Am. J. Trop. Med. Hyg., 102(6), 2020, pp.

1164–1165
doi:10.4269/ajtmh.20-0325
Copyright © 2020 by The American Society of Tropical Medicine and Hygiene

Editorial
Nonessential Research in the New Normal: The Impact of COVID-19
Stephanie K. Yanow1,2* and Michael F. Good2,3*
1
School of Public Health, University of Alberta, Edmonton, Canada; 2Department of Medical Microbiology and Immunology, University of Alberta,
Edmonton, Canada; 3Institute for Glycomics, Griffith University, Gold Coast, Australia

With an extraordinary show of solidarity, scientists across projects; they now feel uncertain about their productivity, com-
the globe have mobilized to combat novel coronavirus disease pleting their degrees, and building their careers. Although su-
(COVID-19). Yet, for those who could not redirect their efforts to pervisors are trying to keep their trainees engaged virtually, they
COVID-19, research came to a sudden standstill. Researchers also recognize the profound impact of lost momentum—
at many institutions were first advised to “wind down” their a critical driver of research that keeps trainees motivated amid
research activities, and then, with little warning, laboratories the many challenges and failures in a laboratory. Without an end
were closed. Simultaneously, many clinical studies on diseases in sight, it is difficult to instill confidence in trainees that the
other than COVID-19 were halted in their tracks. pandemic will not have major repercussions on their careers. We
The impacts of research shutdowns will be felt long after the also cannot overlook the missed opportunities for international
pandemic. Many scientists study diseases that do not share students to gain valuable experiences abroad. Until travel bans
the same obvious urgency as COVID-19 and yet take a are lifted, there are no viable options for international students.
shocking toll on human life. For example, malaria infects more This will be especially damaging to students from lower resource
than 200 million people and takes the lives of nearly half a million countries who perhaps stand to gain the most from international
people, mostly young children, each year.1 During laboratory experiences. The global scientific community will pay a heavy
closures and without clinical studies, there will be no progress price in untapped research potential.
toward treating and preventing malaria: no progress toward Research on COVID-19 is considered essential, and rightly
new drugs, vaccines, or diagnostics. A PubMed search of arti- so, but we ask how research on other diseases was deemed
cles published in 2019 alone† revealed at least 416 articles that “nonessential.”
describe preclinical studies of promising drugs, 492 articles on Clearly, there was a calculated assessment of relative risks
vaccines, and 1,023 articles on diagnostics for malaria. A for people working in laboratories versus staying at home.
“Lens” (lens.org) search revealed that in 2019, 3,350 patents Although the shutdown of “nonessential” laboratories aligns
were filed in the broad field of malaria. A search of clinical trials with public health messaging and measures imposed to
in progress‡ that were registered on clinicaltrials.gov as of contain the virus in our communities, we must recognize that
April 15, 2020 listed 119 malaria drug trials, 61 malaria vaccine this is not a simple formula. Lives are at risk because of
trials, and 66 clinical studies on malaria diagnostics. This stopping research on diseases that, in addition to COVID-19,
demonstrates the level of activity in malaria research that has have a major impact on public health. Most public funding
recently been shutdown. systems assess research grants based on their potential for
There will clearly be a void in direct, measurable research impact, and those funded are expected to contribute to
outputs during and following the current hiatus imposed by healthier societies. Closing laboratories and halting clinical
the COVID-19 pandemic. But, there will be other impacts that studies undermine this system. We recognize that we are liv-
are more qualitative yet equally profound, such as effects on ing under exceptional circumstances and that decisions are
our next generation of young scientists. Many students and being made considering the best interests of the public. But
fellows were caught off-guard by the sudden laboratory clo- we argue that governments and academia must allow scien-
sures, ill-prepared to stop experiments on a few days’ notice. tists to resume their work, considering all research essential.
Trainees give their blood, sweat, and tears to their research Personal protective equipment is already mandated to protect
scientists from the hazards of laboratory work. Physical dis-
tancing in laboratories is feasible and currently implemented in
* Address correspondence to Stephanie K. Yanow, School of Public laboratories working on COVID-19.
Health, University of Alberta, Katz Group Centre 6032B, Edmonton Governments are applying significant funding to COVID-19-
T6G 2E1, Canada, E-mail: [email protected] or Michael F. Good,
Institute for Glycomics, Griffith University, Gold Coast, Australia, related research. For example, as recently reported§ by the
E-mail: michael.good@griffith.edu.au. NIH, the organization has allocated ∼$1.8 billion in extramural
† Searches were restricted to publications between January 1, 2019 funding for COVID-19-related research, in addition to regularly
and December 31, 2019. The following search terms were used: appropriated funds. However, because of the economic down-
(“antimalarials”[Pharmacological Action] OR “antimalarials”[MeSH turn as a result of COVID-19, we fear that governments will be
Terms] OR “antimalarials”[All Fields] OR “antimalarial”[All Fields]) tempted to divert funding from non-COVID-19 research instead
AND (“in vitro techniques”[MeSH Terms] OR (“vitro”[All Fields] AND of expanding the research budget to accommodate the new
“techniques”[All Fields]) OR “in vitro techniques”[All Fields] OR
demands. This will further slow the discovery of new treatments,
“vitro”[All Fields] OR “in vitro”[All Fields]); “malaria”[MeSH Terms]
vaccines, and diagnostics for non-COVID-19 diseases. Novel
OR “malaria”[All Fields]) AND (“diagnosis”[MeSH Terms] OR
“diagnosis”[All Fields] OR “diagnostic”[All Fields]); (“malaria”[MeSH coronavirus disease has become a new source of human suf-
Terms] OR “malaria”[All Fields]) AND (“vaccines”[MeSH Terms] OR fering; it is not taking the place of other diseases.
“vaccines”[All Fields] OR “vaccine”[All Fields]).
‡ Studies were listed as “not yet recruiting,” “recruiting,” “enrolling by § https://nexus.od.nih.gov/all/2020/04/13/covid-19-funding-and-funding-
invitation,” and “active, not recruiting.” opportunities/. Accessed April 19, 2020.

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Three of the leading drug candidates against COVID-19 Published online April 24, 2020.
emerged from research on malaria (hydroxychloroquine), Authors’ addresses: Stephanie K. Yanow, School of Public Health,
HIV infection (lopinavir/ritonavir), and Ebola (remdesivir). University of Alberta, Edmonton, Canada, E-mail: [email protected].
Based on their in vitro activity against COVID-19 or related Michael F. Good, Institute for Glycomics, Griffith University, Gold Coast,
viruses such as SARS-CoV-1 or MERS-CoV, these drugs Australia, E-mail: michael.good@griffith.edu.au.
are currently being evaluated in clinical trials.2 Potential This is an open-access article distributed under the terms of the
repurposing of these drugs speaks volumes about the value Creative Commons Attribution (CC-BY) License, which permits un-
restricted use, distribution, and reproduction in any medium, provided
of research on all diseases. We must acknowledge the harm the original author and source are credited.
that will be caused by neglecting areas of research that are
not tied to COVID-19 and ensure we balance our priorities to
save lives. If we assume that health and medical research are REFERENCES
essential to reduce morbidity and mortality, then every 1. WHO, 2019. World Malaria Report. Geneva, Switzerland: World
month that research is delayed will ultimately lead to in- Health Organization.
creased suffering. 2. McCreary EK, Pogue JM, 2020. Coronavirus disease 2019 treat-
ment: a review of early and emerging options. Open Forum
Received April 20, 2020. Accepted for publication April 20, 2020. Infect Dis 7: ofaa105.