Unit response to Coronavirus (COVID-19)

Current operational status

Many Unit members have now returned to working in our facilities, though often continuing to work from home for part of the time. Internal and external meetings are being held in–person, online or hybrid events, depending on which is most appropriate in the specific circumstances.

Field testing and volunteers

All active field testing as part of our research studies that involves direct contact with volunteers was temporarily suspended in March 2020. Our research study teams are now welcoming participants back to our facilities.

For any enquiries about a study you are participating in please check the contact details for individual studies on our Study Contacts web page, or email us at: studyhelp@mrc-epid.cam.ac.uk

Seminar series

The MRC Epidemiology Unit seminar series was moved online in March 2020, where they are provided for free and with no need to register. Some seminars are currently held as hybrid in-person/online events. You can find a list of upcoming seminars on our Events page, and our past seminars page has recordings and slides from earlier events. You can subscribe on our online form to receive emails about future seminars and other alerts.

University of Cambridge response

University of Cambridge Coronavirus support pages can be found at www.cam.ac.uk/coronavirus

Our research response

The research work of the Unit is continuing, and Unit scientists are also exploring opportunities to contribute to national efforts, both in response to the COVID-19 pandemic and its broader public health consequences.

Several of our staff are now helping directly with the COVID-19 crisis, working in clinical, public health or lab testing settings, while members of our Global Public Health Research team are leading efforts to crowd-source the translation of WHO facts on Coronavirus into as many African languages as possible.

A major research undertaking is to plan the roll out of a digital platform for obtaining serial information on symptoms and signs of COVID-19 over the next year in the Fenland study with measurement of antibody status when this is available. The aim is to identify early markers of the transition from asymptomatic to symptomatic COVID-19 infection. Update on this here!

We are also engaging in all our cohorts on pursuing record linkage with Public Health England and NHS Digital to describe the risk factors associated with COVID-19 infection and its consequences.

Our public health programmes are engaged nationally and internationally in determining the implications for diet and activity behaviours of the epidemic in terms of food security and the impact on physical activity of the social distancing restrictions.

Finally, members of our genetics programme have joined the COVID-19 host genetics initiative which aims to bring together the human genetics community to generate, share, and analyse data to learn about the genetic determinants of COVID-19 susceptibility, severity and outcomes.

Updates on ongoing Unit research related to COVID-19 and its public health consequences are below.

Genetic and proteomic analysis identifies ELF5 as a respiratory epithelial cell-specific risk gene for severe COVID-19 – August 2022

An analysis of genetic predisposition to COVID-19 from over 2 million samples from more than one hundred thousand cases in the COVID-19 Host Genetics Initiative, accompanied by examination of variations in levels of two thousand plasma proteins, has identified 8 candidate protein mediators of COVID-19 outcomes, including the protein ELF5.

The researchers, led by Dr Maik Pietzner and Dr Claudia Langenberg of the Unit and Berlin Institute of Health at Charité (BIH) and PhD student Robert Lorenz Chua at BIH, found a more than 4-fold higher risk for severe COVID-19 with genetically higher ELF5 plasma levels, and demonstrated that ELF5 is specifically expressed at various sites of the respiratory system in epithelial cells that are also targets of SARS-CoV-2.

Read the full story
Pietzner, M et al. ELF5 is a respiratory epithelial cell-specific risk gene for severe COVID-19 . Nature Communications; 15 Aug 2022; DOI: 10.1038/s41467-022-31999-6

COVID-19 Study demonstrates potential for at home blood sample collection – May 2022

At the height of the COVID-19 pandemic, researchers at the MRC Epidemiology Unit sought to measure blood samples from participants in the Fenland Study cohort for antibodies to assess a previous COVID-19 infection, and investigate whether it is possible to identify the COVID-19 pre-symptomatic phase using remote measurements of signs and symptoms.

A key challenge was to collect blood samples remotely. With home visits not possible the only feasible option was for people to take their own blood sample. This usually involves pricking a finger with a lancet and dropping blood onto special paper or into a blood tube. But many people find this painful, and the sample cannot always be reliably used for analysis due to contamination or insufficient blood being collected.

Unit researchers pioneered and developed the use of a new OneDraw Blood Collection Device that is placed on the upper arm or thigh and blood is collected onto two matrices in a removable cartridge. The device was used to collect over 10,000 samples from around 4,000 participants. A high proportion of participants were able to collect their own blood samples and the study showed that dried blood spot samples from the OneDraw device produced comparable results for assessing COVID-19 antibodies as standard blood samples taken by a needle in the arm by a trained healthcare worker.

Read the full story
Albert Koulman et al. The development, validation and application of remote blood sample collection in telehealth programmes. Journal of Telemedicine and Telecare, May 2022. https://doi.org/10.1177/1357633X221093434

Study finds Covid has caused 28m extra years of life to be lost in 31 countries – November 2021

An international team, led by former Unit member Dr Nazrul Islam who is now at the Nuffield Department of Population Health at the University of Oxford, including Professor Martin White of the MRC Epidemiology Unit, analysed data for 37 countries from the Human Mortality Database for 2005-20.

The researchers found that years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, the number of years lost from premature deaths increased in 2020, with the highest decline in life expectancy in years observed in Russia, the US, and Bulgaria, and overall the excess years of life lost in 2020 were more than five times higher (2,510 per 100,000) than those associated with the seasonal influenza epidemic in 2015.

Read the full story on the Oxford Population Health website
Nazrul Islam, Dmitri A Jdanov, Vladimir M Shkolnikov, Kamlesh Khunti, Ichiro Kawachi, Martin White, Sarah Lewington, Ben Lacey. Effects of covid-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries. The BMJ, 3 November 2021. DOI:10.1136/bmj-2021-066768

Study finds almost 1 million extra deaths in 29 high income countries in 2020 during Covid-19 pandemic – May 2021

An international collaboration, led by researchers at the Nuffield Department of Population Health at the University of Oxford, including Professor Martin White of the MRC Epidemiology Unit, has calculated that approximately one million excess deaths occurred in 2020 across 29 high income countries. The researchers found that in most countries, the estimated number of excess deaths exceeded the number of reported deaths from COVID-19. It was 33% higher for the United Kingdom (UK), but over 50% higher for some countries, which suggests that many countries underestimated COVID-19 deaths and/or experienced a significant increase in non-COVID-19 deaths.

Read the full story on the Oxford Population Health website
Nazrul Islam, Vladimir M Shkolnikov, Rolando J Acosta, Ilya Klimkin, Ichiro Kawachi et al. Excess deaths associated with covid-19 pandemic in 2020: age and sex disaggregated time series analysis in 29 high income countries The BMJ. 19 May 2021. DOI:10.1136/bmj.n1137

Fenland Covid-19 study completes data collection – April 2021

On 30 April data collection for the Fenland Covid-19 study finished. Unit researcher Dr Kirsten Rennie spoke with BBC Look East reporter Richard Westcott about the completion of data collection for the study, discussing the amount and types of information they collected, and how they will now analyse that data to learn about both the levels of Covid-19 infection and the wider impact of the pandemic on health and wellbeing.

Interview broadcast on BBC Look East, 6 May 2021

Quarterly report on progress to address COVID-19 health inequalities – Race Disparities Unit – February 2021

Dr Raghib Ali, a Government expert adviser on COVID and ethnicity, was interviewed on BBC Radio 4’s Today programme (segment starts at 1:17:30) on Friday 26 February about the findings of the second UK Government report on COVID-19 ethnic disparities, and was also quoted in an article in the print edition of the Telegraph.

Professor Nita Forouhi was quoted in the Government announcement of the report’s findings.

Consortium led by Unit researchers develops open platform to help discover COVID-19 drugs – December 2020

An international consortium led by MRC researchers has developed an open access platform to help prioritise drug discovery and repurposing efforts for the current COVID-19 pandemic. The platform provides information on the genetic variation of host proteins involved in SARS-CoV-2 infection, based on analysis of genetic and proteomic data from 10,708 Fenland Study participants.

Read the full story
Pietzner M, Wheeler E, Carrasco-Zanini J, Raffler J, Kerrison ND et al. Genetic architecture of host proteins involved in SARS-CoV-2 infection. Nature Communications, 16 December 2020. DOI: 10.1038/s41467-020-19996-z
Omicscience open access platform: https://omicscience.org/apps/covidpgwas/

Quarterly report on progress to address COVID-19 health inequalities – Race Disparities Unit – October 2020

Dr Raghib Ali was announced as a one of the Government’s new expert advisers on COVID and ethnicity on 22 October, and with Professor Keith Neal of the University of Nottingham briefed science journalists at a Science Media Centre on the Government’s Race Disparities Unit’s first quarterly report on progress to address COVID health inequalities, with particular reference to ethnicity. Dr Ali explained how understanding of risk factors has improved since the Public Health England report in June, and described the action government has taken to date and outline future steps to address disparities.

The report was presented to the Prime Minister by the Equalities Minister, Kemi Badenoch, who also update the House of Commons on progress described in the report on Thursday 22 October.

Read: Quarterly report on progress to address COVID-19 health inequalities – Race Disparities Unit

Research helps NHS support people with diabetes during coronavirus – September 2020

MRC Epidemiology Unit Director Nick Wareham has contributed to recent research that is being used to help the NHS offer greater support to those with diabetes. The research, published in in two papers in Lancet Diabetes and Endocrinology shows that people living with diabetes face a significantly higher risk of dying with COVID-19. A third of deaths in England are associated with the condition. As a result of this research, the NHS in England has called on people with diabetes to access help available to them, including a new dedicated helpline and online tools to help manage the condition during the outbreak.

Read the full story

Vitamin D for COVID-19: a case to answer? – September 2020

In a comment article in the Lancet Diabetes & Endocrinology, Unit scientist Professor Nita Forouhi and Professor Adrian Martineau of the Blizard Institute discuss the available evidence for a role for Vitamin D in preventing or treating COVID -19 infection.

They note that current evidence is inconclusive and recommend population-based trials investigating vitamin D supplementation as a means of reducing the severity of COVID-19. In meantime they urge measures to ensure that people achieve recommended daily amounts of Vitamin D (10 micrograms per day for adults in the UK) saying this “might also reduce the impact of COVID-19 in populations where vitamin D deficiency is prevalent; there is nothing to lose from their implementation, and potentially much to gain.”

Read: Martineau AR, Forouhi NG. Vitamin D for COVID-19: a case to answer? Lancet Diabetes & Endocrinology (2020) 8:9, 735-736.

Unit launches study to monitor COVID-19 in 12,000 Cambridgeshire residents – July 2020

Participants in Cambridgeshire’s Fenland Study are being invited to join an innovative study that will use a home-administered blood sampling device – the Drawbridge Health OneDraw device – to find out how many have evidence in their blood of previous COVID-19 infection.

The primary aim of this study is to quantify the proportion of people who have had COVID-19 in the Fenland cohort, and participants will be tested several times over the duration of the study allow researchers to identify new as well as existing COVID-19 cases. Researchers will also be able to determine if those with COVID-19 antibodies at the start of the study continue to have positive antibody status over the study period, or if antibody levels decline over time.

The study will also investigate whether it is possible to identify the COVID-19 pre-symptomatic phase using measurement of signs and symptoms collected via a smartphone App developed by Huma. Participants will use a smartphone app to record measurements such as heart rate, heart rate variability, respiratory rate, blood oxygen, and temperature. Participants will also enter health information such as body weight and diet changes, medication and supplement use, their mental health and wellbeing, and COVID-19 symptoms and potential risk factors.

Earlier lockdown restrictions linked to greater reduction in new COVID-19 cases – July 2020

A BMJ paper by Dr Nazrul Islam and colleagues – including senior author Professor Martin White at the MRC Epidemiology Unit – examines the association between implementation of physical distancing interventions and new cases of COVID-19 in 149 countries and regions.

Their findings show that physical distancing measures, such as closing schools, workplaces, and public transport, restricting mass gatherings, and restrictions on people’s movement within countries or regions (‘lockdown’), were associated with an overall reduction of 13% in new COVID-19 cases in a study period of up to 30 days after implementation of the measures .

The data also shows that implementing physical distancing measures earlier was associated with a greater reduction in new cases, and that in combination with school and workplace closure, restriction on mass gatherings seemed to be a key component associated with a decrease in COVID-19 incidence.

Read: Islam N, Sharp SJ, Chowell G, Shabnam S, Kawachi I, Lacey B, Massaro JM, D’Agostino Sr RB, White M. Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries BMJ 2020;370:m2743
Read the Nuffield Department of Public Health news report

Genetic architecture of host proteins interacting with SARS-CoV-2 – July 2020

A team led by Unit researcher Dr Claudia Langenberg has published in Omicscience summary statistics for large-scale genomic and plasma proteomic data from over 10,000 individuals to characterise genetic architecture of host proteins reported to interact with SARS-CoV-2. This accompanies the submission of the paper “Genetic architecture of host proteins interacting with SARS-CoV” which is available on BioRxiv.

The summary statistics freely available without restrictions, and include an interactive matrix and annotations for all protein targets and cis-associated genetic loci, as well as interactive tables with pGWAS summary statistics for individual SNPs, genes, or genetic regions from which results can be sorted, filtered, and exported.

Maik Pietzner, Eleanor Wheeler, Julia Carrasco-Zanini, Johannes Raffler, Nicola D. Kerrison et al. Genetic architecture of host proteins interacting with SARS-CoV-2. BioRxiv. 01 July 2020.
Summary statistics on Omicscience

Sentiment and opinion analysis of public space physical activity in Lagos during lockdown – June 2020

Research has started on a Cambridge Africa Alborada COVID emergency call award: Sentiment and opinion analysis of public space physical activity in Lagos during lockdown: a data-driven approach to developing context-aware public health messaging to reduce disease vulnerability and improve COVID-19 control.

This project is led by Tolu Oni from our Global Public Health Research programme, and is a collaboration with Associate Professor Taibat Lawanson at the University of Lagos Centre for housing and sustainable development and Associate Professor Camaren Peter at the Graduate School of Business and Centre for Analytics and Behavioural Change at the University of Cape Town.

This project aims to conduct opinion analyses of public space leisure physical activity to explore perceptions of government lockdown restrictions (and enforcement), and the impact of these lockdown measures on the perceptions, nature and frequency of appropriation of public space for activity in Lagos. Findings will inform development of context-aware public health messaging that safely encourages physical activity in the short term and health foresight interventions to reduce co-morbidity-associated vulnerability to future health emergencies long-term.

Sentiment and opinion analysis of public space physical activity in Lagos during lockdown – Cambridge Africa updates

COVID-19 and ethnicity: who will research results apply to? – June 2020

In June Professor Nita Forouhi was an author on the Lancet Comment article “COVID-19 and ethnicity: who will research results apply to?”.

Read: Treweek S, Forouhi NG, Venkat Narayan KM, Khunti K. COVID-19 and ethnicity: who will research results apply to? Lancet (2020) 395(10242): 1955-1957

Recruitment starts for SWiM-C: Supporting Weight Management during COVID-19 – June 2020

Recruitment has started for the Supporting Weight Management during COVID-19 (SWiM-C) study, which seeks to evaluate whether a new online self-help programme is better than standard advice at helping people to prevent weight gain and supporting good physical and mental health.

SWIM-C is recruiting 360 adults adults (aged over 18 years) with overweight or obesity and access to weighing scales at home

Update 9 September 2020: Recruitment to the SWiM-C study has now finished. Many thanks to everyone who contacted us to enquire about participating in this study, and enabled us to reach our recruitment target.

More information about SWIM-C and how to participate
Contact the SWIM-C study team at: swimcovid.study@mrc-epid.cam.ac.uk

OneDraw feasibility study launches – June 2020

Social distancing measures and new ways of working mean that new methods of blood sample collection are urgently needed for Unit studies. In preparation for a large-scale surveillance study in the Fenland cohort to determine the prevalence of previous infection with COVID-19, a study has been launched to evaluate a self-applied blood collection using a device called OneDraw.

It is important that we obtain adequate blood samples from participants using the dried blood spot (DBS) method that can be standardised as far as possible to undertake the COVID-19 serological testing repeatedly over a 6-month period.

More information about the OneDraw feasibility study and how to participate
Contact the OneDraw feasibility study team at feasibilitystudy@mrc-epid.cam.ac.uk

NIHR video appeal for people from BAME backgrounds to take part in COVID-19 Research – May 2020

Professor Nita Forouhi of our Nutritional Epidemiology programme helped to organise, and featured in, a video appeal by the National Institute for Health Research (NIHR) for more people from Black, Asian and minority ethnic (BAME) backgrounds to take part in COVID-19 research studies.

Alongside Professor Forouhi the video featured British actors, comedians and broadcasters Omid Djalili and Sanjeev Bhasker, and American Oscar winning actor Whoopi Goldberg, as well as Professors Kamlesh Khunti and Azhar Farooqi from the University of Leicester. The appeal was shared widely on social media, with the Omid Djalili’s twitter video viewed more than 125,000 times, and was reported in more than two hundred local and regional UK print and online news outlets.

Analysis of NHS health records of 3.8 million adults yields estimate of COVID-19 mortality according to underlying conditions and age – May 2020

An analysis published by a team of scientists that includes Unit researcher Dr Claudia Langenberg and colleagues at UCL, University College London Hospitals NHS Foundation Trust, and Health Data Research UK, indicates that at least 20% of the UK population has a high-risk underlying condition for COVID-19 infection listed by Public Health England.

The authors have created a publicly accessible COVID -19 risk calculator showing how age, sex and underlying health conditions can affect mortality rates in different scenarios. They write that the analysis, which used NHS health records from 3.8 million adults in England, shows that the UK government must ensure that measures to ease the lockdown take into account this clinical vulnerability.

Read Banerjee A, Pasea L, Harris S, Gonzalez-Izquierdo A, Torralbo A et al. Estimating excess 1-year mortality associated with the COVID-19 pandemic according to underlying conditions and age: a population-based cohort study. Lancet May 12, 2020 DOI: 10.1016/S0140-6736(20)30854-0
Read the UCL News report (12 May 2020)
OurRisk.CoV calculator

A preprint of this paper was published as a ResearchGate Rapid Communication on 22 March 2020.

Read Rapid communication published on 22 March 2020: Spiros Denaxas, Harry Hemingway, Laura Shallcross, Mahdad Noursadeghi, Bryan Williams et al. Estimating excess 1- year mortality from COVID-19 according to underlying conditions and age in England: a rapid analysis using NHS health records in 3.8 million adults. Rapid communication 22 March 2020. DOI:10.13140/RG.2.2.36151.27047
Read the UCL News report (22 March 2020)

COVID-19 prevention information translated into several widely spoken African languages – April 2020

An Engage Africa Foundation translation team led by Dr Ebele Mogo, a member of the Global Diet and Activity Research (GDAR) Network, has translated information on preventing the transmission of COVID-19 into 19 languages spoken across Africa.

Select a language, click, and download at http://www.engageafricafoundation.org/covid-19

The Unit is a founding member of GDAR, which is funded through the NIHR Global Health Research initiative. GDAR`s goal is to help prevent non-communicable diseases, such as type 2 diabetes, heart disease, and cancers, in low and middle income countries.

Found in Translation – University of Cambridge Stories article on the crowdsourced volunteer translation initiative led by Dr Ebele Mogo and the Engage Africa Foundation.

School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review – April 2020

Researchers including Dr Oliver Mytton undertook a systematic review of published and pre-published studies to identify what is known about the effectiveness of school closures and other school social distancing practices during coronavirus outbreaks They conclude that school closures have much less impact on the spread of these viruses than other social distancing interventions, and recommend that policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19, and consider combinations of social distancing measures.

Read Russell M Viner, Simon J Russell, Helen Croker, Jessica Packer, Joseph Ward et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Health. 6 April 2020 S2352-4642(20)30095-X. DOI: 10.1016/S2352-4642(20)30095-X.
Reported by the BBC, Guardian, Telegraph, and several other UK and international news outlets.

Slum Health: Arresting COVID-19 & Improving Well-Being in Urban Informal Settlements – 5 April 2020

Dr Tolullah Oni of our Global Public Health Research programme was part of an international team of reseachers that pre-published a set of practice and policy recommendations that aim to dampen the spread of COVID-19, improve the likelihood of medical care for the urban poor whether or not they get infected, and provide economic, social and physical improvements and protections to the urban poor that can improve their long-term well-being.

Read Jason Corburn, David Vlahov, Blessing Mberu, Lee Riley, Waleska Teixeira Caiaffa et al. Slum Health: Arresting COVID-19 & Improving Well-Being in Urban Informal Settlements. Journal of Urban Health (2020) 97, 348–357.