COVID-19 Partnerships: ArgoPond Teams with Doctors Emma Meagher and Ian Frank, University of Pennsylvania

The Leaders and their Roles Prior to the Pandemic

Emma Meagher, a cardiologist and clinical researcher by training, is the Vice Dean for Clinical Research and the Perelman School of Medicine and the Senior Associate Vice Provost for Human Subjects Research at the University of Pennsylvania. She considers herself foremost an educator, and at Penn she leads the institution’s clinical research mission and a translational research training program that has enjoyed over 20 years’ NIH funding. In her Vice Dean and Vice Provost roles, she devotes her time to implementing Penn’s clinical research strategy by making clinical research easier and more impactful for Penn’s many life scientists while managing the risks that accompany studying diseases and their treatments in people.

When They Understood the Magnitude of the Coming Pandemic

On January 28th, 2020, Emma was visiting several of the University of California schools when COVID-19 started quickly changing from a few cases in Washington state to early outbreaks in several cities. She suddenly became worried that air travel might shut down. Ultimately, she was able to travel, but prior to leaving the west coast she participated in “what if” conversations at UCSD as they considered what they were facing. That conversation prepared her for a similar conversation that followed at Penn upon her return. Sitting in her home the evening after the first planning meeting is when it really struck her what might be about to happen. ‘The feeling that there was always another shoe to drop was so unnerving in the earliest days.’

Their Biggest Challenges During the Pandemic

For Ian and Emma and the large group of investigators they support, the biggest initial challenge was worry. “Early on we were scared — we didn’t know how dangerous this was. We worried about our health and our families’. Some researchers wouldn’t go home at all- others stayed in one room in their home away from everyone else.” Additionally, the new contact precautions and procedures slowed everything down. Consenting a patient to participate in a clinical trial could require a researcher spend more than an hour in a contagious patient’s room; simple blood draws and other tests suddenly involved multiple people and required special planning to minimize team exposure.

Lessons Learned

For Ian, “it has been an enormously exciting opportunity, to be part of a really important new infection. Most days, we’re more excited than scared.” One of the things Ian found most exciting has been the speed of innovation over the past year. This includes not only the accelerated advances in biotechnology and especially vaccine technology, but other innovations that will improve the care of his patients. Telemedicine has transformed how he cares for patients with HIV and other long-term patients, especially those in rural areas. “I have a lot of patients that come to see me from southern Delaware or central Pennsylvania. Now, rather than have them drive for two hours I can interact with them through telemedicine. We’re never going to do visits the same again.”

The Role of Research Institutions During Public Health Emergencies

A central question that arose during Argo Pond’s work with Penn during the pandemic is what is the role for such a large research university and health system should be in advancing new therapies for the infection? Ideas for new therapies were almost unlimited among the Penn faculty, but the number of patients available for research participation — and the infrastructure needed to enroll and care for them — was finite. Would the school’s scientific and clinical resources best be deployed by contributing to large multicenter trials? Or by pushing the envelope by studying therapies that were probably too early to make an impact on the current pandemic but might play a major role in the future? Emma notes, “There’s not a real answer. I think we’ll always struggle to make decisions about prioritization. A large university’s mandate is so broad, and in that moment, every pillar needs attention. Academia’s long arc produced the technology that became antibody therapy and vaccines for COVID-19. Yet in the chaos of times like this past year, we will be challenged like all large institutions in how to most effectively deploy limited resources.”

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