COVID-19’s disproportionate harm on communities of color is “heartbreaking” and demands more inclusive efforts as the federal government underwrites attempts to develop a vaccine and improve testing, the head of the National Institutes of Health said.
Dr. Francis Collins, director of the NIH, the federal agency funding vaccine development efforts, said it’s critically important to build trust in Black and Hispanic communities as vaccine and drug developers seek volunteers to test potential vaccines and drugs.
“We recognize that credibility is not going to come from another bunch of government officials pounding the table and saying this is good for you,” Collins said Tuesday in an interview with USA TODAY’s Editorial Board. “It is going to have to come from the grassroots.”
Collins said recruiting volunteers for clinical trials must be “particularly vigorous” and involve outreach groups to encourage participation as Black Americans join medical studies at lower rates than whites, in part due to historic distrust stemming from experiments such as the decades-long Tuskegee syphilis study, which tracked the progression of the disease last century in Black men who were not given treatment.
Francis Collins speaks to the USA TODAY Editorial Board in 2014. (Photo: Jack Gruber, USA TODAY)
Collins said he’s already heard questions about the federal agency’s aggressive timeline for the vaccine, but said it’s important the public knows the federal agency won’t cut corners on safety and effectiveness.
He said the agency, which includes the National Institute on Minority Health and Health Disparities, has worked to recruit more racial and ethnic groups to medical studies and address health disparities. For example, the agency’s All of Us precision medicine study includes about 300,000 volunteers, over half of whom are racial minorities. He hopes similar outreach efforts will boost diverse enrollment in vaccine studies for COVID-19, a disease that “has taken way too many lives.”
Collins also said the NIH will spend $500 million to accelerate testing through a new initiative that aims to make millions of tests available each week, particularly in hard-hit communities. He said vulnerable communities “suffered severe consequences” because the lack of access to testing.
“It’s heartbreaking to see the way in which this disease has particularly affected those of lower socioeconomic status – how it’s affected African-American communities and Hispanic communities,” Collins said.
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Collins predicted that the nation would have “a vaccine that might actually reach approval by the end of 2020.” He said vaccine development is proceeding at an unprecedented pace by limiting delay time between different stages of research, and by making candidate vaccines before they have been fully vetted, so that the supply will be there if one or more prove successful.
Asked whether he had a favorite among the vaccine candidates, Collins said: “I love them all.”
He’s thrilled, he added, that there are multiple vaccine candidates. Eleven candidate vaccines have begun to be tested or will soon be tried in people.
“It’s a really good thing that we don’t just have one that we’re banking on,” he said. “We know there is a history here of vaccines not always working. We want to have as many shots on goal as we can, because the world is waiting for this kind of protection.”
He then went on to explain the government’s role in helping to develop one of the candidate vaccines, based on new genetic technology, which Collins, a geneticist, said he finds particularly exciting.
“It looks like it’s on the right track,” he said, but the approach is new, “so, who knows” whether it will prove safe and effective.
In terms of treatments, Collins referenced remdesivir, an antiviral that has shown to be helpful for hospitalized patients, and a steroid, dexamethasone, that a recent study found life-saving for some of the sickest COVID-19 patients.
He said the government is working to winnow a list of more than 400 possible treatments, planning to support the most promising of them with clinical trials to start next month.
Collins said he’s been impressed with the safety of convalescent plasma – a blood product from people who have recovered from COVID-19. But research has not yet shown whether convalescent plasma is truly effective for COVID-19 patients and at what stage of disease.
More promising, he said, is what are called monoclonal antibodies – immune system molecules identified from recovered patients that can then be manufactured with predictability and consistently.
“It worked for Ebola, so it’s got a precedent,” said Collins, who was head of the NIH when that outbreak occurred. At least six companies are developing monoclonal antibodies that are ready for testing in people.