Pandemic Ready: Safeguarding Our Future Through Preparedness

Recommendation 2: Scientific input to pandemic preparedness

The aim of the Partnership is to ensure that the standing capacity, partnerships and ways of working of existing institutions in Scotland are kept in place and can be rapidly deployed and scaled up as and when needed. The experience of COVID-19 demonstrated that an effective response is one that is proactive and is built on systems that have been set up in advance.

Much of the research activity that provided invaluable data and analysis during the COVID-19 pandemic has now either been disbanded or endures with significantly lower funding. Examples of this include the ONS surveys, EAVE II, ISARIC-4C, COG-UK, ZOE, CoMix, UNCOVER, QCOVID, UK-CIC, G2P. It is likely that the functions of these consortia, or very similar ones, will be needed in the next pandemic. The Partnership should be well placed to ensure that they can be activated much faster than was possible in the first half of 2020.

Priority topics for the Partnership to consider and provide advice to the SG, PHS and NHS include the following three overarching areas.

Figure 2. Priority Topics for the Scottish Pandemic Sciences Partnership

1. Early Warning

A. Pandemic intelligence

B. Real-time threat, system readiness, and risk assessments

C. Pathogen characterisation and phenotyping

D. Evidence evaluation

2. Information, data and analysis

A. Clinical care networks and information systems

B. Community prevalence and symptom surveys

C. Behavioural studies and monitoring, including assessments of level of trust and adherence, and movements and travel patterns

D. Risk assessment and analysis of the impacts of protective measures on inequalities and vulnerable groups, including children and young people

E. Enhanced surveillance and genomic epidemiology

F. Mathematical modelling

G. Data sharing, data linkage, and analysis

H. Use of new critical technologies, such as the role of Artificial Intelligence in future pandemic preparedness

3. Interventions

A. Emergency response planning, including exercising

B. Diagnostics, therapeutics, and vaccines

C. Clinical care

D. Social and behavioural interventions

E. One Health, animal health, and environmental aspects

F. Public messaging, engagement, effective communication, and misinformation resilience and management

G. Legal and ethical frameworks

H. Safety studies and effectiveness studies

Many ongoing research projects within the HEI sector in Scotland will be pertinent to the Partnership and a core task should be to identify these and build a community of researchers whose work can provide evidence to be used to inform and improve pandemic preparedness. The Partnership should then be uniquely placed to identify research and delivery gaps that need to be filled to inform a high level of preparedness. The model proposed for the Partnership has similarities with the Health Research Protection Units, funded by the National Institute for Health and Care Research (NIHR) in England.

New research priorities identified should be supported by a mixture of funding from the Partnership, CSO grant schemes, external funding and grant income available to HEIs such as from NIHR, UKRI, and Wellcome Trust, and the link and pivot of existing activities within Scottish institutions. Throughout, the Partnership should ensure that publications and data are shared openly with other researchers, demonstrating a commitment to open and transparent science.

The Partnership should also foster a cross-cutting programme of work on evidence quality, recognising that policy decisions during a crisis will often have to be made in the absence of ‘gold standard’ evidence (such as a clinical trial). This should include an examination of approaches to communicating uncertainty and the ways that reasonable worst-case scenarios are developed and used.

Outputs from the Partnership’s programme of work should include:

• regular pandemic intelligence updates and real-time threat assessments;
• annual situation reports for Scotland, including an assessment of inequalities in vulnerability to a pandemic and a review of gaps in relation to preparedness;
• horizon scanning, international best practice and opportunities for innovation;
• scientific publications;
• policy briefs and evidence papers;
• protocols (e.g. clinical care reporting, patient recruitment, data sharing) for activation during an emergency;
• working group reports;
• an annual conference and a series of discussion meetings and workshops; and
• communications via web site, social media, and targeted messaging.

All of this activity should mean that the Partnership will be well placed to ensure the long-term provision of scientific advice to the SG on pandemic preparedness, replacing the Committee in due course.

The Partnership should also build and maintain connections with UK and International networks, including the UK Pandemic Sciences Network. Following the publication of the Committee’s interim report, the CSA along with the SG ScotScience network, developed proposals aimed at fostering greater connectedness between the scientific community and the SG around pandemic preparedness, working in partnership with existing networks such as the SSAC and the learned societies.

Those proposals envisaged the creation within the Partnership, of a network of scientific experts from Scotland and from further afield who could provide advice on pandemics. This looks to build on the experience of COVID-19 where advisory groups were brought together by the SG, often at short notice, and provided a forum for high-quality discussions. Building those relationships ahead of future emergencies should enable continued input from the academic and wider scientific community into pandemic preparedness work being taken forward by the SG, as well as ensuring relationships are in place ahead of an emergency response. The importance of connecting to and leveraging existing networks, such as those of learned societies, is reiterated here.

The Partnership should play a leading role in coordinating and supporting this network, through a programme of events, discussions and workshops. These would serve to maintain and strengthen the activity of this network and encourage networking and greater collaboration. These events should also provide the opportunity to bring SG officials and experts together to consider cross-cutting challenges such as misinformation and the unequal impacts of pandemics on society.

Across the range of relevant issues there will be existing Scottish, UK or international mechanisms which the SG and PHS are connected to. The aim here is not to duplicate or seek to replace those structures, but instead to build in greater connectedness and identify areas where additional collaboration can support Scotland’s pandemic preparedness.

Key partners in the Partnership will include but not be limited to:

• RDS
• ISARIC
• EAVE II
• EPIC
• CSO
• Scottish Genomes Partnership
• MRC-University of Glasgow CVR
• Edinburgh Infectious Diseases
• The Behavioural Research UK Leadership Hub (BR-UK)
• Health Data Research UK (HDR UK)
• NHS Scotland’s Accelerated National Innovation Adoption pathway (ANIA)
• NHS Boards, Local Authorities, and Local Resilience Partnerships
• Learned societies, including the RSE and SSAC
• UK Pandemic Sciences Network

2. Fostering connectedness among the academic and wider pandemic preparedness community

We recommend that:

A. the Partnership promotes, supports, and contributes to research programmes that deliver policy-relevant research in periods between pandemics and, crucially, helps maintain and support activities that will be needed during a pandemic. This should be done in partnership with existing learned institutions and bodies, such as the SSAC, the RSE, and the CSO and CSA office; and

B. the Partnership supports the SG to identify and maintain links with a network of experts from Scotland, the UK, and internationally. The Partnership should maintain engagement with these through a programme of events on themes relating to pandemic preparedness.