NIH Musters Million-Person Study to Track Covid’s Spread

The NIH is deploying the muscle of its million-person national research program to trace the spread of Covid-19 and figure out which response measures are most effective.

The All of Us Research Program, the National Institutes of Health’s push to advance targeted treatments known as precision medicine, announced Tuesday three new projects that Executive Director Josh Denny said can answer critical questions on the outbreak while informing future health emergency responses. The projects involve antibody testing, surveys on the patient experience, and culling data from electronic health records to glean insight on symptoms and health problems associated with the virus.

“For everyone involved in NIH and really everyone in biomedical research, Covid-19 was a call to action for what can we do,” Denny said in an interview.

The goals align well with the All of Us, which aims to highlight the importance of diversity in the U.S., he said. Covid-19 has highlighted existing health disparities in the U.S., as the disease has disproportionately affected black and Hispanic populations that experience higher death rates and worse outcomes.

“We are really keen on how we can help alleviate health disparities and promote health equity in this program, and we are really eager to contribute to the solution there. And certainly SARS-Cov-2 has highlighted the importance of this but it’s true of all diseases,” Denny said.

About 350,000 Americans have enrolled in All of Us since the program opened nationwide two years ago, about 200,000 of whom have donated their electronic health records and about 10,000 of whom have provided blood samples since March.

Researchers will work backward from the middle of March to see if they can trace how the virus entered into the U.S. based on samples. The body makes antibodies to fight off an infection like Covid-19, so the presence of antibodies could indicate where the disease was prevalent. Combined with other data, these antibody tests could answer questions about where the virus spread and why it affected certain communities.

“It is retrospective thinking about how the pandemic spread and then people will use that to help inform maybe future policies,” Denny said.

Monthly Surveys

On top of the antibody work, All of Us has developed monthly surveys that will ask both those who have and haven’t been infected with SARS-Cov-2 to answer questions about mental health, social distancing, and the economic impact of the virus.

“It becomes that baseline measure of how our population responded to Covid-19 regardless of infection and then we’ll be able to look at,” he said. The first surveys went out May 7 and will repeat for at least the next few months, Denny said.

The electronic health record project aims to standardize data in the records, making it easier for researchers to look for treatment patterns and gather data on medication and treatment. Combined with the antibody data, these findings potentially could indicate whether antibodies provide some kind of protection against the virus.

“That will take time to discover, but we’ll be able to do things like that as well,” Denny said. “And then we’ll be able to look at all those variables across diverse populations. In our populations, we have the ability to ask those questions across different populations to start to get up maybe the root of some of these health disparities that are so important to address.”

All of Us paused in-person recruitment in March and plans to resume in July. Volunteers can still enroll online, and Denny said the pandemic shouldn’t affect the long term goal of enrolling a million volunteers over the next four or five years.

“In fact, I think it’s brought the importance of research into forefront of everyone’s mind,” he said.