Australia's chief scientist warns against claims of breakthroughs on coronavirus cures
Australia’s chief scientist has urged the public to be wary of claims of breakthroughs and sudden cures for coronavirus and instead to rely on Covid-19 information based on evidence.
Amid a proliferation of reports of cures and treatments relating to the virus, Dr Alan Finkel on Wednesday launched the Rapid Research Information Forum alongside the head of the Australian Academy of Science.
The forum will be chaired by Finkel to ensure Covid-19-related questions from the federal government are answered by experts based on the strongest available evidence.
“I strongly believe that research is the way out of the epidemic; we need to continue to highlight that science is complex, and it’s always developing,” Finkel, a neuroscientist, told Guardian Australia.
“The community needs to be alert to ‘fake news’. Open sharing of data is critical for research and collaboration, but with openness comes the need for the public to understand that the answers are not simple and that understanding is achieved through the weight of evidence from multiple trials.”
New studies and reports about “breakthroughs”, treatments and potential “cures” for Covid-19 have become a daily occurrence as scientists tackle the disease, which has killed more than 200,000 people and changed the way we live.
There are positives to this intensive effort. Trials are being fast-tracked and properly funded. A vaccine may be found within a faster timeframe than for other less pressing diseases.
But there are serious concerns being raised by bioethicists, clinicians and scientists that scientific rigour and peer review is falling by the wayside in the race to understand how the virus spreads and why it has such a devastating impact on some people.
Data from trials is being published before it has been scrutinised. Findings in the laboratory at a pre-clinical stage, long before any humans have been tested, are being described as ‘breakthroughs’.
The latest Australian finding sparking excitement, from the University of Queensland, was from a pre-clinical test that showed a potential vaccine raised high levels of antibodies that can neutralise the virus.
But media reports of this finding failed to mention the testing was done in cell cultures from animals. Or that many breakthroughs in the lab prove disappointing come trials on people. For this reason, pre-clinical trials are rarely reported by the media, the findings too preliminary. There is often no peer-reviewed data or studies accompanying the claims.
The Australian Academy of Science president, Prof John Shine, told Guardian Australia: “There is a high volume of Covid-19 research available, some of which is in the pre-print stage, meaning it has not been peer reviewed – an imperative pillar of the scientific method – so we urge the public, media and decision-makers to draw conclusions and interpretation with caution.”
Associate Prof Ian Seppelt said he found some of the hype for these findings “disturbing”. Seppelt, the director of clinical research for the Nepean hospital’s department of intensive care medicine, said: “There have already been cases, for example, of clinical trials published prematurely, with profound impacts on practice, which have then been retracted after problems with the trials were identified. By sidestepping the usual scientific processes of scrutiny and review we risk making some very big mistakes.”
He cited hydroxychloroquine as an example, an anti-malarial drug widely hyped by some scientists and the US president, Donald Trump, as being a potential treatment and preventative for Covid-19 despite a lack of evidence for it. The scientific paper that fuelled much of the initial excitement has since been retracted, full of spurious data. Australian trials of the drug are under way, including an intensive care trial Seppelt is involved with. But he said he would never promote the drug as a treatment ahead of strong research.
“None of these agents including hydroxychloroquine are magic, and many of the early reports are guilty of magical thinking,” he said. “But all potential treatments need to be studied systematically and properly, in controlled trials. Anything in this space without a control group should go in the garbage bin straight way.”
In a well designed study, there is the experimental group who are given the drug or intervention, and the control group who are not. Ideally, neither the researcher nor patient will know whether they are being given the treatment or the placebo.
This is known as a double-blind randomised control trial, and is often referred to as the gold standard of scientific study. These trials then undergo rigorous review and if they are published in a respected scientific journal are then reported on by media.
But many of the hundreds of Covid-19 studies are nowhere near human trial stage. While randomised control trials aren’t always possible due to ethical or practical reasons, there are still factors such as sample size and peer review that should be considered for all types of study before the results are promoted.
The World Health Organization [WHO] was forced to retract advice about ibuprofen after it relied on a letter to a medical journal, rather than a peer-reviewed study, to issue advice that Covid-19 patients should not take ibuprofen. WHO backtracked on that advice one day later following pushback from scientists who said the letter lacked rigour.
The associate professor of clinical pharmacy and paediatrics at the University of Southern California, Irving Steinberg, said the pace of Covid-19 science combined with panic about a lack of treatments was putting a strain on normal scientific safeguards.
“There is also competition everywhere,” Steinberg told Guardian Australia. “Everybody is looking for the eureka moment, whether it’s a research lab that’s looking for more funding, whether you’re a scientific publication wanting to get an edge on another publication. If people are attempting to bypass or speed up the peer review process, then we will encounter problems including some terrible science.
“In the meantime the press has picked up on these studies and reports on them without context as if they’ve gone through peer review.”
There would be a real risk to public health if the public or government relied on this science to inform decisions, he said.
“Right now, we’re spinning out of control.”