In Frontiers in Science: rethinking medicine after the pandemic

The health emergency caused by the COVID-19 pandemic has led to a radical shift in numerous fields of medicine. The review “Standing the Test of COVID-19: Charting the New Frontiers of Medicine,” published in the scientific journal Frontiers in Science and authored by Simon Cauchemez, Giulio Cossu, Nathalie Delzenne, Eran Elinav, Didier Fassin, Alain Fischer, Thomas Hartung, Dipak Kalra, Mihai Netea, Johan Neyts, Rino Rappuoli, Mariagrazia Pizza, Melanie Saville, Pamela Tenaerts, Gerry Wright, Philippe Sansonetti, and Michel Goldman, analyzes the impact of the COVID-19 pandemic on medical research and innovation.

Rethinking diseases. The COVID-19 pandemic has highlighted the importance of rethinking the concept of disease based on the dynamic and heterogeneous interrelationships between physical and genetic characteristics, comorbidities, environmental exposures, and the socioeconomic status of each individual. These complex connections have led some experts to label COVID-19 as a “syndrome,” prompting integrated public health and healthcare responses capable of addressing these new factors in concert with the research community.

The progress of research. Between 2020 and 2022, there was a 9% increase in scientific publications, with about 7% of the total involving or referencing the SARS-CoV-2 virus or COVID-19 disease. The lessons learned from the pandemic experience extend beyond infectious disease science, underscoring the need for a global view of health as a complex balance of multiple factors. Thanks to the diverse experiences and expertise of the authors, the paper “Standing the Test of COVID-19: Charting the New Frontiers of Medicine” offers a multidisciplinary perspective on the future of medicine based on insights gathered during the pandemic years. The focus is on four different areas: identifying new strategies to combat infectious diseases, implementing personalized medicine to meet individual patient needs, enhancing systems medicine and data science to improve processes, and strengthening public health science to address health disparities more effectively.

New strategies against infectious diseases. The advent of vaccines, thanks to the pioneering experiments of Edward Jenner and Louis Pasteur, marked the first major successes in the fight against infectious diseases. Today, nearly two centuries later, vaccination remains crucial in protecting millions of lives and will continue to be a key element of public health in the future. However, according to the authors, an additional step is needed to increasingly adopt a One Health approach, an integrated strategy that recognizes the interconnection between human health, animal health, and ecosystem health. This concept is based on the premise that the health of all living species and the environment are closely linked and that effectively addressing diseases and global health issues requires a collaborative and interdisciplinary approach.

Personalized medicine. The phenotypic heterogeneity of COVID-19 was evident from the start of the pandemic: the same virus could be lethal for some individuals and completely asymptomatic for others. Studies have shown that advanced age was a significant risk factor along with obesity, type 2 diabetes, and other comorbidities, leading to the development of targeted therapies for vulnerable individuals. Based on these and other observations, it is clear that the approach of personalized medicine can bring significant benefits in treating diseases, allowing therapies to be tailored to the specific characteristics and needs of individual patients, thereby improving treatment efficacy and reducing associated risks.

Systems medicine and data science. The COVID-19 pandemic has highlighted how public health decisions depend on numbers: disease incidences, positivity rates, hospitalization rates, and deaths became daily concerns not only for decision-makers and public health officials but also for a wider audience. This has underscored the need for robust analytical methods to interpret large volumes of complex data, support the definition of best practices in a context of high uncertainty, and obtain accurate scientific information. In this context, as the review suggests, advanced computational analysis and artificial intelligence can be crucial. Additionally, the ability to integrate clinical and genomic characteristics, immune factors, microbiome data, and other anthropometric measures into a systems medicine approach could enable the repurposing of existing medical interventions in a personalized manner.

A global and inclusive approach. Populations in lower-income countries have been among the hardest hit by the SARS-CoV-2 infection. According to the authors, economic, geographical, and ethnic variables have doubled or even tripled mortality rates, also due to the limited availability of vaccines and adequate treatments. This situation requires specific corrective measures, including the integration of low- and middle-income countries within the strategies developed for pandemic preparedness and response or other health emergencies.

Click here to read the review in Frontiers in Science: “Standing the Test of COVID-19: Charting the New Frontiers of Medicine”.