaborate and integrate the efforts to ensure that other than scientific expertise, a complete spectrum is covered, including epidemiologists, data managers, laboratory technicians, emergency management and risk communications specialists, public health managers and medico-legal personnel. Active participation and cooperation of representatives of different sections of the community will be an absolute must for tackling the situation. The Preliminary Stakeholder Engagement Plan (SEP) of the India COVID-19 Emergency Response and Health Systems Preparedness Project has elaborated the requirement for strengthening pandemic research and multi-sector, national institutions and platforms for “one health.” This is in the form of a separate component of the strategic plan which seeks to develop core capacity to deliver the “one health” approach to monitor, detect and manage infectious disease outbreaks in animals and in humans. India is uniquely positioned to play a key role in research on viruses, other disease pathogens and vaccines for its own emergency response and for global public good.
This component will support research on COVID-19 by Indian institutions working in collaboration with the Indian Council for Medical Research (ICMR). It will support biomedical research to generate evidence to inform the short-term and medium-term response to the COVID-19 pandemic. The component will build capacity for research at Central and State levels to position India to better respond to pandemics.
Scientific information availability for research: Availability of credible information on a global platform is crucial for scientists for their research and to avoid duplicity of efforts. It typically takes time to organise scientific research efforts and/or access the data generated. To address this, the World Health Organisation (WHO) has created a platform to integrate the global research information on COVID-19. This platform provides updates on research activities, international clinical trials registry platform for vaccines and therapeutics and solidarity clinical trials.
The platform also provides access to the WHO’s COVID-19 database that provides global literature on the disease. It is a valuable information resource and is of great importance to the global scientific fraternity conducting research on the virus. The National Institute of Health (NIH), Office of Data Science and Strategy, too, is hosting a platform to provide open access data and computational resources to address the health emergency. It is an important resource to access information on genomics, clinical studies, digital images, expression counts, bioactivity data, case studies, visualisation tools, epidemiology, community participation and participant-level clinical data. Several countries, including India, are providing such platforms to their scientists. There is an effort to find cohesive groups internationally so that such collaborative groups can come up with quick alternatives to the global pandemic.
Scientific solutions through samples: The COVID-19 represents a great challenge for our healthcare systems. The situation and the working conditions are difficult in many places and direct patient care has the highest priority. The next challenge, however, is to support those who are finding a cure for it. Biobanks are crucial in the run towards a vaccine and/or treatment. Biobanks can provide key services to researchers, such as efficient and high-quality storage of samples in clinical and research settings, samples from healthy individuals and standards for targetted identification, collection and conservation of important samples.
Biospecimens offer researchers opportunities to understand the pathogen better and develop diagnostic, therapeutic, and preventive measures, that may mitigate the damage by similar outbreaks in the future. At the same time, long-term storage of biospecimens involves potential risks to individuals and communities. These risks can be managed through adherence to guidelines relevant to the long-term storage of biological specimens collected during infectious disease outbreaks. Only biobanks and researchers with the appropriate equipment, training and facilities can collect, share and handle samples from COVID-19 affected patients. India has set up a number of biobanks but all positive samples are required to be transported to ICMR-NIV, Pune for the purpose of maintaining a bio-repository for health research purposes.
Scientific efforts that will shape the future: The WHO has pooled in resources and scientists from across the world in its search for a potential vaccine and several scientific endeavours all across the globe are shaping social, economic and political decisions on managing the disease and behavioural patterns. India is also playing a big role in association with WHO and independently for tackling the disease burden and its spread. In addition, thousands of researchers around the world are offering their expertise, time and help through international platforms such as Crowdfight COVID-19 to fight against the contagion. Scientists are connecting through social media apps such as Twitter, Facebook, and LinkedIn to provide their services voluntarily.
With no vaccine in sight for at least the next 12-18 months, it seems the fight for rescuing humanity from this deadly virus has only just begun. With no real global consensus on the response mechanism, each nation is finding its own way to protect its citizens.
While India’s “containment/lockdown” approach to fighting the pandemic is happening on one side, the slowdown in trade between India and the world is counter-productive. This disruption in trade is hitting the supply chains of many essential commodities needed for the fight. This includes COVID-19 testing kits, masks, alcohol-based sanitisers, personal protective equipment (PPEs), dress materials for frontline health workers, ventilators and so on. All efforts at global and local levels are being made to hasten the availability of the essentials so that humanity does not suffer.
India has set up a ‘COVID-19 Task Force’ for mapping virus-related technology capabilities in start-ups, academia, research and development labs and industry. The capacity-mapping group consists of representatives from the Department of Science and Technology (DST), Department of Biotechnology (DBT), ICMR, Ministry of Electronics and Information Technology (MEIT), Council for Scientific and Industrial Research (CSIR), Atal Innovation Mission (AIM), Ministry of Micro, Small and Medium Enterprises (MMSME), Startup India and All India Council for Technical Education (AICTE). This task force has identified over 500 entities in the areas of diagnostics, drugs, ventilators, protection gear, disinfecting systems and so on. The solutions identified include masks and other protective gear, sanitisers, affordable kits for screening, ventilators and oxygenators, data analytics for tracking, monitoring and controlling the spread of outbreak through Artificial Intelligence and Internet of Things-based solutions, to name a few.
Many research groups are focussing on basic science and other social aspects of this pandemic like virus morphogenesis and development, sequencing of local strain, virus-host interaction, genetic variants linked with virulence, evolution and transmission pattern, pathogenesis studies and collection of epidemiological data. These studies are necessary for development of vaccines and therapeutic drugs against COVID-19. In the end the scientific community has a responsibility to find a solution to this pandemic soon.
(Writer: Deepika Bhaskar Feroz Khan Suri; Courtesy: The Pioneer)