UWA's Professor Toby Richards shares his insight on COVID-19 treatment, clinical trials and why buying time through isolation and ramping up collaboration is our best chance of defence.
WA's success at flattening the curve by embracing social isolation has bought enough time to combine the efforts of hundreds of its best research minds and put it in a unique position worldwide to identify the most effective treatments and therapies for COVID-19.
Supercomputers have also been linked to the patient's beside and homecare services with hospital care, ensuring an across-the-board 'one voice' joint clinical response that will allow real-time rather than retrospective feedback to guide local decision-making and enable personalised care.
As UWA's COVID clinical trial leader, Professor Richards says WA finds itself in contrast to Europe, UK and USA where health services had been suddenly overwhelmed by the sheer volume of cases, with hospitals short of personalised protective equipment (PPE) and overworked doctors even resorting to social media for help. As a result, studies to develop the best treatments for COVID-19 and research to test new drugs had floundered, with reports focusing on small numbers of the total patients and even 'compassionate' use.
"The only way to develop the best COVID treatment options is in a robust scientific environment," Professor Richards said. "In WA, because we have had time we are prepared, we can now help the rest of the world with treatments moving forwards.
"We have had time to catch our breath and work how to come together to tackle this. Everyone is rallying together in one direction and it is fantastic. It is a system that will lead to higher quality studies and more accurate results. The outcome will be a genuinely world-leading response to the viral threat."
WA's COVID Research Response (CRR), with World Health Organization-endorsed protocol, is being coordinated by the WA Health Translation Network (WAHTN) and brings together the efforts of UWA with four other universities, six major research institutes, public and private hospitals and the WA Department of Health.
The WA Government has provided $3 million to fund the local COVID-19 research and a further allocation is expected to be made by the Federal Government. Already the first WA COVID patients have been recruited by the CRR team. A core platform has also been developed that will enable these patients to assist the teams of expert researchers, scientists and doctors to help find the problems and potential cures for COVID-19.
CRR will allow clinical trials to properly evaluate treatments and therapies for the acutely ill, interventions to minimise transmission, a data repository and biobank to understand pathogenesis and personalise care, and efforts to develop a vaccine for prevention of disease in the longer term care.
UWA and Murdoch University were key to the initial establishment of the CRR, providing support and infrastructure, and they have also supplied an extensive volunteer workforce of medical students and skilled postdoctoral students.
"It's crucial that the WA public understands the importance of researchers and taking a unified approach in this fight against COVID," Professor Richards said.
"We have an illness that has not really hit us yet and we have no proper treatment. The reality is, at the moment, all we have to give people with COVID-19 is oxygen as there are no proven treatments per se - that is all that you can do.
"There are many proposed drugs often designed for other conditions such as other viruses or the treatment of malaria, but we need to properly test what else works and ensure that they may not actually worsen the situation due to side effects.
"Only by analysing the data and looking at patterns and testing can we work out if you present with COVID, are you safe to go home or do you need to come into hospital, if it is likely that you might respond to drug A versus drug B or are you likely to require to be on a ventilator in intensive care.
"We may not yet have the answers to every question, we may not even know what those questions are. But if I was a patient coming into a WA hospital, yes I would be scared, but I would be reassured by knowing that the medical staff looking after me is working as one team, with one voice.
"I'd be reassured to know that the information is coming from a large panel of experts and that I am getting choice of the best treatments available today."
What West Australians can do to support our COVID-19 research
To ensure success, West Australians will be called on to embrace the COVID Research Response trials in the same way they have in the past by participating in the high-quality long-running Busselton and Raine studies.
"We are all coming together to find answers and we are asking the people of WA to help us," said Professor Richards. "And WA has a history of saying 'yes' when we ask.
"We would like to get 30 per cent of COVID cases that walk through the door of a hospital. That would be a very good result.
"We are facing an unprecedented situation - we have a new infection for which there is no cure. There are ideas. We need to find which group of patients benefit most from what therapies. Are children and the elderly the same? What treatments are available? Are they better or are they worse than other treatments? Andthe only way to do that is to test.
"So moving forward, we're asking individuals to allow us access to their non-identifying data and results when they are in hospital or tested in the community so we can put WA's best minds behind this to work out the potential cure.
