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PLoS One . Clinical academic research in the time of Corona: A simulation study in England and a call for action

tetano

Editor, Senior Moderator
PLoS One


. 2020 Aug 13;15(8):e0237298.
doi: 10.1371/journal.pone.0237298. eCollection 2020.
Clinical academic research in the time of Corona: A simulation study in England and a call for action


Amitava Banerjee[SUP] 1 2 3 [/SUP], Michail Katsoulis[SUP] 2 3 [/SUP], Alvina G Lai[SUP] 2 3 [/SUP], Laura Pasea[SUP] 2 3 [/SUP], Thomas A Treibel[SUP] 4 [/SUP], Charlotte Manisty[SUP] 4 [/SUP], Spiros Denaxas[SUP] 2 3 [/SUP], Giovanni Quarta[SUP] 5 [/SUP], Harry Hemingway[SUP] 2 3 [/SUP], Jo?o L Cavalcante[SUP] 6 [/SUP], Mahdad Noursadeghi[SUP] 7 [/SUP], James C Moon[SUP] 1 4 [/SUP]



Affiliations

Abstract

Objectives: We aimed to model the impact of coronavirus (COVID-19) on the clinical academic response in England, and to provide recommendations for COVID-related research.
Design: A stochastic model to determine clinical academic capacity in England, incorporating the following key factors which affect the ability to conduct research in the COVID-19 climate: (i) infection growth rate and population infection rate (from UK COVID-19 statistics and WHO); (ii) strain on the healthcare system (from published model); and (iii) availability of clinical academic staff with appropriate skillsets affected by frontline clinical activity and sickness (from UK statistics).
Setting: Clinical academics in primary and secondary care in England.
Participants: Equivalent of 3200 full-time clinical academics in England.
Interventions: Four policy approaches to COVID-19 with differing population infection rates: "Italy model" (6%), "mitigation" (10%), "relaxed mitigation" (40%) and "do-nothing" (80%) scenarios. Low and high strain on the health system (no clinical academics able to do research at 10% and 5% infection rate, respectively.
Main outcome measures: Number of full-time clinical academics available to conduct clinical research during the pandemic in England.
Results: In the "Italy model", "mitigation", "relaxed mitigation" and "do-nothing" scenarios, from 5 March 2020 the duration (days) and peak infection rates (%) are 95(2.4%), 115(2.5%), 240(5.3%) and 240(16.7%) respectively. Near complete attrition of academia (87% reduction, <400 clinical academics) occurs 35 days after pandemic start for 11, 34, 62, 76 days respectively-with no clinical academics at all for 37 days in the "do-nothing" scenario. Restoration of normal academic workforce (80% of normal capacity) takes 11, 12, 30 and 26 weeks respectively.
Conclusions: Pandemic COVID-19 crushes the science needed at system level. National policies mitigate, but the academic community needs to adapt. We highlight six key strategies: radical prioritisation (eg 3-4 research ideas per institution), deep resourcing, non-standard leadership (repurposing of key non-frontline teams), rationalisation (profoundly simple approaches), careful site selection (eg protected sites with large academic backup) and complete suspension of academic competition with collaborative approaches.
 
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