Blog posts

One year on – how our researchers have responded to the pandemic

A COVID-19 antibody testing stick

“We’re in this together.” One year ago, on 11th March 2020, the World Health Organization declared COVID-19 a global pandemic.

Back then, little over 100,000 cases had been reported globally. Today that number is 1,000 times greater and growing ceaselessly.

With a barely known virus rippling across the world, so too did fear and uncertainty spread as the WHO Director-General addressed all people and nations to make the declaration. Shifting the focus from COVID-19 to people and unity, Dr Tedros also sparked glimmers of optimism by emphasising that innovation and learning would be integral to saving lives and minimising the impact of the pandemic.

Innovation is the beating heart of IGHI, and we’re proud of our community that has joined this long and winding path of discovery in many different ways. A year on, our people reflect on their COVID-19 response journeys and impart the lessons they’ve learned along the way.

Read their stories below.

Tracking COVID-19 past and present – the REACT study

In April 2020 we launched the biggest and most comprehensive study of home coronavirus testing. With colleagues across the College, Imperial College Healthcare NHS Trust, and Ipsos MORI, the REACT programme has been testing hundreds of thousands of people across England every month to track infections past and present. Alongside understanding how many people are currently infected, REACT is identifying people who are most at risk of infection while offering a range of other important insights, such as antibody responses to vaccination. The programme has also worked closely with members of the public to ensure that the research is guided by people’s needs.

This work has been instrumental in the monitoring of England’s epidemic and offers robust, timely evidence on the evolving situation, which is continuing to shape the government’s response.

“One phrase has dominated Government pronouncements on the roadmap out of lockdown: ‘Data, not dates,’” said Professor Ara Darzi, REACT programme sponsor and co-director of IGHI. “And rightly so. The Covid crisis has caused terrible suffering, wrecking lives and livelihoods. But unless we understand it, we cannot defeat it.

“Among the most pressing questions over the last year have been how many people are currently infected with the virus, and how far has it spread through the population? REACT has been a key element of the effort to answer these questions, providing among the most accurate and up-to-date data on its progression across England.

“By regularly testing 160,000 randomly selected people every month, the study has played a vital role in informing the Government’s decision over when to impose lockdown and when to lift it.

“In doing so it has proved the central importance of accurate data gathering to control this and any future pandemic. We forget this lesson at our peril.”

Man with COVID-19 test
Prof Darzi demonstrating an antibody testing kit

Read more about REACT here.

Designing for dementia – Community Makers

Social distancing measures have helped keep the virus at bay, but not without cost. The loneliness and isolation that come with keeping people apart are negatively impacting people’s wellbeing, particularly so for those who depend on support from others in their everyday lives, such as people with dementia.

In response to this issue, our Helix Centre partnered with collaborators to develop a digital resource to help community groups create online networks as a way to maintain support and connection for people affected by dementia. Called Community Makers, the initiative is also building a toolkit of creative ideas for digital involvement, including how to reach people who may not have access to technology.

“Community Makers was a project that addressed a real-time need we saw in the people we were working with through our dementia research,” said Matt Harrison, senior designer at IGHI’s Helix Centre and project lead at Imperial. “People with dementia were some of the least able to adapt to lockdown measures and keep themselves isolated, yet very vulnerable to COVID.

“Collaborating daily with colleagues I have never met in person, at Alzheimer’s Society and University of Worcester, it has been inspiring to work with community groups across the country and see how they have adapted to using digital tools to support their members, and see how technology has evolved to match the need. However, the need is still not met, and there is much more to be done. The post-COVID world will be made up of the best of in-person and digital connections, and we are now seeking funding to help facilitate that change.”

Read more about Community Makers here.

A graphic representing an online dementia community support group
An illustration of Community Makers

Monitoring people’s changing attitudes and behaviours

Washing our hands regularly, taking public transport, avoiding meeting people outside of our household – many of the things we do affect our risk of COVID-19. Public health measures and campaigns have been designed to encourage people to behave in ways that reduce this risk, but how well are people sticking to them? And how are people’s attitudes in relation to the crisis changing over time?

Launched in March 2020 with YouGov, our ongoing COVID-19 health behaviour study is the largest of its kind, surveying thousands of people across the globe every month – half a million in total to date – to understand how citizens are responding to the pandemic. By making the findings freely available, and collaborating with a range of partners, our work is enabling decision-makers to tailor their response based on evidence.

“The stories that emerged, their common threads and their remarkable differences have helped many scientists, public health authorities, members of the press, government leaders and the public to come to grips with many of the driving forces behind the spread of COVID-19,” said Sarah P Jones, project co-creator and doctoral researcher at IGHI.

“When I look back across the year I’m struck by not the divisions sown between us, but by the overwhelming cooperation the world has generated.

“At the beginning of the pandemic I saw every new announcement as a rule, a constraint or a liberty taken away.

“But starting from the very first time YouGov returned our global survey results, I realised something incredible was happening in the world.

“Every hand washed, every mask worn, every metre of distance we placed between ourselves and others have been a gesture towards each other, a signal of respecting one another’s safety.

“I personally cannot wait to get back to hugging, to hearing stories in person and to caring for those I love who are still far away.

“But as we emerge from this cocoon the question on many peoples’ minds should not be “How can we get back to normal?” but rather “Is there anything we cannot accomplish together?

Find out more about the behaviour tracker here.

Understanding the impact of the COVID-driven digital shift in primary care

Digital technologies have been poised to transform the delivery of health care for some time. When the pandemic hit, their promise was quickly put to the test as health systems were forced to shift much of their care from in-person to remote delivery.

Switching from face-to-face consultations to phone calls and video meetings has enabled services to continue while keeping both patients and healthcare staff safe. But what has been the impact for patients and professionals? Our international InSIGHT study has been working with global collaborators to explore this in primary care, using a survey to gather the perspectives of thousands of GPs across 20 countries.

“We were pleased to hear that GPs identified a range of benefits, including reducing COVID-19 transmission risks, guaranteeing access and continuity of care, greater efficiency, faster access to care, and improved convenience for patients,” said study lead Dr Ana Luisa Neves, Advanced Research Fellow and Associate Director of our NIHR Imperial Patient Safety Translational Research Centre.

“We also learnt about the main challenges of using remote care, faced by both patients and doctors – digital exclusion from lacking access to technology, clinical uncertainty, potential delays in diagnosis and treatment, and unsuitability for certain types of consultations.

“The work also highlighted other challenges such as the lack of formal guidance, higher workloads, and technical difficulties. Unsurprisingly, digital exclusion and the potential to entrench existing health inequities were among the major concerns of the participants.

“We believe that listening to the GPs’ experience during the pandemic is especially valuable to understand how digital remote care can be safely delivered in the future. We hope we can learn together from this massive real-life experiment and use this opportunity to take the best technology has to offer and change primary care for the better.”

Find out more about InSIGHT here.

How does branding and pricing affect our spending on over-the-counter drugs?

Blister of ibuprofen tabletsWhen we’re having issues with our health, as well as visiting the doctor or hospital, one option we have is purchasing over-the-counter (OTC) medicines to treat ourselves at home.

OTC drugs can be purchased without a prescription from a doctor. They tend to be affordable and have low production costs.

(more…)

#ForUsByUs – co-designing a mental health solution owned by the Black community 

Image credit: 1388843 from Pixabay

Growing up in Caribbean family that had experienced various traumas and challenges, I had some awareness of how mental illness impacted myself and my relatives. However, it wasn’t until I attended a masterclass last year on Black mental health hosted by BAME in Psychiatry & Psychology and the Centre of Pan African Thought that I realised the nuanced challenges faced by members of the Black community.  (more…)

IGHI people: Meet Neil Clifford, Computer Systems and Security Administrator, Big Data and Analytical Unit

Computer motherboardIGHI is home to a team of staff who are skilled and passionate about their roles. Our talented people are the reason we’re able to tackle some of the most pressing global health challenges through cutting-edge innovation.

(more…)

Has COVID-19 shifted the dial on digital healthcare?

Elderly woman typing on a laptop

Health and care organisations have historically lagged behind those in other industries in making the most of digital technologies and data solutions. Yet the rapid onset and escalation of the COVID-19 pandemic has essentially forced organisations to embrace these tools to quickly adapt to new ways of working and delivering their services.

This overhaul of industry norms has led to a number of key questions: how widespread has this adoption been? Which tools and technologies have been implemented, and how have these solutions affected staff productivity and service delivery? What will ‘stick’ after the pandemic ends and we return to some semblance of pre-COVID normality?

Our new report, Embracing digital: is COVID-19 the lasting catalyst for change?, delves into these questions and more. The bulk of this paper centres on a multi-country survey by YouGov of over 2,200 people working in health and human services (HHS). The survey was conducted in September of last year, approximately 6 months after many countries had implemented lockdown measures and other restrictions aimed at curbing the spread of the pandemic. We also carried out expert interviews to flesh out additional insights.

The rise of digital health technologies

Unsurprisingly, we found that nearly two-thirds of survey respondents reported an increase in the use of digital and data solutions since the onset of the pandemic. Use of phone and video consultations was most common, with phone consultations offered by 81% of respondents (compared to 39% pre-pandemic) and video consultations offered by 71% of organisations (compared to 22% pre-pandemic). While less widespread, the use of AI-powered diagnostic tools also more than doubled among our sample (38% compared to 18% pre-COVID).

Encouragingly, our survey suggests that adoption of data solutions and digital technologies has led to a number of positive effects. 63% of respondents agreed that the use of these tools has improved staff productivity since the onset of the pandemic. A similar number reported that the use of these solutions has been effective in improving access to care when and where people need it; and 62% cited an improvement in the quality of care experience for citizens.

Short-term solution or long-term shift?

With coronavirus vaccines being rolled out across the globe, many organisations are beginning to plan for post-pandemic operations. So the question remains: was the use of many of these digital solutions a temporary measure, or will we see lasting, transformative change?

The picture is mixed among our respondents, with almost half agreeing that the introduction of data solutions and digital technologies was a temporary measure to help their organisation get through the pandemic period. Yet a third neither agreed nor disagreed, highlighting a number of uncertainties in the industry over future strategies.

Continued use, broader adoption, and sustainability of these tools will depend on a number of factors. While emergency funding and temporary reimbursement fuelled an uptake in digital/remote delivery of care, permanent changes to incentives and reimbursement will be necessary to sustain these services. Similarly, hastily developed and implemented tools may need updating to comply with standard privacy and data regulations, which may have been relaxed during the pandemic.

Additionally, once the acute need for these solutions ebbs, health and care providers may be hesitant to continue using clunky tools that lack interoperability and contribute to additional administrative burden. This highlights the need for organisations to invest in coordinated strategies and infrastructures across these solutions, as well as ensuring that all tools are user-friendly. People’s preferences may also play a role, with many now becoming accustomed to tech-enabled services that offer speed and convenience.

Maintaining momentum

We are at a unique crossroads with the opportunity to use the traction gained for these solutions to drive further improvements in care delivery and outcomes for citizens across the globe. To achieve this, all stakeholders – payers, regulators, vendors, and providers – must each do their part to ensure that we move forward and do not lose momentum.

The report, ‘Embracing digital: is COVID-19 the lasting catalyst for change?’ was led by the Institute of Global Health Innovation and commissioned by our partners, EY. Download the report here.

Didi Thompson is a Policy Fellow at the Institute of Global Health Innovation

Community Makers: Designing for dementia during the COVID-19 pandemic

Woman with dementia reaching out to another woman through a window

People with dementia are some of the most vulnerable, most isolated, and least able to adapt. COVID-19 has therefore made our work with Imperial College’s UK Dementia Research Institute Care Research and Technology Centre all the more urgent.

The Centre develops technologies for a smart ‘Healthy Home environment‘, supported by remote clinical monitoring, to improve the lives of people affected by dementia and further our understanding of this common disease.

The technology aims to make an impact in a number of ways, including early identification of infection, preventing falls, understanding the relationship between sleep and dementia symptoms, and predicting and managing agitation and difficult behaviours. All with the goal of reducing hospitalisation and improving the resilience of at-home care.

Our team at the Helix Centre is using our human-centred design methods to put patient and carer needs at the core of everything the Centre does. This includes designing the monitoring dashboard to optimise the relationship between the monitoring team and the at-home participants, and creating a companion app for people to access their data and assist with the daily tasks of caring for someone with dementia.

We’re also working with science and engineering labs throughout Imperial College London and the University of Surrey to inform the creation of new devices. These range from at-home UTI diagnostics with the synthetic biology team, a smart speaker voice agent to assist in care tasks, and radar sensors and wearables to help monitor behaviour within the house.

Adapting during COVID-19

Our co-design process relies on spending time with people, in their homes, getting to know their lives, aspirations and needs. In response to COVID-19 restrictions, we moved this process online, using video conferencing software to hold regular co-design sessions with a surprising increase in engagement and richness of connection.

Out of this came an idea to help reduce isolation for people with dementia and their family carers during the pandemic. We joined forces with the Alzheimer’s Society Innovation team and the Association of Dementia Studies at the University of Worcester to explore how technology could play a role for this vulnerable and extremely isolated group.

Families living with dementia rely heavily on community support groups, visiting friends, neighbours, carers and community services to help manage the heavy burden of caring for someone with dementia in their own home. All of this support evaporated when lockdown measures were imposed, and the isolation has had a profound impact on the wellbeing and resilience of carers. The alternative of residential care homes has been even less attractive during lockdown for well-documented reasons.

Through this collaboration, we identified a need to help existing groups in the community to go digital and move their support online, so that they could continue to reach their members.

A graphic representing an online dementia community support group
An illustration of Community Makers

Supporting people affected by dementia

We developed Community Makers, a digital resource to help groups set up local online networks to replace the face-to-face meetings that provided key support pre-COVID. This includes a knowledge exchange network that meets online monthly to share experiences and advice, and a library of creative ideas to inspire groups with different approaches to digital involvement.

We also have a Slack workspace, currently consisting of 64 community organisers representing groups from Scotland, Wales and England, rural and urban settings, and including groups focussing on ethnic and minority populations. Groups within the network vary in size from supporting over 150 people with dementia to new groups just setting up. One example is Dementia Matters Here(forshire), established during the pandemic as a digital-first group on the back of our Community Makers collaboration.

If you’re part of a support group that you want to bring online, you can head to our website and use our guide to getting started. We look forward to welcoming you to our growing community.

Community Makers has been led by Matthew Harrison, Senior designer in Helix Centre, supported by Alice Blencowe and Lenny Naar.

Palliate, a digital tool to support community end-of-life care

A photo showing the Palliate app for end of life care

The majority of people who die every year would prefer to die at home, yet only about half achieve this.

This is often due to not being able to manage symptoms at the end of life. People often have to wait longer than what feels acceptable to them for district nurses to come and administer injections. When this happens, symptoms can escalate, carers and patients can become distressed and families lose control of the situation. (more…)