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At the Institute for Global Health, we are immensely proud to have our staff actively engaged in the fight against the coronavirus/COVID-19 pandemic. Examples of some of this work are compiled below.
Public Engagement and Advice
Guy Harling answered listener questions on BBC Radio 5’s ‘Nihal Arthanayake Show’ (from 16 mins 13 secs), and the next day appeared on BBC Breakfast, providing a brief overview of the epidemic and giving advice on how to minimise risk of catching the virus and spreading it to others.
Therese Hesketh took part in a debate for the Economist's weekly podcast, on the subject "What can countries do to prepare for covid-19?".
Chikwe Ihekweazu wrote for The Conversation about steps Nigeria is taking to prepare for cases of coronavirus, incorporating knowledge gathered and systems put in place following the Ebola outbreak.
Lara Gosce's research on how influenza-type illnesses are spread on the London Underground was widely quoted in the media as the UK began to increase containment measures. Lara was interviewed by various outlets including on BBC London News.
Anne Johnson and Graham Hart took part in the UCL Minds podcast series in the episode "What can we learn from the history of pandemics?" The panel discussed outbreaks through history, including HIV/AIDS in the 1980s and the Black Death in the 14th century.
Other UCL staff have been interviewed by the mainstream press. The resulting articles are too numerous to list comprehensively, but a few are highlighted here:
- What can Britain learn about containing Covid-19 from countries that got it right? (The Guardian, quotes Anne Johnson)
- Face masks could give false reassurance (The Sun, quotes Ben Killingley)
- Scientists warn Britain to step up coronavirus testing (Financial Times, quotes Tim Colbourn)
- Coronavirus: Government releases official advice to protect your mental health (Yahoo! Style, quotes Rochelle Burgess; Rochelle was also interviewed for BBC World Service's Newshour talking about mental health and community psychology)
Treatment
Along with their UCL colleagues from other departments, all 37 of IGH's clinical academics have been released to work on frontline NHS duties.
These academics are applying their practical knowledge and experience to test and treat patients, not only close to our London base but nationally and internationally.
Marie Francis and Julian Surey, based at the Mortimer Market Centre, have teamed up with Find and Treat and NGOs to visit London's homeless population and arrange accommodation in hotels. The specialist nurses, who usually work on outreach screening services such as HepCare, are testing this vulnerable population for COVID-19 and ensuring they are treated and housed accordingly.
Mental Health
Rochelle Burgess wrote about causes and consequences of mental health and COVID-19 for Nature magazine; "COVID-19 mental-health responses neglect social realities." Rochelle's commentary piece calls for mental health services to do more to support people during the pandemic.
Rochelle is also working with Hertfordshire County Council on their COVID-19 public mental health strategy (see "Strategic Input" section below), and took part in UCL's podcast "Coronavirus: The Whole Story - How is it affecting our mental health?" and on BBC World Service's Newshour speaking about mental health and community psychology (from 19 minutes 10 seconds).
Ethnic Group Analysis
Delan Devakumar, Anne Johnson, Ibrahim Abubakar and their co-authors discovered that the likelihood of death from COVID-19 is two to three times higher among England’s Black, Asian and Minority Ethnic (BAME) groups than the general population.
Their findings were widely reported in the UK media including on ITV's Good Morning Britain (from 9 mins 22 seconds) and the BBC World Service's Newsday (from 14 minutes 48 seconds).
Gender Analysis
Data suggests men are more likely than women to die from the virus. Understanding why could alter the way we administer treatment to vulnerable groups, as explained by Sarah Hawkes on CNN and in the BMJ.
Global Health 50/50 have launched a live data tracker which monitors the sex-disaggregated data on COVID-19 as reported by countries. At present, this covers the 25 countries with the highest number of cases but will be expanded to further countries over the coming weeks. To date, this is the only tracker that compiles sex-disaggregated data on COVID-19.
GH5050 are also conducting a review of academic literature to assess sex-disaggregated data on COVID-19. They are looking at the role both sex and gender may be playing in the pandemic.
Clinical Research
Members of our Centre for Clinical Research in Infection and Sexual Health (CRISH) have mobilised to assist UCLH on a study looking into healthcare worker risk of SARS-CoV-2 acquisition. The CRISH team is running recruitment and follow-up care for the SAFER study (SARS-CoV-2 Acquisition in Frontline Health Care Workers – Evaluation to Inform Response).
Shortness of breath (dyspnoea) is the only symptom of COVID-19 that is significantly associated with severe cases of the disease and admission to intensive care units (ICU), according to a systematic review and meta-analysis led by Vageesh Jain.
The Centre for Pragmatic Global Health Trials is collaborating with UCL Comprehensive Clinical Trials Unit to deliver an interventional cohort study to evaluate the benefit of rapid COVID-19 genomic sequencing on infection control in preventing the spread of the virus in United Kingdom NHS hospitals. The PI is Prof Judy Breuer based at UCL and within IGH Andrew Copas, Oliver Stirrup and Fiona Mapp are contributing their time and expertise.
Modelling
Lara Goscé built a model for the spread of the new Coronavirus in London calibrated to COVID-19 London data released by PHE.
At the same time, Lara collected data from TfL to study the levels of contact between the different London boroughs. This data allowed Lara and her team (Ibrahim Abubakar, Andrew Phillips, Rishi Gupta and Paula De Souza Leao Spinola) to analyse the spread on the smaller scale and test multiple scenarios of control strategies.
Lara is now adapting the model to study transmission in Nigeria.
Guy Harling has been working with the Africa Health Research Institute (AHRI) and Massachussets General Hospital on mathematical models requested by the KwaZulu-Natal government to predict the epidemic trajectory of the virus in the South African province. The models were then adapted for colleagues working with governments in Botswana, Malawi and Eswatini.
The models helped KwaZulu-Natal officals make early decisions regarding social distancing. The team has since collaborated with colleagues in the United States on ongoing, more complex models to understand the options for prevention, treatment and care provision in the province.
Tim Colbourn has been reviewing modelling papers for The Lancet and Nature, and is involved in expert forums in the UK, in Malawi, and globally.
Tim and Andrew Phillips are also part of a team who are to trying to estimate the appropriate scale and type of responses needed in Malawi, given unknowns the country may face on comorbidities such as HIV, TB, Malaria and malnutrition common in lower-income countries, as well as the key COVID-19 comorbidities such as diabetes, CVD and COPD that are also prevalent in wealthier countries.
Support to Humanitarian Programming
Naomi Saville, who is based in Kathmandu and has 25 years' experience in Nepal, is working with DFID to provide thematic advice on food security and nutrition during the country's COVID-19 response to inform programme interventions and delivery.
Naomi will be working with the Nepalese government, local partners, UNICEF, the UN World Food Programme amongst others to support efforts to maintain food and nutrition security throughout the outbreak.
Observational Studies
Guy Harling and AHRI colleagues are supporting the work of South Africa's Human Sciences Research Council (HSRC) in building a knowledge base around the national public's understanding of COVID-19, and its impact on their lives.
Guy is also working with AHRI on their longitudinal population surveillance to ascertain incidence of COVID-19 in a rural South African setting among residents in the AHRI surveillance area. Regular (weekly for a sub-cohort) telephone interviews with household heads will screen for symptoms of the virus and the impact of related social distancing policies on residents. Those screening positive will be followed-up for testing, referral for care if needed and contact tracing-based on government protocols.
Guy and partners at Massachusetts General Hospital have posted a pre-print on the effects of state-wide social distancing policies in the United States. Their analysis suggested that these measures may have had an impact on the epidemic curve, with a significant fall in the growth rate.
Strategic Input
Researchers from across our Institute have been prominent advisors and commentors, often helping to shape government policy using their expert knowledge.
Anne Johnson and Guy Harling were part of a team who wrote a wide-ranging report identifying the potential for Testing, Tracing and Isolation to help control the UK COVID-19 epidemic, as part of a wider package of interventions.
By reviewing successful programmes internationally, conducting modelling exercises and drawing on experiences from multiple academic fields, the team highlighted the importance of speed, compliance and coverage for TTI to be effective, and the need for integration with the wider response.
The team acted as members of DELVE (Data Evaluation and Learning for Viral Epidemics), a multidisciplinary group convened by the Royal Society to support a data driven approach to managing the COVID pandemic.
Anthony Costello was interviewed by various national media outlets including the BBC's Newsnight, Channel 4 News and The Independent regarding early measures by the UK and other national governments to prevent the spread of the virus. Tim Colbourn also provided commentary in specialist publications such as The Lancet Public Health and via mainstream media including the BBC's Jeremy Vine show (from approximately 15 minutes).
Prof Costello also gave evidence to the UK Government's Health and Social Care Committee for their inquiry into the country's management of the coronavirus outbreak.
Rochelle Burgess is contributing to the development of Hertfordshire County Council's COVID-19 public mental heath strategy. Rochelle has been advising on a socially informed public health response that responds to a range of socio-political drivers of mental ill health linked to the outbreak (including food insecurity, poverty and violence) and developed the structure for a stepped care intervention to provide mental health and wellbeing supports across the county, which has over a million residents.
Rochelle also wrote about causes and consequences of mental health and COVID-19 for Nature magazine; "COVID-19 mental-health responses neglect social realities."
Social Sciences
Nehla Djellouli and UCL colleagues from the Rapid Research, Evaluation and Appraisal Lab (RREAL) are working with UCLH and international partners to capture frontline staff perceptions and experiences of COVID-19 in 11 countries: Australia, Brazil, Chile, Italy, Mexico, Pakistan, Spain, South Africa, Switzerland, UK and USA.
The RREAL group is also expanding their work to explore the impact of COVID-19 on non-COVID-19 healthcare delivery through a global survey (currently focused on chemotherapy treatment for cancer patients).
Ilan Kelman has been examining how and why the pandemic is unlikely to foster new, lasting diplomatic or peace initiatives. Ilan has also been conducting information surveys, understanding where people receive their COVID-19 information, what they believe, and why.
More detail on Ilan's research can be found in his blogs for Polar Connection and Nautilus, and his comments have been featured in mainstream media including the Telegraph and the New York Times.
Education
Our teaching team responded to the crisis by ensuring the remainder of the academic year could be completed offsite. Systems are in place to ensure that students are contacted regularly by their personal tutors and supervisors to check on their wellbeing and provide guidance.
Course leaders are finding innovative ways to engage with their students, such as the new COVID-19 seminar series that has been established by the MSc Applied Infectious Disease Epidemiology tutors.