In this update:
- A summary of our regular fortnightly report to SAGE
- How HDR UK is responding to recent developments (including the new National Core Studies rapid funding call)
- COVID-19 research highlights and insights generated
- Reminder to register for the HDR UK Alliance Symposium on Tuesday 1st December
HDR UK’s latest report for SAGE
This week marked our 25th report to SAGE since the initial report in April, demonstrating the significance of the health research sector’s contribution to informing the national response to COVID-19. Thank you to all members of our community, partners and colleagues for their ongoing contribution and support to our COVID-19 strategy.
An endorsement for the importance of all types of data in responding to a pandemic came this week in a significant new report published by a multi-disciplinary group convened by Royal Society: Data Readiness: Lessons from an Emergency .
Since the establishment of the National Core Studies in October, our reports to SAGE are structured around our work leading the “Data and Connectivity” National Core Study (in partnership with the Office for National Statistics) to enable the development of data infrastructure and services across the UK which allows priority research questions to be answered efficiently, in a transparent and trustworthy way.
As the encouraging news of a further vaccine emerged in recent days (“The Oxford Vaccine”), we report a substantial increase on the body of research into COVID-19 in the last two weeks; with additional 130 new, non-peer reviewed pre-print papers (and one new published paper); adding to our growing understanding of the virus. Summaries of the best exemplars of insights underpinned by health data research are provided below. There are now over 200 active research projects into COVID-19 across the infrastructure provided by our delivery partners, an increase of 23 new projects in the last two weeks.
Our work engaging with data custodians to make further datasets available for the National Core Studies has continued over the past month and we will publish our next progress report in the week commencing 7th December. In addition, we have made further improvements to the quality of the metadata for datasets made available last month
The datasets for the National Core Studies continue to be made discoverable through the HDR UK Innovation Gateway, and are now enhanced by our new NCS “Collections”. which give a broader overview of the key research aims and data sources used by the national core studies.
Clinicians, policy makers, patients and the public are actively involved in the National Core Studies to help inform the developing research agenda; with 63 members of the COVID-19 Patient and Public Engagement and Involvement group available to support researchers. Feedback highlight on this SAGE report:
“It is vital to understand transmission among children in school to ensure they can stay in school for longer. Research about COVID-19 in social care settings must also not be forgotten.”
HDR UK – responding to the most recent developments
Our initial strategy back in April 2020, set out three key priorities to organise the UK’s health data research response to COVID-19:
- To co-ordinate and connect national data science driven research efforts related to COVID-19
- Accelerate access to UK-wide priority data relevant to COVID-19 for research
- Leverage the best of the UK’s health data science capability to address the wider impact of the COVID-19 pandemic, supporting high risk and vulnerable groups that will be hardest hit
One of the ways in which we contributed to the scaling up of existing work to accelerate insights was through the coordination and publication of COVID-19 research questions and activities through the COVID-19 Matchmaker tool.
This interactive platform set out as a means for researchers, clinicians, policy makers, patients and the public to put forward urgent research questions to be addressed, as well as opportunities for industry partners wishing to contribute to the challenge.
Since March 2020, the Matchmaker gathered over 111 questions and projects related to COVID-19 and has provided over 60 individuals the opportunity to collaborate across diverse domain areas.
Whilst COVID-19 continues to affect all our lives, the research landscape looks very different as we approach the end of 2020 to the early days of the pandemic. The speed of vaccine development has been unparalleled, with three different vaccines already showing promising efficacy in large scale trials.
The Matchmaker Tool helped to catalyse the research effort and through that has played a part in the national response to the novel coronavirus SARS-COV-2. But to adapt to the changing environment, and as part of the cross-cutting Data and Connectivity component of the National Core Studies Programme in partnership with the ONS, HDR UK has instead opened a rapid funding call for already funded UKRI COVID-19 Open Call and UKRI/NIHR Rapid Response Initiative research to use and enrich the data within the Data & Connectivity NCS capability in partnership with UK Research and Innovation (UKRI).
Wider funding calls are also adapting to address these new research needs, such as the joint UKRI and NIHR initiative to support research into the longer-term effects of COVID-19 (so called “Long COVID”). In addition, the ICODA Grand Challenge grant programme will focus on building global collaboration to unite data to enable discoveries and reduce the harm of the current and future pandemics.
As the needs change, HDR UK continues to adapt. All the while, the Health Data Research Gateway continues to adapt provide an open, transparent platform for sharing research projects, available datasets and other data-related tools and resources. It enables scientists, data custodians and other partners from all sectors to collaborate in efforts to tackle a wide range of diseases and conditions, not just COVID-19.
Summary of latest SAGE report research
Protein levels being used to predict COVID-19 outcomes
A study has shown that by looking at protein levels, researchers are able to accurately predict those who will be asymptomatic vs those experiencing severe symptoms when infected with COVID-19. These predictive markers are able to guide clinical decision-making and point to novel therapies. By reporting these biomarkers, we are able to create risk-adapted treatment strategies, weeks earlier than before.
COVID-19 symptom study app data used to detect hotspots
By performing modelling on longitudinal, self-reported data from users of the Symptom Study App and a predictive model provided by the Department of Health, researchers were able to estimate number of cases, prevalence and effective reproduction numbers for different areas around England. Using the data provided by more than 2.6 million app users, researchers were able to estimate and highlight regions before they were subject to local government lockdowns. This demonstrates the important role self-reported data in research being undertaken into COVID-19.
People with immune-mediated inflammatory disease recommended to shield to mitigate risks
A study has shown that risk-mitigating behaviour (such as shielding) for those who suffer from immune-mediated inflammatory diseases may contribute to lower risk of adverse COVID-19 outcomes. Online surveys were completed over the summer of 2020 including 3,720 participants from 74 countries which concluded that shielding had an adverse effect on COVID-19 outcomes and therefore highlights the need for better patient communication around the benefits of risk-mitigating behaviours.
Previous SARS-CoV-2 infection associated with protection against reinfection
Testing of 12,219 healthcare workers at Oxford University Hospitals has revealed that those who had a prior SARS-CoV-2 infection which generated antibody responses, had protection from reinfection for most people for the 6 months following infection. They concluded that more work needs to be done to determine the long-term duration of post-infection immunity, which will play a key role in predicting infection rates long-term.
Antibody responses wane earlier for young adults and those without symptoms
In a study of 3,217 health care workers in the UK, antibody levels were found to rise to a peak at 24 days post-first positive test, before beginning to fall. The estimated mean time to loss of a positive antibody test result is 137 days. They also found that increasing age, Asian ethnicity and prior self-reported symptoms were associated with higher antibody levels. This indicates that young adults and those without symptoms are most at risk of depleted antibodies over time.
Primary care interactions dropped dramatically after first lockdown
A study using CPRD health records of around 10million people has concluded that primary care (GP) contacts for conditions dropped dramatically after the introduction of population-wide restrictions due to COVID-19. These conditions included anxiety, depression, acute alcohol-related events, asthma, diabetic emergencies and some heart diseases. They found that by July 2020, except for unstable angina and acute alcohol-related events, contacts with doctors for all of these conditions had not recovered to pre-lockdown levels. This is important learning as it demonstrates that there will likely be a deficit in care for these conditions which may lead to premature mortality in those experiencing these conditions.
Reduced number of bacterial infections reported during the COVID-19 pandemic
An international study has reported that rates of infectious bacterial diseases have dropped due to the measures put in place due to the pandemic. Bacteria which cause diseases including pneumonia and meningitis, which are typically transmitted via respiratory droplets, have shown decreasing infections. This study across 26 countries using the Oxford COVID-19 Government Response Tracker and Google COVID-19 Community Mobility Reports to show that containment of these bacteria are in large due to population-wide measures and increased use of face masks.
No marked change in psychiatric prescribing due to pandemic
The Clinical Record Interactive tool was used by researchers to access de-identified health records of people receiving mental healthcare from South London and Maudsley NHS Foundation Trust. Although there was a decrease in in-person prescribing, there was an increase in the frequency of remote contacts (mostly in working-age adults, children and adolescents). Despite the change in the method of patient-contact, the levels of psychiatric prescribing remained similar. However, it is noted that further work is needed to ensure that older patients are able to access mental health care remotely.
Risk of infection amongst health care workers is influenced by working location, role, age and ethnicity
A study at a UK teaching hospital has found that 7.2% of staff tested positive for COVID-19 antibodies. This level was higher in those working in designated COVID-19 areas (9.47%) and those working in acute medicine and medical sub-specialities. The study also found that staff from BAME backgrounds had an increased risk independent of COVID-19 are working. 31% of those staff which tested positive reported no prior symptoms.
No evidence of increased risk of severe COVID-19 outcomes for those living with children
On behalf of NHS England, a study investigated whether risk of COVID-19 infection and severe outcomes differed between adults living with and without children. Amongst adults living with children 0-11 years, there was no associated increased risk of recorded COVID-19 infection. Those living with children 12-18 years old showed a small increased risk. Overall, there was no association found between living with children and outcomes related to COVID-19 and there were no consistent changes in risk following school closures.
RECOVERY trial participant becomes first person in England to receive then donate convalescent plasma treatment
Convalescent plasma is being used as part of the RECOVERY trial to investigate whether it is more effective in helping people recover from COVID-19 than other standard hospital care. John Curtis from Romford received his transfusion in August and pledged to donate himself when he was able. The level of antibodies may be higher if antibodies remain from the original doner. People can register online to offer to donate plasma here.