To address COVID-19 and future pandemics, we must answer fundamental questions

David Skorton, MD

Being in the middle of a global pandemic feels unsettling and frightening. Part of that fear is rooted in the unknown, because we still have many unanswered questions: fundamental information researchers don’t know about the coronavirus and how viruses like it will act in the future. At the moment, we’re rightly focused on urgent issues such as securing personal protective equipment and ventilators. But we need more research, because to win the battle we need to understand our enemy so that better diagnosis, treatment, and prevention will become a reality.

As I wrote recently in USA Today, “Rarely in recent memory has it been this difficult to see beyond the next day. ... But that is exactly what we should be doing, and we have no time to waste.” To see our way past this crisis — and advance a step ahead of the next one — we need to invest in two types of research that will answer some key questions.

First, if we can explore questions of fundamental basic science, we can gain a better understanding of how novel viruses like the coronavirus operate within the human body, including at a cellular level. And second, we must examine the way a virus spreads throughout our society, using public health research that can inform the policies we implement locally and nationally.

Some questions for fundamental researchers

Now is the time to launch basic research into wide-ranging questions such as:

  • When does a person who is infected with the coronavirus become contagious?
  • What factors influence whether someone who was infected becomes symptomatic?
  • If someone is asymptomatic, what enables them to be contagious without coughing, sneezing, or otherwise generating infectious droplets? This characteristic of the coronavirus has very limited precedents. Most viruses are spread when an individual is becoming symptomatic.
  • If someone has developed serious complications, are they contagious for a longer period of time?

Answering these questions would enable us to establish science-based policies for lifting “stay at home” restrictions. It would also improve our understanding of how to control the spread of disease both for today and in the future.

Some questions for public health researchers

It’s just as critical to study how social factors affect a virus’s impact. We need comprehensive studies to answer questions such as:

  • Does living in a food desert, being a single parent, or experiencing another social factor affect your risk?
  • How can we better protect against and address disease spread in vulnerable communities such as people who are homeless, imprisoned, or poor?

Knowing these answers will guide how we dedicate future resources.

Long-term commitment to research for our future

Now more than ever, investments in both types of research are essential. Although NIH funding has increased and the CARES Act includes additional funding for vaccine development, I hope our federal investment continues to expand. Greater NIH and National Science Foundation funding is needed to address our fundamental science questions, and CDC funding is crucial to adequately study population health.

With greater federal investment in research, and the ongoing great work of public-private partnerships, I believe we can answer the questions we have today and get ahead of those that will occur tomorrow. The question is, will we invest in this research now? Let’s make it happen.

 

David J. Skorton, MD, is president and CEO of the AAMC (Association of American Medical Colleges), a not-for-profit institution that represents the nation’s medical schools, teaching hospitals, and academic societies.

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Without continued support for health research, many of the most promising young scientists, their ideas and a myriad of potentially life-changing scientific breakthroughs will vanish into oblivion.
Paul Marinec, PhD; University of California San Francisco