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COVID-19 clinical trials leading to "chaos": medical article

ROCKVILLE, MD - JULY 27: Rabbi Shmuel Herzfeld has his arm disinfected by Dr. Chao Wang during a clinical trial for a Coronavirus vaccine at Meridian Clinical Research in Rockville, Maryland on Monday, July 27, 2020. The Coronavirus vaccine was created by the biopharmaceutical company Moderna. (Photo by Amanda Andrade-Rhoades for The Washington Post via Getty Images)
Rabbi Shmuel Herzfeld has his arm disinfected by Dr. Chao Wang during a clinical trial for a Coronavirus vaccine at Meridian Clinical Research in Rockville, Maryland on Monday, July 27, 2020. (Photo by Amanda Andrade-Rhoades for The Washington Post via Getty Images)

The abundance of COVID-19 clinical trials taking place internationally is leading to complete chaos in the research world, according to a group of experts. The rush to find answers has led to oversights in the distinct phases of the mysterious disease. The findings were outlined in a piece published online by the Lancet last month, and was authored by several Canadian researchers.

The article states that “inadequate details on the trial and only superficial scrutiny by the public and scientific decision makers” have lead to “disastrous effects on clinical trial funding, permission, recruitment, and interpretation.”

Edward Mills, a professor at McMaster University who runs several COVID-19 clinical trials internationally, is one of the authors of the piece.

He says there have been more clinical trials planned for COVID-19 than other diseases in history, which has resulted in rushed and haphazard planning. In turn, most of the trials won’t end up getting funded, and thus won’t be completed.

COVID-19 clinical trials focus on one of at least five stages of the sickness: pre-exposure prophylaxis, post-exposure prophylaxis, outpatient treatment, hospital admission, and late-stage critical care.

Mills says problems arise when clinical trial findings from one stage of the disease is applied to another stage of the disease.

“Most trials that get reported, they have occurred within the hospitalization population and then the media and social media reports as if they’re applicable to all stages of the disease,” he tells Yahoo Canada. “It’s having disastrous effects on people trying to do clinical trials on other aspects of the disease.”

Mills won’t point the finger at the media for the misreporting of information. Rather, he believes the onus is on the medical community for not communicating how complicated the disease is, or even having a proper understanding of it.

“You have an awful lot of commentators and people giving advice on COVID, but the reality is there’s very little cohesion in terms of opinion on what to do with the disease,” he says.

An example of this would be the media attention that surrounded the malaria drug hydroxychloroquine, which was being studied as a potential treatment for COVID-19. That was further politicized, after U.S. President Donald Trump and Brazilian President Jair Bolsonaro touted the drug. While there was compelling evidence for the drug, it was focused on the prevention stage or during the early onset of COVID-19. When studies looked at the drug’s effect on hospitalized patients, it didn’t prove successful. As a result, many trials got cancelled.

“We still don’t know whether hydroxychloroquine works for the condition it was initially purported for, which was prevention or early treatment,” he says.

Mills says because people are stuck at home, genuine scientific discussions and debates aren’t happening like they would at conferences or grand rounds, where findings could be debated.

“Because we’re not having that at the moment, we’re having a preponderance of advice being handed out that is not based on good evidence at all,” says Mills.

Of the 1,900 trials currently registered, Mills believes only about a dozen will provide reliable information. He adds that in Canada, there’s no leadership on clinical trials.

“We have publicly funded health care, which means we could perform ideal clinical trials, but we’re not doing it,” he says. “We’re constantly being told that the government is spending an enormous amount of money on COVID response, but it isn’t going into research.”