Severe cases in swine flu: lack of clinical details

Two elite flu reporters, Helen Branswell (Canadian Press) and Declan Butler (Nature), both noted yesterday the dearth of clinic information on the serious and fatal swine flu cases. First Butler:

Clinical researchers have been slow to respond to the 2009 flu pandemic, lament researchers writing in today’s Lancet. “Public health officials, virologists, epidemiologists, and policy makers have done well in responding to a rapidly emerging and complex problem. By contrast, the clinical research community’s response has been delayed and modest, ” writes Jeremy Farrar, a researcher in Ho Chi Minh City, Vietnam and colleagues from Vietnam, the US and Mexico.

They deplore the “lack of information” on the pathogenesis and clinical aspects of those with severe illness, and argue that trials and other clinical research are urgently needed to better understand the disease, and learn of necessary tweaks to treatment regimes. What research is being done isn’t being published fast enough, add Farrar et al., contrasting this with the speedy publication by researchers in other disciplines who have published in fast-tracked journal articles, or shared on public wikis – eg here – in advance of formal publication. Clinical researchers need to “catch up,” they conclude, “To do otherwise would be unethical.” (Declan Butler, The Great Beyond [Nature blog])

I don’t know the slowness is “unethical.” Clinicians in the midst of an outbreak have their hands full managing critically ill patients. Papers don’t write themselves. They require time, effort and spare energy, three things not so abundant in such circumstances.

Branswell offers a view what those circumstances look like and a few hospitals:

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