Table 2.

Illustrative examples of restrictions for PD research during reopening period.

Context and state of affairs	Restrictions of PD research during transition period between lock down and re-opening
Singapore - Currently in opening transition phase	Clinical studies in PD restarted after daily community spread dropped to <5% Biospecimen and blood collections for PD are not allowed unless approved under special circumstances and satisfying certain inclusion criteria Neuroimaging for PD research given restricted slots and only during routine patient visits Remote prescriptions are allowed for repeated drugs Audit visits not allowed unless specifically approved in non-clinical areas.
Korea - Resurgences are seen with new clusters	Restriction of entry into the hospital for research subjects and entry allowed only after completion of a screening questionnaire Patients are required to undergo COVID-19 testing to be admitted Lock down measures reinstituted in areas with new clusters of COVID-19
Italy - Has gradually resumed most activities, after moving from the epidemic to the endemic phase	National policies allow resuming of clinical trials including PD Regional health authorities provide further regulation and hospital authorities define procedures Hospitals limit access to caregivers aiming to reduce overcrowding Telehealth is allowed for clinical studies, but teleprescription is not recognized by law
India - COVID-19 cases are still increasing	Hospitals are primarily focusing on management of COVID-19 patients Patients with PD are discouraged to visit hospitals unless an emergency arises Many patients prefer telemedicine which many hospitals and private practitioners are providing Hospital admission mandate COVID-19 testing Clinical studies in PD have been halted indefinitely (at time of writing) due to lack of staff, patients, insurance and funding, lack of dedicated space and also quarantine issues Government advisory is to temporarily cut down any new research staff recruitment except for essential services Funding for existing research projects have been withheld in most places COVID-19 related research to be given priority
USA - COVID-19 cases are still increasing	Policies and procedures vary by state, and even between institutions in a single state Some areas remain in lockdown for all but “essential” research, while others may continue many research activities The use of telehealth technology is complicated by state-dependent licensing, making it illegal for an investigator or clinician to conduct certain activities with research subjects across state lines
Brazil - COVID-19 cases are still increasing	COVID-19 cases are still increasing Outpatient visits have been limited to people with urgent needs Fast track approval of law allowing nation-based telemedicine visits and remote prescription Substantial number of staff relocated to COVID-19 units in several areas of the country Severe restrictions of access to rehabilitation units
UK - Early reopening phase	Clinical research has resumed with rolling back of lock down measures Insufficient staff to deliver services after restart and no sufficient funding for some crucial survey-based research Research funded by existing grants that were halted can recommence
Malaysia - Has gradually resumed most clinical and research activities	During the strict lockdown period, research subjects e.g., in industry-sponsored drug trials were contacted via phone in place of in-hospital visits, and medicine was dispatched to them Restrictions are gradually lifted during the “recovery movement control order (RMCO)" phase Entry into hospitals is allowed for staff and patients/caregivers only after passing a screening questionnaire, and caregiver numbers are limited in outpatient clinics (only 1 caregiver allowed) and wards, sometimes posing difficulty when collateral history is needed from multiple family members Conferences with max. 200 persons are now allowed, provided SOPs, including physical distancing, are observed. Some hospitals are now looking into starting telemedicine services (for which there was little development previously)
China - Early re-opening phase	Restrictions of entry into the hospital both for the patients and research staff, only after screening questionnaire All clinical trials were stopped before 15 Jul in Beijing, the capital city All patients must undergo the following procedures before admission: (a) epidemiological screening questionnaire; (b) COVID-19 Nucleic acid detection; (c) Chest CT scan; (d) Respiratory tests to exclude other viral pneumonia. Research subjects need to be received and processed separately from general patients Investigators or raters to follow-up and assess the subjects with telemedicine if they are from different provinces or remote cities