COVID-19 Response Interim Report
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JUNE 2021 COVID-19 response interim report Interim Report (January 2020 to March 2021) Medical Research Council Evaluation and Analysis Team I Foreword The intent of this report is to document the main activities undertaken by Medical Research Council (MRC), part of UK Research and Innovation (UKRI), and its community of researchers in response to the SARS-CoV-2 pandemic and to recognise the impacts and insights arising from these activities. As the response and outcomes will continue past 2021, this is an interim report covering January 2020 to March 2021. It is proposed that a final form of this report is produced in 2022. The report is a collection of eight summaries of separate components of the MRC-led aspects of the UKRI COVID-19 response and their impact rather than a connected narrative of events. Highlighted blue and bold text provide links to more detailed descriptions either within the document and the Annexes or external webpages. Methods and acknowledgements The information in this paper has been gathered live throughout 2020. Funding activity data was collated from various off-line call processes by Matt Coles. Activity, outcomes, and impact information from the research community was primarily self-reported in project and Institute, Unit and Centre surveys and Researchfish®. Interviews were undertaken with MRC staff in May and October 2020 and in January 2021. The data was gathered, and the report composed by Emily Gale, Ian Viney, Buddhini Samarasinghe, and James Carter. Additional analysis was provided by the members of the Evaluation and Analysis Team: Joe Murphy and Dominic Hedges. Data on the individual calls and community activities was collected by Rebecca Barlow, Jo Jenkinson, Graham Campbell, Jessica Boname, Kath Giles, David Pan, Anne McGavigan, Mario Moroso (National Institute of Health Research, NIHR), Catrin Bailey, Anne McKeown, Jonathan Pearce, Alistair Lamb, Samia Majid and other MRC staff. More than 20 MRC Programme Managers have provided detailed monitoring of individual COVID-19 research projects. Financial information was provided by Caroline Fitzpatrick. II Contents SECTION 1 Executive Summary 5 Timeline of pandemic-related events divided by world or background events, MRC activities and their impacts 7 SECTION 2 Impacts arising from MRC supported COVID-19 research 8 Treatment 9 Vaccines 11 Surveillance 12 Modelling 12 Data connectivity and co-ordination 13 Clinical care guidance 14 Public engagement and global communication 15 Understanding SARS-CoV-2 biology and pathology 15 SECTION 3 Strategic activities 17 Leading an agile research response 17 Forward planning and relationship building 17 Clarity on the setting of research priorities and identifying gaps in the research landscape 20 Balance of bottom-up and top-down funding mechanisms 21 International coordination 22 SECTION 4 MRC funding response to the COVID-19 pandemic 24 Activities Summary 24 MRC supported COVID –19 research 24 Funding calls – summary and abbreviations 24 Other COVID-19 awards 25 MRC co-ordinated/supported research platforms/knowledge infrastructure 25 MRC support for strategic initiatives 27 International coordination 27 MRC COVID-19 portfolio 28 3 SECTION 5 COVID-19 response from the MRC community of major investments 33 Research initiated within partnerships, institutes, units and centres 33 Understanding virus biology and immune responses 33 Modelling disease outbreak and understanding transmission 33 Societal and psychological impacts of COVID-19 33 Understanding the global context 33 Coordinating big data 34 Refinements to diagnostic testing and vaccine delivery 34 MRC-supported community response: other support activities 34 SECTION 6 Knowledge platforms – prior investments and research themes 36 SECTION 7 COVID-19 response implications for MRC resources 38 SECTION 8 Lessons learned: Impediments to research progress during the first year of the COVID-19 pandemic 41 SECTION 9 ANNEXES 42 Version 1.1 (03/08/2021) - updated with bookmarks to sections/annexes to aid navigation, and revised hyperlinks to WHO pages following their website revamp. 4 SECTION 1 Executive Summary The UK Biomedical research community has been in the forefront of the global response to the COVID-19 pandemic. Mobilising existing expertise, infrastructure and a knowledge base developed over decades of funding, the work of MRC-funded researchers provided global leadership and world leading research in clinical trial implementation, health data management, vaccine development, and genome sequencing throughout 2020. MRC is now leading a £256m portfolio of COVID-19 relevant projects (£177m of which is funded from budgets managed by MRC). More than 60% of this funding will be spent by the end of 2021 and has been allocated to projects that have explicit objectives to have a rapid impact to prevent, treat and manage the pandemic. The community response has been unprecedented, with more than 3000 applications submitted to MRC-led COVID-19 research calls in 2020. This was in addition to the business-as-usual submissions to MRC Research Boards and panels1. Researchers from across the MRC community have speedily formed collaborative research efforts both within and between research organisations. Three of the MRC supported COVID-19 research platforms include academics from more than 15 research organisations. From the outset of the pandemic, MRC’s major strategic investments have worked collaboratively and individually re-aligning their work to progress hundreds of new COVID-19-relevant research projects. Additionally, the staff have delivered practical support for local clinical needs as well as providing analyses or compounds for research projects carried out by others. Some have built on their existing networks of laboratory expertise. For example, through the creation of the Protein Portal, a new international resource which provided key COVID-19 reagents for fellow investigators in the first year of the pandemic, the COVID-19 Protein Production Consortium contributed significantly to accelerating COVID-19 research. The rapid development and scale up of production of the Oxford/AstraZeneca vaccine at unprecedented speed2, has delivered an intervention that is suitable for global distribution. This assistance in bringing the global pandemic under control could provide benefits, in global income of almost 9 trillion dollars by end-20253. The OECD has positively upgraded UK growth estimates specifically due to its successful vaccination programme4. The ongoing UK vaccination programme which primarily utilises the Oxford/ AstraZeneca vaccine has, in combination with social distancing, brought the UK epidemic under control and provided considerable protection for the population against severe disease and future infection. The development of the Oxford/AstraZeneca vaccine was substantially founded on years of MRC- funded research, and publicly funded by MRC and partners in the early clinical studies. 1. All applications considered by MRC research boards and panels in 2019/20 totalled 2169 and totalled 2070 in 2020/21. 2. Previously the four-year development of the mumps vaccine was the most rapid. (Why a coronavirus vaccine could take way longer than a year (nationalgeographic.com); Maurice Hilleman, M.M.R. Vaccine’s Forgotten Hero - The New York Times (nytimes.com); Pinkbook | Mumps | Epidemiology of Vaccine Preventable Diseases | CDC) 3. IMF estimate Transcript of October 2020 World Economic Outlook Press Briefing (imf.org) 4. In December 2020 the OECD economic outlook estimated that UK total GDP growth in 2021 would be 4.2%, in March 2021 this estimate was revised to 5.1%, and then in May 2021 the estimate was further revised upwards to 7.2% https://stats.oecd.org/ index.aspx?DataSetCode=EO. 5 In the year since the pandemic started, MRC UKRI-supported research has directly led to important societal impacts. COVID-19 targeted clinical guidance has been developed, effective treatments have been identified (as well as many proven to be ineffective), and these treatments implemented internationally. Validation of the effectiveness of dexamethasone therapy by the RECOVERY trial resulted in an estimated 12,000 lives saved in six months of implementation. The development of methodologies for efficient clinical trial management and coordination, along with the establishment of infrastructure for big data and health data management have positively impacted the research landscape. These investments will enhance our ability to face future pandemics and other population health challenges as well as continuing to support world-leading biomedical research. UKRI-funded research has provided government and clinical policy makers with data to inform decision- making in several key areas. These include transmission, variant evolution, population group variance in vulnerability, patient metabolic responses, susceptibilities and mortality, and the population compliance and response to government restrictions as well as the mental health effects of the pandemic. There is growing evidence that during the pandemic MRC researchers have engaged to a greater extent than usual with stakeholders to provide successful, rapid translation of knowledge into public policy or guidance. In surveys, MRC-funded researchers were able to tell us about the highly interactive relationships5 developed between academic researchers and policymakers. They also demonstrated their ability to modify research questions and direction to serve the needs of policy makers in a rapidly changing