COVID-19: Responding rapidly through applied health research

PROJECT STATUS: Ongoing
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START DATE AND DURATION: February 2020
Summary

We have rapidly mobilised our research community during the COVID-19 pandemic, to respond to the most urgent national and regional needs for evidence, to inform decision making, resource allocation and healthcare provision. 
NHS CHECK

NHS CHECK is investigating and working to mitigate the psychosocial and occupational impact of the COVID-19 pandemic on NHS staff in England.

Around 26,000 staff across all staff types in participating NHS trusts responded to online and paper surveys. The sample recruited to date have reported symptoms of poor general psychological health. Around a quarter of the sample report symptoms of anxiety (23%), depression (28%), and PTSD (26%). We will be following up with respondents to validate survey data.

We have provided briefing notes to NHS England and NHS Involvement (NHSE/I) and the House of Lords about the impact of the pandemic on NHS workers' mental health and wellbeing.

Contact: Dr Danielle Lamb d.lamb@ucl.ac.uk

Learn more about NHS CHECK

 

Living with covid recovery programme

A digitally-enabled rehabilitation programme for people with Long-Covid

It’s thought that up to 10% of people who have had COVID-19 go on to develop Long-Covid. Symptoms can include feeling breathless, anxiety, aches and pains, loss of appetite, tiredness and fatigue.

This project, led by UCL Professor Elizabeth Murray, aims to develop, implement and evaluate a programme to provide effective and cost-effective rehabilitation to patients affected by Long-Covid, within the available NHS resources. The programme includes: a clinical pathway; a digital dashboard which enables clinicians to review and advise large numbers of patients swiftly and effectively; and a patient-facing app.

As of Aug 2021, the Living With Covid Recovery programme is currently helping to support over 1,500 patients across 23 clinics in 16 NHS trusts, with plans to roll out to more Trusts to meet the growing need for support.

Contact: Prof Elizabeth Murray elizabeth.murray@ucl.ac.uk  

Learn more about the Covid Recovery programme


STIMULATE-ICP: Understanding long COVID to improve diagnosis, treatment and care

The STIMULATE-ICP consortium brings together more than 30 researchers, health professionals, patients and industry partners from over 30 organisations, with the aim of finding our what long COVID is, how to diagnose it and how to manage. The team is led by UCL Professor and UCLH consultant cardiologist Prof Amitava Banerjee. 

The team will interview patients and health professionals and analyse data from NHS records,to inform understanding of patterns of long COVID and the outcomes of current clinical practice and care pathways. Researchers will also work alongside patients to improve access to care and support, and to address care inequalities. 

It is hoped that the programme will deliver knowledge to clinicians and scientists, evidence to policymakers and improved care to patients, while collecting real-world data at scale.

Contact: Kailey Nolan kailey.nolan@uclpartners.com

Learn more about STIMULATE-ICP


LONDON EVALUATION cell

The Evaluation Cell was established in 2020 to define and prioritise specific evaluation and research questions for regional health and care delivery planning in London, and to develop a regional learning health system programme.

The Cell has agreed a set of criteria with regional clinical and academic leaders to prioritise regional evaluation plans. We led one of the first prioritised rapid evaluations of evidence on remote consultations in secondary care settings in COVID. We are currently working with our Pan-London colleagues to design a second phase of work in this area, that will be used to directly inform how remote consultations are incorporated within routine healthcare delivery. 

The Evaluation Cell is a collaboration between the three London Academic Health Science Networks (AHSNs) and the three London NIHR Applied Research Collaborations (ARCs), working with London regional NHS and chaired by an NHS chief executive.

Contact: Niran Rehill nirandeep.rehill@uclpartners.com

Learn more about The London Evaluation Cell.

 

Primary Care response to domestic abuse in the COVID-19 pandemicDuring the COVID-19 pandemic, instances of domestic abuse in the UK and globally have risen. At the same time, GPs have switched from face-to-face consultations to phone, digital and video consultations, potentially increasing the risk to women of reporting violence.

This mixed-method research project is exploring whether and how GPs have managed to ask safely about abuse, offer support and make referrals when consulting with patients remotely. It will also examine how GPs have adapted to online training about domestic violence and abuse.

Funded by UK Research and Innovation (UKRI) and the Department of Health and Social Care (DHSC), in collaboration with NIHR ARC West.

Contact: Prof Chris Griffith c.j.griffiths@qmul.ac.uk

Learn more about the Primary Care Response to Domestic Abuse in COVID project

 

Delirium and Population Health Informatics Cohort (DELPHIC): a COVID-19 study

There is an urgent need to better understand the transmission and prognosis of COVID-19, particularly in older people where outcomes appear worse. ARC North Thames researchers are studying:

  • why some older patients progress to severe illness while others have mild disease
  • the physiological processes that may cause severe and fatal illness

We are using data from an existing cohort of 1500 active patients over 70 years old (DELPHIC) to ascertain weekly symptoms (for diagnosis), acquire samples and to follow COVID-19 cases as their illness evolves.

Data and clinical samples are now being collected to identify immunological pathways underlying differences in elderly peoples’ response to the virus. This work is funded by the Medical Research Council (MRC), Wellcome Trust, Rosetrees Trust and the NIHR UCLH Biomedical Research Centre (BRC).

Contact: Dr Daniel Davis daniel.davis@ucl.ac.uk

Learn more about DELPHIC

 

A rapid response to sharing emerging clinical experience in a pandemic

The COVID-19 pandemic has put intense pressure on intensive care units (ICU). In the very early days of the pandemic, ICU clinicians were in urgent need of guidance; however, the rapid spread of this new infection meant that neither research-based guidelines nor clinical consensus were available for COVID-19.

We delivered a series of ICU Network webinars for the rapid dissemination of emerging learning around COVID-19, in partnership with UCLPartners and the Intensive Care Society.

From these webinars, we created reports that were widely disseminated nationally and internationally, enabling ICU clinicians’ observations of COVID-19 patient’s evolving symptoms and effective counter-measures to be rapidly shared. For example, we were able to spread the benefits of proning (whereby the patient is purposefully nursed on their stomach for several hours) globally within 36hrs. 

Contact: Niran Rehill nirandeep.rehill@uclpartners.com

 

Determining the optimal strategy for reopening schools, the impact of test and trace interventions, and the risk of occurrence of a second COVID-19 epidemic wave in the UK

ARC-North Thames supported study, led by Dr Jasmina Panovska-Griffiths from University College London. 

Read the article (Lancet Child & Adolescent Health) 

 

Modelling the health and economic impacts of different testing and tracing strategies for COVID-19 in the UK

ARC-North Thames supported study led by Dr Jasmina Panovska-Griffiths from University College London. 

Read the article (preprint)


Determining the level of social distancing necessary to avoid a second COVID-19 epidemic wave

ARC-North Thames supported study led by Dr Jasmina Panovska-Griffiths from University College London. 

Read the article (preprint)

 

Development of an ICU minimum common dataset for COVID-19

Our Academic Health Science Partner, UCLPartners, was commissioned by NHS London to facilitate the development of a core Intensive Care Unit (ICU) clinical data set, to standardise data entry for the management of COVID-19 related ICU admissions across London hospitals. The aim was to support a better understanding of which interventions were being made to which patients and inform best clinical practice.

The data set outline has been developed by an expert group of clinical academics, including ARC North Thames researchers, and it is now out to consultation with a broader group of ICU and allied clinicians across London.

Contact: Professor Mike Roberts mike.roberts@uclpartners.com

 

COVID-19 Rapid evidence reviews

During the COVID-19 pandemic, the research community came together to respond to the needs of our health and care systems during the early stages of the pandemic. Researchers identified and reviewed evidence, which was summarised in accessible reports for widespread distribution to front line clinicians and commissioners, and to help inform decision-making.

These include:

  • COVID-19 diagnostic testing in recovered dialysis patients (Rojas-Garcia, A., Raine, R.)
  • COVID-19 and rehabilitation needs (Rojas-Garcia, A., Raine. R)
  • Ethical framework for resource allocation in intensive care units (Lamb, D., Raine R.)
  • Medium to long term physical health impacts of COVID-19 (Rehill, N.)

These reports were conducted in collaboration with UCLPartners.

Learn more and download the COVID-19 rapid evidence reports

 

Teaching and training support for researchers and workforce

To support researchers and health and care workers during the COVID-19 pandemic, the ARC North Thames Academy rapidly took action to offer online support and training, and support delivery of funded research across our region. We:

  • provide a CPD-accredited online 'Introduction to Evaluation in Public Health and Care' course.
  • developed an online support page where we provide an active research communication network, providing weekly one-to-one methodology clinics to support health and care workers with their evaluation or research ideas, alongside support offered by the NIHR Research Design Service.
  • provide online social support to early career researchers through a support hub and weekly 'Switch off and write'
  • provide a weekly newsletter, highlighting training and engagement opportunities to health and care staff from across our partner networks.

This work is in collaboration with UCLPartners. We are developing an online version of our ‘Economic Evaluation’ course in collaboration with Barts NHS Trust and NIHR ARCs South West Peninsula (PenARC) and Yorkshire and Humber (ARC YH).

Contact: Dr Silvie Cooper arc.academy@ucl.ac.uk 

Learn more about the ARC North Thames Academy