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What lessons were learned for future research in a pandemic?

As with any condition, research is needed to identify the best treatment and management of flu. The results can be used with routine surveillance data to improve the outcomes for individuals and the population as a whole.

Research results about the usual seasonal flu might not apply in pandemic years, so new studies can be needed, perhaps at short notice, to help with the impact of a rapidly spreading virus.

A commentary on the achievement of the 2009 research programme was published in early 2010, at about the time when results from the research were appearing.

We learned that the research community, funders and regulators can work effectively to get research done quickly, and the whole-system approach of NIHR was very helpful. There will still be difficulties in meeting `real-time’ demand for evidence so with that in mind, NIHR funded some new projects, such as the two described here, which will use pre-existing systems and infrastructure (for example the Practice Team Information system in Scotland or the UK Obstetric Surveillance System) to respond quickly and effectively to the next crisis.

“The series of studies undertaken by NIHR during the 2009 pandemic provided us with a blueprint for how to respond to health emergencies such as pandemic flu. Similar processes were later used to fast-track early-phase studies to evaluate Ebola vaccines in the wake of the Ebola outbreak in West Africa, making the UK the leader in such studies.”

Professor Andrew Pollard, University of Oxford

NIHR gives potential flu research a head start

Getting ethics and other approvals exceptionally quickly was also essential to enable research to be undertaken during the pandemic. This is not always possible; trials, in particular, may need time to develop their protocols and pilot their methods. One way around this is to pre-approve study protocols based on some preliminary preparatory work. This has been done by NIHR, and it is an approach that is endorsed by the Academy of Medical Sciences report Treating Influenza (http://www.acmedsci.ac.uk/policy/policy-projects/treating-influenza/).

There are currently a number of funded, approved, projects ‘in hibernation’ until a pandemic appears again (if one does). This research was fast-tracked to provide answers to uncertainties at the time of the pandemic and in preparation for any future crises.  

“I think it’s a fantastic idea that we now have some studies that are ‘hibernated’, ready to be activated in the event of a future pandemic. We all know that our health services are very pressurised when we have emergency situations like that. Now we’ve got these studies ready to go to give us the answers we need, we will be able to get those answers much more quickly next time.”

Professor Marian Knight, leader of the UK obstetric surveillance system

Although they will need reviewing periodically for continuing relevance, this ability to start important research quickly enough for the results to be used in real time during a pandemic is a major step forward in research in a global emergency.

“We can be sure of one thing: there will be another influenza pandemic. We don’t know when that will be or which strain of influenza will cause it. Therefore we need to be ready to respond again next time, just as we did in 2009, to protect the health of our population.” Professor Andrew Pollard, University of Oxford

 

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