February 6, 2023: Five Lessons NCATS Learned During the Pandemic
Faced with the greatest health crisis of our lifetimes, the research community mounted a rapid and robust response to the COVID-19 pandemic. In a new Science Policy Forum, former NIH Director Francis Collins and others — including myself — reflected on the impact of NIH-led activities and the lessons we have learned so far.
We engaged our research networks to complete clinical trials quickly, our informatics infrastructure to probe real-world data in near-real time, and our platform technologies to speed the understanding of whether therapeutics and vaccines were effective against the virus.
Here is my short list of NCATS’ COVID-19 activities and the insights we gained that can ready us for the future:
Expand clinical trial–ready networks. The Clinical and Translational Science Awards (CTSA) Program institutions have established scientific and operational expertise and resources at the local and regional levels that quickly came together to launch, enroll, and deliver topline results for nationwide trials testing potential treatments. Engaging and including community-based organizations as valued research partners is key to the rapid success of such multisite initiatives, as is creating innovative approaches to streamline trial design and management. The decentralized structure of the sixth Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV-6) protocol, for instance, made it easier for people to participate because they could take part from the comfort of their homes. We must enable nimble clinical trial networks to stand ready to reach people where they are.
Engage underserved, diverse populations. We need to consistently engage all communities so a foundation of trust exists when public health emergencies arise. Working with local clinics in communities hardest hit by the pandemic, for instance, boosted enrollment in NCATS-managed COVID-19 clinical trials. Furthermore, clinical trials like ACTIV-6 demonstrated that local clinics with long-standing connections to community organizations help raise awareness and enable successful completion of trial enrollment from diverse communities. With those partnerships, academic medical centers efficiently tested the effectiveness of medications using clinical trial protocols designed with the highest standards of scientific rigor, which produced unbiased results.
Aggregate, harmonize, and share data. These steps should be baked into research plans from the very beginning to maximize impact and avoid duplicating efforts. They also require a team science approach that includes informatics and policy experts guiding decisions about data access and protections. Taking these approaches allowed us to build the OpenData Portal and National COVID Cohort Collaborative (N3C) to support research and decision-making needs as the pandemic evolved. N3C in particular has become a groundbreaking success story in achieving interoperability across electronic health record systems nationwide to provide real-world data on urgent public health COVID questions.
Expand telehealth services. The United States saw a massive expansion in telehealth in response to the COVID-19 public health emergency. Even before the pandemic, CTSA Program institutions used the benefits of telehealth in many ways, including direct-to-patient services and health care provider-to-provider mentoring. However, the digital divide continues to impede rural and underserved communities’ access to quality health care. We must redouble our efforts to close that gap.
Pivot existing resources. NCATS focuses on addressing many diseases at a time, so we had already developed disease modeling tools (such as tissue chips) and drug repurposing capabilities, among other approaches that could be applied readily to the research needs of the COVID-19 pandemic.
As SARS-CoV-2 continues to evolve and the global pandemic persists, it is ever clearer that no matter the challenges, collective determination is a powerful force. It is also clear that we must keep building research capacities and platform technologies not just for the current pandemic, not just for future pandemics, but also for the health needs of today and tomorrow.
Your partner in science and health,
Joni L. Rutter, Ph.D.
National Center for Advancing Translational Sciences