Critical time for research as virus marches on

As economic suffering and social stress arising from the Covid-19 scourge loom, research questions linger.

Perhaps of the greatest magnitude is how long will it take to discover, test and apply a vaccine for the disease?

But even more immediate is when medication or treatment will be found, with the aim of lowering the death rate, especially among the most vulnerable.

Three other tangential but also critical questions need to be addressed through research. The first, as reported by Time, is whether, and to what extent, those who recover from the disease are immune from reinfection, and for how long.

The answers to these questions have a critical bearing on just who might return to work, and how fast, so that locked-down economic activity can, at least, be partly restarted.

Closely related to the above is whether the antibodies in the blood of the survivors can be used to immunise those not yet infected and treat those with the most severe symptoms, as discussed in Science News.

The second is whether, or to what extent, the virus spreads less rapidly and/or with lower virulence in hotter and more humid climate.

ETHICAL PROBLEMS

As discussed in a recent BBC article, since certain other viruses, including that which causes influenza, are less common or vicious in such climates or seasons, the same may apply to the coronavirus.

Finally, just how much wearing a face mask protects one from infection, if at all? But how would such questions be answered through research?

I know nothing about epidemiology but it seems certain basic protocols that we use in social science would also apply.

These include having samples that are large and representative enough so that the results may be generalised to entire or sections of populations; either eliminating or taking into account extraneous factors that could affect results; replicating such trials a sufficient number of times, and developing clear scales of severity in terms of the condition of and impact on those infected, besides recovery or survival versus death.

Certain unique features of the issue at hand raise practical and ethical problems. On the first question, is it moral to recruit the survivors to re-infect them to see if they really are immune?

DISCOVER VALUE

If they are, how many times, and after how long, would this be done to determine the duration?

Regarding the second question, is it really possible to find people in two contrasting climates, even in the same country, who are identical in every medically relevant way, so that any contrasts in the incidence of the disease can be attributed to climate as opposed to one or more other factors (such as nutrition or ‘inherited’ immunity)?

And how many such tests would be required to dismiss this hypothesis?

For the third question, would it be ethical to recruit a sample of non-mask wearers to compare their rate or severity of infection with wearers who are their match in every other aspect?

And given the extreme virulence of Covid-19, what precautions would have to be taken by those undertaking such medical research without putting their own well-being in jeopardy?

However tragic the Covid-19 consequences, the intense interest, if not cold fear, that has gripped the world should help to more broadly disseminate the value — indeed, the absolute necessity — of research that is properly conducted, validated, reported and, when appropriate, put to practical use.

Dr Wolf is a research analyst in Nairobi. [email protected].