Some asshole with a blog vaguely remembers using the phrase “Going Manhattan Project on [X]’s ass”, by which said asshole meant that there are certain kinds of science and research objective that need far more top down direction from NIH program officers and less academic panel format input (this applies to other funders too). That is, the program officers, rather than keeping the trains running on time, will have to take a far more assertive and directing role. Needless to say, this involves some risk: bad decisions by (and heeded advice to) the program lead can result in poor results.

But there’s also a risk if there isn’t enough direction, and that appears to be happening with long COVID research (boldface mine):

It’s almost impossible to tell where the NIH’s $1.2 billion pot of long Covid money has gone.

There is no single NIH official responsible for leading RECOVER, and the initiative has failed to share basic information that would typically be available for a government research project of this scale.

Unlike Operation Warp Speed and other Covid efforts, the NIH has outsourced much of the work of running RECOVER to outside organizations. New York University, RTI International, Mayo Clinic, Massachusetts General Hospital, and Duke University are responsible for various parts of the initiative.

Many of the research projects associated with RECOVER have been funded through these organizations rather than directly from the NIH. This process makes it hard to track how decisions are made or how money is spent through public databases, said Michael Sieverts, a member of the long Covid Patient-Led Research Collaborative who has a background in federal budgeting for scientific research.

Public records requests that MuckRock filed to the agency in late 2022, intended to answer questions about RECOVER’s funding, are still incomplete as of mid-April. Sieverts has similarly asked questions to NIH officials and received no responses….

“There’s a complete lack of transparency. When we ask who made this decision … they won’t tell us,” Stiles said.

As a result, when RECOVER says it’s running out of funds, it’s hard to identify who is responsible for major decisions.

A common theme throughout the pandemic has been that various agencies and institutions have evolved to do certain things in certain ways. NIH is very good at investigator-driven research, but, unless there is considerable attention being paid from the highest levels (e.g., development of a COVID vaccine), it typically lacks the cultural and institutional ‘by-ways’ to do a biomedical Manhattan Project. Instead, it can fall back to relying on ‘established’ researchers for advice and direction, which can lead to a muddle. While this seems risk-averse (and it stems in part from that aversion), this strategy actually isn’t: if you don’t accomplish the mission, then the political fallout is worse.

Anyway, we should have gone Manhattan Project on long COVID’s ass.