- Northwell Health has treated more than 100,000 COVID-19 cases since March and we’ve learned valuable lessons.
- While we wait for a vaccine, we need to keep researching new treatment therapies, establish a governance structure at each research enterprise, and stop politicizing therapies. We also need to increase investments in vacccines and new therapies.
- COVID-19 is not a one-time event. We need to be ready for the next pandemic.
- Michael J. Dowling is president & CEO of Northwell Health, New York’s largest health system, and Kevin J. Tracey, MD, is president & CEO of Northwell’s Feinstein Institutes for Medical Research.
- This is an opinion column. The thoughts expressed are those of the authors.
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As COVID-19 passes its first birthday, the virus is surging again to record levels throughout most of the US, threatening a continued lethal and expensive assault on the nation’s health and economy.
Researchers in universities, government, and industry are actively pursuing new vaccines and therapies, but we still lack an effective or curative treatment. Having treated more than 100,000 COVID cases since the beginning of the pandemic last March, including over 16,600 inpatients, Northwell Health gained invaluable knowledge of how to manage the response for our communities throughout the New York area.
It is timely now to consider how the lessons learned through research can help guide preparations for future resurgences, based on what we are seeing currently and our experiences from past pandemics. Although we can hope for the best, we have an obligation to prepare for the worst.
Keep researching new therapies.
Promising developments with vaccines in Phase Three clinical trials announced recently by Moderna and Pfizer/BioNTech offer hope for controlling COVID-19. But even if the Food & Drug Administration approves emergency use authorization, a vaccine won’t be broadly available to the public until well into next year. Until that rollout it is imperative to keep pursuing new therapies to treat the disease.
Clinical trials during a pandemic require enormous staffing, oversight and financial support. During an eight-week period from March through May, we staffed a 200-member, rapid-response clinical trial group that enrolled more than 1,200 patients into COVID research trials. The results of our research findings were published in more than 200 manuscripts, providing clinicians throughout the world with timely, useful information on how to treat the virus.
Prioritize and coordinate clinical trials.
No one knows which therapies will prove safe and effective. The answer can only come from doing multiple parallel clinical trials. But to avoid needless duplication of effort, inefficiencies and competition for patients, we recommend a two-prong approach.
First, establish a central governance structure at each research enterprise governed by the highest standards of feasibility, FDA approval and scientific impact, And second, a national clinical trials council to provide a clearing house of information to be shared among all clinical trial sites.
Stop politicizing therapies.
Today’s hyper-politicized world has ensnared medical research. Drugs and vaccines are neither Democratic nor Republican, neither politically left nor right. Researchers, physicians, regulators and industry, guided by the Hippocratic oath to “first do no harm,” should be the sole source of treatment guidelines. It is dangerous when politicians speak out for or against the use or disuse of a drug unless it has been fully scrutinized by teams of researchers. In other words, “let the science decide.”
Increase investments in vaccines and new therapies.
We will find a vaccine or a cure for COVID-19, but we don’t know yet what it will be. Vaccines have eradicated diseases like polio and smallpox, but sometimes it is difficult or impossible to make them effective and safe.
Despite billions of dollars spent over four decades, there is still no approved vaccine for HIV. Thankfully, additional billions spent on HIV therapies produced drugs used by millions of HIV-infected patients, saving untold lives. If there is never a vaccine for COVID-19, then we need to double down investments in research for new therapies.
Unfortunately, US investments in research have not kept pace with inflation for more than 20 years. This has cost us time and lives because our science needs to catch up to COVID-19. It’s time to reinvest in science, make up for lost time and prepare for future pandemics.
This is not a one-time event.
COVID-19 was highly predictable, forecast by countless researchers, epidemiologists and public health experts in hundreds of books and publications. It felt like a surprise only because government leaders and policy makers chose to ignore the risks and failed to prepare.
In 2003, in the wake of SARS-CoV-1, co-author Kevin Tracey, MD, was one of four physician-scientists who participated in a panel convened by the US Department of Health & Human Services. The group recommended the US stockpile PPE, drugs, ventilators and other essential equipment to deal with a pandemic. They also used a forecasting model to assess the impact to the US from a virus more lethal than the current SARS-CoV-2. Their analysis predicted that within the first six months, up to 40%of the US population would be dead, compared to the 243,000 COVID-19 deaths so far.
While we are confident that our nation will defeat COVID-19, it’s only a matter of time before another pandemic will come. The larger question is whether we will face another virus with a relatively low death rate, or one far more dangerous like the one predicted 17 years ago.
Preparing for the worst-case scenario should be a priority for national security. To be ready, we need to significantly increase the nation’s investments in research, clinical trials, operational excellence and public health.
Michael J. Dowling is president & CEO of Northwell Health, New York’s largest health system, and Kevin J. Tracey, MD, is president & CEO of Northwell’s Feinstein Institutes for Medical Research.
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