Corresponding with the pandemic’s ever-altering pace are changes to Scotland’s responses, research, and restrictions. SPR catches up on some of the latest coronavirus-centric news – and how, together, we’re moving forward.

Research Rolls on

Science and study remain core components of Scotland’s strategy for contending with the coronavirus pandemic.

Aberdeen ‘Warning Sign’ Study Builds Momentum

As the sector forges ahead in its quest to discover emerging revelations regarding coronavirus – and new mechanisms for assisting patients – the University of Aberdeen have been playing a vital role, developing a study that aims to identify crucial biological ‘warning signs’ of an aspect of COVID-19, which is being supported by almost £100,000 from NHS Grampian Endowments. Dr Nicola Mutch and her team will look for defining key ‘biomarkers’ of a particular aspect of COVID-19.

Up to one-third of patients hospitalised for COVID-19 experience a severe form of lung disease that can be fatal, in which it’s known that part of the problem is that the air space in the lung is consumed by a build-up of deposits of a protein called fibrin. These fibrin deposits restrict the amount of oxygen being absorbed into the lung and patients with severe disease require oxygen support, which in very severe cases requires mechanical ventilation.

Dr Mutch and her team will attempt to find out why excessive fibrin forms in the lungs of COVID-19-infected patients. The study will also explore whether specific ‘biomarkers’ of fibrin formation and its breakdown can be used to identify patients at risk of developing more severe disease.

Dr Nicola Mutch further revealed, ‘Blood clots, which are jelly-like masses of cells, and a protein called fibrin are observed in around 30 per cent of patients with COVID-19. We do not yet understand why these patients are so prone to the development of these clots in big and small blood vessels throughout the body.

‘Defining key ‘biomarkers’ associated with blood clot formation and persistence in patients will allow us to identify early those at risk of severe outcomes and help guide medical treatment. We are hugely grateful to NHS Endowment Fund for supporting this important study.’

Luan Grugeon, Chair of Trustees of NHS Grampian Endowment Fund, added, ‘Our trustees agreed at the start of the pandemic to support research into COVID-19 and are delighted to award research funding of £96,652 towards the University of Aberdeen’s COVID-19 ‘warning signs’ study project.’

New Insights into Long-Term Health Impacts of Coronavirus

The repercussions of the pandemic will undoubtedly be far-reaching – but just what shape will their severity take? Set to elevate our knowledge is the launch of a major UK research study into the long-term health impacts of COVID-19 on hospitalised patients.

The PHOSP-COVID initiative has been awarded £8.4 million jointly by UK Research and Innovation and the National Institute for Health Research (NIHR), and is one of a number of COVID-19 studies that have been given urgent public health research status by the Department of Health and Social Care.

The University of Glasgow will share expertise with a national consortium of leading researchers and clinicians from across the UK to assess the impact of COVID-19 on patients’ health and their recovery.

Around 10,000 patients are expected to take part in the study led by the NIHR Leicester Biomedical Research Centre – a partnership of the University of Leicester and University Hospitals of Leicester NHS Trust – making it one of the largest comprehensive studies in the world to understand and improve the health of survivors after hospitalisation from COVID-19.

Professor Colin Berry will lead the work for the University of Glasgow, and the team will contribute MRI imaging scans of the heart, brain and other body organs, as well as supportive research into the overall health and wellbeing of the patients.

Professor Berry, Chair in Cardiology and Imaging at the University of Glasgow, explained, ‘This study will provide vital information on the long-term effects of COVID-19 on patients. Harnessing the resources of clinical and research teams from around the UK, we will be able to rapidly gather evidence so that better test and treatment strategies can be developed.’

The PHOSP-COVID team will subsequently develop trials of new strategies for clinical care, including personalised treatments for groups of patients based on the particular disease characteristics they show as a result of having COVID-19 to improve their long-term health.

Home DNA Test Data Wanted to Boost COVID-19 Fight

Data from popular home genetic-testing kits could help scientists shed light on why some people who catch coronavirus have no symptoms while others become very ill.

Researchers are asking people who have used DNA-testing services – such as Ancestry DNA, FTDNA and 23andMe – to gain ancestry or health insights to join a study that aims to identify key genes involved in the body’s response to the infection. Understanding the effect genes have on susceptibility to COVID-19 could aid efforts to tackle the pandemic, and help combat future disease outbreaks, the researchers have reported.

More than 30 million people worldwide have utilised genetic- testing services, and researchers are urging them to share their DNA data to help speed up discoveries that could help fight the virus. By providing these data, volunteers will help the team avoid the costly, time-consuming task of collecting the hundreds of thousands of DNA samples that would otherwise be needed to map the genes involved. Volunteers who haven’t used these services will also be able to provide the project with DNA, once current lockdown restrictions have been eased.

The team aim to identify genes that influence the risk of developing COVID-19 and those that affect disease severity, by comparing volunteers’ symptoms – or lack of them – with their DNA. Those taking part in the University of Edinburgh study – called Coronagenes – will complete online questionnaires about their health, lifestyle, and any symptoms they have experienced, such as a fever or a persistent cough.

Essentially, updating the survey before, during, and after an infection will help scientists detect any patterns that might indicate how the virus progresses, as well as assist in the analysis of the long-term health consequences of infection and self-isolation.

Jim Wilson, Professor of Human Genetics at the University of Edinburgh, who is co-leading the study, said, ‘Some people suffer no ill effects from coronavirus infection, yet others require intensive care. We need to identify the genes causing this susceptibility, so we can understand the biology of the virus and hence develop better drugs to fight it.’

Continued Caution and Collaboration

A number of initiatives and critical decisions relating to the COVID-19 emergency are being regularly revealed to the public.

Next Steps in Tackling the Crisis

As restrictions ease, the way in which Scotland is dealing with COVID-19 is now shifting from containing the virus nationally through lockdown to monitoring and responding to localised outbreaks wherever and whenever they occur.

COVID-19: Surveillance and Response sets out how existing planning arrangements and guidance will be applied to continue to suppress the virus at a national and local level, including the timely and co-ordinated sharing of data between key organisations, such as local health professionals, local authorities and other local responders.

The publication is accompanied by updated Public Health Scotland guidance on the management of public health incidents to reflect the new COVID-19 legislation. Additionally, NHS Scotland’s Test and Protect programme will continue to play a significant role in the ability to monitor the ongoing impact of COVID-19 within communities across Scotland.

Deputy First Minister John Swinney commented, ‘As we move into the next phase on easing lockdown restrictions we know that our response to the pandemic also needs to adapt. Monitoring the virus and taking action to suppress transmission is increasingly important.

‘Scotland has a world-class public health system and our surveillance and response approach, along with NHS Scotland’s Test and Protect programme and local resilience services, will enable us to respond rapidly and collaboratively to any incident or outbreak at a local, regional and a national level.

‘Of course, we all need to continue to play our part to reduce the risk of the virus spreading through physical distancing, good hand and respiratory hygiene and the appropriate use of face coverings.’

Online Resource to Help Engagement Under Pandemic Restrictions

A new online resource has been launched for NHS boards and Health and Social Care Partnerships to help them continue to engage effectively with local communities while COVID-19 restrictions remain.

Measures to control the COVID-19 pandemic have created a challenge for the traditional ways of engaging with people over changes to local services – for example, focus groups and carrying out surveys in shopping centres can currently not take place.

The new online resource, called Engaging Differently, has been created by Healthcare Improvement Scotland – Community Engagement, with it containing hints, tips and examples to help organisations achieve a mix of approaches, including the repurposing of existing engagement methods, to ensure the focus is not solely on digital and online technology. The resource will grow as new information becomes available.

Lynsey Cleland, Director of Community Engagement, explained why Engaging Differently is so important, saying, ‘People who use health and social care services can expect to be consulted about their local health and social care services in a way that works for them. COVID-19 presents challenges to carrying out meaningful engagement and people may automatically think that engagement can only be carried out digitally.

‘While many people have access to online platforms to enable this, some do not and not everyone is comfortable using this technology. Engaging Differently is about ensuring new barriers to engagement are not created for people and communities in the current circumstances.’

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