Halfway through this 2020 fiscal year (FY), we experienced a global pandemic, SARS-CoV-2, that has thus far resulted in over 34 million cases (over 7 million in the US) and over 1 million deaths (over 200,000 in the U.S.), disproportionately affecting those already experiencing health disparities (e.g., under-resourced minorities, poor, vulnerable). All of us, even those not infected, have experienced life disruptions unprecedented in our lifetimes.
NIH rapidly responded to the public health crisis and the research needs of the crisis. Development and evaluation of therapeutics and vaccines have occurred at a robust and rapid pace, combining and coordinating public and private sector resources through the ACTIV program. Complementing this is the RADx program to speed innovation in the development, commercialization, and implementation of technologies for COVID-19 testing.
To lessen the transmission of SARS-CoV-2 virus as this medical research is proceeding rapidly, nations across the globe have been employing various public health containment and mitigation efforts, many based on research from mitigation of prior infectious disease epidemics. These mitigation strategies, at their core, are social and behavioral interventions, and their impacts on social activity, economic activity, and health care access are predominately social and behavioral impacts. Therefore, it has been important for NIH to mobilize not only testing, therapeutics, and vaccine research, but also social and behavioral research to address the pandemic. With the conclusion of the 2020 fiscal year, I wanted to highlight some of the behavioral and social science research initiatives to address COVID-19.
- COVID-19 Survey Item Repository: Soon after the public health emergency began, researchers were developing and fielding survey items to answer questions about the impact of the pandemic and the mitigation strategies on health and well-being. These items needed to be developed and fielded rapidly, providing insufficient time to develop consensus guidance for harmonized survey items assessing these various experiences. Therefore, the NIH developed the COVID-19 Survey Item Repository, asking researchers to post their survey items for others to use and to link to each other’s data. There are currently over 100 surveys posted in this repository that is available on the DR2 and PhenX platforms, some from large, nationally representative samples. These platforms continue to work on organizing, prioritizing, and linking these surveys to improve their usefulness to the research community.
- Institute and Center Specific Supplement Funding: Last spring, as the extent of the pandemic was unfolding, a number of NIH Institutes and Centers (ICs) issued IC specific urgent competitive and administrative supplement requests addressing a range of social and behavioral research questions regarding COVID-19 relevant to their IC missions. Many of these initiatives are still open, and a full list is available on the Office of Behavioral and Social Sciences Research (OBSSR) site. The OBSSR also released a NIH-wide initiative supplementing existing longitudinal studies that address key social and behavioral questions related to the COVID-19 pandemic. In FY 2020, the OBSSR provided over $2.8 million in co-funding to support the OBSSR led NIH-wide COVID-19 initiative as well as support for IC-specific COVID-19 supplement initiatives. This amount represents nearly half of the co-funding of new initiatives that the OBSSR provided in FY 2020.
- Social, Behavioral, and Economic Health Impacts of COVID-19, Particularly in Vulnerable and Health Disparity Populations (SBE COVID): In the early stages of the pandemic, NIH leadership met to discuss crosscutting initiatives to address COVID-19 research needs. One of these crosscutting initiatives is the SBE COVID initiative encouraging research to (1) improve prediction of various mitigation efforts, (2) assess the downstream health and healthcare access effects from the economic downturn, and (3) evaluate digital and community interventions to ameliorate these health effects. Led by the National Institute of Mental Health, National Institute on Minority Health and Health Disparities, National Institute on Aging, Office of Extramural Research, and the OBSSR, a consortium of 21 NIH ICs pooled funds and received $11 million in Office of the Director jumpstart funds to launch and begin funding key aspects of this initiative. Fifty-two awards, mostly supplements to existing studies, were made to address these research questions. The SBE COVID initiative is currently receiving applications to Funding Opportunity Announcements (FOAs) for digital health and community-based interventions research, and if additional appropriations for COVID research are provided to the NIH, a number of future FOAs are planned.
- Rapid Acceleration of Diagnostics in Underserved Populations (RADx-UP): The last COVID-19 supplemental appropriations from Congress provided $1.8 billion for a number of COVID diagnostic testing research projects called RADx. A substantial proportion of those funds ($500 million) was dedicated to RADx-UP, an initiative to understand COVID-19 testing patterns better among underserved and vulnerable populations; strengthen the data on disparities in infection rates, disease progression and outcomes; and develop strategies to reduce these disparities in COVID-19 testing. On Sept. 30, NIH announced the first round of funding, $234 million, to support community-engaged research projects across the United States that will focus on populations disproportionately affected by the pandemic. The program involves a collaborative community research network, a coordination and data collection center, and projects specifically focused on the social, ethical, and behavioral implications of health disparities on the development and evaluation of testing programs. In the coming months, the RADx-UP program will award additional funding, pending availability of funds, to address the evolving needs of the pandemic response, integrate new scientific and/or technologic advances such as vaccines, novel therapeutics, and new testing approaches—and expand the studies and/or populations being reached.
These four initiatives represent a substantial investment in behavioral and social sciences research to address the COVID-19 pandemic, and many are summarized in a recent commentary from NIH leaders. The RADx-UP initiative alone is the largest predominately behavioral and social sciences research initiative, in my memory, that the NIH has ever supported. It is imperative that the behavioral and social sciences research community take advantage of these research resources to deliver urgently needed findings that will hasten the resolution of this current pandemic, prepare us to better address future infectious disease epidemics, and provide scientifically important research findings applicable to our understanding of behavioral and social systems more generally.