Our thanks go to the following experts:
In June 2020, the Executive Committee decided to have the general concept of Corona Immunitas reviewed by international experts. Therefore, the Executive Committee made a call via our Partners – Frontiers – network to find interested experts from around the world to review the general concept. This general concept of Corona Immunitas is a very brief summary that points out several key parameters of the program.
Seven international experts reviewed the short concept summary and answered 4 related questions. The result was overwhelming and helped the Corona Immunitas program to further strengthen the concept and to adjust a few aspects.
CORONA IMMUNITAS International Review Process
Prof. Arthur L. Reingold
Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley
Prof. Beate Ritz
UCLA School of Public Health
Prof. Jordi Sunyer
ISGlobal Barcelona, Institute for Global Health, Head of the Childhood and Environment programme
Prof. Francesco Castelli
Scienze Cliniche e Sperimentali, Università degli Studi di Brescia
Prof. David E. Bloom
Professor of economics and demography at Harvard T.H. Chan School of Public Health
Prof. Josep M. Antó
ISGlobal Barcelona, Institute for Global Health, Childhood & Environment, Respiratory diseases
Prof. Neil Pearce
London School of Hygiene and Tropical Medicine
Question 1
What is your general opinion about the scientific public health value of the SSPH+ Corona Immunitas Program?
«By coordinating the scientific efforts carried out in different Cantons, the Corona Immunitas Program has the potential to produce valuable and scientifically sound epidemiological evidence on a nationwide scale that can inform public health policies.»
«The proposal is excellent in order to create evidence- based knowledge to inform the forthcoming interventions.»
«At the same time Corona Immunitas will reinforce SSPH+ as a key public health infrastructure in Switzerland.»
«Pulling studies across Switzerland using standardized tools is a very powerful and unique strategy.»
«It makes a lot of scientific and policy sense to design and implement a coordinated program that operates within an open science paradigm and coordinates testing, standardizes procedures, and also allows for collaboration between local authorities and academic institutions under one umbrella while building a resource of 20 studies across Switzerland.»
«This will generate an extremely valuable research and public health screening and policy tool.»
Question 2
Where do you see the programs major strengths and weaknesses?
Strengts
- broad view of the situation
- well-planned organisation based on cooperation and mutual trust
- standardized methodologies; „common work for the common good“
- SSPH+ has a proven record of collaborative activities and I am confident that this challenge will be managed easily
- Corona immunitas represents, and should be represented as, an ¨ excellent model for the rest of the world, governance arrangements and transparency too
- addresses an area of most importance
- integrative program, open science approach, applicable knowledge and implementation research
- good involvement from a number of relevant Swiss studies and databases
- standard protocols and procedures
- address new and emerging questions in a rapid manner
Weaknesses
- hard to know how the sample sizes were arrived at and how representative the samples will be; uncertainty created by the poor understanding of the immune response that could limit the knowledge based in the use of serological tests
- short paper does not give enough information to evaluate the weaknesses
- the research questions that the program wants to address should be better defined the overall (umbrella) study design is not
- enough clear (multicentric study, network of analysis to be metanalyzed, independent studies using similar standardized methods) the local crossectional studies may lack
- enough granularity as to be useful
Question 3
How would you see the balance between (repeated) serological studies in the general population versus among specific subpopulations (e.g. based on occupational settings, age or diseases)?
«I do not see the two approaches as alternative, but rather complementary.»
«Longitudinal data are essential here.»
«Elderly and in nursing homes are underrepresented».
«Both are important, though if only one is fundable the management of the epidemic will be more important, and thus the option of following up the specific groups would be a priority.»
«My concern is that crossectional studies in local general populations with a relatively low prevalence of infection may not get sufficient granularity as to provide useful information. Obviously, the latter will depend of the sample size. A limitation of this approach is that is based on the assumption of complete population mixing, which is unlikely to apply to the current situation. By contrast studies in closed populations at high risk of infection may be in better conditions to monitor the occurrence of isolated cases and institutional outbreaks.»
Question 4
What do you think is currently the most urgent research question that Corona Immunitas should address with priority?
«Find predictors for silent infections and super-spreader events»
«What’s the probability that children (by age range) infect the contacts?»
«Probability of infection according to the different interventions by specific sectors?»
«Effectiveness of social distancing interventions»
«Assess the extent to which a positive serologic test does protect against re-infection, and for how long, as well as what the immune correlates of protection are, if any.»
«Vanishing time of immune protection»
«Durability of antibody protection.»
«Mental health impact»
