Exeter - Celebration of our Centres

Today we share an insight into the NIHR BioResource Exeter Centre (which covers the South West Peninsula) since the beginning of the pandemic.

How the Pandemic affected us:  

From the start, all studies became subject to the NIHR risk classification. Our team focus changed to projects set up at unprecedented speed to help combat COVID-19. Clinical staff were redeployed to support a range of Urgent Public Health (UPH) studies (e.g. RECOVERY, ISARIC, NOVAVAX, SNAPSHOT PCR HCW, REMAP-CAP), and provide clinical care when hospital staffing levels were critical, demonstrating both flexibility and co-operation. However we were aware of living through unprecedented times with the associated fears/anxieties.  

Home-working enabled our administrator to continue to ensure all BioResource-related amendments/updates were actioned, while developing 'super user' status for the newly introduced Trust-wide IT system (i.e EPIC) which is hoped will help facilitate BioResource recruitment.  This changed working pattern had both upsides (less interruption, get more done), but also downsides (loss of participant/colleague contact, loneliness, missing shared environments). We were able to continue with the phase II CLARITY study (BioResource Study Ref. NBR077). 

Our key local project (as a BioResource team) was the Exeter COVID-19 Sequencing project (ExCoSe). Over a 12 month period we identified and contacted 557 COVID-19 positive individuals, an overwhelming 75% consented to the use of their “leftover” clinical samples to enable viral Genotyping linked to patient data. Genotyping and information on patient/staff locations and movements within the hospital informed the understanding of hospital transmission of COVID-19, establishing early in the pandemic, before it was apparent that asymptomatic individuals could be infective, that staff to staff transmission was important. This work directly transformed hospital infection control measures, reducing infection between staff, and between asymptomatic patients and staff.  

We gained insights into the impact on those affected, particularly the need to talk through their experiences. Staff have said: “I think in some ways being invited to be part of the research has made their experience feel listened to – especially at the start when it was all very new and more symptoms where emerging” . … “I did lots of listening; people just needed their story to be heard”. Patients were very keen to help with research. 

The ability to have 'ownership' of this project provided a focus for our team during this challenging time. Regular team/project meetings provided a forum for discussion, sharing fears, supporting each other and reinforced some semblance of day-to-day working normality.

With an inability to undertake our normal outreach activities, we increased our social media presence, taking every opportunity to raise awareness of the importance of NIHR research and the need for the public to be involved. 

We have learned resilience and an ability to identify alternative ways of working. However we are 'people people': we need and miss contact with participants and colleagues.  Working at 'crisis levels' is also not sustainable in the long term.  

Looking to the future:   

Local restart to the Generic, Rare Disease, and IBD programmes of the BioResource began in February 2021. We are about to open four new rare disease cohorts (identification of local PI’s and site approvals obtained during lockdown).  Active recruitment is being undertaken during routine clinical care or at the time of relevant research visits. Our outreach programme will re-commence this month.