Informing healthcare policy with COVID-19 data
The SARS-CoV-2 virus has resulted in more than 235 million cases of COVID-19 and more than 4.8 million deaths worldwide, including approximately 137,000 deaths in the UK (October 2021). Since March 2020, researchers have used health data from a range of sources for examining, modelling and reporting disease trends to inform healthcare and public health policies.
In mid-2020, a new secure data resource covering 54.4 million people – over 96% of the English population – was established for researchers. This work was led by a UK consortium (CVD-COVID-UK) in partnership with NHS Digital. The new resource linked a wide variety of health data, such as those from General Practice records, hospital data and COVID-19 laboratory test and vaccination data. Researchers at the NIHR Cambridge BRC developed data-management strategies, statistical methodologies and computer code1.
The population-wide resource is being used to study individuals with and without health-related problems across all age groups, ethnicities, geographies and socioeconomic settings. The team determined:
- people have higher risks of major cardiovascular and blood clotting diseases for several months after a COVID-19 infection and,
- the COVID-19 Astra-Zeneca vaccine but not the Pfizer vaccine is associated with a small excess risk of rare blood clotting events; but the risk is small compared with the vaccine effect in reducing COVID-19 morbidity and mortality. The results have directly informed health policy decisions by the Chief Medical Officer and Joint Committee on Vaccination and Immunisation.
Researchers played a key role in COVID-19 Genomics UK (COG-UK), the world’s largest SARS-CoV-2 genome sequencing initiative, in partnership with Public Health England and the Wellcome Sanger Institute2. By October 2021 the team sequenced more than 1 million SARS-CoV-2 genomes. COG-UK results guided the Scientific Advisory Group for Emergencies (SAGE) and major policy decisions of the UK government throughout the pandemic, including investigations of outbreaks at local and regional levels across the UK and the importance of different variants3 as well as identification, characterisation and monitoring of “variants of concern”.
For instance, knowing the surge of COVID-19 in Spring 2021 was driven by the Delta variant, prompted stricter travel controls and urgent research into vaccination efficacy against Delta. Once it was clear that one vaccine dose provided less protection against the Delta variant, the population was encouraged to get their second dose earlier.
1 BMJ 2021 PMID:33827854
2 Lancet Microbe 2020 PMID:32835336
3 Lancet ID 2021 PMID:34461056