Many Small Steps Take Medical Research a Long Way

Even those who escape the infection suffer during a pandemic like the one we are still living through. Families have lost loved ones, people have lost jobs or worked from home, students have lost personal interactions with teachers and classmates. We are all tired of the disruptions, the isolation, the adjustments, and the seemingly endless flood of warnings, requirements, instructions, and recommendations. We just want it to be over!
 Unfortunately, it isn’t. Case rates and deaths are lower than a year ago, but we are still losing 400 or more people a day in the U.S., and 2022 will likely be the third year in a row that COVID was the third highest cause of death.
Medical research, like all scientific investigation, takes time. When something is actively killing millions of people, as COVID-19 has, the research process can be speeded up by devoting more resources to it. This is how we have made such incredible progress in understanding SARS-CoV-2 and developing the vaccines and treatments that have saved millions of lives.
We have a lot more to learn, partly because the rapidly evolving virus is a moving target, but also because that’s just how scientific research works. It’s an incremental process in which new studies confirm and build on previous research. Dr. A studies one aspect of COVID-19, Dr. B studies another aspect, Dr. C yet another, and so on. Each adds their findings to the growing understanding of COVID and how to fight it.
Such studies follow the six basic steps of the scientific method:
1. Ask a question, such as, “Can COVID-19 infections be reduced or prevented with vaccines?”

2. Review background information; how is SARS-CoV-2 like and different from other coronaviruses; have vaccines worked against them?

3. State a hypothesis – an expected or predicted result: a new mRNA vaccine will reduce or prevent COVID-19.

4. Conduct a test (an experiment) to see if the hypothesis is true or false. A clinical trial comparing the rate and severity of COVID infections in patients receiving the vaccine versus those who did not get immunized is such a test.

5. Analyze the data and draw a conclusion. If the study confirms the hypothesis, you can start getting that vaccine into people’s arms. If the results don’t jibe with the hypothesis, develop a new hypothesis and a new experiment. Either way, the information gained adds to what we know about COVID-19.

6. Communicate the results.
Medical research findings are communicated primarily in journals read by other health professionals. During the current pandemic, many publishers took the unprecedented step of removing paywalls for COVID research articles so that anyone could read them. However, most of us learn about medical research in the popular press, via cable news, or on social media.
And let’s face it—”news” is a commodity. It has to sell itself to survive. Every purveyor of news wants us to read or watch “their” news. In this age of 24-7 broadcasting, online publishing and social media, there are more of them than ever, all clamoring for our attention. And the baited hook each of them casts into the ocean of potential consumers is the headline, that bold, enticing, provocative phrase that shouts, “Read me! I’m the news you need.”
Good headlines are clear, concise, and above all, accurate. Sometimes headline writers exaggerate the importance or relevance of the news they are selling. Sometimes they misrepresent what follows the headline (click bait.) Too often, they are selling misinformation or – because they have some ideological or political agenda – disinformation.
The highly respected Cochrane Library conducts systematic reviews on medical questions by identifying relevant studies, selecting those that fit certain criteria, evaluating the selected studies and their findings, and summarizing the results as the best available evidence on the topic. Cochrane recently published a review on various physical measures for limiting the spread of respiratory viruses. Popular press headlines exploded, most focused only on masking and often flatly contradicting each other.
Some studies are better than others, and apparently even Cochrane can roll out an occasional clunker. This review’s shortcomings include the small number of COVID-specific studies, apples-to-oranges comparisons due to the variety of studies (including less infectious flu virus compared with COVID, for example), and inconsistent mask-wearing in many of the studies.
Despite headlines claiming otherwise, “There is uncertainty about the effects of face masks,” say the authors, and we need better evidence from better studies.
I’ll be wearing my mask for a while yet.

Michael Heyd, a retired medical librarian from Fairfield Township who spent more than forty years searching the literature for professional hospital staff, is a member of Let’s end COVID!
Published: 2/26/23

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