Adapting Medical And Scientific Practices During The COVID-19 Pandemic

The novel coronavirus has changed the world overnight. Businesses have had to adapt and people have had to make significant changes to their daily lives in order to stop the spread. The greatest impact has been on health care and health care workers, and the weight of ending this pandemic is resting squarely on their shoulders.

Researchers are working frantically to come up with a vaccine that will at least lessen the impact of the virus, but these things take time. Ensuring that people are treated medically, emotionally, and safely remains a top priority in the medical world.

Seniors Have Been The Most Vulnerable

When COVID-19 first hit the United States, it ravaged nursing homes. It quickly became apparent older people and people with medical conditions were the most susceptible to the virus and had the highest likelihood of dying from it. The decision was made to lock down facilities where older people live and limit the visitors who could visit, including outside medical professionals.

For older people who didn't live in a nursing home, life became significantly more complicated. Many older people or people with disabilities depend on adult daycare or home health visits to get daily things done like cooking meals, going to the grocery store, cleaning and more.

While many of these services were able to be done with limited contact, there has been one aspect that has been quite elusive: social interaction. In nursing homes, adult daycares, and even with home health situations, people depend on these situations for social interaction. This social interaction is crucial to staving off depression and cognitive decline, and it gets more difficult with each passing day to satisfy the social needs of the most vulnerable populations.

Even medical interactions have been halted in order to prevent the spread of the disease while protocols were established. This led to a new term: medical distancing.

It's Time To Stop Medical Distancing

In the early days of the pandemic, shutting everything down while everything got sorted out was the best course of action. There was a serious shortage of PPE early on, which necessitated a moratorium on non-emergency medical visits so PPE could be retained for more serious cases.

Telehealth has been a lifeline for people who needed routine medical care, and thanks to relaxed regulations from the start of the pandemic more people have had access to it than ever before. Even teletherapy has kept people connected to their mental healthcare providers throughout this trying time.

But as PPE stocks became replenished it became safer for people to seek medical attention once again. Now that procedures are established and wearing masks has become commonplace, medical providers are calling for an end to medical distancing. Things like physical therapy, which has become increasingly necessary thanks to more sedentary lives recently, are quite safe.

A Vaccine Could Come Soon

Typically it takes 12 years for a new drug to reach the market. Research and clinical trials take time and are heavily regulated to ensure safety and efficacy. The fastest vaccine that ever got developed from scratch was the mumps vaccine, taking just four years to complete.

However, when diseases have similarities to other diseases it can dramatically decrease the research phase for a vaccine. In fact, the H1N1 vaccine took just six months to complete as it was a strain of flu and researchers already had a wealth of knowledge on which to base their trials.

Clinical Trials Take Time

After the research is done clinical trials involve four main phases. In Phase 1, 20-100 volunteers receive increasingly larger doses until they start to experience side effects. Phase 2 copies this process with 100-500 healthy volunteers, and Phase 3 uses a pool of 1,000-5,000 volunteers, some of whom receive the vaccine while others receive a placebo without knowing who is who. The FDA has to approve the drug for the market before Phase 4 can take place, and then in Phase 5 volunteers are continually monitored for long-term side effects while researchers look for other applications of the drug.

While many of these phases can be done simultaneously to save time and the FDA has guaranteed it will fast track any promising studies, clinical trials are not without faults.

Clinical Trials Are Not Without Faults

Unfortunately, the history of modern medicine has made conducting holistic clinical trials more difficult. Not even a hundred years ago the medical establishment would routinely conduct tests and experiments on African Americans, disabled people, and more without their knowledge or consent, leading to a historically justified distrust of the medical system. 

As a result, only 5% of clinical trial participants are African Americans, while they make up at least 20% of the population. The results of clinical trials aren't always accurate across different demographics for this reason.

The Future Of A COVID-19 Vaccine

We hear daily about COVID-19 vaccines across the world that are almost ready for widespread use, but when can we realistically expect to see a working COVID-19 vaccine?

Because of the knowledge gained during the SARS-1 outbreak several years ago, the research phase for clinical trials has been shortened significantly. Clinical trials were able to start worldwide within a few months of the initial outbreak, and in many cases trial phases are happening concurrently to save time.

Technology is helping these trials along, and analysis of big data is one of the catalysts behind such a rapid research phase. Testing multiple treatments at once and adapting when better research comes available is just one of the methods being used to hasten the process. Testing more people concurrently also speeds the process along as it yields more data faster. Finally, adaptive trials use all this data enabled by algorithms to maintain the integrity of the data throughout the fast-moving process.

There is hope on the horizon, and by many accounts, we could see a functional vaccine start to become available this winter.