Clinical academic research in the time of Corona: a simulation study in England and a call for action

Abstract

Background: Coronavirus (COVID-19) poses health system challenges in every country. As with any public health emergency, a major component of the global response is timely, effective science. However, particular factors specific to COVID-19 must be overcome to ensure that research efforts are optimised. We aimed to model the impact of COVID-19 on the clinical academic response in the UK, and to provide recommendations for COVIDrelated research. Methods:We constructed a simple stochastic model to determine clinical academic capacity in the UK in four policy approaches to COVID-19 with differing population infection rates:"Italy model" (6%), "mitigation" (10%), "relaxed mitigation" (40%) and "do-nothing" (80%) scenarios. The ability to conduct research in the COVID-19 climate is affected by the following key factors: (i) infection growth rate and population infection rate (from UK COVID-19 statistics and WHO); (ii) strain on the healthcare system (from published model); and (iii) availability of clinical academic staff with appropriate skillsets affected by frontline clinical activity and sickness (from UK statistics). Findings:In "Italy model", "mitigation", "relaxed mitigation" and "do-nothing" scenarios, from 5 March 2020 the duration (days) and peak infection rates (%) are 95(2.4%), 115(2.5%), 240(5.3%) and 240(16.7%) respectively. Near complete attrition of academia (87% reduction, <400 clinical academics) occurs 35 days after pandemic start for 11, 34, 62, 76 days respectively -with no clinical academics at all for 37 days in the "do-nothing" scenario.Restoration of normal academic workforce (80% of normal capacity) takes 11,12, 30 and 26 weeks respectively.Interpretation: Pandemic COVID-19 crushes the science needed at system level. National policies mitigate, but the academic community needs to adapt. We highlight six key strategies: radical prioritisation (eg 3-4 research ideas per institution), deep resourcing, nonstandard leadership (repurposing of key non-frontline teams), rationalisation (profoundly simple approaches), careful site selection (eg protected sites with large academic backup) and complete suspension of academic competition with collaborative approaches.

Smart Healthcare for Diabetes During COVID-19

“…It is estimated over 59 millions people being diabetic across 44 countries and territories [30]. A study shows that out of total death in UK due to COVID-19, approximately 26 % suffered from either type-1 or type-2 diabetes [31]. Thus, making recovery of these patients a challenging task.…”

Healthcare Workers Bioresource: Study outline and baseline characteristics of a prospective healthcare worker cohort to study immune protection and pathogenesis in COVID-19

“…Many infections are asymptomatic 6 , therefore surveillance of symptomatic coronavirus disease 2019 (COVID- 19) underestimates the infection burden. This has led to calls for regular surveillance of asymptomatic HCWs [7][8][9][10] , to ensure that health care facilities do not become transmission hot-spots, to protect the workforce and vulnerable patients and to prevent community reseeding.…”

The impact of COVID-19 on Medical education and Medical Students. How and when can they return to placements?

“…These students entered the workforce to support clinical services from April onwards (Patel et al, 2020). Furthermore, Medical Academics were requested to provide direct care and the impact of this on UK academic medical research is likely to be very significant (Banerjee et al, 2020).…”