Director’s Corner

Dec. 21, 2020: In response to unprecedented challenges, a breakthrough year for translational science

Christopher Austin

One of my favorite aspects of this time of year is that time itself seems to slow down, inviting reflection on our experiences of the last 12 months. My reflections have led me to a place of gratitude. The people of NCATS — our scientists, staff, grantees and collaborators — responded to the greatest public health crisis of our time with their signature can-do attitude, bringing innovation across the translational spectrum to the understanding and treatment of COVID-19. They have led in every aspect of the response and recognized that many challenges remain that we need to address, such as the significant health disparities experienced by those from marginalized communities.

The pandemic — and the urgent need to understand the disease and treat it — has allowed NCATS to demonstrate our effectiveness in overcoming fundamental problems in the translational process, a mission that started nine years ago this month, when our Center was established to transform the translational process so that new treatments and cures for diseases can be delivered to people faster. A key strategy has been to develop platforms, technologies and programs that address the translational issues common to all diseases. This approach allowed us to pivot many of our existing efforts to address COVID-19 beginning as early as March.

My earlier messages this year introduced you to many NCATS COVID-19 efforts. In this message, I bring them all together to showcase how they leveraged the strategies and generalizable approaches NCATS has spent nearly a decade supporting, both to address the pandemic quickly and to provide a roadmap for future efforts beyond COVID-19.

To understand the nature of this new disease and its demographics, we turned to our collaborative networks and optimized technical solutions. Efforts include the National COVID Cohort Collaborative (N3C), which brought together electronic health records from millions of patients and now is enabling research projects across the country, and the rapid development of a SARS-CoV-2 antibody test to analyze blood samples from about 10,000 participants from diverse communities.

To identify potential treatments that would be immediately usable in patients, we used our platform technologies to create multiple high-throughput drug screening assays, test all approved drugs for anti-COVID-19 activity, and make all data quickly available via the new OpenData Portal.

To clinically test promising therapies as rapidly and safely as possible, we utilized our innovative clinical trial designs, operations and enrollment capabilities across the country to perform two nationwide, multisite trials evaluating blood plasma donated by people who have recovered from COVID-19. A third trial, ACTIV-1 Immune Modulators, has an adaptive master protocol and is evaluating three drugs that aim to reduce the harmful COVID-19 cytokine storm.

To ensure that patients and communities affected by COVID-19 are included in the research and clinical trials and will benefit from their outcomes, NCATS-supported community engagement initiatives and resources are being leveraged by the NIH Community Engagement Alliance (CEAL) Against COVID-19 Disparities and the Rapid Acceleration of Diagnostics (RADxSM) Underserved Populations programs to expand COVID-19 testing in underserved communities and facilitate the inclusion of underrepresented populations in COVID-19 vaccine and therapeutic clinical trials. Community engagement also was a key component of the broad survey of rare disease patients that launched in April to understand the impact of COVID-19 on individuals with rare diseases, their families and their caregivers and inform future research efforts.

These translational science priorities, principles and approaches dramatically sped up the understanding and treatment of COVID-19. But they don’t just apply to COVID-19: They can similarly speed solutions for any disease. This is the “boundless promise” of translational science. Please explore our website for more examples of how we addressed COVID-19, and if you’re interested in collaborating with us to speed the development and delivery of treatments to the people who need them, please visit our Expertise and Resources page.

Happy holidays, and stay well,

Christopher P. Austin, M.D.
Director
National Center for Advancing Translational Sciences