Availability of COVID-19 preprints has also accumulated at higher rates
than preprints addressing both cholera, of which there has been an
epidemic in Yemen since late 2016 \citep{camacho_cholera_2018}, and influenza virus,
considering the onset the seasonal influenza epidemic in 2019 for
comparability (Table 1). However, research addressing cholera and
influenza initiated sooner after the first reported cluster (Figure 2),
likely reflecting a level of constant research attention given the
endemicity of these diseases.
Whilst an increase in preprint accumulation beyond prior outbreaks is to
be expected due to growth in preprint recognition in recent years
\cite{asapbio_biology_2019}, the magnitude of acceleration for COVID-19 preprints is
remarkable when considering the modest rates of preprint development
over multiple seasonal influenza periods as a benchmark (Supplementary
Figure).
Preprints in the context of the wider epidemic response
This exceptional speed of preprint development has been just one
component of a paradigm shift towards rapidly mobilised, open-platform
research in outbreak responsiveness. This new scientific territory
investigating COVID-19 has also involved rapid development and sharing
of SARS-CoV-2 genome sequences through dedicated repositories, e.g.
GISAID’s surveillance network \citep*{shu_gisaid_2017} and digital workspaces for rapid
international communication \cite{kupferschmidt_preprints_2020}.
While preprint infrastructure has shown clear effectiveness and value in
making novel COVID-19 findings swiftly available, evaluating its
influence in active outbreak control is difficult. Preprints regarding
estimates of R0 have been linked to influence upon
policy and media interest based on news reporting and search trends
\citep*{majumder_early_2020}, though more specific impacts of preprints will require
citation tracing and meta-research over the full course of the epidemic.
Although effective at distributing knowledge, preprint servers have been
critiqued as not fulfilling an intended function of developing peer
discussion
\cite{anderson_biorxiv_2019}. Several external platforms aim to facilitate this
pre-review commentary, including the Outbreak Science Rapid PREreview
platform for active epidemics (
https://outbreaksci.prereview.org/). However, community uptake has
been slow. Pre-review feedback has been requested for 50 COVID-19-related preprints to date, of which only 9 have received any.
Peer discussion around COVID-19 research appears more likely to take
place on platforms featuring novel results not yet in article format,
such as Virological (
https://virological.org). Better integration of peer discussion
into existing preprint platforms may improve the efficiency and
transparency of research responses to future epidemics.