One year of Welsh research into COVID-19

On 28 February, it was confirmed that the first person in Wales had tested positive for a virus called coronavirus.

Just a few weeks later, on 10 March the first urgent public health COVID-19 study opened in Wales, an observational studying which enabled the scientific community to understand more about the spread of this deadly infection. The following day on 11 March the World Health Organisation confirmed we were in fact in a pandemic.

For a whole year, the Welsh research community has played a key role in, not only supporting the development of multiple vaccines, but also looking at new treatments, diagnoses and tests. This research effort has brought together the NHS, academia, research staff, volunteers and patients and their families.

Wales has been involved in a staggering 46 urgent public health research studies, including vaccines trials which have provided a crucial route out of the pandemic (the urgent public health studies are determined through a UK prioritisation panel).

Over 36,000 participants have been recruited into 114 COVID-19 research studies under the leadership of Health and Care Research Wales.

Dr Nicola Williams, Director of Support and Delivery at Health and Care Research Wales said: “It’s a strange milestone to mark and I definitely didn’t think we would be in this situation 365 days later.

"What we have achieved in Wales is remarkable. The NHS and academia have come together as a community and we've been able to put Wales on the map in terms of its ability to be responsive, to set up studies really quickly and then really deliver, in terms of recruiting successfully to those studies.

“We also wouldn’t be where we are today without the outstanding efforts from the delivery staff, volunteers, patient families and carers who have all been fundamental in our research efforts. "

Over the past 365 days COVID-19 research has made a huge difference to all of our lives. Here’s an overview of the studies which show how now more than ever, we rely on research.

Most notably is the Welsh contribution to the national vaccine trials, with leadership from Public Health Wales and Health and Care Research Wales we have recruited at Aneurin Bevan University Health Board for the Oxford/AstraZeneca vaccine, at Betsi Cadwaladr University Health Board for the Novavax vaccine and University Hospital Wales for the Janssen vaccine. Research into vaccines is not over and will continue for months and years to develop and react to the virus.

As well as the vaccine trials, Wales has also been part of key research into treatments including a trial called RECOVERY which has seen more than 1,000 Welsh participants treated within the study across seven NHS organisations in Wales. The study helps identifies treatments for people hospitalised with suspected or confirmed COVID-19. The trial has shown a low-cost steroid (dexamethasone) reduces death by up to one third in those with severe respiratory complications and arthritis drug, tocilizumab could save 1 in 25 people who are severely ill with coronavirus. The study has also been valuable in showing that other treatments show no clinical benefit (the antibiotic azithromycin, convalescent plasma therapy, hydroxychloroquine).

Over the past year, all health boards with intensive care provision in Wales have, and are still, recruiting to the REMAP-CAP trial which aims to identify treatments that may be beneficial for people who are severely ill with COVID-19 and require intensive care. The trial has shown two rheumatoid arthritis drugs (tocilizumab and sarilumab) reduce risk of death by nearly 10%.

In the community setting, the PRINCIPLE study is aiming to find treatments for people who have milder COVID-19 infection and do not need to go to hospital. Those with coronavirus symptoms, or a confirmed COVID-19 infection, can be a part of this trial from anywhere in Wales. Most recently, it was found that two commonly prescribed antibiotics, azithromycin and doxycycline, provide no benefit to patients who are more than 50 years old and being treated for COVID-19 at home, which is just as important to give clinicians valuable evidence to inform their treatment of patients with COVID-19 in the community.

Without naming all 46 urgent public health studies, this past year has shown the contribution from the Welsh research community. Ongoing studies include genetic research to understand the virus’ varied effects on people and support the search for treatments; understanding infection and reinfection in health care workers, including post-vaccination; in long-covid, investigating new and repurposed drug treatments and development of post-hospital treatments.

All global and national research is being brought together at Health and Care Research Wales and Welsh Government’s first Wales COVID-19 Evidence Centre analysing the impact and use research-based evidence to address new challenges as a result of the global pandemic.

Newly appointed Director, Professor Adrian Edwards said: “There are hundreds of studies that have been commissioned over the last year across a range of things.

“What we don’t want to be doing is repeating stuff and reinventing the wheel. We’ll be able to identify the evidence, often find that it’s actually been examined elsewhere, and come up with answers very quickly. We all want to get through the pandemic and see what life is like on the other side. Research and evidence can provide us all with the hope we need right now.”

Research is the way out of this pandemic.

It’s important to recognise how far we’ve come and thank all involved, not only for the work over the past year, but for years and years of work to get us here today.