AP NEWS - Desperate to solve the deadly conundrum of COVID-19, the world is clamoring for fast answers and solutions from a research system not built for haste. The ironic, and perhaps tragic, result: Scientific shortcuts have slowed understanding of the disease and delayed the ability to find out which drugs help, hurt or have no effect at all.
“People had an epidemic in front of them and were not prepared to wait,” said Dr. Derek Angus, professor of health policy and critical care chief at the University of Pittsburgh Medical Center. “We made traditional clinical research look so slow and cumbersome.”
Research is still chaotic — more than 2,000 studies are testing COVID-19 treatments from azithromycin to zinc. The volume might not be surprising in the face of a pandemic and a novel virus, but some experts say it is troubling that many studies are duplicative and lack the scientific rigor to result in clear answers.
“Everything about this feels very strange,” said Angus, who is leading an innovative study using artificial intelligence to help pick treatments. “It’s all being done on COVID time. It’s like this new weird clock we’re running on.”
LEARN AS YOU GO
In Pittsburgh, Angus is aiming for something between Trump’s “just try it” and Fauci’s “do the ideal study” approach.
In a pandemic, “there has to be a middle road, another way,” Angus said. “We do not have the luxury of time. We must try to learn while doing.”
The University of Pittsburgh Medical Center’s 40 hospitals in Pennsylvania, New York, Maryland, and Ohio joined a study underway in the United Kingdom, Australia, and New Zealand that randomly assigns patients to one of dozens of possible treatments and uses artificial intelligence to adapt treatments, based on the results. If a drug looks like a winner, the computer assigns more people to get it. Losers are quickly abandoned.
The system “learns on the fly, so our physicians are always betting on the winning horse,” Angus said.
A small number of patients given usual care serve as a comparison group for all of the treatments being tested, so more participants wind up getting a shot at trying something.
Mark Shannon, a 61-year-old retired bank teller from Pittsburgh, was the first to join.
“I knew that there was no known cure. I knew that they were learning as they went along in many cases. I just put my trust in them,” he said.
Shannon, who spent 11 days on a breathing machine, received the steroid hydrocortisone and recovered.
Doris Kelley, a 57-year-old preschool teacher in Ruffs Dale, southeast of Pittsburgh, joined the study in April.
“It felt like someone was sitting on my chest and I couldn’t get any air,” Kelley said of COVID-19.
She has asthma and other health problems and was glad to let the computer choose among the many possible treatments. It assigned her to get hydroxychloroquine and she went home a couple of days later.
It’s too soon to know if either patient’s drug helped or if they would have recovered on their own.
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7/08/2020