"I feel like I've been involved in making history"

"In a way, I feel like I’ve been involved in making history, and that I’ll be looking back on it for many years to come."

Nina Breinholt Stærke looks back exactly two years, to a time when she had ample time to carry out her PhD degree alongside her position as a medical doctor in the Clinical Research Unit at the Department of Infectious Diseases at Aarhus University Hospital.

However, 11 March 2020 was epoch-making for both Nina Breinholt Stærke and the majority of people in Denmark. On this date, Prime Minister Mette Frederiksen (Social Democratic Party) had announced a press conference approximately two weeks after the first case of Covid-19 infection was registered in Denmark.

The prime minister began the press conference with the words "What I'm going to say this evening will have consequences for all Danes", before announcing that large parts of society had to be shut down because of the risk of the spread of infection.

At the time, Nina Breinholt Stærke was about halfway through a PhD degree programme on tuberculosis among the socially disadvantaged, which included visits to homeless shelters. After the Prime Minister's press conference, she took the decision to put everything on hold.

She therefore contacted the professor and chief physician at the department of infectious deseases Lars Østergaard and expected to be sent home.

"I expected to be involved in the emergency staff as a doctor, but Lars emphasised that the research was certainly classified as critical to society, and that he naturally expected the research department to continue working,” says Nina Breinholt Stærke.

As manager of the Clinical Research Unit, she was responsible for coordinating and planning clinical research studies at the Department of Infectious diseases at AUH.

And shortly after the Prime Minister’s press conference, her everyday life changed dramatically.

"Only a couple of days went by before the first Covid-19 treatment studies began to roll in, and it quickly became very intense, especially in the spring and winter of 2020, where we participated in an extreme number of studies with medical doctors and companies in both Denmark and abroad."

New virus was a new brick in virus research

Søren Riis Paludan, who is professor at the Department of Biomedicine, had spent around two decades carrying out research into how the immune system reacts to viral infections by the time the Covid-19 outbreak washed over Denmark in the spring of 2020.

This meant that not much readjustment was required for him and a group of researchers at the Department of Biomedicine to be among the first to start studying the new virus in Denmark.

"The Covid-19 virus was a good match for our research, because we were already working to understand immunological activities that sometimes protect us against viruses, and sometimes contribute to making us ill. So we were actually already using the Lego bricks that were involved in Covid-19, but now we had a new brick to work with," says Søren Riis Paludan, who has helped develop and test a vaccine against Covid-19.

For his research team, to begin with the biggest challenge was collecting samples of the new virus, as these had to retrieved from countries such as China, South Africa and Brazil.

During a major shutdown, this quickly turned out to be both troublesome and costly. The transport of a small test tube the size of a finger could therefore cost DKK 50,000, he says.

Massive media interest

Another time-consuming challenge for Søren Riis Paludan was the media's sudden and massive need to get comments from a "coronavirus expert" on the latest developments in the pandemic. At times he received around forty calls a day from journalists.

"In the beginning I said yes to a lot, probably too much, but I believe that you have an obligation to be available when knowledge in your area of expertise is in urgent demand, as was the case at the beginning of the pandemic. I also thought that the public information part was exciting, especially in the beginning. But at the same time, I felt pressured to comment on things that were on the periphery of my expertise, and sometimes, especially in connection with the whole mink affair, I found that what I said was used in a political agenda," says Søren Riis Paludan.

From long processes to fast approvals

For Nina Breinholt Stærke, what was formerly a secondary occupation became her all-consuming work , as she suddenly had to plan studies, familiarize herself with protocols and recruit patients for several Covid-19 studies.

"It was a huge escalation compared to before, where we ran a few studies at a time. Suddenly, my work changed from being two days a week to being much more than a full-time job, and solely focusing on Covid-19," says Nina Breinholt Stærke.

During periods with high rates of infection, her work at the Department of Infectious Diseases has taken up all of her time. And although it has been hard and exhausting, it was also liberating to see how the fight against the global health crisis really meant pulling out all the stops.

"I was used to long processes and waiting on grants and approvals, and suddenly it only took a month from sending an application to the grant and approvals being in place, and then you could just start. Of course, I've also been tired of Covid-19 sometimes, but it's also been incredibly exciting to be involved in research into something that everyone is interested rather than just a small group of experts," says Nina Breinholt Stærke.

The contribution made by research has become obvious to everyone

For Søren Riis Paludan, the great media interest in the research has never been a motivating factor. On the contrary, he thrives best without all the attention from the media on his current research.

"I am a scientific nerd who finds research most exciting when I really get to delve into the detail. That requires in-depth work and time, and I don't find it particularly fun or rewarding when national newspapers ring and ask about the results you've just uncovered so they can write news stories about them. It’s out of proportion, and it does not promote long-term confidence in science," he says.

However, Søren Riis Paludan hopes that the great interest in a field of research that is normally left in peace and is free of media attention has meant that more Danes have opened their eyes to how research benefits society.

"It’s become quite obvious for at least the majority of the population who are thinking people, that science is a prerequisite for the way of life we have in the Western world. Without antibiotics and vaccines, for example, we would in many ways live as people did in the nineteenth century, and this is an awareness that I believe far more Danes have today than before the pandemic. Whether this will also mean that there will be more investment in research in future is something you can only speculate about. We can only hope that’s the case."

Continuing on the same track

Even though the infection rates are today – two years after the first shutdown – falling, and all restrictions have been lifted, Nina Breinholt Stærke still expects to work with the development of vaccines and the treatment of Covid-19.

Today she can look back on two epoch-making years.

"In twenty years I'll probably be telling people about the time I was involved in studying Covid-19, just as the consultants at the department today talk about how they were involved during the HIV epidemic thirty years ago," says Nina Breinholt Stærke, who will shortly complete her PhD dissertation on tuberculosis among the socially disadvantaged.

Top 6 - Health researchers with most citations in the media during the last year. (Covid-19 related)

Contact

Professor Søren Riis Paludan
Aarhus University, Department of Biomedicine
Phone: 28 99 20 66
Mail: srp@biomed.au.dk

PhD-student Nina Breinholt Stærke
Aarhus Universitet, Department of Clinical Medicine
Phone: 23 64 79 84
Mail: ninabreinholt@clin.au.dk