Pandemic Ready: Safeguarding Our Future Through Preparedness

Recommendation 1: A Scottish Pandemic Sciences Partnership

The chair’s Foreword to the Committee’s Interim Report noted that the dominant theme of the Interim Report was the recognition of the value and importance of collaboration. This is expanded on in this Final Report through the recommendation that the SG and PHS establish the Partership.

Since the Interim Report’s publication, PHS has led work to develop a business plan for the Partnership, establishing a Short Life Working Group to undertake a programme of work to engage with stakeholders to identify the key considerations in establishing and supporting the Partnership. Three stakeholder events involving 250 academics, researchers and many others representing over 50 organisations, including the SG, NHS Scotland and Local Authorities, gathered ideas to develop options to support pandemic preparedness in Scotland.

The Committee is grateful to those participants and their organisations and commends the work undertaken by PHS to engage with and inform such a wide range of interested parties. That has been invaluable in helping to inform its consideration of this issue and continuing engagement with those communities of interest will be vital in taking forward the next steps in progressing these proposals. If delivered, the benefits would be an increased connection between the SG, public health bodies at national and local level, and the academic and research communities. The benefits from this would also include:

• independent, robust advice on pandemic risks;
• enhanced alignment of research and public health priorities;
• trusted and rapidly available wider networks during future crises; and
• skills development that will also be useful in smaller outbreaks, within Scotland and with UK/international partners.

The Committee recommends establishing the Partnership in Scotland as a dynamic network rather than a ‘bricks-and-mortar’ institution. This network should connect and integrate the diverse expertise essential for Scotland’s preparedness and response to pandemic threats. The Partnership should be independent, hosted by PHS, and function as a boundary organisation that bridges the SG, PHS, and the wider academic, scientific, and industrial science communities. It should actively promote an ethos of openness, transparency, equity and inclusivity.

Clarity of purpose and distinctive contribution is important. The Committee recommends that, to enhance Scotland’s readiness for future pandemics, the Partnership should harness a diverse range of expertise and perspectives by:

• effectively directing scientific efforts to mitigate the risk of future pandemics and infectious disease outbreaks;
• providing expert advice and support to the SG and PHS in assessing, formulating, and developing specifications and infrastructure for pandemic preparedness and response;
• acting as a pivotal platform to strengthen collaboration and amplify the contributions of Scotland’s academic and research communities to national, UK- wide, and global pandemic preparedness initiatives;
• conducting regular horizon-scanning activities to complement and support existing public health intelligence sources in identifying and assessing emerging infectious disease threats;
• ensuring clear responsibility and accountability for delivering independent scientific advice to the SG and PHS; and
• supporting the execution of simulation exercises to evaluate and enhance preparedness efforts.

The Partnership should have a focus on human infectious disease outbreaks and pandemics, complementing the existing SG-funded Centre of Expertise on Animal Disease Outbreaks (EPIC) that has successfully fulfilled a similar function for livestock and wildlife diseases over the past 18 years. The intent is that the Partnership – like EPIC – will add value, operating as a boundary organisation at the interface between government, policy and the public health and scientific communities. This will help ensure the best possible situational awareness – a key enabler of effective decision- making.

This recognises that Scotland’s higher education institution (HEI) sector and associated institutes have a dynamic and vibrant infectious disease research community that represents a substantial pool of expertise and facilities which can considerably enhance that which can be provided by PHS and NHS Scotland. This community already works on many infectious diseases affecting Scotland – ranging from E. coli O157 and Legionnaires’ disease, to influenza, hepatitis C and TB – and it was called upon to address COVID-19 in 2020, with many notable and globally recognised successes. The Partnership should provide the SG with a framework for utilising this vital resource during and between human infectious disease emergencies.

The Partnership should also facilitate data and evidence gathering and decision- making during the crucial early weeks and months of an outbreak or pandemic, minimising delays in setting up the systems needed to deliver knowledge, data and advice to government in real time.

The Partnership should support PHS’s leading role in Scotland’s response to pandemics. It should supplement PHS’s expertise and resources to deliver a more comprehensive, cross-sector pandemic response capability. An effective collaborative partnership should also be able to leverage different funding sources and pivot existing research strengths in areas related to pandemic preparedness. While the detailed arrangements for the governance and funding of the Partnership are a matter for the SG and PHS, we recommend that the governance draws on the EPIC approach (see case study, p.17) to ensure that HEI and research communities have representation and are adequately resourced to generate evidence and provide advice supporting decision making within overall priorities set by the Partnership Director, in consultation with the SG and PHS. As is noted in the UK COVID-19 Inquiry Module 1 Report, “the massive financial, economic and human cost of the COVID-19 pandemic is proof that in areas of preparedness and resilience, money spent on systems for our protection is vital and will be vastly outweighed by the cost of not doing so.”^[16] Whilst the Partnership should leverage a wide range of funding sources to support its research activities, core funding will be required to support the operation of the Partnership.

Case Study: EPIC – The Centre of Expertise on Animal Disease Outbreaks

EPIC has been funded by the SG since 2006, as a collaborative interdisciplinary research consortium between major scientific research institutions that focus on animal health in Scotland, including both universities and other research providers. The consortium aims to foster a culture in which researchers from different disciplinary and professional domains (i.e. veterinary medicine, epidemiology, genetics, ecology, mathematics, statistics, science-policy knowledge brokerage, social science, and economics) come together to address policy-relevant questions on an on-going basis, not just during animal disease emergencies.

EPIC builds scientific skills, strong networks between EPIC scientists and between researchers and policymakers, expertise in promoting effective knowledge exchange between science and policy staff, well curated and readily accessible data resources, and scientific resources such as mathematical models and analytical codebases, all of which are essential elements in making an effective response to any future animal disease outbreak.

EPIC employs the equivalent of 16 full-time equivalent scientific staff, comprising approximately 50 scientists, supported by a full-time project manager and a part time administrator. Most scientific collaborators contribute to the EPIC team for only part of their working week alongside their other research and other commitments, although a small number of researchers are 100% dedicated to EPIC, providing a valuable element of continuity and focus. The multi- disciplinary expertise of EPIC’s members means that it has the capacity to deliver interdisciplinary research to policymakers to address questions which range from the very applied (e.g. operational or tactical decisions regarding disease control) to the very strategic (e.g. foresighting activities, research and development of innovative methodologies). On an ongoing basis, EPIC agrees a programme of research with the SG, addressing questions arising from current disease outbreaks, while also delivering work that meets longer-term strategic priorities. As and when new questions and requirements arise from SG, the work of EPIC scientists will be reprioritised, as necessary, to respond to these immediate needs.

In particular, in the event of an outbreak, as many EPIC scientists as are required switch to projects that will inform the outbreak response. The ability to provide a rapid response to emergency outbreak events is facilitated by trusted partnerships between consortium members and SG and Animal and Plant Health Agency veterinarians, scientists and policy officials.

EPIC’s impact is illustrated in its contribution to the current avian influenza outbreak. Its contributions include:

• producing a risk assessment for the Scottish Government which considers the removal of bird carcasses as a mitigation strategy to reduce onward transmission of the virus;
• developing an interactive dashboard to determine hotspots of outbreaks in space and time and generate relative risk maps to predict patterns of transmission and support preventative control measures;
• mathematical modelling to help understand disease spread and support in planning prevention and control strategies in the event of an outbreak; and
• using phylogenetics to track the evolution of the outbreak strain, by combining data on the genetics of the virus and patterns of disease occurrence.

The Partnership’s leadership should have experience of the issues to be dealt with by the Partnership. The part-time appointment of a Scientific Director, similar to that used for the CSA, which maintains links with the academic and wider research communities would enhance the role of the Partnership as a boundary organisation, operating at the interface between government, policy, and the scientific community. The governance and reporting of the Partnership should be clearly set out and the Committee recommends that it should report to the lead SG Minister with accountability for future pandemic preparedness.

1. The establishment of a Scottish Pandemic Sciences Partnership

We recommend that:

A. a Scottish Pandemic Sciences Partnership should be established and adequately resourced, operating at the interface between government policy, national public health, and the scientific community;

B. a Scientific Director be competitively appointed, providing leadership to the Partnership and having responsibility for establishing the network, leading the business case development, and building and maintaining links with the academic and research communities; and

C. the SG and PHS lead work to develop the governance and funding model for PHS to host the Partnership, which includes the representation of the research community and supports the provision of data, evidence and advice on pandemic preparedness. The Committee recommends that the Partnership should report to the lead SG Minister with accountability for future pandemic preparedness.