19 May, 2020

COVID 19 Chronicles: Silver Lining on Dark Clouds by Drs. Shrestha and Karmacharya

The first COVID 19 case was reported on the 24th of January 2020 in Nepal. As of May 6th, 99 cases have been confirmed with no reported death.

dark cloud with silver lining
Dark Cloud With Silver Lining Photo Credit: Multunus.com

Nepal established health-desks at the international airport as well as on border checkpoints with India, starting in mid-January. Land borders with India as well as China were later completely sealed off, and all international flights suspended. All academic examinations were cancelled, schools and universities were closed. The country-wide lock-down came into action on the 23rd of March, with the announcement of the second confirmed case.

COVID-19 is having a profound impact on research work. The researchers across the country are staying home to help flatten the COVID-19 curve, as a consequence, the field research work has come to an abrupt stop. The ever-evolving COVID-19 situation has made it nearly impossible to make and execute research plans. Almost all of the research works are affected: the participant’s recruitment has completely stopped; follow up strategies have changed from in-person meeting to telephonic interviews, thus, jeopardizing the quality of information; the predetermined timeline of the research activities are disrupted; research participants have lost interest resulting in huge loss-to-follow up; and overwhelmed health system are setting research priorities aside to combat the urgent COVID-19 needs. All of the national scientific conferences have been postponed or cancelled, leaving less space for academic discussion and slowing down the scientific community.

The research disruption has hit especially hard the graduate students who are forced to change their research approach from in-person to online. Applying for ethical review modifications and deadlines extensions have added stress and pressure. The Master’s students spent the whole semester making plans for their thesis and field research. However, the current lockdown and future uncertainties have made it impossible for them to achieve what they have planned. Many have scrambled to make a second plan, including finding datasets to work from home or to be restricted to a ‘cyber’ field. This seems practical for now, but steals the field data collection experience from them, which is a huge part of the scientific process.

Panelist sitting opposite each other with facemasks
Dr. Archana Shrestha presenting at the Epidemiology and Disease Control Division, Ministry of Health and Population, Nepal

It is sad to see how research labs and field stations are vacant; and researchers are struggling to keep their job or to be productive at home. A large number of research staff are furloughed. Those who are working from home, are facing challenges to balance their family and work because their home was never designed to be a full-time work space – especially female scientists are struggling because of lack of support for child care and household chores. Many have changed their academic trajectory in a short span of time to meet urgent COVID response needs. Researchers are concerned about the impact of COVID-19 on the economy and on funding for research with changing priorities. Some funding agencies are offering time extensions but that do not come with any financial buffering.

COVID-19 has opened a plethora of research needs in the areas of surveillance, epidemiology, implementation science, clinical research, risk communication, mental health, and societal impacts. It has also shown the existing strengths and limitations of the research system and culture. Two specific issues have become evident. First is the need of accessing comprehensive data for rapid response. Currently, the data are mostly fragmented. For example, local authorities have information on migration and foreign returnees, laboratories have data on testing, logistic division keeps log of supplies and equipment, and epidemiologic disease center holds data on COVID cases and their contacts. This fragmentation has led to establishment of an integrated data collection, management and analysis system for swift evidence-based decision-making to address time-sensitive situations like these. Second is the need of wider interdisciplinary collaboration in health research. These times have mandated joint pursuits on research questions that need to be answered through a multi-disciplinary team of professionals, like public health researchers, government officials, security forces, clinicians, biomedical technicians, statisticians and mathematicians handling big data, and others. Researchers are also taking time to step back, rethink and re-structure their work – being adaptive to the evolving situation, engaging in new conversations and collaborations like never before.

Haruki Murakami wrote, ‘When you come out of the storm, you won’t be the same person who walked in. That’s what this storm’s all about.’ This applies to the field of health research as well. After all this is over, just like other sectors, the field of health research will also be substantially transformed, for good.