As 2020 draws to a close and the pandemic rages on, it’s worth examining the role that science has played in both the prevention and politics of COVID-19. While doctors and nurses have battled the virus from the front lines, public health experts have waged war on an equally relentless scourge: COVID-19 misinformation. Since January, when the virus first made landfall in the United States, medical experts have faced an uphill battle to keep the public informed amidst the contradictions of skeptical politicians — chief among them President Donald Trump. Although non-scientific sources deserve the lion’s share of blame, the scientific community played no small role in fueling pandemic confusion.
In the breakneck race to find effective medicines and flatten the curve, scientific journals were inundated with research of wildly varying quality. According to an article published in the Journal of the American Medical Association (JAMA), submissions to JAMA Network Open increased by a factor of 200 percent since 2019, with a projected total of 1350 studies being published by year’s end. To accommodate the staggering pace of research, journals began drastically decreasing the time budgeted for editing and peer review. According to an article by Dr. Serge Horbach, a researcher at Radboud University in the Netherlands, “compared to articles published in the same journals before the pandemic, turnaround times have decreased on average by 49%.” For many coronavirus researchers, however, these efforts to expedite the review process fell short, especially when compared to the increasingly popular venue of preprint servers. By providing a means of quickly and publicly disseminating findings prior to peer review, preprint servers such as medRxiv and arXiv have enabled researchers to achieve the timely publishing demanded by a rapidly evolving pandemic. Accelerating, or altogether eliminating the peer review process, however, does not come without risks.
Accelerating, or altogether eliminating the peer review process, however, does not come without risks.
Back in mid-April, Horbach warned that “legitimate concerns can be raised on whether speeding up the review process might harm the process’ ability to filter incorrect or invalid findings.” One major testament to the risks of preprint was the case of a paper published by researchers including Stanford’s Dr. John Ioannidis on the preprint server medRxiv. Ioannidis’s paper quickly came under fire for its misleading conclusion that the infection fatality rate of COVID-19 was around 0.17 percent — little worse than the flu. Yet despite the server’s disclaimer that the article “has yet to be evaluated and so should not be used to guide clinical practice,” it has nonetheless provided politicians with ammunition to oppose lockdowns and stay at home orders, often in defiance of National Institutes of Health and World Health Organization public health recommendations.
The consequences of expedited review have even reached The Lancet, a journal amongst the most prestigious in medicine. In one article published on May 22, researchers including Dr. Sapan Desai detailed the results of a study on hydroxychloroquine as a COVID-19 treatment, which employed data collected by Desai’s Surgisphere company. The study “did not observe any benefit of hydroxychloroquine or chloroquine,” and even linked the drugs to an increase in mortality. Confronted with the possibility of patient endangerment, WHO’s hydroxychloroquine trials were abruptly halted. It wasn’t long, however, before the legitimacy of Surgisphere’s data was called into question. Upon investigation, the bulk of the data appeared to be fabricated or fraudulent, with purported patient numbers in excess of case numbers in some regions, and none of the “671 hospitals in six continents” mentioned in the paper having attested to providing Surgisphere with data. Digging into Desai’s past and Surgisphere’s history, The Guardian found that Desai had been named in three medical malpractice suits, and that Surgisphere’s employees, numbering in the single digits, included an adult model and a science fiction writer. The Lancet article, along with others using Surgisphere’s data was retracted as suspicions mounted. Although most major hydroxychloroquine trials resumed shortly thereafter, the redaction of this likely fraudulent study from a preeminent journal of medicine represents a massive oversight in the scientific review process at a time when politicians were downplaying the validity of medical science to the general public.
With COVID-19 cases spiking once more in the U.S., the need to adhere to effective, science-based guidance is more pressing than ever.
With COVID-19 cases spiking once more in the U.S., the need to adhere to effective, science-based guidance is more pressing than ever. And with a Pew Research Center survey finding some 78 percent of Americans concerned by the fast pace of vaccine approval, investing in public confidence in medical science could make all the difference in ensuring public cooperation. After a year of breakneck research, it appears that slow and steady could be the key to winning the race against COVID-19.
JAMA (2020). DOI:10.1001/jama.2020.15194
bioRxiv (2020). DOI:10.1101/2020.04.18.045963
PLoS Biology (2019). DOI:10.1371/journal.pbio.3000151
medRxiv (2020). DOI:10.1101/2020.04.14.20062463.
JAMA Intern Med (2020). DOI:10.1001/jamainternmed.2020.6319
Lancet (2020). DOI:10.1016/s0140-6736(20)31180-6.
Image source: Pixabay.
