Rapid research in a pandemic: foresight, preparedness, and collaboration

The pandemic was not what we expected. A new respiratory virus had been identified and the WHO declared a public health emergency of international concern. Predictions of possible mortality rates were terrifying. But the H1N1/09 “swine flu” pandemic turned out to be different to predictions. It had a lower mortality rate than other influenza pandemics, although it still probably killed over a quarter of a million people worldwide.

During the swine flu pandemic, the UK’s Department of Health collected survey data using telephone polling and our team came together to analyse these. We were lucky with swine flu and it allowed planning to be put in place for a next pandemic, a much more serious one. The National Institute for Health Research and the Department of Health put out a novel call for research projects that would focus on preparing ahead of time for the next pandemic, and we had successful bids. Tracking public behaviour is key to managing an emerging pandemic and we developed a template for a survey the UK Government could use for the next one, although we presumed it would be another flu pandemic. The research funding included a planned reactivation component so that the work could re-start quickly. Try explaining to a university’s research costings department that we need to agree costings with the funder for work that we don’t know whether we will be doing next year or in 20 years’ time. At one point, in order that costings could be calculated, we had a notional start date for the next pandemic of 1 April 2020.

The project was officially reactivated on 3 February 2020. The Department of Health and Social Care had already started using our survey template, with the first survey starting on 25 January 2020. The planning and preparation worked, although changes in how people use their phones meant that telephone surveys had been replaced by online ones. Precarious employment structures in academia meant some colleagues on short-term contracts were put into financial difficulties by the pandemic, with individuals leaving research entirely. Others were waiting months to hear about funding decisions. But we were able to move quickly.

The pandemic was not what we expected. We had not envisaged the scale of covid-19, the global lockdowns nor how long they would continue. What had been planned as a research study that could inform government became a service evaluation as we hurriedly turned out reports to answer specific government questions and assess the impact of official messages and policies. Navigating the competing pressures from the academic and policy worlds was not always easy. Conducting this work was challenging: working at speed, discussing issues closely with policy teams, revising questions as the situation changed and having to put these demands above peer-reviewed scientific publications. After covid-19, there will have to be planning for the next pandemic. We are continually learning: about the virus, how best to support the response, and how to conduct and disseminate methodologically rigorous science under immense pressures. Despite differing approaches at times of scientists and policymakers, we have the common goal of protecting physical and mental wellbeing in these difficult times. The CORSAIR project (COVID-19 Rapid Survey of Adherence to Interventions and Responses) has helped to demonstrate the vital importance of preparedness, not just for organisations tasked with tackling major public health emergencies. Foresight on the part of research funders, and commitment from academic and Government teams to rapidly establish ways of working closely together are also needed.

Henry WW Potts, Professor of Health Informatics. Institute of Health Informatics. Twitter: @HWWPotts

Richard Amlȏt, Head of Behavioural Science in the Emergency Response Department at Public Health England. Twitter: @DrRichardAmlot 

Nicola T Fear, Professor of Epidemiology. Department of Psychological Medicine, King’s College London.

Susan Michie, Professor of Health Psychology. Centre for Behaviour Change, University College London. Twitter: @SusanMichie

Louise E Smith, Post-doctoral Researcher. Department of Psychological Medicine, King’s College London. Twitter: @louisesmith142

G James Rubin, Assistant Director, NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London.

Competing interests: None declared

Funding statement: LS, RA and GJR are supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia. RA is also supported by the NIHR HPRU in Behavioural Science and Evaluation, a partnership between Public Health England and the University of Bristol. HWWP receives funding from Public Health England and NHS England. NTF is part funded by a grant from the UK Ministry of Defence. The views expressed are those of the authors and not necessarily those of the NIHR, Public Health England, the Department of Health and Social Care or the Ministry of Defence.