Bridging the Gap – November 2020

If we winter this one out, we can summer anywhere.

Seamus Heaney

The last eight months have been unlike anything any of us have ever experienced, and I want to begin by thanking each and every one of our NIHR Manchester BRC staff and our research participants for their extraordinary efforts, understanding, and flexibility during this unprecedented time.

By working together and realigning our focus, Manchester BRC has been part of the vital global effort to enhance understanding and develop potential treatments for COVID-19. Many of our clinical staff also played an important role in providing direct frontline clinical care during the first wave of the COVID-19 crisis and laboratory researchers contributed to the diagnostics support services across Greater Manchester (GM). Notably, Professor Caroline Dive, Cancer Precision Medicine Theme Lead, was central in helping coordinate the rapid scale-up of the huge Lighthouse Laboratory at Alderley Park that was established in record time.

The speed at which our scientific community in GM stepped up to respond to the COVID-19 outbreak was outstanding and a testament to the “One Manchester” approach, enabling a coordinated approach to maximise our impact.

We created the Research Rapid Response Group (RRRG), which linked across the universities, the NHS trusts and our research infrastructure in GM – including Manchester BRC. RRRG brings together our strengths across many research areas and disciplines, aligned behind shared goals to minimise lives lost and reduce the impact of the pandemic on GM’s health and social care system and the wider community. The collaborative work and big ideas supported by the RRRG are now having national impact.

A vital part of GM’s research response has been prioritising research that will have an immediate impact in responding to the pandemic, aligned to the NIHR Urgent Public Health (UPH) classifications.  We are now in the second wave of the pandemic and we are encouraged to keep going with our business as usual as much possible. Nationally and regionally, however, there are incredible pressures on the healthcare system, especially in the North West and Greater Manchester. From a research perspective, this means that we have been advised by the NIHR to also ensure that we prioritise and support Level 1 research. For example, GM will shortly have two vaccine trials recruiting and we have several COVID-19 Therapeutic Trials underway. BRC academics and research support staff will be playing their part in these high-priority studies. This may require a slow-down or brief pause in our own research projects, but this will not be to the extent that was necessary during the first wave.

So much work has already been undertaken as part of the Manchester BRC response to COVID-19. In addition to our own research projects, the infrastructure we have developed over the past three and half years was also optimised and utilised to support other COVID-19 activity. It would be impossible to discuss all these achievements in this issue, and so I will mention a few highlights and come back in future editions with more detail on these and others:

The ADAPT-Sepsis study at Salford Royal, led by Professor Paul Dark, our BRC Respiratory Non-fungal Infections Programme Lead, has recently  been awarded UPH status. Initially opened in 2017, the study has been adapted to include COVID-19 patients and aims to make antibiotic prescribing for critically ill patients – including those with suspected sepsis as a result of COVID-19 – more effective and targeted.

The COVID-RT Lung project, led by Professor Corinne Faivre-Finn, Dr Kathryn Banfill and Dr Gareth Price at The Christie, is building a national database assessing radiotherapy treatments for lung cancer patients during the pandemic, and how this has affected patient outcomes. The project highlights how NHS services across GM are working together to provide continuity of care for patients, whilst ensuring their safety during the pandemic.

BRC infrastructure has also supported the multi-site, Manchester-led, COVID-19 National DiagnOstic Research and Evaluation Platform (CONDOR) platform, which is assessing new tests that may give doctors COVID-19 results in minutes rather than days.

Away from COVID-19, we are working with all local, regional and national partners to get “back to business” as much as possible, in line with the national priority levels.

Two of our Respiratory Theme PhD students have found that around 550 million people worldwide have Chronic Obstructive Pulmonary Disease (COPD); this is more than double the previous estimate and is important when planning health services globally.

In October, we were delighted to recruit the first UK patient to the NIHR IMID BioResource. The NIHR BioResource is a network of 13 centres recruiting volunteers who are willing to be recalled for future research. The Immune Mediated Inflammatory Diseases (IMID) BioResource – led by Manchester Royal Infirmary’s Kellgren Centre – recruits UK patients with IMIDs, including rheumatoid arthritis, psoriasis and connective tissue diseases such as lupus. In the first month we have recruited more than 50 participants and are now setting up in a number of partner hospitals.

I would also like to pass on my congratulation to Professor Gareth Evans, our Cancer Prevention and Early Detection Theme Lead, who not only published his 1000th paper recently, but also received a prestigious honorary fellowship from the Royal College of Obstetricians and Gynaecologists for his major contribution to scientific advancements in improving women’s health. Gareth, along with Professor Emma Crosbie, our Cancer Early Detection Lead, have been pivotal in changing NICE guidelines to include screening for Lynch Syndrome for women diagnosed with womb cancer. This is a real breakthrough in Women’s Health and will enable hundreds of women to join prevention and early detection programmes.

Understandably we’ve also switched most of our training events to online. These have had excellent attendances and have been of a very high standard; they remain available to watch on our YouTube channel. In September, we explored how Greater Manchester researchers are using artificial intelligence for predicting disease, while October saw some of our early career researchers showcasing their projects, including across cancer, musculoskeletal, hearing health, and dermatology. Coming up on November 25 is our Respiratory Theme Infection Programme showcase, including topics on sepsis, Aspergillus, and antimicrobial resistance. Other training opportunities can also be found on our training webpage.

Several of our researchers have also take part in recent Manchester Academic Health Science Centre (MAHSC) Seminar events, hosted by Health Innovation Manchester (HInM) which you can watch back here. Further seminars will be announced soon, which we’ll share on Twitter and events page.

I want to thank our whole BRC team for their hard work across their own research, as well as how they played their part in the COVID-19 response in GM. While so much about COVID-19 is still unknown, we do know that the challenges it will bring during the second wave will require the very best of the NHS, research, and clinical science.

Take care and look after yourselves.

Professor Ian Bruce