For future medical breakthroughs, we must rebuild research lost to COVID
Perhaps even more than past breakthroughs, the novel COVID-19 mRNA vaccines have inspired immediate and widespread relief and optimism. Biomedical scientists labored for decades to develop the expertise and proof of feasibility that led to the vaccines; this innovative work has saved countless lives and promises an end to a pandemic that has killed millions of people and disrupted normal life around the world for more than a year.
But scientific progress and breakthroughs that enhance and save lives don’t happen overnight or without sustained investments of time and resources. When the pandemic began in March 2020, it forced the immediate shutdown of thousands of scientific laboratories throughout the United States, delaying progress against cancer, Alzheimer’s, ALS, substance use disorders and existing and emerging threats that affect people worldwide.
Important work stopped — in both fundamental science and the translation of basic discoveries into advances that benefit people everywhere.
In many states, laboratories conducting non-COVID-19 research were closed for several months in response to public health orders. Even when they re-opened, it was under socially distanced conditions, which slowed productivity. Scientists could not start new clinical trials other than those related to COVID-19 and enrollment in most ongoing trials stopped or slowed substantially.
At Johns Hopkins, enrollment in clinical trials dropped by more than 70 percent between March and August of 2020. At the University of Pennsylvania’s Abramson Cancer Center, nearly 90 percent of cancer clinical trials suspended enrollment last spring. Those that continued last April and May had less than a third of their baseline enrollments. As teams have learned how to safely resume in-person clinical research activities, enrollments for some trials have moved toward pre-pandemic levels but many institutions have still not fully recovered. That will markedly slow the translation of new therapies into FDA approved medications.
Scientists are now returning to their labs and clinical researchers are working to bring new trials to life. Some research teams are still at reduced capacity, while others are fully functioning. Whatever their current state, no one has been able to simply flip a switch and pick up where they left off last March. Much work was lost due to the abrupt shutdown of laboratory research that occurred across the country. Research teams have had to purchase or create materials for their experiments, rebuild genetically engineered mouse colonies, recruit new patients into studies and take other steps to restart research that was paused or slowed in response to COVID-19.
The pandemic has been especially difficult for trainees and early-career investigators. Graduate students on the verge of finishing important papers and getting their doctoral degrees lost the grant money that will let them continue their work. Many younger scientists, especially women, who were frontline clinicians or who were caring for young children were disproportionately impacted over the past year. A report last month from the National Academies of Science, Engineering and Medicine found that as a result of the pandemic, we may actually lose gains made in recent years to increase the representation of women in science.
The pandemic, while demonstrating the ability of science to save lives, threatens to erode our nation’s scientific progress. As President Biden and Congress discuss important and necessary infrastructure proposals, we urge them to also protect ongoing research by providing federal agencies with supplemental funding to support studies interrupted by COVID-19. Without additional resources to restart research, agencies may need to forego new research at a time when the National Institutes of Health (NIH) already can fund only one in every five proposals.
The bipartisan RISE Act aims to mitigate the pandemic’s impact on research by directing a one-time supplemental investment of $25 billion to federal research agencies, including $10 billion to the NIH. Not only would these resources help maintain a strong research workforce in the aftermath of the pandemic, but they would allow the scientific enterprise to finish pre-pandemic work while looking toward new opportunities to advance discovery.
We are grateful that Biden is highlighting the need for robust commitments to medical research and research and development more broadly. Strong bipartisan support for the NIH over the years has been critical in driving the life-saving treatments, vaccines and preventive innovations that support both the nation’s physical and fiscal health.
Between 1970 and 2000, research-related gains in average life expectancy had an estimated economic value of $95 trillion. A healthier workforce will contribute more to our economy, which is a significant societal benefit that can be directly linked to research and development. Indeed, U.S. leadership in the development of COVID-19 vaccines is itself a strong argument for robust support of our scientific ecosystem.
The pandemic has taught us that investment in research pays huge dividends, sometimes in unexpected ways. We must invest in our research infrastructure to regain our momentum and ensure that we do not impede the scientific pipeline of discoveries or lose the next generation of scientists.
Larry Jameson, MD, PhD, is executive vice president of the University of Pennsylvania for the Health System and dean of the Perelman School of Medicine. Paul B. Rothman, MD, is dean of the Medical Faculty of the School of Medicine, chief executive officer of Johns Hopkins Medicine and vice president for Medicine for Johns Hopkins University. David J. Skorton, MD, is president and CEO of the Association of American Medical Colleges.
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