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In this video, we interview Dr Rui Castro, EASL Educational Committee Member and Assistant Professor, Faculty of Pharmacy and Research Institute for Medicines, University of Lisbon.

27/05/20

Dr Castro describes how his country and his institution have reacted: with agility, collaboration, and innovation. He reflects on the impact of the pandemic on research, describes dynamic and innovative collaboration underway, talks of the responsibilities of researchers in using social media, and highlights the importance of exchange at professional events, which are increasingly digital. He also looks to the future, as priorities shift for all – government, medical workers, and the lay public, who also serve as essential workers.

Watch the VIDEO and read the interview below.

 

Questions discussed

    1. How do you see research and the quality of it being affected by the COVID pandemic, immediately and in the longer term?
    2. What role can social media play for researchers in the current crisis?
    3. What kind of collaboration are you experiencing in Portugal, among the medical workforce and research community?
    4. Relating to the public control measures being implemented in Portugal, how do you think the pandemic might evolve?
    5. When the pandemic slows down, what kind of longstanding issues in society or in health systems might have been exposed and will need to be resolved?

Read the full interview below.

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When the pandemic slows down, what kind of longstanding issues in society or in health systems might have been exposed and will need to be resolved?

I think this pandemic has raised critical health, economical and political challenges that will take time to resolve. For a start, we became aware of the shortcomings of healthcare systems worldwide. We will need to scale up support to medical staff, which involves upgrading and readapting hospital infrastructures and operational procedures.

We will have to ensure manufacturing capability for critical medical supplies, which demands rethinking the model on how the government should address public health issues. In particular, this model should contemplate development of new strategies for better data, evidence, and technology use, in order to control future viral outbreaks and reduce their impact in health, economy, and society.  

This is particularly important because we are witnessing how this pandemic is shifting research priorities towards the launch of clinical trials for new treatments and vaccines against coronavirus and how healthcare professionals are working non-stop to treat these patients. And rightly so, of course. But this leaves important clinical trials for other diseases suspended and the follow up and surgeries of cancer patients, for instance, being delayed, which is not good.

Within the research community, I think the importance of open research and sharing of data finally became clear to everyone. This has allowed for major breakthroughs on COVID-19 research that quickly translated to the benefit of society. 

For instance, sequencing of (SARS-CoV-2) allowed for the rapid development and implementation of diagnostic tests, while epidemiological studies have been helping to better track viral response and spreading. In this regard, the Portuguese health authorities have recently started to disclose COVID-19 patient data to the scientific community, and I hope this process is streamlined and made more efficient in the future.

We also learned quite a few lessons from being in quarantine and working from home. I think we all gained much more appreciation for social professions that we took for granted, including childcare providers, teachers, and supermarket employees. I think these positions should be recognised as essential work when shifting priorities.

Scientific meetings have been cancelled worldwide, and this provided an opportunity to rethink the model on how researchers collaborate and engage with each other, with many congresses and conferences turning to online platforms, including EASL’s International Liver Congress.

I think with time we will realise that a balance between online offerings and physical meetings is actually a good approach, as it will allow for more accessible and wide-reaching scientific gatherings. EASL is actually a good example, as it has been significantly increasing the content of its open access eLearning platform, EASL Campus. I’m really honoured to be part of this initiative as well. 

How do you see research and the quality of it being affected by the COVID pandemic, immediately and in the longer term?

There is no doubt that the COVID pandemic has affected pretty much every research laboratory worldwide. But I think it is important to stress that most of these changes were directed towards the benefit of COVID patients and the support of healthcare systems and governments.    

The rapid response from many research centres allowed for the quick implementation of reliable diagnostic tests and ground-breaking work on potential treatments and vaccines for the new coronavirus. Still, many researchers working on more distant topics, which includes myself, were faced with having to transition to working from home, at least during the initial outbreak.

We had to adapt to this new reality and reinvent new ways or carrying out our projects. In our case, this involved engaging in very fruitful theoretical discussions over weekly teleconference calls, and redirecting laboratory work towards writing review papers and new grant applications. We also took this opportunity to explore how we could increase our online presence and make our results more visible to the general public, so it’s been rewarding in a different sense. And a couple of weeks into the quarantine, our institute and faculty came together to implement a diagnostic test unit at our facilities, so I’ve been really busy since working on that front.

So, all of this to say that I don’t really believe the quality of research being performed in most parts of the world has decreased. The outputs might have changed a bit, or a lot in some cases, but the quality remains.  

In the long term, I think some research groups might indeed face some problems. With researchers confined to their homes, laboratory benchwork has been halted, making it difficult to comply with grant deadlines or resume work and salaries paid by these same grants.

Thankfully, many public and private research funding agencies have already come forward with increased flexibility to the researchers they fund, as well as extending or postponing deadlines for new research proposals. And it is my hope that the prospect of a long-term economic downturn doesn’t change this, and that governments and policymakers, as well as funding agencies and charities, don’t forget that scientific research has been at the forefront of our fight against COVID-19 from the beginning. 

 

What role can social media play for researchers in the current crisis?

I think researchers have witnessed different scenarios on social media since the beginning of the COVID-19 outbreak. From the outset, it has been a very effective way to get up to date on the evolution of the pandemic in the different countries worldwide. We received real-time information: on what was going on in hospitals, the difficulties medical staff were facing, the efforts being put forward by different researchers, leading to the creation of international consortiums aiming to know more about this new coronavirus, and so on.

But the good thing about social media is that everyone has access to it and you can quickly find any type of information, which can also be the bad thing.The spread of misinformation on COVID-19 quickly became a global social media epidemic of its own. From out-of-context information to miraculous treatments and conspiracy theories, you can find pretty much anything, in part, because most social media platforms offer very little curation of their content.

And this brings me to the scenario I think we are currently facing, with respectful, official and prestigious individuals or organisations, such as the World Health Organization, working really hard to fight misinformation around COVID-19. And as  researchers, I think it is also our responsibility to have a very active role in social media, fighting pseudoscience and misinformation. This can be done by sharing or replying with evidence-based information, as well as regularly posting updates with links to trusted websites of research labs and scientific journals, or official health organisations.

At the same time, I think researchers should tailor their messages to both the medical and scientific research community, as well as the general public (being the most likely to come across and reshare misinformation). I would even add that, while sticking with evidence-based facts, one should also aim for positive and uplifting messages.  

We can do this by including a more personal post once in a while. We have been “living in isolation”, with strict rules of social distancing for quite some time now, with all the psychological tolls that it implies. It always makes my day to see a world renowned scientist who I admire post something so simple and unexpected like “Today I baked a cake with my five-year-old daughter” or “#walkingthedog through the neighbourhood on a #sunnyday”. I think this is great example of the role social media can play for researchers – and everyone – in the current crisis.

 

What kind of collaboration are you experiencing in your country among the medical workforce and research community?

I am really proud of all the collaborative efforts that have been and continue to be implemented among the research community here in Portugal to support the medical workforce.  

A group of researchers have developed a prototype ventilator using components of medical devices mounted as independent modules that can be re-adapted in the event of a stockout. Scientists and engineers are working in conjugation with the Ministry of Health to develop apps that allow for symptoms tracing and patient follow-up. Consortiums have been established between different research centres to design novel serological trials specific for COVID-19, to be used at the national level in epidemiological studies, but also to screen healthcare professionals who have contact daily with COVID-19 patients and who might be asymptomatic, thus allowing for further disease containment.

And several research centres, including our own, have redirected research activities towards the establishment of diagnostic units to significantly increase the capacity of the Portuguese national health system to test its population.

In our case, we at the Faculty of Pharmacy and at the Research Institute for Medicines have started by developing and validating a novel protocol for RNA isolation from patient samples, at our biosafety level 3 (BSL-3) facilities. This protocol is cheap, fast and does not rely on the availability of commercial kits, whose stocks remain extremely low. We further optimised and increased the capacity of the real-time RT-PCR step of the protocol. All this was only possible due to the huge number of volunteers that committed early on to this project; and we got approval by the Portuguese health authorities to start the tests at the end of March. Since then we have established partnerships with several local hospitals and clinics and we are performing tests on a daily basis to provide relief to the public health system.

More recently, we also established agreements with the National Pharmacy Association, to test professionals from both hospital and community pharmacies, as well as with the Ministry of Labour, Solidarity and Social Security, to test people in risk groups. Other colleagues from the Faculty of Pharmacy have also prepared and donated disinfectant solutions to local hospitals, and are performing quality control analyses and validating the production of such products, coming from other centers or facilities.

These are just a few examples of the many initiatives being led by researchers all over the country and I am truly honored to be part of this community and thus help healthcare professionals at the frontline in the war on COVID-19. 

 

Relating to the public control measures being implemented in Portugal, how do you think the pandemic might evolve?

I think the Portuguese government has been responding very well to the COVID-19 pandemic. Portugal declared a state of emergency on March 18, just two days after the first COVID-19 death in the country was reported. Individuals infected with the virus were required to undergo mandatory self-isolation, with the general population advised to stay at home unless strictly necessary. All schools and commercial establishments were closed. In general, people obeyed confinement measures, which I think helped managing the coronavirus outbreak.

Of course, resuming economic and social activity is vital and the state of emergency was cancelled on 2 May. We are now in the so-called “state of calamity”, with scheduled release of restrictions and confinement measures in stepping phases, to allow for readjustments when necessary.

For instance, small shops have now opened, although social distancing measures are still in place and everyone has to wear a mask. But people can practise physical exercise outdoors, use public transportation to go to work, in cases where remote work is not possible, use public services upon appointment, and so on.

Similar measures are being implemented in research Institutes, with the establishment of staff rotations, a limited number of researchers per laboratory,  and strict adherence to hygiene and sanitisation measures, as indicated by the Health Ministry.

I think it is impossible to predict how the pandemic will evolve. This new coronavirus we are fighting against has many particularities that make it difficult to give a straight answer, including its ease of transmission and its broad range of symptoms, which can be mild or even barely noticeable to potentially deadly

In my opinion, it would be important for us to quickly adapt to this new reality of social distancing, which for us Portuguese people is quite challenging, I must say. But it is perhaps the best way, mid-term to long-term, to minimise further negative impacts on the economy while giving more time for researches around the world to come up with effective treatments and, ultimately, a vaccine to stop viral transmission.   

Disclaimer: As the COVID-19 pandemic unfolds, treatment strategies are being developed and adjusted accordingly. EASL Viewpoints serve as snapshot interviews from the frontline and are intended to reflect the experiences at the time of the interview only.

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