# Operational Research to Support Rapid Evidence-Based Responses to Outbreaks: Learnings from COVID-19

## TL;DR

This paper discusses lessons learned from rapid operational research during the COVID-19 pandemic to improve outbreak responses through community-based testing strategies.

## Contribution

The paper identifies six key success factors and challenges for implementing rapid operational research during outbreaks, emphasizing the need for international guidelines.

## Key findings

- Collaboration, stakeholder buy-in, affordable supplies, flexible financing, effective approvals, and a skilled workforce are essential for success.
- Ethics committees often lack the capacity to assess operational research during outbreaks.
- Adaptability of research protocols is crucial due to the unpredictable nature of outbreaks and pathogen mutations.

## Abstract

During the COVID-19 pandemic, the need for making testing readily available was recognized as an important factor for individuals to help make informed decisions, including to isolate or seek care, and for policymakers to control transmission. Toward this end, FIND and the Access to COVID-19 Tools Accelerator funded 16 rapid operational research studies and one implementation project in Africa, the Caribbean, and Asia evaluating the utility, acceptability, and feasibility of different community-based SARS-CoV-2 testing approaches. Here, we discuss common factors and challenges encountered during study implementation. We note six key factors essential for success: 1) collaboration and partnerships; 2) buy-in of local stakeholders, including communities; 3) access to affordable supplies; 4) flexible financing; 5) effective approval systems; and 6) a skilled and motivated workforce. We also note various challenges that must be addressed to fully capitalize on these success factors. In particular, ethics committees are often not well equipped to assess operational research during outbreaks. Outbreaks, especially of novel pathogens, are unpredictable, and transmission dynamics are even more likely to change if the pathogen is prone to frequent mutations, such as SARS-CoV-2. Research that aims to evaluate strategies for curbing transmission must hence be easily and swiftly adaptable. This requires flexibility from researchers, funders, staff conducting the studies, and ethics and other approval committees. International guidelines for evaluating operational research protocols in outbreaks are needed to provide timely evidence to enable informed decisions by individuals, communities, and policymakers, thereby reducing both the human and the economic impact of outbreaks.