Welcome side effects of the pandemic

• It is without a doubt that a crisis will bring the best of us, and this holds true especially when it comes to medical research. It is widely known that research advanced tremendously during the two World Wars. As they say necessity is the mother of all invention.
  
  
  We are just seeing a similar orgasm of research collaborations happening all around the globe at present. One look at this trials tracker will show that there are currently 548 registered  trials (as of 8th of April 2020) with 44 participating countries. China, the USA and Iran are the three countries participating in most trials perhaps due to self interest or realization of the opportunity at hand, followed predictably by Italy, Spain and France due to the tremendous impact of the pandemic on these countries. It would be a real waste for healthcare systems of these countries to treat so many patients and not learn from the clinical experience or produce significant amounts of data that will advance medical knowledge and treatment.
  
  
  If I counted correctly there are trials for 151 different modalities or regimes to be studied ranging from the use of oxygen to fancy remedies like recombinant Cytokine Gene-Derived Protein and anything in between, inclusive of traditional or non-conventional medical treatments. It is worth noting that this tracker does not list purely observational studies, studies of diagnostic tests, or studies of prognostic markers for these patients. So there are 151 ongoing trials of interventional measures or treatment regimes. Most of these regimes are studied in combination so the number of trials may be smaller than the one I quoted. 
  
  
  Predictably most modalities focus on treatment and the aftermath of suffering from the infection (e.g. rehabilitation) and sadly fewer on non pharmacological preventive measures. For example, anyone who follows the news and the W.H.O. proposals would be aware of the ambiguity and the endless discussions around a simple preventive measure such as wearing a mask when in public. There is currently only one trial focusing on the use of the N95 respirator. 
  
  
  The “happy side effect”of the pandemic is the rush of research it produced, that will hopefully be important for the future of medical research in general. It shows how the medical community in times of need can mobilise swiftly. Barriers can be broken and multicentre trials can be organised within a couple of months. Assuming that all the trials had due diligence procedures completed it is surprising how many steps have been overcome in a fraction of the usual required time. Ethics applications were completed, funding obtained, launching of data collection platforms and multicentre applications were carried out, staff training & allocation and onset of recruitment was completed in record time. Of course, the infrastructure was already there but necessity demonstrated how procedures that appear cumbersome and tedious were fast tracked. 
  
  
  Knowing how research is the Cinderella of medical practice one has to wonder whether during normal circumstances we are asking the right questions and if so why isn’t research the tip of the spear? It also demonstrates that the systems are ready and in place for future global trials. It is just willingness that is lacking. 
  
  
  Resources for COVID-19 related research trials:
  • WHO International Clinical Trials Registry Platform, 
  • European Clinical Trials Registry, 
  • clinicaltrials.gov, 
  • Chinese Clinical Trial Registry, 
  • German Clinical Trials registry, 
  • Japan Primary Registries Network, 
  • Iranian Clinical Trial Registry, and 
  • Australian & New Zealand Clinical Trials Registry