Rarely in recent memory has the world faced such an immediate and widespread global threat as complex as COVID-19. In its face, a select few have risen to the occasion, none more cherished and admired perhaps than the health care workers staffing the front lines. But standing close behind them in the trenches are the scientists and researchers who are among the very few who truly understand the scope of our evolutionary battle with the virus. Since the start of the pandemic, our scientists have acted with unprecedented speed and coordinated action to deliver us an armamentarium of medical weaponry to confront this global threat.
For someone who has spent a lifetime in science, someone who understands the pressures and constraints faced each day in every lab, it has been phenomenal to witness the transformation that has taken place within the scientific community. It is not just the speed and focus with which the scientific community responded, nor simply the use of new technologies to draw out new discoveries, but rather the singular willingness of scientists, all over the world, to share new ideas and data immediately and transparently, in some cases well before the idea or the research is fully formed.
Within weeks of the first case of COVID being reported, Chinese researchers had identified the virus they suspected of causing the disease and had decoded an initial genome sequence. It was a remarkable achievement in such a short amount of time, made more remarkable by the fact that the researchers published the sequence in an open discussion forum online, and encouraged a fellow researcher in Sydney, Australia, to share it via Twitter with the world.
During the first 24 hours after publication, an evolutionary biologist in Scotland had figured out the similarities between this virus and SARS-CoV-1 and, like the Chinese researchers, shared the findings immediately online. A researcher in the U.S. openly published the new virus’ phylogenetic tree. And another started reverse-engineering a live virus from the sequence, letting colleagues around the world know that the first steps towards developing an antibody test were already underway. At each moment, the goal was not acclaim or attention, but rather the possibility that openly sharing an early finding may influence the work of others and inch the world ever closer to a treatment or a cure.
Of all the arenas in life that COVID has upended, science is perhaps the field that has been transformed the most. The pandemic has created an entirely new research environment, one that is now structured for collaboration and communication above all else. This revolution was inspired by the initial transparency of those early researchers but has since been institutionalized by some of the most well-respected research institutes in the world today, including our very own biomedical nerve center in Boston.
Shortly after the virus emerged, Harvard Medical School pulled 20 Boston-area universities, medical schools and research institutes together to launch the Massachusetts Consortium on Pathogen Readiness (MassCPR). The initial goal was to formally join forces with researchers in China to answer the call to action to take down the emerging threat, with the hope that any lessons learned from this outbreak would enable a more rapid response to future emergencies.
This alone was a notable step. The scientific community in Boston typically works in relatively isolated fashion, with barriers built up between departments, disciplines and entire institutions. But with COVID-19 and MassCPR those floodgates between institutes upriver and down were quickly opened.
With a collaborative research grant from the Evergrande Group, MassCPR began funding dozens of new research projects, some of which have led to field-defining studies on the epidemiology, pathogenesis and immunopathology of COVID-19. Over the past year, MassCPR clinicians have written clinical management guidelines that have influenced patient care across the globe, and the consortium’s investigators have conceptualized, designed and developed the single-dose Johnson & Johnson vaccine and spearheaded clinical trials for the Moderna one.
The dean of Harvard Medical School, George Daley, leads the effort, along with Arlene Sharpe, Bruce Walker and David Golan. As Daley describes it, “Our collective efforts over the last year have given us demonstrable proof that we are strongest when we work together across institutional boundaries, when we reach out across geographic and national borders. We are strongest when we transcend scientific silos and build bridges across disciplines. Cooperation to confront a common threat is what MassCPR represents, and the achievements speak for themselves.”
MassCPR’s immediate efforts are focused on the basic biology of SARS-CoV-2 and the pathogenesis of COVID-19—developing new diagnostic tools, vaccines and therapies. But while the researchers stay firmly focused on the now, they are also looking towards tomorrow. “We must refine our capacity to track the rise of new viral variants,” warns Daley. “We must refine our prevention strategies—an armamentarium of treatments—by developing new antiviral drugs, panviral therapies, and polivariant vaccines. And we must anticipate the post pandemic realities of COVID-19. A major goal of MassCPR 2.0 will be to define the scope of post-COVID-19 syndrome and understand the long-term effects of multiple organ systems. The knowledge will have relevance beyond this pandemic and, indeed, beyond this pathogen.”
Beyond MassCPR, other critical global partnerships have emerged over the course of the past year to bring recent scientific advancements on the virus to the masses, not the least of which is the Access to COVID-19 Tools (ACT) Accelerator and its vaccines pillar, COVAX. The ACT Accelerator is a global philanthropic partnership—not a new agency or institution but rather a framework for collaboration launched by the WHO, the European Commission, France and the Bill & Melinda Gates Foundation in April 2020.
ACT is focused on accelerating the development and production of COVID-19 tests, treatments and vaccines (via COVAX) and, perhaps most critically, on ensuring that all people, and all countries, can access and afford these miracles of science. While richer countries have been able to roll out vaccines at no cost to residents, lower-income countries are still struggling to determine how to procure and pay for the vaccines in the first place, much less distribute them fairly across their countries. Rough estimates suggest that it would cost around $30 billion to mass-vaccinate the world—a price rich countries may not choose to shoulder. Take for example the United States, whose portion of the cost to help vaccinate the world is $7 billion. That figure is less than 0.5 percent of what was approved as part of the March 2021 economic stimulus package, mere pennies in relative terms but critical to ending the pandemic.
Global fundraising for health is by no means without precedent, but what makes the ACT Accelerator unique is the burden-sharing formula it proposes to generate the funds. Every country is given a recommended range to contribute, which is adjusted based on GDP and the size of the country itself. The goal is to create a fair and equitable framework to respond to this crisis and future emergencies, including other pandemics—a systematic plan to prevent any country from having to choose again between who lives and who dies.
This collective solution to the problem at hand also has scientists in the lead, with researchers monitoring the vaccine landscape and advising COVAX on the most suitable candidates based on scientific merit and scalability and with major pharmaceutical companies committing to providing hundreds of millions of doses—eventually billions—to distribute around the world. Scientists have not only worked together to develop COVID treatments and vaccines, but they are among the loudest voices calling for rich countries to collaborate and to deploy their wealth across all countries to end the disease.
Yet even with these remarkable scientific efforts, there is perhaps no better indicator of the extent to which the scientific community is focused on collaboration than by how entirely the scientific publication process has been upended. Publication in a well-respected journal is a competitive and highly prized honor, considered so by even the most accomplished scientists. Whereas in the past, researchers were willing to wait months and sometimes more than a year for the distinction, those imperatives have since been set aside. Researchers now proactively share preprint versions of their studies immediately after they determine their results, not only for recognition but in the hopes that their discoveries will help other scientists further their own. Between the start of the pandemic in December 2019 and November 2020, around 75,000 scientific papers were published on COVID-19, with one third published as preprints, released to other scientists and the public at large, before being fully reviewed and accepted for journal publication.
As scientists choose to forgo some of the academic recognition that comes with waiting for traditional publication, the journals themselves have shifted their approach as well, rethinking work flows to publish COVID-related papers much faster than normal. Yet this has not been without consequence. In the spring of 2020, two COVID studies were famously retracted over concerns about the veracity of the primary data. Some journals have admitted they may need to slow the process down again to ensure the quality of the work. Still, the knowledge gained has arguably outweighed the risks, given that the rapid advancements on vaccines, treatments and our understanding of the disease are owed in large part to the immediate and transparent release of new data.
The question still remains whether this sense of shared purpose and transparent cooperation is a temporary measure or the beginning of a new era of scientific collaboration and global partnership. I can’t help but hope that this is indeed the beginnings of a new milestone in human achievement. Science is a tradition built on thousands of years of incremental progress. Imagine the exponential increase if our collaborative efforts continued—a global community united against the most pressing economic, social and environmental problems of our time.
As Daley of the Harvard Medical School and MassCPR put it, “I cannot help but think that [it] provides a blueprint for moonshot projects that bring together the strongest and most dynamic forces of our formidable, biomedical ecosystem. What if we could marshal these forces against future pandemics, other diseases and larger global challenges? I dare to imagine the possibilities.”
With all the tragedy of the past year and the losses we have suffered, this revolution in the scientific community and beyond may be the one exquisite thing to emerge.