Making Sense of Medical Science (MSMS)

A friend recently asked me, "Can you explain how the various universities, hospitals, NIH and others share data to build off each others work?" That is a good question. These are not normal times and normal avenues of science communication will not suffice.

Typically, data from the lab and clinic are shared between Universities, NIH, CDC, and hospitals in the US and beyond via word-of-mouth between friends and collaborators, via annual meetings, and via publication. The informal word-of-mouth sharing of observations and data can be quite fast, but also is quite limited to a narrow range of recipients. The other, more formal, ways to share data via publication and meetings are slow (it can take a year or more to write a paper and get it published) but can reach a very wide professional audience.

During this time of urgency, I see that short cuts are being taken to get papers about the disease out very rapidly to a broad audience. For example, in early March a prominent French infectious disease expert quickly published very preliminary data on the encouraging effects of hydroxychloroquine on a small number of COVID-19 patients.

Normally, a paper with such preliminary results would not have been approved for publication at all. Normally, it also would have gone through three months or more of peer review and then put in the back of the queue of other papers approved for publication a couple of months after that. However, in this example, the paper was rushed past a couple of editors then put at the head of the publication queue and quickly published. Other journals are doing the same.

Also, an international consortium of EU and US healthcare and public health groups, including the CDC and NIH, has recently formed in order to provide oversight into the 70-some vaccines that are underway. The consortium provides a central clearing house for collecting and sharing information on the progress and testing of the vaccines.

In sum, many of the normal, stodgy, careful avenues for science communication have been set aside in order to facilitate rapid exchange of information about this virus and disease. It seems that this is needed in this time of urgency, but it also comes with some risks of sharing information that may not be solid or well vetted. Unfortunately, non-experts in the press and politics see these rushed results and leap to unwarranted conclusions ignoring the caution that should be given such preliminary data. We saw that with the early enthusiasm around hydroxychloroquine and people drinking aquarium cleaner. Later, more thorough studies indicated that the early enthusiasm over hydroxychloroquine was not warranted.

There is a trade off. We need information that will help us learn how to fight this virus and treat the disease, and we need it fast. Fast means we also compromise a bit in confidence in the data.  

But, what do you do during a pandemic?