21/04/2020 - 08:59

Time, teamwork put WA on front foot in viral fight

21/04/2020 - 08:59

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Hard-border closures and a partial lockdown in WA are providing medical researchers with the opportunity to explore potentially life-saving COVID-19 treatments.

Dana Henderson says it’s important clinical trials are started as soon as possible. Photo Gabriel Oliveira

Hard-border closures and a partial lockdown in WA are providing medical researchers with the opportunity to explore potentially life-saving COVID-19 treatments.

Recent data suggests Australia as a whole is doing a good job of reducing the rate of new COVID-19 infections and managing to flatten the curve.

However, of all states and territories, Western Australia has stood apart for its comparatively aggressive response to the disease in recent weeks, implementing strict border controls and expanding its testing criteria.

Those measures have contributed to the caseload in WA currently standing in the hundreds, with little evidence to indicate sustained community transmission of the disease as is the case in Victoria, NSW and Queensland.

And while the research community as a whole is prioritising the fight against COVID-19, WA’s success in suppressing the virus has bought the state’s researchers time and resources to begin clinical trials that could lead to the discovery of potentially life-saving treatments for patients.

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Gary Geelhoed, who has been executive director of Western Australia’s Health Translation Network for the past two years, understands the urgency of the task at hand.

The network was founded in 2015 in response to a request from the National Health and Medical Research Council, the industry’s peak funding body, to ensure the states were facilitating original and cooperative research where possible.

Responsible for coordinating research between WA’s major universities, medical research institutes, private and public hospitals, and the Department of Health, Professor Geelhoed said WA had structures in place that uniquely positioned it to devise treatments for COVID-19.

For instance, he said the state’s biobank – a repository of biological samples used for medical research – had improved markedly in recent years, with the network having instituted greater organisation and standardisation of how samples were collected from patients.

It’s the rapid scale-up of that sort of vital infrastructure and the widening of access to it that Professor Geelhoed said had given WA a strong base from which to perform urgent clinical research.

“Having that largely in place now as the pandemic has started has been very useful,” he said.

“That’s an example in the past of work we’ve done bringing everyone together.

“What we’re doing now is the vision we had at the WAHTN.

“Slowly, year after year, we’re edging towards that and getting much more collaboration.”

Vicki Rasmussen says COVID-19 has required a collaborative approach from WA’s health services sector. Photo: Gabriel Oliveira

Immediate outcomes

WAHTN’s aim to invite and encourage cooperation has taken on renewed importance in recent weeks, as major medical research foundations from across the state have appealed to businesses and philanthropists to fund the network’s COVID Research Response initiative.

Among the foundations leading that effort are Spinnaker Health Research Foundation, Charlie’s Foundation and the Royal Perth Hospital Medical Research Foundation.

Seeking $1 million in immediate funding (to be matched by the state government), the foundations are appealing for a further $5 million to ensure the state’s researchers have sufficient resources to undertake comprehensive clinical trials in the coming months.

“What we’re trying to do is coordinate everything,” Professor Geelhoed said.

“Research can be academic, but in this case it’s very clinical.

“As everyone knows, there is no treatment for COVID-19.

“You can be supported to the extent of being intubated, and then it’s in the lap of the gods whether you live or die.

“These trials will give you access to possibly … effective or life-saving treatment.”

Professor Geelhoed said the immediate focus for the program would be ensuring the state’s sickest patients had access to experimental treatments if necessary, with an expansion of clinical trials integral to that goal.

One of the most prominent trials the network is seeking to expand is experimental treatment into community-acquired pneumonia originally set up after the 2009 swine flu pandemic.

Professor Geelhoed said by expanding the patient eligibility for those trials as well as rolling it out to major hospitals outside of the CBD, the research community would be able to better understand its efficacy in treating COVID-19.

Elsewhere, he said the network was supporting the Telethon Kids Institute’s proposed studies into repurposing existing treatments for tuberculosis and some cancers in acting as a prophylactic to prevent community spread of the virus.

WAHTN is also emphasising support for longer-term studies into the COVID-19 pandemic, such as work by Sean Hood at the University of Western Australia and Christopher Reid at Curtin University into the mental health effects of quarantines and social distancing.

“What we’re doing here in WA is working across the board so it’s much more efficient, there’s less duplication, and we’re creating these platforms to standardise biobanking and getting consent,” Professor Geelhoed said.

“It makes it so much easier to start trials and collaborate easily with people doing similar things.

“There’s certainly a lot more activity going on the east coast, but [we’re doing] it much more efficiently and in a much more targeted way.”

Though clinical research can sometimes be thought of as something disconnected or too academic to be immediately useful, Professor Geelhoed insisted research performed now into COVID-19 would yield immediate benefits for patients.

Perhaps best known for his stint as president of the WA arm of the Australia Medical Association as well as his tenure as WA’s chief medical officer between 2012 and 2018, Professor Geelhoed said his career had focused on promoting collaboration between the health services for the benefit of patients.

“It’s never been considered all that important in some health services, yet evidence [shows] that [when] you can combine academia, research and clinical services together, you get better patient outcomes,” he said.

Funding

With researchers in WA now scaling-up their work and preparing to roll-out clinical trials on a state-wide scale, several medical foundations have expressed a need to highlight the direct impact clinical trials will have in the near term.

Dana Henderson, chief executive of SHRF, explained that WAHTN’s response program differed from typical research because the focus was on directly treating patients infected with virus, rather than on academic or abstract understandings of the illness.

“It’s not about the project, it’s about how the research will impact people as they come into hospital, mitigate death and save lives,” Ms Henderson said.

“The fact is that we don’t know how to treat this, and unless we get clinical trials in place, no amount of PPE will save you when you need a respirator.

“We need to get people on clinical trials as soon as possible, from the first moment they present in hospital.

“More importantly, we have to have a sense of understanding which clinical trials … are working.”

The aspect of collaboration for foundations funding the COVID-19 response program that are otherwise operating in a competitive environment is testament to the urgency of the work at hand.

Vicki Rasmussen, executive director of Charlie’s Foundation, said given the vast impact the pandemic would have on the community, it made sense for WA’s health services community to work collaboratively.

“The hospitals, the three main ones, have their niches and areas of focus, but this is one focus and it’s statewide,” Ms Rasmussen told Business News.

“It’s giving us the opportunity to … put one project for the entire state before everybody and work on this collaboratively.”

Jocelyn Young, executive director of RPH’s Medical Research Foundation, expressed a similar sentiment, noting a need for everyone in the health services sector to work towards the singular goal of treating COVID-19.

“There have been many researchers speak about how important it is that we’re linked to the work of the global community,” Ms Young said.

“We can’t operate in isolation.

“By being connected and working with colleagues both nationally and internationally, the impact [of clinical research] can be fast tracked.”

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