FEATURE
Research in the COVID era Local researchers are contributing to ways of combating the COVID-19 pandemic.
Western Australia has, so far, been relatively isolated from the COVID-19 pandemic, allowing clinicians and researchers time to prepare for what could come, while also offering the opportunity to push for a collective, world-first research effort to understand the virus. With no definitive treatment and a vaccine being projected to be anywhere from 18 months to years away, the best defence is risk mitigation, particularly through an understanding of how the virus establishes itself in hosts. There has been substantial variation in susceptibility of impact with some cases experiencing little or no apparent effect while other cases have been fatal. By understanding these individual variations, researchers hope to develop effective treatments and vaccines for COVID-19 and also help in preparing for another coronavirus pandemic. The clinical and research response, organised by the WA Health Translation Network (WAHTN), comprises six major research institutes, five universities, public and private hospitals, the WA Department of Health and PathWest.
accurate patient data supported by biological samples that can be relayed in a de-identified manner for all researchers and scientists. Such a multidisciplinary, multiinstitutional clinical and research response demonstrates the capability of translation networks to leverage tangible outcomes. According to WAHTN executive director Professor Gary Geelhoed, although his organisation may be the fulcrum around which the response revolves, it is the collegiality of the clinicians and researchers to be so open and collaborative in such a short period of time that has made the response in WA so unique. “With the advent of the COVID-19 crisis, we were a rallying point to bring together all the research and researchers with weekly meetings including as many as 50 researchers and representatives from all of the groups involved,” Prof Geelhoed said. WA was well positioned to respond as the population was large enough to provide meaningful data, while the medical and research community was small enough to be well connected and collaborative.
Building on blocks
Part of the response is the WA COVID Research Response (CRR), which proposes “a harmonised platform of integrated research to clinical care…bringing together researchers, scientists and clinical trial teams under the WAHTN as ‘one voice’ in collaboration.”
Part of the response will support existing trials, including one that is specifically designed to anticipate pandemics, with Prof Geelhoed emphasising the global REMAPCAP trial that is currently being run in 13 countries and in more than 50 research hospitals, including Royal Perth Hospital.
The immediate core objective is to build a platform for real-time
REMAP-CAP is a randomised controlled trial of different treatment
16 | MAY 2020
modalities for patients in intensive care due to community-acquired pneumonia. It is unique as it is an adaptively designed trial where the treatment interventions are simultaneous rather than sequential as usually found in traditionally designed trials, allowing clinicians to continuously adapt optimal treatments based on real-time data. Although the REMAP-CAP trial was initially focused on communityacquired pneumonia, it has been adapted to include COVID-19 domains and has since been named as a key clinical trial for COVID-19 by the Chief Medical Officer in the United Kingdom. “Much of our effort is to ensure this trial is supported completely and also rolled out to other hospitals as a matter of equity. There are promising treatments that may help and these trials will allow people access to these potentially effective or even lifesaving treatments. So, while we are talking about research, there is a very practical clinical application,” Prof Geelhoed said. While an existing trial such as REMAP-CAP could provide clinicians with new treatment modalities, so too could new trials, specifically designed for COVID-19. “If we see trials very early on that tick all of the boxes, in the sense that the group has the capability to do it and there is an immediate impact, we will move to fund them as early as we can,” he said. The WA Government has provided $3 million for COVID-19 research and has also moved the Guardianship and Administration Amendment (Medical Research)
MEDICAL FORUM | WOMEN 'S HEALTH ISSUE
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James Knox investigates
