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As the nations of the world very slowly emerge out of the various states of lockdown and adjust to the new normal of social distancing, working from home, and staggering shifts, it gives us an opportunity to reflect on the past six months of world-changing events driven by the COVID-19 pandemic.
This year’s Signal’s blog carnival has asked its writers to put their minds to work to assess the negative impact of COVID-19 on regenerative medicine, but also to determine whether new opportunities might be identified for building a stronger and more resilient field into the future. (Read what the other bloggers have to say on this topic.) As regular readers will know, I’m not one to dwell on the negative aspects of life, but it would be remiss of me not to acknowledge the vast impact that COVID-19 has had on our field, and stem cell research in general.
Early on in lockdown, I was approached by my good friend Raj Kannan to help write a piece around some survey data that the International Society for Stem Cell Research had collected from its members. That paper, “COVID-19 Lockdown Hits Young Faculty and Clinical Trials” was published in Stem Cell Reports and really tried to distil from the 750+ respondents what the immediate impact of COVID-19 was on the stem cell science community.
It is clear that there will be substantial losses when it comes to the generation of young scientists in precarious career positions – from hiring freezes through to financially broken funders, time keeps ticking while early career researchers scramble to minimize the damage.
It is also clear that the negative impacts of COVID-19 will be felt much harder by female scientists who have, more often than not, been called on to bear a larger share of childcare and household management. As well, it will be incredibly difficult to assess the true impact of COVID-19 on lost paper/grant submissions, lost research time, etc., as scientific outputs are often spread over many years.
On the clinical side, the acute impact on current clinical trials was sharply felt when hospitals stopped just about everything that wasn’t an essential service and pretty much every aspect of the clinical trial pipeline experienced disruption (including some trials being completely abandoned).
All these issues were identified early and some action is being taken – although not nearly enough to protect the precarious careers of young female scientists.
Now that COVID-19 is likely here to stay, we can turn to the medium term impacts on our field and, again, it would be unfair to ignore the fact that major national hospital and research resources will be dedicated to understanding and managing COVID-19 – understandably so, but we must be aware that there is no magic money tree.
Funding pumped into COVID-19 has the potential to suck the life out of other experimental medicine programs of both a research and a clinical nature, and people resources can only stretch so far. It will therefore be of utmost importance for the field of regenerative medicine to become more nimble and efficient in resource management in the medium term and it is here that we can take some excellent learning points from COVID-19 and its impact on the research and hospital settings. I’ve highlighted three of these below:
- Common purpose has spurred new (sometimes unconventional) interactions: there is nothing like a worldwide pandemic to bring scientists and clinicians together for the common good. The network of research has been vast and interconnected and these relationships will last well beyond the acute phase of the pandemic. This is a great learning lesson for scientists who can sometimes be more obsessed with protecting data for their own grant, paper or career rather than sharing for the common good.
- Funding decisions and trials frameworks can be more efficient. Many organizations have created fast-track review processes for COVID-19 research, with some review timelines being as short as 24 hours. While I could never imagine a major funding organization moving that quickly for project grants, the 10-12 months that is common in some agencies is far too long and could be expedited to move research forward faster. Similarly, COVID-19 clinical trials have tested every aspect of the trials framework with respect to speed. Getting a vaccine approved within a year is virtually unheard of and some scientists are concerned about the potential recklessness in this approach. That said, the red tape that has been slashed for COVID-19 trials isn’t all to do with the science, and trials of other compounds/therapies could be expedited without substantial risks if the framework was improved.
- Remote medicine is being given a major test run. Many countries, including the UK where I am based, have been running non-essential appointments over tele- or video-conferencing. This could be a huge boost for clinical trials if adopted widely by the public. Not only might more consistent monitoring via video conferencing be made possible, but it could also pave the way for AI-assisted technologies and the sort of cultural shifts that can sometimes only be instigated by forcing a behavioural change (in the way that a stay-at-home pandemic can do). I think this is one of the biggest opportunities for future clinical trials and patient management in general. While I’m not certain that such a transition will be an easy one (or even a desirable one!), this enforced period of remote medicine is a one-of-a-kind opportunity to test it out across the world.
As with most crises, there are opportunities: to learn from mistakes, to disrupt patterns/habits and see new solutions, and to galvanize people under a common mission. COVID-19 has given the world a serious shake-up that has been felt in every area of work and life with regenerative medicine being no exception – we can and will seize these opportunities.
David Kent
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