The COVID-19 Crowding-Out Effect

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Examining the High-Stakes Impact of COVID-19 on Scientific Research

The massive effort by the scientific community to understand COVID-19, the disease caused by SARS-CoV-2 (“coronavirus”), and identify potential treatments and vaccines to treat it, is a testament to the extraordinary ability of this community to rally resources to face this daunting pandemic. The researchers who have taken up the challenge, however, were not sitting idle prior to the pandemic. They were actively engaged in important research on thousands of other diseases, meaning that the massive shift in medical research to focus on COVID-19 has come with an accompanying reduction in research into other serious diseases. 

This “crowding-out effect” has serious potential long-term ramifications. Medical research is a cumulative process, and typically, there’s a significant time lag between most research and improvements in patient outcomes. Consequently, the diversion of resources to COVID-19 will almost certainly lead to a long-term slowdown in advances for these conditions.

But which diseases are most severely impacted by this shift to coronavirus research? To find out, we leveraged the powerful technology that underpins MediFind, a platform built to help patients find experts and stay on top of recent medical advances.

Our process uses Artificial Intelligence combined with medical experts to continuously monitor the body of biomedical literature for every known disease. While we monitor multiple research sources, we restricted this particular analysis to research sourced from Pubmed, the world’s largest repository of peer-reviewed biomedical research. We looked at the monthly research output (that is, volume of research articles published) for every disease in our database since the beginning of 2019. In total, this represents nearly 2 million research articles covering thousands of diseases.  We then compared the research output for each disease from April-July 2020 relative to the same period last year to identify which diseases showed the greatest increase or decrease in research output (note: since there is a lag between the publication date and the time an article actually appears in PubMed, we expect to see declines in research for every condition, which is why we looked at relative growth rates). Since the vast majority of diseases have relatively low output, we further restricted our analysis to the 250 conditions with the largest research output in the 2020 period.

The results are clear and striking:

  1. Research into COVID-19 and closely-related conditions now represents 23% of all research output
  2. Research into nearly every other condition is down, with particularly steep declines in cancer and infectious disease research

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Finding 1: Research into COVID-19 and related conditions now represents 23% of all research output

Overall, research into COVID-19 and related conditions now represents 23% of all research output. Given that research resources are finite and constrained, this indicates a significant crowding-out effect for most other conditions.

While most conditions have seen a sharp decline in research output, a handful of conditions closely related to COVID-19 have seen a significant increase in research. These conditions are:

  • Coronavirus
  • Severe Acute Respiratory Syndrome (SARS)
  • Middle East Respiratory Syndrome (MERS)
  • Pneumonia
  • Acute Respiratory Distress Syndrome (ARDS)

Growth in the research volume for these conditions comes from both direct analysis (e.g. researching aspects of SARS itself) as well as researching the intersection of these diseases with others (e.g. researching how SARS impacts people with asthma or cancer). The latter situation is one in which research resources within an area of study must be diverted to assess the impact of COVID-19, a topic that would not have been prioritized in a time before the pandemic.

Finding 2: Research into nearly every other condition is down, with particularly steep declines in cancer and infectious disease research

Research output is down overall, across nearly every known disease, with specific categories bearing the brunt of the impact. Since the coronavirus is primarily the research domain of infectious disease experts, it is not surprising to see the largest research reductions coming from other infectious diseases that are not closely related to coronaviruses. For example, we see dramatic reductions in research for all of the following:

  • Syphilis
  • Zika Virus Disease
  • Pulmonary Tuberculosis
  • Pseudomonas
  • Salmonella
  • Strep Throat
  • Secernentea
  • Arbovirosis
  • Toxoplasmosis
  • Malaria

Similarly, and perhaps more ominous for long-term patient outcomes, is the dramatic drop in basic research. With many research labs being shut down during the initial phase of the pandemic along with the reallocation of funds to coronavirus research, basic research into numerous other diseases is slowing. This is evidenced by the dramatic drop in research into nearly all cancers, with output down by an average of 40% from last year. For example, all of the following cancers are within the bottom quintile of the 250 conditions included in this analysis in terms of year-over-year research growth (declines): 

  • Bone Cancer
  • Colorectal Cancer
  • Ovarian Cancer
  • Leukemia
  • Breast Cancer
  • Liver Cancer
  • Lung Cancer
  • Prostate Cancer
  • Pancreatic Cancer
  • Bladder Cancer

The groups of health conditions highlighted in this analysis represent only a few of the many areas of research being crowded-out by COVID-19. The full dataset assesses the impact of coronavirus on research output for thousands of other conditions.

The pandemic represents an immediate danger to everyone, and the scientific community is admirably rallying together to come up with treatments and, hopefully, a vaccine. While this effort is critically important, we must also recognize the resultant slowdown in research for nearly every other disease, as well as the long-term implications of that slowdown on patient health for years to come.

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