Catching Chances: The Movement to Be on the Ground and Research Ready before an Outbreak

Abstract

After more than 28,000 Ebola virus disease cases and at least 11,000 deaths in West Africa during the 2014–2016 epidemic, the world remains without a licensed vaccine or therapeutic broadly available and demonstrated to alleviate suffering. This deficiency has been felt acutely in the two, short, following years with two Ebola virus outbreaks in the Democratic Republic of Congo (DRC), and a Marburg virus outbreak in Uganda. Despite billions of U.S. dollars invested in developing medical countermeasures for filoviruses in the antecedent decades, resulting in an array of preventative, diagnostic, and therapeutic products, none are available on commercial shelves. This paper explores why just-in-time research efforts in the field during the West Africa epidemic failed, as well as some recent initiatives to prevent similarly lost opportunities.

Advanced Preparation Makes Research in Emergencies and Isolation Care Possible: The Case of Novel Coronavirus Disease (COVID-19)

“…In each emergency, some structures preexist, some must be applied anew, and priorities must be set. 16 For COVID-19 with a remdesivir drug trial from NIAID on site and its potential to impact care generally, UNMC/NM tiered offers of enrollment to its patients, first screening for the drug trial before considering other research on a given patient.…”

Rapid establishment of a COVID-19 perinatal biorepository: early lessons from the first 100 women enrolled

“…(4) Is breastfeeding safe and does it provide protection for the neonate? (5) What is the impact of maternal immune response to COVID-19 on the developing fetus? The establishment of a COVID-19 biorepository of specimens from the maternalneonatal dyad is a critical first step to answering these questions; new data suggesting that pregnant women are at increased risk for severe illness from COVID-19 compared to non-pregnant counterparts further demonstrates the importance of research in this unique population [4].…”

“…Overcoming barriers to the establishment of prospective observational cohort studies during a pandemic requires strategic planning and multidisciplinary effort [5]. Academic medical centers with the ability to leverage available resources, identify shared common goals across stakeholders, and adapt to changing clinical and research needs may be at an advantage [6].…”