COVID-19 PANDEMIC AND THE VALUE OF ANTIBODIES TESTING: STILL MORE MATTERS IN THE WORKS
The ‘COVID-19 Pandemic’ has remained a ‘Troublesome Unprecedented 21st Century Storm’ tasking the ‘Interventional and Intellectual Ingenuity’ of the World! ALL ‘Interventional Strategies’ are being explored as ‘Matters in the Works’ towards ‘Globally Weathering the Storm’1-4!! Lately, there has been much focus on the ‘Value of Antibodies Testing’ as a ‘Rational Evidence-based COVID-19 Pandemic Intervention’5-8. There are several ‘Outstanding Issues’ for ‘Research Resolution’ as ‘Challenging Unfinished Business in the Works’ concerning the ‘Role of Antibodies Testing’ as part of the ‘Interventional Armoury’ for the ‘Global Fight’ against the ‘COVID-19 Pandemic’9-14!
The ‘Serological Testing for the SARS-CoV-2 Antibodies’ are important for ‘Monitoring the COVID-19 Pandemic’ and for ‘Responding to the COVID-19 Pandemic’8! There are, however, ‘Outstanding Unresolved Antibodies Conversational Issues’ pertaining to: ‘Optimal Testing Time in the Disease Course’, ‘Protection’, ‘Duration of Protection’, ‘Reinfection and Reactivation’, ‘Antibodies Level and Individual Protection’, ‘Population Coverage and Herd Immunity’ etc5-13!! There are also ‘Communications’ reporting the ‘Implications for Detected Antibodies’ as they relate to: ‘Symptomatic and Asymptomatic Infections’, ‘Severity of the Disease and Antibody Levels’, ‘Population Diversity and Antibody Response’ etc5,9-13!!
The ‘Quality of Antibodies Testing’ remains a ‘Contextual Conversational Unresolved Issue’ and several ‘Possibilities’ have been explored with differing ‘Test Sensitivities’ and ‘Test Specificities’ as reported in a recent Meta-Analysis6! From the 40 Studies evaluated, the plethora of ‘SARS-CoV-2 Antibodies Testing Techniques’ includes, among others, with differing ‘Sensitivities’, ‘Specificities’ and ‘Risks of Bias’: Enzyme-Linked Immunosorbent Assay (ELISA), Lateral Flow Immunoassays (LFIAs), Chemilluminiscent Immunoassays (CLIAs) etc6! The ‘Antibody Test Techniques’ depend on different ‘SARS-CoV-2 Antigens’: ‘N Nucleocapsid Viral Protein’, ‘S Spike Viral Protein’ etc!! The ‘Meta-Analysed Studies’ had only 4 evaluating ‘Out-Patients Populations’ and only 2 evaluating the LFIAs as ‘Point-of-Care Antibodies Tests’. The Meta-Analysis indicates that no ‘Single Test’ commands combined ‘Sensitivity’ and ‘Specificity’ that is good enough for the desired ‘COVID-19 Pandemic Intervention’. A ‘Combination of Antibodies Testing’, taking cognizance of their differing ‘Sensitivities’ and ‘Specificities’, is necessary for the development of ‘COVID-19 Pandemic Interventional Algorithms’15!! The ‘Pandemic Interventional Algorithm’ may also take cognizance of the ‘Time in the Course of the Disease’ when the ‘Antibodies Testing’ is conducted!!
It is also reported that several ‘Antibodies Testing Techniques’ developed early in the ‘COVID-19 Pandemic Era’ were of limited ‘Proven Performance’ and were hurriedly purchased by several Governments worldwide with obvious implications for ‘COVID-19 Research Outpourings’ and the attendant bothersome ‘Unreliable Research Data’16! This is the basis of the now worrisome reported ‘COVID-19 Research Waste’17-19!! The imperative to eclipse or minimize the ‘COVID-19 Research Waste Quantum’ has been previously communicated17-22!!! The ‘Earlier Research Reports’15 are currently being critically re-evaluated to appropriately re-situate them with more deserving attention to the ‘Time-tested Robust Research Governance Pillars and Date Governance Principles’14,18,23-25!!! It is bad enough grappling with the ‘COVID-19 Pandemic’ and the World cannot afford the concomitant ‘COVID-19 Infodemic as Another Pandemic’. The ‘COVID-19 Research Waste’ will enlarge the ‘COVID-19 Infodemic Quantum’ and MUST be aggressively Systematically and Systemically addressed!!
An unusual and unique ‘COVID-19 Pandemic Characteristic’ is the ‘Rapidly Dynamically Transmuting Pandemic Specifics’ increasingly by the day, therefore, necessitating the imperative for equally ‘Rapidly Emerging COVID-19 Research Outpourings’ BUT the ‘COVID-19 Research’ MUST also of necessity be ‘Research Best Practices-compliant’! A recent ‘Communication’ critically identified ‘10 Strategic Determinants’ that MUST be addressed to assure improved ‘COVID-19 Research Output with Data Reliability’ with the imperative to ‘Paradoxically Make Haste Slowly’21! The identified ’10 Strategic Determinants’ span over a plethora of ‘COVID-19 Pandemic Composite Dimensions’ starting from the ‘Novel Coronavirus Origin’ through ‘Appropriate Pandemic Nomenclatural Issues’ and ‘COVID-19 Susceptibilities, Transmissibility, Vulnerabilities, Manifestations, ‘Pandemic Interventions’, Determinant COVID-19 Epidemic Curve Metrics, COVID-19 Analytics, Diagnostics, Therapeutics, Holistics, Social Disparities’! It ends with the ‘Technical Soundness, Timeliness and Appropriateness of Advisories, Guidelines, Guidance by Relevant National and Global Bodies’!! The ‘COVID-19 Research Waste’ has also been presented as ‘Another Pandemic’ that MUST be avoided in the ‘Global Fight’ against the ‘COVID-19 Pandemic’
The ‘Value of SARS-CoV-2 Antibodies Testing’ MUST also be disposed in relation to ‘Clinical Usefulness’, ‘Implications for the General Population’ and ‘Policy Formulation Guidance’. The deployment of the ‘COVID-19 Antibodies Testing’ in the ‘Pandemic Interventions’ must be evaluated for their value in ‘Monitoring the COVID-19 Pandemic’ re: ‘COVID-19 Prevalence in the Population’, ‘Shield Protective Immunity’, ‘Individual Immunity’, ‘Herd Immunity’, ‘Determinant Metrics for Reopening from Country Pandemic Interventional Lockdowns’, ‘Considered Variables for Reopening Schools, Sports Championships, Businesses’ etc!!
For the ‘SARS-CoV-2 Antibodies Testing’, the ‘Matters Still in the Works’ include, among several others: ‘Relevance to Detecting Prior Infection’, ‘Prevalence of SARS-CoV-2 Antibodies in the Population’, ‘Detection and Assessment of Pre-Symptomatic and Asymptomatic Transmissions in the Community’, ‘Level of Protection’, ‘Duration of the Immunity against COVID-19’ etc8! Additionally, ‘Other Matters’ to be determined include, among others: ‘Possible Cross-Neutralization’, ‘Clonal Expansion’, ‘Specific Receptor-Binding Domain and Equally Specific Antibody Targeting’, ‘Somatic Hyper-Mutation’ etc9-11!!
This ‘Communication’ is a ‘Contribution’ to the raging ‘COVID-10 Pandemic Antibodies Testing Conversation’ and seeks to amplify the various ‘Conversational Dimensions’ that MUST be addressed in discussing and evaluating the ‘Value of the SARS-CoV-2 Antibodies Testing’ in the ‘Global Fight’ against the ‘COVID-19 Pandemic’.
REFERENCES
1. Godlee F. COVID-19: Weathering the storm. BMJ 2020; 368:m1199 of 26th March 2020
2. Eregie CO. COVID-19 pandemic tragic octad: The evolving conceptual qualitative interventional equation to fight the pandemic. https://www.bmj.com/content/369/bmj.m2303/rr-9 of 24th June 2020
3. Semlyen J, Hariharan B, Josiah B, Okongwu K, Quarshie LS, Rodrigues V. Medical schools and other institutions need to tackle racism head on. BMJ 2020; 370:m2746
4. Eregie CO. Covid-19 Pandemic, social disparities and medical education reformation: A reminder of the imperative for ‘Medical Socioeconosophy (MSE)’. https://www.bmj.com/content/370/bmj.m2746/rr of 1st August 2020
5. Zhu N, Zhang D, Wang W et al. China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020; 382:727-33
6. Lisboa Bastos M, Tavaziva G, Abidi SK et al. Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis. BMJ 2020; 370:m2516
7. Premkumar L, Segovia-Chumbez B, Jadi R et al. The receptor binding domain of the viral spike protein is an immunodominant and highly specific target of antibodies in SARS-CoV-2 patients. Sci Immunol 2020; 5:eabc8413
8. Duong YT, Wright CG, Justman J. Antibody testing for coronavirus disease 2019: not ready for prime time. BMJ 2020; 370:m2655
9. Antibodies Brouwer PJM, Caniels TG, Straten K et al. Potent neutralizing antibodies from COVID-19 patients define multiple targets of vulnerability. https://science.sciencemag.org/content/2020/06/15/science.abc5902
10. Deeks JJ, Dinnes J, Takwoingi Y, et al. Antibody tests for identification of current and past infection with SARS-CoV-2. Cochrane Database Syst Rev 2020; 6:CD013652
11. Eregie Antibodies Eregie CO. Covid-19 Pandemic, SARS-CoV-2 antibodies and testing: Still searching for more facts. https://www.bmj.com/content/369/bmj.m2584/rr of 16th July 2020
12. Liu A. Regeneron scales up manufacturing, eyes human tests of COVID-19 antibody cocktail in June. Fierce Pharma. 5 May 2020. https://www.fiercepharma.com/pharma/regeneron-scales-up-manufacturing-ey...
13. US Food and Drug Administration. Independent Evaluations of COVID-19 Serological Tests. FDA, 2020 https://open.fda’gov/apis/device/covid-19serology/
14. Branda JA, Body BA, Boyle J et al. Advances in Serodiagnostic Testing for Lyme Disease Are at Hand. Clin Infect Dis 2018; 66:1133-9
15. Andersson M, Low N, French N et al. Rapid roll out of SARS-CoV-2 antibody testing-a concern. BMJ 2020; 369:m2420
16. Clinical Trials.gov. History of changes for study. NCT04280705, 1 May 2020. https://clinicaltrials.gov/ct2/history/NCT04280705?A=10&B=15&C=Side-by-S....
17. Glasziou PP, Sanders S, Hoffmann T. Waste in covid-19 research. BMJ 2020; 369:m1847
18. Eregie CO. COVID-19 Pandemic: The multifaceted picture of compromised COVID-19 research and the COVID Phenomenon’. https://www.bmj.com/content/369/bmj.m1847/rr-12 of 10th June 2020
19. Eregie CO. COVID-19 and the quadruple-barrel tragedy: matters still evolving for the works. https://www.bmj.com/content/369/bmj.m2197/rr of 19th June 2020
20. Eregie CO. COVID-19 Pandemic and the ‘Determinant Nonad’: Rekindling the imperative of the twin medical reformation interventions of ‘Multiparameter-Based Medicine (MBM)’ and ‘Medical Socioeconosophy (MSE)’. https://www.bmj.com/content/369/bmj.m2379/rr of 7th July 2020
21. Eregie CO. COVID-19 Pandemic, the quest for urgent information and solutions and the paradox: making haste slowly to avoid ‘COVID-19 Research Waste’; time for strategic ‘COVID-19 Research Retreat for a Decad’. https://www.bmj.com/content/370/bmj.m2668/rr-0 of 21st July 2020
22. COVID Testing Project. COVID-19 Testing Project 2020. https://covidtestingproject.org/
23. Yan W. Coronavirus tests science’s need for speed limits. New York Times 2020 Apr 14. https://www.nytimes.com/2020/04/14/science/coronavirus-disinformation.html
24. Hoffmann T, Glasziou P. What if the vaccine or drugs don’t save us? Plan B for coronavirus means research on alternatives is urgently needed. The Conversation, 21 Apr 2020. https://theconversation.com/what-if-vaccine-or-drugs-dont-save-us-plan-b...
25. Eregie C.O. COVID-19 Pandemic, ‘COVID Phenomenon’ and the politics of the science, facts, research evidence and ‘evidence-based medicine (EBM): the imperative for rekindling the ‘multiparameter-based medicine (MBM) in the 21st Century. https://www.bmj.com/content/369/bmj.m1336/rr-20 of 17th April 2020
Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria and
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria.
UNICEF-Trained BFHI Master Trainer and ICDC-Trained in Code Implementation.
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria.
*No Competing Interests.
Competing interests:
No competing interests
14 August 2020
CHARLES OSAYANDE EREGIE
MEDICAL DOCTOR
Professor of Child Health and Neonatology, University of Benin and Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria. Also, UNICEF-Trained BFHI Master Trainer and ICDC-Trained in Code Implementaion. Also a Technical Expert/ Consultant on FMOH-UNICEF-NAFDAC Project on Code Implementation in Nigeria
Institute of Child Health, College of Medical Sciences, University of Benin, Benin City, Nigeria.
Rapid Response:
COVID-19 PANDEMIC AND THE VALUE OF ANTIBODIES TESTING: STILL MORE MATTERS IN THE WORKS
The ‘COVID-19 Pandemic’ has remained a ‘Troublesome Unprecedented 21st Century Storm’ tasking the ‘Interventional and Intellectual Ingenuity’ of the World! ALL ‘Interventional Strategies’ are being explored as ‘Matters in the Works’ towards ‘Globally Weathering the Storm’1-4!! Lately, there has been much focus on the ‘Value of Antibodies Testing’ as a ‘Rational Evidence-based COVID-19 Pandemic Intervention’5-8. There are several ‘Outstanding Issues’ for ‘Research Resolution’ as ‘Challenging Unfinished Business in the Works’ concerning the ‘Role of Antibodies Testing’ as part of the ‘Interventional Armoury’ for the ‘Global Fight’ against the ‘COVID-19 Pandemic’9-14!
The ‘Serological Testing for the SARS-CoV-2 Antibodies’ are important for ‘Monitoring the COVID-19 Pandemic’ and for ‘Responding to the COVID-19 Pandemic’8! There are, however, ‘Outstanding Unresolved Antibodies Conversational Issues’ pertaining to: ‘Optimal Testing Time in the Disease Course’, ‘Protection’, ‘Duration of Protection’, ‘Reinfection and Reactivation’, ‘Antibodies Level and Individual Protection’, ‘Population Coverage and Herd Immunity’ etc5-13!! There are also ‘Communications’ reporting the ‘Implications for Detected Antibodies’ as they relate to: ‘Symptomatic and Asymptomatic Infections’, ‘Severity of the Disease and Antibody Levels’, ‘Population Diversity and Antibody Response’ etc5,9-13!!
The ‘Quality of Antibodies Testing’ remains a ‘Contextual Conversational Unresolved Issue’ and several ‘Possibilities’ have been explored with differing ‘Test Sensitivities’ and ‘Test Specificities’ as reported in a recent Meta-Analysis6! From the 40 Studies evaluated, the plethora of ‘SARS-CoV-2 Antibodies Testing Techniques’ includes, among others, with differing ‘Sensitivities’, ‘Specificities’ and ‘Risks of Bias’: Enzyme-Linked Immunosorbent Assay (ELISA), Lateral Flow Immunoassays (LFIAs), Chemilluminiscent Immunoassays (CLIAs) etc6! The ‘Antibody Test Techniques’ depend on different ‘SARS-CoV-2 Antigens’: ‘N Nucleocapsid Viral Protein’, ‘S Spike Viral Protein’ etc!! The ‘Meta-Analysed Studies’ had only 4 evaluating ‘Out-Patients Populations’ and only 2 evaluating the LFIAs as ‘Point-of-Care Antibodies Tests’. The Meta-Analysis indicates that no ‘Single Test’ commands combined ‘Sensitivity’ and ‘Specificity’ that is good enough for the desired ‘COVID-19 Pandemic Intervention’. A ‘Combination of Antibodies Testing’, taking cognizance of their differing ‘Sensitivities’ and ‘Specificities’, is necessary for the development of ‘COVID-19 Pandemic Interventional Algorithms’15!! The ‘Pandemic Interventional Algorithm’ may also take cognizance of the ‘Time in the Course of the Disease’ when the ‘Antibodies Testing’ is conducted!!
It is also reported that several ‘Antibodies Testing Techniques’ developed early in the ‘COVID-19 Pandemic Era’ were of limited ‘Proven Performance’ and were hurriedly purchased by several Governments worldwide with obvious implications for ‘COVID-19 Research Outpourings’ and the attendant bothersome ‘Unreliable Research Data’16! This is the basis of the now worrisome reported ‘COVID-19 Research Waste’17-19!! The imperative to eclipse or minimize the ‘COVID-19 Research Waste Quantum’ has been previously communicated17-22!!! The ‘Earlier Research Reports’15 are currently being critically re-evaluated to appropriately re-situate them with more deserving attention to the ‘Time-tested Robust Research Governance Pillars and Date Governance Principles’14,18,23-25!!! It is bad enough grappling with the ‘COVID-19 Pandemic’ and the World cannot afford the concomitant ‘COVID-19 Infodemic as Another Pandemic’. The ‘COVID-19 Research Waste’ will enlarge the ‘COVID-19 Infodemic Quantum’ and MUST be aggressively Systematically and Systemically addressed!!
An unusual and unique ‘COVID-19 Pandemic Characteristic’ is the ‘Rapidly Dynamically Transmuting Pandemic Specifics’ increasingly by the day, therefore, necessitating the imperative for equally ‘Rapidly Emerging COVID-19 Research Outpourings’ BUT the ‘COVID-19 Research’ MUST also of necessity be ‘Research Best Practices-compliant’! A recent ‘Communication’ critically identified ‘10 Strategic Determinants’ that MUST be addressed to assure improved ‘COVID-19 Research Output with Data Reliability’ with the imperative to ‘Paradoxically Make Haste Slowly’21! The identified ’10 Strategic Determinants’ span over a plethora of ‘COVID-19 Pandemic Composite Dimensions’ starting from the ‘Novel Coronavirus Origin’ through ‘Appropriate Pandemic Nomenclatural Issues’ and ‘COVID-19 Susceptibilities, Transmissibility, Vulnerabilities, Manifestations, ‘Pandemic Interventions’, Determinant COVID-19 Epidemic Curve Metrics, COVID-19 Analytics, Diagnostics, Therapeutics, Holistics, Social Disparities’! It ends with the ‘Technical Soundness, Timeliness and Appropriateness of Advisories, Guidelines, Guidance by Relevant National and Global Bodies’!! The ‘COVID-19 Research Waste’ has also been presented as ‘Another Pandemic’ that MUST be avoided in the ‘Global Fight’ against the ‘COVID-19 Pandemic’
The ‘Value of SARS-CoV-2 Antibodies Testing’ MUST also be disposed in relation to ‘Clinical Usefulness’, ‘Implications for the General Population’ and ‘Policy Formulation Guidance’. The deployment of the ‘COVID-19 Antibodies Testing’ in the ‘Pandemic Interventions’ must be evaluated for their value in ‘Monitoring the COVID-19 Pandemic’ re: ‘COVID-19 Prevalence in the Population’, ‘Shield Protective Immunity’, ‘Individual Immunity’, ‘Herd Immunity’, ‘Determinant Metrics for Reopening from Country Pandemic Interventional Lockdowns’, ‘Considered Variables for Reopening Schools, Sports Championships, Businesses’ etc!!
For the ‘SARS-CoV-2 Antibodies Testing’, the ‘Matters Still in the Works’ include, among several others: ‘Relevance to Detecting Prior Infection’, ‘Prevalence of SARS-CoV-2 Antibodies in the Population’, ‘Detection and Assessment of Pre-Symptomatic and Asymptomatic Transmissions in the Community’, ‘Level of Protection’, ‘Duration of the Immunity against COVID-19’ etc8! Additionally, ‘Other Matters’ to be determined include, among others: ‘Possible Cross-Neutralization’, ‘Clonal Expansion’, ‘Specific Receptor-Binding Domain and Equally Specific Antibody Targeting’, ‘Somatic Hyper-Mutation’ etc9-11!!
This ‘Communication’ is a ‘Contribution’ to the raging ‘COVID-10 Pandemic Antibodies Testing Conversation’ and seeks to amplify the various ‘Conversational Dimensions’ that MUST be addressed in discussing and evaluating the ‘Value of the SARS-CoV-2 Antibodies Testing’ in the ‘Global Fight’ against the ‘COVID-19 Pandemic’.
REFERENCES
1. Godlee F. COVID-19: Weathering the storm. BMJ 2020; 368:m1199 of 26th March 2020
2. Eregie CO. COVID-19 pandemic tragic octad: The evolving conceptual qualitative interventional equation to fight the pandemic. https://www.bmj.com/content/369/bmj.m2303/rr-9 of 24th June 2020
3. Semlyen J, Hariharan B, Josiah B, Okongwu K, Quarshie LS, Rodrigues V. Medical schools and other institutions need to tackle racism head on. BMJ 2020; 370:m2746
4. Eregie CO. Covid-19 Pandemic, social disparities and medical education reformation: A reminder of the imperative for ‘Medical Socioeconosophy (MSE)’. https://www.bmj.com/content/370/bmj.m2746/rr of 1st August 2020
5. Zhu N, Zhang D, Wang W et al. China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020; 382:727-33
6. Lisboa Bastos M, Tavaziva G, Abidi SK et al. Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis. BMJ 2020; 370:m2516
7. Premkumar L, Segovia-Chumbez B, Jadi R et al. The receptor binding domain of the viral spike protein is an immunodominant and highly specific target of antibodies in SARS-CoV-2 patients. Sci Immunol 2020; 5:eabc8413
8. Duong YT, Wright CG, Justman J. Antibody testing for coronavirus disease 2019: not ready for prime time. BMJ 2020; 370:m2655
9. Antibodies Brouwer PJM, Caniels TG, Straten K et al. Potent neutralizing antibodies from COVID-19 patients define multiple targets of vulnerability. https://science.sciencemag.org/content/2020/06/15/science.abc5902
10. Deeks JJ, Dinnes J, Takwoingi Y, et al. Antibody tests for identification of current and past infection with SARS-CoV-2. Cochrane Database Syst Rev 2020; 6:CD013652
11. Eregie Antibodies Eregie CO. Covid-19 Pandemic, SARS-CoV-2 antibodies and testing: Still searching for more facts. https://www.bmj.com/content/369/bmj.m2584/rr of 16th July 2020
12. Liu A. Regeneron scales up manufacturing, eyes human tests of COVID-19 antibody cocktail in June. Fierce Pharma. 5 May 2020. https://www.fiercepharma.com/pharma/regeneron-scales-up-manufacturing-ey...
13. US Food and Drug Administration. Independent Evaluations of COVID-19 Serological Tests. FDA, 2020 https://open.fda’gov/apis/device/covid-19serology/
14. Branda JA, Body BA, Boyle J et al. Advances in Serodiagnostic Testing for Lyme Disease Are at Hand. Clin Infect Dis 2018; 66:1133-9
15. Andersson M, Low N, French N et al. Rapid roll out of SARS-CoV-2 antibody testing-a concern. BMJ 2020; 369:m2420
16. Clinical Trials.gov. History of changes for study. NCT04280705, 1 May 2020. https://clinicaltrials.gov/ct2/history/NCT04280705?A=10&B=15&C=Side-by-S....
17. Glasziou PP, Sanders S, Hoffmann T. Waste in covid-19 research. BMJ 2020; 369:m1847
18. Eregie CO. COVID-19 Pandemic: The multifaceted picture of compromised COVID-19 research and the COVID Phenomenon’. https://www.bmj.com/content/369/bmj.m1847/rr-12 of 10th June 2020
19. Eregie CO. COVID-19 and the quadruple-barrel tragedy: matters still evolving for the works. https://www.bmj.com/content/369/bmj.m2197/rr of 19th June 2020
20. Eregie CO. COVID-19 Pandemic and the ‘Determinant Nonad’: Rekindling the imperative of the twin medical reformation interventions of ‘Multiparameter-Based Medicine (MBM)’ and ‘Medical Socioeconosophy (MSE)’. https://www.bmj.com/content/369/bmj.m2379/rr of 7th July 2020
21. Eregie CO. COVID-19 Pandemic, the quest for urgent information and solutions and the paradox: making haste slowly to avoid ‘COVID-19 Research Waste’; time for strategic ‘COVID-19 Research Retreat for a Decad’. https://www.bmj.com/content/370/bmj.m2668/rr-0 of 21st July 2020
22. COVID Testing Project. COVID-19 Testing Project 2020. https://covidtestingproject.org/
23. Yan W. Coronavirus tests science’s need for speed limits. New York Times 2020 Apr 14. https://www.nytimes.com/2020/04/14/science/coronavirus-disinformation.html
24. Hoffmann T, Glasziou P. What if the vaccine or drugs don’t save us? Plan B for coronavirus means research on alternatives is urgently needed. The Conversation, 21 Apr 2020. https://theconversation.com/what-if-vaccine-or-drugs-dont-save-us-plan-b...
25. Eregie C.O. COVID-19 Pandemic, ‘COVID Phenomenon’ and the politics of the science, facts, research evidence and ‘evidence-based medicine (EBM): the imperative for rekindling the ‘multiparameter-based medicine (MBM) in the 21st Century. https://www.bmj.com/content/369/bmj.m1336/rr-20 of 17th April 2020
Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria and
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria.
UNICEF-Trained BFHI Master Trainer and ICDC-Trained in Code Implementation.
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria.
*No Competing Interests.
Competing interests: No competing interests