Three clinical trials into potential COVID-19 treatments are among 13 government-funded studies announced today to help combat the current coronavirus outbreak and prepare New Zealand for future infectious diseases.
The Health Research Council of New Zealand (HRC) and Ministry of Health have awarded more than $3.8 million to COVID-19 research in the fields of health and social science, as a result of an urgent funding call issued by the agencies last month.
The HRC’s chief executive, Professor Sunny Collings, says the studies will contribute to global research efforts to manage COVID-19 while meeting evidence gaps specific to New Zealand, with careful consideration to health equity for Māori and Pacific groups.
“This research has the potential to contribute answers to questions the world is grappling with, especially those concerning treatment options for COVID-19,” she says.
Three funded clinical trials, for example, will test the role of existing medications that have gained a high profile for their potential use in this crisis.
One trial, led by Auckland City Hospital intensive care specialist Dr Colin McArthur, will test immune modulation treatments as well as anti-viral drugs such as hydroxychloroquine (currently used to treat autoimmune diseases like rheumatoid arthritis and lupus, or malaria) and lopinavir-ritonavir (currently used to treat HIV) for their effectiveness in critically ill COVID-19 patients.
This study is an extension to a wider international study (REMAP-CAP) that’s been recruiting patients with severe community-acquired pneumonia – the main cause of death from COVID-19 – for the past three years. New Zealand, through earlier HRC funding, was already part of the wider study which was pre-designed to adapt when a pandemic occurred. With 10 of New Zealand’s ICUs already taking part in that study, they’re now set up and ready to test a range of treatments for COVID-19 patients.
Dr McArthur says that clinicians and researchers learned from the last influenza A/H1N1 pandemic (in 2009) that a clinical trial must be in place and operating prior to a pandemic, to enable effective interventions to be identified and assessed quickly and efficiently during a pandemic.
Another clinical trial (Australasian COVID-19 Trial - ASCOT), led in New Zealand by Middlemore Hospital clinical microbiologist and infectious diseases physician Dr Susan Morpeth, will test the use of those same anti-virals in people unwell enough to need admission to hospital, but not so unwell that they need intensive care. The study will be carried out at multiple sites across Australia and New Zealand to see which treatment, or combination of treatments, will reduce the risk of death or needing ventilatory support among COVID-19 patients.
A separate trial, led by Wellington Regional Hospital physician and Medical Research Institute of New Zealand director Professor Richard Beasley, will test the use of hydroxychloroquine in front-line healthcare workers. Preventing infections in healthcare workers has been identified as a key strategic objective by the World Health Organization and vital for continuity of health services, says Professor Beasley.
These clinical trials have been designed to contribute to World Health Organization (WHO) COVID-19 research priorities and objectives.
REMAP-CAP has been deemed a WHO pandemic special study in its own right, but both this trial and ASCOT are compatible with and complementary to the WHO Solidarity clinical trial. The Solidarity trial is also investigating the role of hydroxychloroquine and other potential agents for the treatment of COVID-19 and is an especially valuable opportunity for countries who don’t have established hospital trials already in place.
Professor Sunny Collings says New Zealand is well-placed, well-resourced and highly capable of contributing to the evidence base needed to inform future treatments for COVID-19, as well as broader management strategies for diagnosing and containing the virus.
Ministry of Health Chief Science Advisor Dr Ian Town says the calibre of funded projects and the exceptional response to this call for proposals has highlighted just how adaptable and prepared our research sector is, to respond to a crisis like this so quickly.
“The projects selected will make a real difference to our understanding of how to manage this epidemic and how wider society is responding to efforts to break the chain of transmission,” he says.
“From some of these studies, we will get a comprehensive picture of the effectiveness of self-isolation measures in New Zealand and important guidance on how to better support Māori and Pacific communities with their concerns and reactions to COVID-19.”
All 13 projects announced today will get underway as soon as feasibly possible. Below is the full list of funded studies.
2020 COVID-19 New Zealand Rapid Response Research
(Request for Proposals funded by the Ministry of Health and Health Research Council)
Ms Lesley Gray, University of Otago
Improving effectiveness and equity in the operation of COVID-19 ‘self-isolation’
Dr Colin McArthur, Medical Research Institute of New Zealand
Clinical trial of COVID-19 treatments for the critically ill
Dr Marama Muru-Lanning, The University of Auckland
Harirū, hongi and hau in the time of COVID-19
Professor Ilan Noy, Research Trust of Victoria University of Wellington
Economic risks from COVID-19 in Pacific Island Countries
Dr Olin Silander, Massey University
Rapid diagnosis and genome sequencing to follow CoV-2019 outbreak
Associate Professor Jo-Ann Stanton, University of Otago
An effective point-of-care screening pathway for COVID-19
2020 COVID-19 and Emerging Infectious Diseases Grant
(Researcher-initiated proposals funded solely by the Health Research Council)
Professor Michael Baker, University of Otago
COVID-19 Pandemic in Aotearoa NZ: Impact, inequalities & improving our response
Professor Richard Beasley, Medical Research Institute of New Zealand
Clinical trial of hydroxychloroquine prophylaxis in frontline healthcare workers
Dr Liangni Liu, Massey University
Social response to COVID-19 in New Zealand: Obligations and stigmatisation
Mr John Mackay, Dnature Diagnostics & Research
Distinguishing COVID-19 from influenza with rapid 15-minute diagnostics
Dr Susan Morpeth, Middlemore Clinical Trials
Australasian COVID-19 Trial (ASCOT)
Professor Anthony Phillips, The University of Auckland
Attenuating lung injury during prolonged ventilation for COVID-19
Professor Colin Simpson, Research Trust of Victoria University of Wellington
Predict and Prevent COVID-19: a data driven innovation project