COVID-19 and clinical trials : point of view of Vincent Poitout
In light of the exceptional situation surrounding COVID-19, CATALIS interviewed clinical research leaders in Quebec to find out their perspectives on the crisis and to look for ways to adapt. The following statements detail the point of view of Vincent Poitout, Professor, Université de Montréal and Director, CRCHUM
Q. How do you think the COVID-19 pandemic will alter current and future clinical research, both internationally and here in Quebec?
There is a lot of concern within the industry over the short term. Many research teams are at high risk since their revenues depend on the continuation of clinical trials. However, the CHUM has suspended most clinical trials not directly related to COVID-19, forcing several researchers to lay off members of their teams. Cutting-edge research expertise takes a long time to develop, and unfortunately, it can be lost quickly. The institutions are trying to maintain their infrastructure and retain their staff, but the current financing parameters do not provide them with the means to support all research teams financially. The paradox is that these fears come at a time when we need research the most.
University hospital research centers are expected to balance their budgets, but they anticipate a substantial decrease in their revenues as a result of the pandemic. Measures must be taken to ensure research centers’ financial sustainability if Quebec’s clinical research strength is to be maintained. Otherwise, this strength could be greatly weakened even though the Ministry of Economy and Innovation’s seeks to attract studies to Quebec and preserve the province’s competitiveness.
“Loss of financing is putting clinical research at risk.”
The teams most at risk are those financed by private contracts, whose revenues are directly tied to patient recruitment. Sources of revenue are scarce, and government measures do not apply to research. Government action is needed to support clinical research in Quebec during the crisis.
Teams financed through subsidies are also at risk, even though they have a little more visibility since this type of project’s funding does not depend on the number of participants. No one knows what the financing agencies will decide. Some foundations that provide financing for research have recently announced that due to a lack of funds, they will not be able to honour subsidies they had already awarded due.
“The crisis has highlighted the need to foster data sharing.”
The current situation could lead to the regulatory and legislative framework for clinical-administrative data being loosened more quickly. The government should take steps to foster data sharing while ensuring compliance with confidentiality rules.
For example, the CRCHUM’s CITADEL team is exceptionally proficient in predictive modelling. It has developed real-time models of care capacity during the crisis using data from the CHUM. Giving the team access to provincial data would make it possible to generate high predictive power models that are essential to public health.
“Process harmonization is welcome, but must take into account each research center’s distinctive features.”
The rules are the same across the province but are sometimes interpreted differently from one center to another. Varying interpretations are often brought to light when multi-center projects are in the planning stages. The idea behind process harmonization is appropriate and should be further developed, but it requires flexibility. Each research center has its own structure, and these differences must be taken into account.
“We must seize the opportunity to highlight research’s vital role.”
This crisis is an excellent time to prove how useful research is. Right now, our lack of knowledge is causing us to respond reactively to the pandemic. A more substantial and sustained investment in research is crucial for us to be able to respond more quickly to this kind of health crisis. The pandemic is teaching a lesson that we, as a society, must learn.
Research should not be viewed as an ancillary activity. The pandemic is providing us with a great opportunity to showcase the essential nature of research while forcing us to review our priorities and our organizational and structural paradigms thoroughly. The current crisis highlights our lack of autonomy in several health-related sectors, which we should consider addressing. We will need support to advance the science and offer people the best health.