Researchers balancing scientific rigour with speed on COVID-19

Researchers in the race against time to provide a proven treatment for COVID-19 will have to balance speed with scientific rigour, according to global experts.

Clinical trials for possible treatments and cures have begun around the world, including an unprecedented international study by the World Health Organization.

But the scientific gold standard to test the efficacy of new, unproven treatments isn't always practical with new cases of COVID-19 spreading around the world.

"Things are faster and so we're having to cut some corners," said Dr. Srinivas Murthy, an associate professor with the faculty of medicine at the University of British Columbia.

"Given the speed at which we need to get this up and running, it’s probably a small sacrifice to make in the grand scheme."

In ideal circumstances, medical studies follow a double-blind process, with neither participants nor researchers knowing which patients were randomly selected to receive the treatment being tested.

"Getting all that set up in the course of a week or two is impossible," Murthy said.

For example, preparing placebos would take up precious time.

Some studies have relaxed those standards in the midst of COVID-19.

Murthy is participating in the World Health Organization's massive international study to look into whether existing drugs can be repurposed to treat the viral disease. It's designed to make sure even overloaded hospitals can take part.

The WHO said the study is remarkable not only because of its size, but because it was put together in only two weeks. However it is not double-blind: that is, physicians know which drug they're giving to which patient.

Murthy said making the trial double blind isn't as necessary, because the researchers are measuring objective factors like whether the patient lives or dies.

"If the outcome was how they felt, for example, that might make a difference," he said.

The WHO released guidance for researchers doing clinical trials for COVID-19, including the fact that this is no time for "methodological orthodoxy."

Still, scientific rigour can't be abandoned in even the most desperate times.

Earl Brown, a professor emeritus of virology at the University of Ottawa, says even in a pandemic, studies still need to meet all the usual scientific checks and balances.

"They're likely to push it as far as they can," Brown said.

"But you can't use people as guinea pigs, even if you're well intentioned."