Academic Neurology and the COVID-19 Pandemic: Resilience, Hope, and Solutions.

The SARS-CoV2 (COVID-19) viral pandemic dramatically impacted human health, healthcare delivery, healthcare workers and healthcare research worldwide. The field of academic neurology was no exception. In this 2022 Presidential Plenary, we discuss the challenges faced by neurologists and neuroscientists professionally and personally. We review the threat posed by the pandemic to neuroscience research activities, materials, productivity, and funding. We then discuss the impact of the pandemic on clinical trials for neurological diseases. Restrictions to patient enrollment due to reduced in-person access to laboratory testing, imaging and study visits led to delay in both clinical trial enrolment and study completion but also to innovative new means to engage clinical trial participants remotely and to strategies to critically appraise the frequency and design of trial-related patient evaluations. Clinical care was also challenged by initial pandemic prioritization of urgent visit and inpatient care and the rapid pivot to telehealth for most other neurology care encounters. Front-line neurology care teams faced their fears of infection, with the first months of the pandemic being characterized by uncertainly, inconsistent national health care strategies, limited personal protective equipment and the alarming rate of human illness and death caused by COVID. The personal and societal toll of the pandemic is incalculable. Across research and clinical neurology providers, women and particularly those with young families juggled the impossible balance of career and family-care as schools closed and children required home-based education. Shining through this dark time are lessons that should shape a brighter future for our field. We are resilient and the advances in neuroscience and neurology care continue to advance improved neurological outcomes. The National Institutes of Health devised multiple support strategies for researchers to help bridge the pandemic. Telehealth, clinical trial designs that are more participant-centric with remote monitoring, and flexible work schedules are strategies to rebalance overworked lives and improve our engagement with our patients. As we re-emerge, we have the chance to re-frame our field.