On communicating with the public
Jha: The real lesson of communication and of engagement is you've got to engage across a broad range of individuals. You have to understand what their values are, and you have to meet them where they are. I think when we did that well in the pandemic, it served us well. When we tried to be dogmatic — [along the lines of] “this is the right answer that everybody has to follow” — that did not do us as much good in some ways.
Levine: One thing we learned during Ebola outbreaks was that we need to use trusted messengers to convey important health information. In surveys, people said they trusted physicians, health workers, family members, religious leaders. We needed to do a better job, here in the U.S. and in many other countries, of using those trusted mediators to educate people about COVID vaccines. I'm not sure why somebody thought it was a good idea to just put Anthony Fauci in front of the entire country and tell everyone to get vaccinated and thought that that was going to work. We needed a much more nuanced approach.
On vaccine development
Raimondo: I was working with nucleic acid-based therapeutics, which is the platform technology that enabled the COVID-19 vaccines, when our lab was shut down in 2020. This technology had already emerged as having great potential. In early 2020, Moderna was running nine clinical trials for mRNA-based technologies, including some that were exploring respiratory illnesses and vaccine technologies. Some of the challenges from a research perspective were that this had not been tested on a large clinical scale yet, and manufacturing capabilities needed to be built up. But steps were not skipped; phase one, two and three trials were conducted very rapidly and in parallel, but went through all the checks. Now we have the data analytics and the computational tools already put in place to say, once we have the sequence and the genetic information for a new virus, we know what pieces of it are going to generate a protective or therapeutic response. While we have more to learn, we now have a much more robust understanding of the safety, of how to get a vaccine through FDA approval, how to do quality control, and [what to expect in terms of] clinical response from patients with different backgrounds and comorbidities, and how to cover it.
On recognizing success
Nuzzo: There were also some moments of success and positive innovation that this crisis helped bring about. The development, within a year, of multiple safe and effective vaccines, was a historic humanitarian achievement. We also have whole new types of [disease] surveillance approaches: we can, in the privacy of our own home, test ourselves for not just single viral pathogens, but multiple viral pathogens, and use that information to decide if it's safe to go see our elderly loved ones or if we should stay home. We have wastewater surveillance as a totally new approach that was set up because we were scrambling to track COVID, despite the fact that our access to health care was suboptimal and that there are biases in our public health data sets. This platform is one of the best ways that we have right now to understand the H151 virus and where it is.
Levine: In 2020, I was the primary investigator for the Rhode Island Hospital site that would become the largest trial of convalescent plasma for early treatment of COVID-19 ever conducted, led out of Johns Hopkins. We were able to get a study off the ground in a month and a half, and when it was published in the New England Journal of Medicine, found a 50% reduction in hospitalization with early treatment of convalescent plasma. As a result, this is the treatment that will be available early on in the next pandemic — we’ll have an effective option to offer people.