In December 2020, HDR UK, the Office for National Statistics (ONS) and UK Research and Innovation (UKRI) put an urgent call out for research projects that could harness the power of our national datasets to answer COVID-19 research questions at pace.
As well as addressing major challenges in the pandemic, the projects were designed to leave a legacy for future research by creating new links between datasets, improving the quality of data and creating shared tools for future work. All of the pandemic-related datasets and tools used by these teams are available for future research via the National Core Studies collection on the Health Data Research Innovation Gateway.
Here, five of our research teams tell us their top insights from their projects – from the impact of COVID-19 on working life and care services, to how the pandemic has paved the way towards new best practices in data research.
1. Big-scale data can be used to find small-scale side effects
At the beginning of the vaccine roll out, there were still many unanswered questions about who was being vaccinated, what kind of protection from COVID-19 they offered, and how safe they were on a national-scale.
To answer these questions, Aziz Sheik and his team turned to national healthcare records – like GP, hospital and COVID-19 testing data – from people in England, Northern Ireland Scotland and Wales. They looked for patterns relating to COVID-19 vaccinations, first looking in each of the four nations, and then combining them to give a UK-wide understanding of the vaccination programme.
“By looking at all records from each country, we could pick up rare side effects that may not be found from smaller numbers during clinical trials.” Aziz told us.
“For example, we looked at a very rare side effect in the brain called cerebral venous sinus thrombosis (CVST). In our Scottish analysis, we didn’t find a link between COVID-19 vaccines and CVST, but this may have been because the number we studied was too small to find such a rare event.
“To address this, we repeated the analysis in England and Wales and brought results together into a single analysis of 11.6 million people. We found a slightly increased risk of CVST – 0.25 extra cases of clots per million people – in the 28 days after a first dose of the Oxford-AstraZeneca vaccine. The good news is, this is very, very low compared with the risk of COVID-19 hospitalisation and death in people who have not been vaccinated.” This evidence was picked up by medicines regulators globally as they developed policies on which vaccines were safest to offer to different groups.
2. Covid-19 had a major impact on our working lives, but not everyone was affected equally
The pandemic changed the way we work. It created job loss, work instability, financial hardship and great insecurity. But it also impacted different groups in very different ways.
Tracey Warren and Luis Torres-Retamal wanted to understand how the pandemic impacted the working lives of women and men differently, focusing on job loss, precarious work and self-employment, as well exploring how class, ethnicity and other factors intersected with these inequalities.
“We analysed data gathered from very many workers across the whole of the UK, including from the Labour Force Survey that provides official measures of employment and unemployment,” the researchers told us.
“We found men had the greater increases in unemployment. Women were significantly more likely to be employed in public sector roles, which was largely protected against redundancies or saw increases in employment (particularly health). But the gender unemployment gap varied when age, ethnicity and occupational class were included in the analysis. For example, women from minority ethnic groups were also greatly affected by unemployment.”
3. Palliative care was an integral part of the UK’s pandemic response
The Covid-19 pandemic continues to cause a huge strain on health care services, including palliative care, which aims to control symptoms and reduce suffering when patients cannot be cured.
Irene Higginson’s project looked to understand how exactly the pandemic had impacted these services by using national data to analyse palliative care service activity.
“While we knew from the UK-wide CovPall survey that palliative care services had been very busy during the pandemic, we believed by studying national routine information about care services we could learn more about the national and regional impacts of the pandemic.
“We found 70% of palliative care services in London, the region with the highest Covid-19 death rates, reported being busier since the pandemic.” The researchers said their work helps demonstrate that, “Palliative care services should be considered integral to any pandemic response and should be funded alongside NHS services, whether charitably or NHS managed.”
4. Comparing data sets can be used to double-down on findings
To stop the spread of COVID-19 we needed to understand how it spreads at home, work, school and other public places and if this is affected by age, ethnic background, time or location.
Andrew Hayward and his team used data from two sources: Virus Watch, a large study of over 50,000 children and adults which used finger-prick antibody tests, PCR or lateral flow tests to track infections during the 2020/21 winter wave of the COVID-19 pandemic; and the Office for National Statistics COVID-19 Infection Survey which regularly PCR-tested 450,000 participants for COVID-19
“Although differences in how COVID-19 infections were identified and the questions asked in the different surveys mean the results cannot be perfectly compared,” Andrew told us, “we were still able to show that leaving home for work, using public transport and coming into close contact with others were in important risk factors for spreading COVID-19.”
5. Putting minority groups front and centre is needed to prevent future health disparities
Early on in the pandemic, reports started emerging that ethnic minority groups were at greater risk of COVID-19.
Kamlesh Khunti and Tom Yates aimed to find out why. They looked at data from healthcare records and linked it to national Census data and specific COVID-19 outcome data on hospitalisations and deaths. They also wanted to make sure people from ethnic minority backgrounds were meaningfully included in their research.
“Through a series of focus groups with the public, we learned what issues mattered to different communities, and used this information to focus our research and identify recommendations for improving health amongst the members of ethnic minority communities.
“For example, although all people who are obese have a higher risk of becoming sicker or dying from COVID-19, this risk was much stronger for people from ethnic minority communities, particularly in South Asian and Black populations. We also found who had a COVID-19 vaccine was related more to ethnic background and religion than to other factors such as income, age, education, job, neighbourhood.
“Our research shows that it’s essential to engage ethnic minority communities and religious groups when planning meaningful ways prevent such disparities in possible future pandemics.” Researchers can now apply to access the linked census and healthcare record dataset that Kamlesh and Tom used via the Health Innovation Gateway.
Find the pandemic-related datasets and tools used by these teams via the National Core Studies collection on the Health Data Research Innovation Gateway.
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