A Critical Partnership: How Libraries Play a Key Role in COVID Research & Response

As 2019 came to a close, the world was awakening to the troubling presence of COVID-19. By the first months of 2020, the United States felt the pressures of a virus that would soon turn lives upside down.

With healthcare workers scrambling to attend to spiking patient counts, they worked frantically behind the scenes trying to learn more. There were countless hours spent gathering every possible bit of literature and research that could lend itself to answers – with doctors often leaning on a quiet yet critical partner: libraries.

“We have never experienced anything like this, with the volume and the pre-prints out there,” says Nasia Safdar, MD, Ph.D., Medical Director of Infection Control at UW Hospital and a leader in UW Health’s response to COVID-19. “The assistance from the libraries in making this a manageable process was essential. We could not have done it without them.”

At UW-Madison’s Ebling Library, librarians have frequently worked with Dr. Safdar’s research groups before the COVID-19 pandemic. Once COVID-19 research became the priority, the Libraries quickly answered the demand for research assistance.

“There was so much information coming out from articles. It was like drinking from a fire hose,” explains Safdar. “We needed to have a process for a focused review of articles so we could answer clinically relevant questions.”

Librarians conducted systematic reviews and collated literature to give researchers and doctors concrete guidance to move forward. As Dr. Safdar explains, the goal is to disseminate information through traditional means like journals and publications. The preprint process has opened up the opportunity to post things that give a better sense of findings. That information can be passed to health systems to consider data and make adjustments.

The task of gathering supporting information to develop these pieces carries significant weight in providing information that ultimately guides critical decision-making.

“A systematic review comes with tremendous responsibility,” says Safdar. “You have to demonstrate that you truly have found everything that is of relevance, and you have evaluated it and left no stone unturned. If we were to do that ourselves, we might do a cursory search. However, there would be a high risk of missing important literature because we do not have the same expertise of librarians in conducting a comprehensive search for information.”

So, precisely what roles did librarians take on in research teams needing information on COVID-19? From developing exhaustive search strategies to obtaining articles through library subscriptions Interlibrary Loan (ILL), librarians assisted researchers with many aspects of the systematic review process. 

“Clinically, the one question that came up was how often do you find influenza with COVID. That was immediately clinically relevant because it was happening commonly, then we needed to treat people with influenza before we knew they had it. If it was rare, then we did not need to.”

Clinical Librarian Leslie Christensen, MA, worked closely with Jackson Musuuza, MPH, MS, Ph.D., a member of Dr. Safdar’s team, on upper airway anti-sepsis research COVID-19 as well as the prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens.

“We found that the prevalence of influenza was very low in patients with COVID,” says Safdar. “What that did was reassure our institution and others that you did not have to treat for influenza necessarily.”

This practical, actionable advice that could be provided in a relatively rapid manner was critical as doctors continued to navigate treating COVID-19 patients. 

“Researchers and clinicians are often required to track down and manage the current research on any health topic,” says Christensen. “This has been particularly challenging with COVID-19. The pace and growth of COVID-19 publications are astounding: In PubMed, there are over 50,000 articles referencing SARS-CoV-2 or COVID-19 published in the first three months of 2021 alone. This is where our search expertise can assist them in retrieving relevant results for their research.” 

Health Sciences Librarian Lia Vellardita, MA, provided guidance for a graduate student in Dr. Safdar’s lab on the impact of COVID-19 on publications and grant submissions. She also worked with Ashley Kates, Ph.D., Post-Doc, on research around how long SARS-CoV-2 remains detectable in respiratory samples via RT-PCR following COVID-19 symptom onset.

“It is always a pleasure working with Dr. Safdar and her research team,” says Vellardita. “Working alongside top researchers, who understand that library expertise is essential in the development, distribution, and awareness of research findings makes the librarian-researcher collaboration very productive. It is wonderful to see a continuing connection between our library and Dr. Safdar’s team.”

Ebling Library Director Christopher Hooper-Lane, MA, AHIP, who has assisted Dr. Safdar on a recent  Infectious Diseases Society of America guideline and co-authored a paper with Dr. Safdar on fomites in the clinic, says the expertise the Libraries bring in sifting through countless resources is nothing new. However, the critical nature has experienced a more prevalent spotlight in recent months. 

“From bench to bedside, a phrase often heard in the health community, describes the flow of information from the results in the laboratory to patient care,” says Hooper-Lane. “Our librarians are involved all along that path, and the expertise we bring is essential during times like these when the immediate need for the best evidence is critical for our care of our community.”

Safdar says the ability to lean on librarians who have the suitable backgrounds and expertise to collaborate on clinical questions and develop the best method for retrieving literature is not just about saving precious time. It is also about avoiding costly errors.   

“Sometimes we make a mistake early on trying to do everything ourselves,” says Safdar. “We want to avoid a scenario where we did not conduct the most comprehensive search possible.”

As the pandemic shifts, more answers are found, and even more, questions surface; researchers and doctors note the importance of having structures in place to efficiently assist with conducting comprehensive searches to the countless inquiries developed. Libraries will continue to serve as an essential partner to those looking for answers to healthcare’s front lines. 

“It is important to connect with the right expertise and background in the library early on,” says Safdar. “We truly cannot take for granted the critical support the libraries provide.”