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Updated: Dec 12, 2025

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Published on: April 6, 2019
Global clinical trial mobilization for COVID-19: higher, faster, stronger
1Department of Community Health Sciences, Cumming School of Medicine and O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada.
Insights
The Coronavirus 2019 (COVID-19) epidemic saw significantly more, faster, and diverse clinical trials than previous epidemics. International coordination is needed to manage trial congestion and risks.
Area of Science:
- Epidemiology
- Clinical Trial Management
- Public Health Emergencies
Background:
- The Coronavirus 2019 (COVID-19) epidemic presented a unique clinical trial landscape compared to prior epidemics like H1N1, Ebola, and Zika.
- A large number of clinical trials were initiated rapidly following the declaration of a Public Health Emergency of International Concern (PHEIC).
Purpose of the Study:
- To analyze the characteristics of the COVID-19 clinical trial landscape.
- To identify potential challenges and propose solutions for managing large-scale clinical trial initiatives.
Main Methods:
- Comparative analysis of clinical trial data from COVID-19 and previous epidemics (H1N1, Ebola, Zika).
- Assessment of trial initiation speed, geographical diversity, and funding sources.
- Evaluation of potential inefficiencies and risks associated with numerous simultaneous trials.
Main Results:
- COVID-19 trials significantly outnumbered those for previous epidemics within the first three months of a PHEIC.
- COVID-19 trials were initiated faster, showed greater geographical diversity, and had less industry funding.
- Hundreds of concurrent trials involving 0.3 million participants across 78 countries pose risks of congestion and inefficiency.
Conclusions:
- The COVID-19 epidemic's clinical trial approach differs substantially from past epidemics.
- The rapid, widespread initiation of trials necessitates international coordination to mitigate risks and enhance efficiency for future public health emergencies.
Abstract:
The clinical trial landscape for Coronavirus 2019 (COVID-19) is radically different from that of previous epidemics. Compared with H1N1, Ebola, and Zika, COVID-19 had an order of magnitude more clinical trials within the first 3 months following the declaration of a Public Health Emergency of International Concern (PHEIC). These trials have started much faster, are more geographically diverse, and are less likely to be funded by industry. However, the almost simultaneous design and initiation of hundreds of trials with 0.3 million participants across 78 countries creates the potential for congestion and inefficiencies and enhances risks for investors. Thus, an international coordination mechanism for clinical trials could be valuable in this and other situations.
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