UK-REACH: United Kingdom Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers
Lead Research Organisation:
University of Leicester
Department Name: Infection Immunity and Inflammation
Abstract
Globally many people, including healthcare workers (HCWs), are becoming ill and dying from COVID-19. We have evidence that people from ethnic minorities have a higher chance of going to intensive care and adying from COVID-19.This may also sbe the case for ethnic minorities working in the health system. We want to investigate this using existing data held by national healthcare organisations to understand what the risk of having, and dying from, COVID-19 is for ethnic minority HCWs. We will also follow a group of ethnic minority HCWs over 12 months to see what changes occur in their physical/mental health. In addition we will interview a smaller group of ethnic minority HCWs to understand how risky their jobs are, and how they have changed their professional/social behaviours in response to COVID-19. Using staff data and linking it to healthcare data may be sensitive and so we will explore how to do this in a way that is acceptable. Finally, we want the findings of this research to be useful for HCWs and so we have a stakeholder group of major national organisations to help us do the research, publicise the findings and make recommendations.
Technical Summary
Healthcare workers (HCWs) from Black, Asian and Minority Ethnic (BAME) groups are disproportionately affected by COVID-19. Collaborating with the General Medical Council (GMC), Nursing and Midwifery Council (NMC) and Professional bodies/associations we will undertake a mixed-methods study with the aim of investigating if, how, and why, ethnicity affects COVID-19 clinical outcomes in HCWs.
We aim to provide rapid evidence through five interlinked work packages (WP).
WP1: Undertake an expedited linkage and analysis of anonymised GMC and NMC registration and NHS datasets, within a Trusted Research Environment (SAIL databank) to calculate the incidence of, and outcomes from, COVID-19 amongst HCWs.
WP2: Rapidly establish a longitudinal cohort study of BAME HCWs, nested within the GMC/NMC datasets. At baseline, survey information will be collected about demographics, HCW role, interaction with COVID-19 patients, social circumstances and physical/mental well-being; baseline biological samples will be collected for genomic and serological profiling. Follow-up surveys and samples will be collected over twelve months to capture changes in survey/serological responses to forthcoming COVID-19 pandemic waves.
WP3: Undertake research to understand and address legal, ethical and acceptability issues around data protection, privacy and information governance associated with the linkage of professionals' registration data and healthcare data.
WP4: Undertake qualitative interviews and focus groups of BAME HCWs to understand risk perceptions, support and coping mechanisms in relation to COVID-19.
WP5: Develop a multi-professional, national stakeholder group including the GMC/NMC, Royal Colleges, BAME Professionals' Associations, and BAME HCWs to facilitate rapid dissemination and translation of the research findings for HCWs/Employers/Policy-Makers.
We aim to provide rapid evidence through five interlinked work packages (WP).
WP1: Undertake an expedited linkage and analysis of anonymised GMC and NMC registration and NHS datasets, within a Trusted Research Environment (SAIL databank) to calculate the incidence of, and outcomes from, COVID-19 amongst HCWs.
WP2: Rapidly establish a longitudinal cohort study of BAME HCWs, nested within the GMC/NMC datasets. At baseline, survey information will be collected about demographics, HCW role, interaction with COVID-19 patients, social circumstances and physical/mental well-being; baseline biological samples will be collected for genomic and serological profiling. Follow-up surveys and samples will be collected over twelve months to capture changes in survey/serological responses to forthcoming COVID-19 pandemic waves.
WP3: Undertake research to understand and address legal, ethical and acceptability issues around data protection, privacy and information governance associated with the linkage of professionals' registration data and healthcare data.
WP4: Undertake qualitative interviews and focus groups of BAME HCWs to understand risk perceptions, support and coping mechanisms in relation to COVID-19.
WP5: Develop a multi-professional, national stakeholder group including the GMC/NMC, Royal Colleges, BAME Professionals' Associations, and BAME HCWs to facilitate rapid dissemination and translation of the research findings for HCWs/Employers/Policy-Makers.
Organisations
- University of Leicester (Lead Research Organisation)
- National Institute for Health Research (Co-funder)
- UNIVERSITY OF EDINBURGH (Collaboration)
- University College London (Collaboration)
- UNIVERSITY OF NOTTINGHAM (Collaboration)
- SAIL Databank (Collaboration)
- British Society for Immunology (Collaboration)
- UNIVERSITY OF BIRMINGHAM (Collaboration)
Publications
Pan D
(2020)
The impact of ethnicity on clinical outcomes in COVID-19: A systematic review.
in EClinicalMedicine
Pan D
(2020)
Frailty and mortality in patients with COVID-19
in The Lancet Public Health
Koeckerling D
(2020)
Awake prone positioning in COVID-19.
in Thorax
Khunti K
(2020)
Is ethnicity linked to incidence or outcomes of covid-19?
in BMJ (Clinical research ed.)
Khunti K
(2020)
The language of ethnicity
in BMJ
Monteiro T
(2020)
A five-year retrospective study shows increasing rates of antimicrobial drug resistance in Cabo Verde for both Staphylococcus aureus and Escherichia coli.
in Journal of global antimicrobial resistance
Nazareth J
(2020)
Early lessons from a second COVID-19 lockdown in Leicester, UK.
in Lancet (London, England)
Pareek M
(2020)
Ethnicity and COVID-19: an urgent public health research priority.
in Lancet (London, England)
Sze S
(2020)
Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis.
in EClinicalMedicine
Description | UK-REACH has provided a range of key outputs relating to: 1. Risk of infection amongst ethnic minority healthcare workers 2. Vaccine hesitancy amongst ethnic minority healthcare workers 3. Access to PPE amongst ethnic minority healthcare workers 4. Impact on mental health of ethnic minority healthcare workers 5. Attitudes towards regular vaccination amongst ethnic minority healthcare workers |
Exploitation Route | The UK-REACH cohort is ideal to examine a whole range of health and non-health related factors amongst healthcare workers. |
Sectors | Healthcare |
URL | https://uk-reach.org/main/ |
Description | UK-REACH is one of th emost detailed healthcare workers cohorts/studies. It has provided key outputs relating to infection risk, vaccine hesitancy, access to PPE and also factors associated with staff well-being. Our work is now focusing on long-COVID and has directly informed policy-makers and also been presented in Parliament. |
First Year Of Impact | 2022 |
Sector | Healthcare |
Impact Types | Societal,Policy & public services |
Description | ECDC Scientific Advisory Group on COVID-19 in migrants and ethnic minorities |
Geographic Reach | Europe |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | Member of the scientific advisory group on COVID-19 and migrants which is being undertaken by ECDC |
Description | NHS England BAME Clinical Advisory Group |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | Member of NHS England Clinical Advisory Group advising on health and well-being of ethnic minority healthcare workers. |
Description | DIRECT - Immunology sub-study of UK-REACH |
Amount | £500,000 (GBP) |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 11/2020 |
End | 03/2021 |
Title | UK-REACH dataset |
Description | Consented cohort of healthcare workers with data linkage |
Type Of Material | Database/Collection of data |
Year Produced | 2021 |
Provided To Others? | Yes |
Impact | The dataset is being developed and should be available in 2021. |
Description | British Society of Immunology PPI |
Organisation | British Society For Immunology |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | Presenting information from UK-REACH and BE-DIRECT to PPI panel |
Collaborator Contribution | Presenting information from UK-REACH and BE-DIRECT to PPI panel |
Impact | BSI report on PPI in vaccine immunology studies |
Start Year | 2021 |
Description | Immunology national core studies group |
Organisation | University of Birmingham |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | We are collaborating with the National Core Studies group on the immune response to COVID-19 vaccines amongst healthcare workers |
Collaborator Contribution | We actively collaborate on research questions relating to vaccine immune responses |
Impact | We are currently writing the papers |
Start Year | 2021 |
Description | UK-REACH collaboration |
Organisation | SAIL Databank |
Country | United Kingdom |
Sector | Public |
PI Contribution | I am Chief Investigator for this programme which inclues academics from multiple organisations. |
Collaborator Contribution | Co-investigators are involved i neach of the work packages |
Impact | Papers are being written |
Start Year | 2020 |
Description | UK-REACH collaboration |
Organisation | University College London |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I am Chief Investigator for this programme which inclues academics from multiple organisations. |
Collaborator Contribution | Co-investigators are involved i neach of the work packages |
Impact | Papers are being written |
Start Year | 2020 |
Description | UK-REACH collaboration |
Organisation | University of Edinburgh |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I am Chief Investigator for this programme which inclues academics from multiple organisations. |
Collaborator Contribution | Co-investigators are involved i neach of the work packages |
Impact | Papers are being written |
Start Year | 2020 |
Description | UK-REACH collaboration |
Organisation | University of Nottingham |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I am Chief Investigator for this programme which inclues academics from multiple organisations. |
Collaborator Contribution | Co-investigators are involved i neach of the work packages |
Impact | Papers are being written |
Start Year | 2020 |
Description | Multiple interviews fo TV, newpapers and radio relating to ethnicity and COVID - national and international |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Multiple interviews about ethnicity and COVID-19 as well as UK-REACH programme. Interviews for national media outlets as well as international news in Canada, India and Australia. |
Year(s) Of Engagement Activity | 2020,2021 |
Description | UK-REACH stakeholder group meetings |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | We meet the UK-REACH stakeholder group on a monthly basis where all aspects of the research programme are discussed. |
Year(s) Of Engagement Activity | 2020,2021,2022 |