‘Hibernating’ research studies on standby to tackle next flu pandemic
Valuable lessons could be learned from a network of United Kingdom health research studies on standby for the next influenza pandemic, says a Victoria University of Wellington epidemiologist who is part of the network.
24 April 2019
The ‘hibernating’ network will ensure the UK is better prepared to tackle a flu pandemic and could be replicated in whole or part by other countries, says Colin Simpson, Professor of Population Health and Associate Dean–Research and Innovation in the University’s Faculty of Health.
Professor Simpson is lead author of a newly published article in The Lancet Infectious Diseases that charts the development and benefits of the network.
As well as being adaptable for flu pandemics in other countries, the network could be used as a model for other health emergencies, including other infectious diseases and chemical, biological and radiation incidents, says the article.
The network was established after the UK health service’s experience during the 2009 flu pandemic, when relevant research was rapidly commissioned, funded and delivered under challenging circumstances, but, even with accelerated processes, some studies were completed too late to have an immediate significant impact on clinical care.
The studies were slowed down by inherent delays in calling for research proposals and assessing, funding and setting up subsequent projects, including obtaining relevant ethical and regulatory approvals.
To combat delays, in 2012 a suite of studies was established (with relevant permissions put in place and arrangements made for data collection), pilot tested where relevant and hibernated in a maintenance-only state awaiting activation if another pandemic is declared.
The studies cover key care and public health aspects of a flu pandemic, including surveillance, vaccination, triage and clinical management.
One study has been funded to develop rapid turnaround flu phone surveys to monitor behaviour across the general population and identify ways to better communicate public health advice.
Another is to advance real-time modelling of flu epidemics and provide a tool to monitor and predict the development of an ongoing pandemic.
Professor Simpson, collaborating with the University of Edinburgh, where he worked before joining Victoria University of Wellington, is leading the EAVE (Early estimation of pandemic influenza Antiviral and Vaccine Effectiveness) project, which incorporates a unique nationally linked community and laboratory dataset.
“The network of studies established and funded by the UK’s National Institute for Health Research is eminently adaptable by other countries’ health systems, many of which experienced similar frustrating research delays during the 2009 flu pandemic,” says Professor Simpson.
“A country such as New Zealand—whose health service has much in common with the UK with its emphasis on primary care and its district health boards and central government funding—could replicate the parts that work best for it, if it thinks there is a role for them.”
Although a lot of performance information will not be available until studies are brought out of hibernation, a number of important lessons have already been learned, says Professor Simpson.
For example, it is necessary to keep key stakeholders (including policy makers and those who initially agree to host the research) interested and engaged and to keep studies up to date in terms of research regulations, scientific and social changes, and technological advances.
One of the network’s benefits is the spirit of cooperation it entails, says Professor Simpson.
“All too often researchers are in competition when trying to answer research questions in an emergency situation,” he says. “In contrast, the UK model allows for advance funding and planning of a complementary suite of studies, system testing and developing a collaborative network of researchers. Existing international networks such as the International Severe Acute Respiratory and Emerging Infection Consortium and the International Network of Obstetric Survey Systems either are or could be primed and ready to go internationally with similar studies.
“The challenge going forward, however, will be for commercially funded studies not to compete for scarce patient resources and to fit within this framework to ensure the highest quality studies are conducted most expediently. With this in mind, is now the time for an international register of planned pandemic and emerging infection studies with agreements over priorities and co-enrolment and collaboration?”
UK lead research institutions with which Professor Simpson is also collaborating in the network include the University of Oxford, University of Cambridge, King’s College London, University College London, London School of Hygiene and Tropical Medicine, University of Sheffield, University of Liverpool and Nottingham University Hospitals NHS Trust.
‘Improving health and wellbeing in our communities’ is one of Victoria University of Wellington’s areas of academic distinctiveness.