Jun 18, 2020

Axios Science

By Alison Snyder
Alison Snyder

Welcome back to Axios Science. This week we look at disparities in clinical trials, children and COVID-19, quantum communications, global spending on research, and more.

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Today's newsletter is 1,761 words, a 6.5-minute read.

1 big thing: The cost of racial disparities in clinical trials

Illustration: Eniola Odetunde/Axios

Black Americans are consistently underrepresented in clinical trials for diseases ranging from diabetes to heart disease to different cancers, despite being disproportionately affected by many of them, Eileen and I write.

Why it matters: The current COVID-19 pandemic is taking an unequal toll on underrepresented communities.

  • As researchers race to develop treatments, having diverse trial participants is key to creating safe and effective drugs and to understanding how socioeconomic and environmental factors influence diagnosis, treatment and outcome.

Case in point: This week, a steroid was hailed as a "breakthrough" treatment and the first to save the lives of some people with COVID-19. The preliminary results from the University of Oxford found dexamethasone reduced deaths by one-third in ventilated patients.

  • Yes, but: There also is some evidence African Americans may respond differently to glucocorticoids like dexamethasone, such as having a diminished response, says Namandjé Bumpus, professor and chair of the pharmacology department at Johns Hopkins University School of Medicine.
  • "[W]e need to make sure that [with] all of this excitement about dexamethasone ... black people are included" in any study on its impact, she adds.
  • The study authors did not respond to requests for information about the racial and ethnic makeup of the 2,104 randomized patients in the study, which has not been peer reviewed or distributed as a preprint.
  • Meanwhile, the University of Pittsburgh Medical Center says its separate trial testing multiple COVID-19 treatments (including corticosteroids similar to dexamethasone) has about 50% African American patients and roughly 50% female participants enrolled so far.

An example: A new class of anti-cholesterol drugs, called PCSK9 inhibitors, was found after working with a small population of African Americans with genetic variants linked to super-low cholesterol levels, says Josh Denny, CEO of the National Institutes of Health's All of Us program, an effort to build one of the most diverse health databases.

The big picture: African Americans, Latinos, women and older people tend to be particularly underrepresented in clinical trials, Bumpus says.

Zoom in: From studies of prostate cancer treatments, prevention and screening to those of new heart disease and cancer drugs, African American people have long been underrepresented in clinical trials — including those for diseases that disproportionately impacts their community.

  • Distrust in the medical system is a big factor because of historical events. For example, the federal government's Tuskegee Study intentionally did not provide penicillin treatment to black men with syphilis so researchers could study the disease.
  • A lack of transportation and child care along with work constraints also play a role, as does having other health conditions that can exclude people from trials and a lack of awareness of or access to them.

What to watch: This week All of Us announced steps it's taking to better study how COVID-19 affects underrepresented communities.

Read the full story.

2. What we (don't) know about kids and coronavirus

Illustration: Sarah Grillo/Axios

Children typically escape COVID-19's most severe complications, presenting a host of questions scientists are just starting to be able to answer, I write with Eileen.

Why it matters: As schools and day cares look to reopen in the U.S. and grandparents long to reunite with their grandchildren, parents and policymakers are trying to assess the risk to kids, their families and their communities.

Driving the news: Children are 35–60% less likely to become infected with SARS-CoV-2, the virus that causes COVID-19, compared with people over the age of 20, according to a study published this week in Nature Medicine.

What's known:

  • As of early April, 1.7% of detected COVID-19 cases in the U.S. were in children under the age of 18, per the CDC. (The age group makes up 22% of the population.)
  • Many who are infected don't have severe complications. 5.7% of pediatric cases in the CDC survey were hospitalized (versus 10% in adults 18–64 years old) and three children died.

Yes, but: COVID-19 is linked to a rare but severe condition in children called multisystem inflammatory syndrome (MIS-C) in which the heart, lungs and other organs become inflamed. In most cases, children recover with anti-inflammatory therapy although long-term implications are unknown.

What's unknown:

  • Whether children are resistant to being infected in the first place, become infected and are less likely to develop symptoms compared to adults, or both.
  • What is protecting children. A recent study suggests it may be the health of their blood vessels that prevents them from having serious complications from the disease. Other researchers suspect children have heightened immunity due to exposure to other coronaviruses, like those that cause the common cold, or their immune systems are better tuned to fight infection.
  • Their role in spreading the virus. Children may make up a small percentage of reported COVID-19 cases, but it is unclear whether they are significant spreaders of the virus, even if they don't have symptoms. It comes back to how much virus they carry —what's known as viral load — and whether that load is infectious, both of which are actively being studied (and debated).
  • The long-term effects. It's too soon to know how COVID-19 affects children and others in the long run.

Between the lines: How the immune system is working in kids remains a giant question mark and is crucial to vaccine development too, as there are concerns a vaccine developed for adults could affect the young differently.

Go deeper: Searching for coronavirus clues in single cells

3. A quantum cryptography record

A telescope in a quantum communication ground station in Xinglong, China. Photo: Xinhua/Jin Liwang via Getty Images

A quantum key for encrypting and decrypting messages has been shared between two ground stations about 700 miles apart, a team of researchers in China reported this week.

Why it matters: It's the latest milestone in an effort to create a long-range and theoretically ultra-secure quantum communications network.

  • Researchers in the U.S., Singapore, Canada and elsewhere are trying to build similar systems, but the team in China, led by Jian-Wei Pan of the University of Science and Technology in Hefei, is at least several years ahead.

How it works: Photons can be entangled in pairs so that the state of one photon is tied to that of another no matter the distance between them.

  • Quantum cryptography leverages entanglement to distribute quantum keys for communications.
  • If there is an attempt to intercept a message sent with a quantum key, the photons would be altered and the key would no longer work.
  • Fiber-optic cables can carry photons only short distances, so researchers want to use satellites to relay quantum keys between ground stations.

What they did: Building on past experiments, Pan and his colleagues report using China's Micius satellite — built specifically for basic research on quantum satellite communications — to send a quantum key that was shared between two newly built observatories.

  • Key advance: The satellite is a blind transmitter and has no information about the key.
  • Previously, the longest distance for distributing a quantum key on the ground was about 62 miles.
  • In the new paper, the researchers report increasing the efficiency of the transmission and decreasing the error rate (to about 4.5%), "enabling the realization of satellite-based entanglement quantum key distribution."

What's next: A global network would require a constellation of satellites to transmit entanglement signals around the globe, says Alexander Ling at the National University of Singapore's Centre for Quantum Technologies, who was not involved in the work and is working on creating quantum-enabled nanosatellites.

Go deeper: China takes the lead in building quantum data security networks

Bonus: Who's spending on R&D
Adapted from Center for Security and Emerging Technology using data from OECD and Global R&D Funding Forecast data; Chart: Andrew Witherspoon/Axios

The U.S. and China are the world's biggest spenders on R&D but still only make up about half of the global investment in research, a recent report highlights.

The big picture: Competition between the two countries — measured by published papers, patents, educational degrees or the extent of investment — dominates discussions about global progress in science and technology.

  • That ignores significant R&D spending by a handful of countries that could be potential collaborators, Melissa Flagg of Georgetown University's Center for Security and Emerging Technology argues.

What's happening: Spending on R&D has grown around the world over the last 30 years and, at the same time, the U.S. share of global R&D fell.

  • China and the U.S. each accounted for about one-quarter of global R&D spending in 2018, according to the CSET report, which draws on data from OECD.
  • "The R&D spending of the United States and just six like-minded nations with a true commitment to R&D funding represents more than 50 percent of global R&D investment," Flagg writes. She cites Japan and Germany as traditional heavy hitters but also countries like South Korea, which spent upward of 3.8% of their GDP on R&D.

Why it matters: Flagg argues that that reality is an opportunity for the U.S. to formally partner with countries and set standards and values around sharing data, transparency, reproducibility and research integrity.

  • The issue is of top concern because in international collaborations and open scientific exchange, some researchers or programs have not held the same values, jeopardizing U.S. research.

Historically, formal science and technology alliances came out of larger political ones and were taken for granted, says Flagg. "If you really believe technology is a foundation for critical aspects of leadership globally, economic security and military capability, then you can’t just have this be a sidebar for politicians."

The bottom line: "No nation will enjoy complete global technological dominance," Flagg writes.

4. Worthy of your time

54 scientists lost their jobs as a result of NIH probe into foreign ties (Jeffrey Mervis — Science)

  • Chinese institutions were the funders in 93% of the cases.

Our galaxy may have more than 30 intelligent alien civilizations (Miriam Kramer — Axios)

  • But, but, but: "[T]here's no guarantee that we'll ever interact with any of them."
  • Bonus: The trouble with counting aliens (Daniel Oberhaus — Wired)

Placentas may help fish outswim predators (James Dinneen — Hakai)

  • Why it matters: "The research has implications for understanding the obscure origins of the placenta in species across the animal kingdom," ecologist Bart Pollux told Hakai.
5. Something wondrous

An experimental soap bubble on a purple campanula flower. Credit: Eijiro Miyako

Soap bubbles could be used to artificially pollinate plants, according to a new study.

Why it matters: The world is facing a loss of bees, which are crucial for pollinating crops and other plants.

What they did: The researchers tested five different surfactants (compounds that decrease a liquid's surface tension) and found one that created a film that could carry grains of pollen to flowers.

  • Pear flowers hit with 2–10 of the bubbles fruited after 16 days, similarly to those pollinated by hand, the team led by Eijiro Miyako of the Japan Advanced Institute of Science and Technology reports. (In earlier work, he proposed pollinating with tiny drones.)

Yes, but: The approach isn't efficient (bubbles are wasted), rain and wind can pop the bubbles, and the environmental and health impacts are unclear, CNN points out.

Alison Snyder