Conducting research during COVID-19 | Dr Estee Torok
15931
post-template-default,single,single-post,postid-15931,single-format-standard,bridge-core-2.5.3,ajax_fade,page_not_loaded,,qode-child-theme-ver-1.0.0,qode-theme-ver-23.8,qode-theme-bridge,disabled_footer_top,qode_header_in_grid,wpb-js-composer js-comp-ver-6.4.1,vc_responsive
 

Opportunities and challenges of conducting research during the COVID-19 pandemic

sharon peacock - peacock lab - research during COVID-19

Opportunities and challenges of conducting research during the COVID-19 pandemic

Blog by Dr Estee Torok, Honorary Consultant in Infectious Disease & Microbiology, Cambridge University Hospitals NHS Foundation Trust

As a highly experienced infectious diseases physician with experience in the UK and overseas, I was faced with the question of what I could contribute to the response during the COVID-19 pandemic. Travel to Singapore in March 2020 helped me make up my mind. In this blog I also discuss the opportunities and challenges of conducting research during COVID-19.

A wake-up call

I first realised the potential threat of the SARS-CoV-2, the virus that causes COVID-19, in January 2020 when I was contacted by my research collaborators in China. They described the clinical and infection control challenges that they faced, and the draconian public health measures being imposed by the government in an attempt to control spread of the virus.

Even so, I was not fully prepared for my experiences during travel to Singapore in March 2020. On arrival at Changi airport, I was screened with a symptom and travel questionnaire and had my temperature checked before being allowed to enter the country. During my stay I visited the National University Hospital where standard personal protective equipment (PPE) was being worn for contact with all patients, and enhanced PPE for patients with suspected or confirmed COVID-19, who were also isolated in individual negative pressure rooms.

Outside healthcare settings, Singaporeans were commonly wearing face coverings as they went about their daily lives. Everyone who had arrived from a high-risk country was being instructed to quarantine as well as being tracked using an electronic app, telephone calls, and in-person visits. The Singapore government was also issuing daily on-line COVID-19 situation reports. 

On my return, I knew that I could put my clinical expertise in infectious diseases and microbiology, as well as research experience in clinical trials and microbial genome sequencing, to effective use.

Opportunities to contribute

I initially volunteered to help with patient recruitment to the RECOVERY trial at Addenbrooke’s Hospital. This is a UK multicentre clinical trial led by the University of Oxford to evaluate potential treatments for COVID-19. To date, the study has recruited over 18,000 patients from 176 NHS hospitals across the UK – an extraordinary achievement. It has so far discovered that dexamethasone (a steroid) reduces mortality in hospitalised patients with COVID-19 who are receiving oxygen therapy or mechanical ventilation. It has also found that two other treatments (lopinavir-ritonavir and hydroxycholoroquine) do not reduce mortality in hospitalised patients with COVID-19.

My second opportunity came via Ian Goodfellow, who is Professor of Virology at the University of Cambridge, and the local lead for the COVID-19 Genomics Consortium. This is a partnership of NHS organisations, academic institutions, and public health agencies that was established with the aim of sequencing SARS-CoV-2 rapidly and at scale across the UK.

I used my clinical and research experience to streamline data and the flow of positive samples for sequencing in Ian’s laboratory, and built a team to analyse the resulting data. Every week we presented our findings to the clinical, infection control and hospital management teams, supporting the investigation and management of suspected outbreaks of COVID-19 in the hospital. More recently, we investigated COVID-19 outbreaks in care homes in the East of England, and have developed a web-based app to help clinicians and researchers conduct similar analyses.  

In May 2020, I became a principal investigator in the Oxford COVID-19 vaccine trial to evaluate the safety and efficacy of a novel coronavirus vaccine (ChAdOx1) in over 10,000 adults in the UK. Parallel studies are ongoing in Brazil, Kenya and South Africa. In very challenging circumstances, I built an outstanding team of over 70 staff across three NHS Trusts in Cambridgeshire that vaccinated more than 300 volunteers in a matter of weeks. This was an extraordinary team effort, as setting up and delivering a clinical trial often takes many months, if not years. The preliminary results of the phase 3 trial have been announced, and showed 70.4% efficacy overall, and 90% efficacy with one of the dosing regimens.

Research during COVID-19; what have I learnt?

So, what have I learnt from these experiences?

That COVID-19 is a global public health emergency that requires local, national and international collaborative efforts to tackle it. I feel fortunate to have been able to use my clinical and research skills to contribute to the UK’s response to COVID-19.

In the face of this challenge, I have been highly impressed by the willingness, energy and enthusiasm of my clinical and academic colleagues to work together, often for several weeks without a break, to deliver important national research studies. I am extremely grateful to each and every one of them for their support, and for their friendship, during these difficult times. Many of us had never even met or worked together before, but we were all united in a common endeavour – to overcome this threat to life.

I shall remember the past few months as one the most challenging, and yet one of the most fulfilling periods of my professional life.

I have also had the opportunity to revisit just how important family life is. I was separated from my children for three months during the first lockdown, and I had to cancel my wedding in June. I consider myself fortunate that we are back together.

Dr Estee Torok is Honorary Consultant in Infectious Disease & Microbiology, Cambridge University Hospitals NHS Foundation Trust

A longer version of a related article can be found at:  https://www.cam.ac.uk/stories/yearofcovid