Research Midwife Rachel Newport has written this blog to highlight how the team at the Royal Oldham Hospital have worked together in response to the Covid-19 pandemic.
This March, life in the UK changed for everyone. Not least for research staff at the Royal Oldham. For the healthcare staff who devote their careers to enhancing care, testing new treatments and improving outcomes for patients, there had never been a more urgent challenge.
The entire research team at Oldham stepped up to the task, willingly changing their hours to work evenings and weekends, and working on wards and specialties outside of their usual areas of expertise.
Research nurses and practitioners have stepped outside their usual roles and have been consenting patients to clinical trials involving testing drugs (CTIMPs – Clinical Trials of Investigational Medicinal Products), a task that comes with an increased level of responsibility.
Some staff within the team were deemed to be at high risk, and so unable to come into their usual place of work; however they have supported the team admirably, working at home at all hours on any aspects of the studies that they could, from organisational essentials to detailed data entry.
The research team have been fully supported by their families at this time, and thanks must go out to them too, as they will understandably have been worried about them working in such close proximity to the virus at this time.
Children of members of staff have made rainbow pictures which they display outside their clinical area, and have made individual cards to thank each member of staff for their hard work.
Recruitment
To date (31 July), the Oldham research team have recruited nearly 900 patients to Covid-19 studies.
This includes 77 patients to the RECOVERY (Randomised Evaluation of Covid-19 Therapy) trial that has led to the recent finding about dexamethasone being a useful treatment for some people with Covid-19. The use of convalescent plasma has recently been introduced as an additional product that might be helpful. One of the research nurses who has recovered from Covid-19 has also applied to donate plasma to further help this study.
The Royal Oldham Hospital is also taking part in the ACCORD-006 (ACcelerating Covid-19 Research and Development) study, the findings of which in turn feed into RECOVERY. The Oldham team recruited the first patient in the UK to this study, testing Zilucoplan – a drug that inhibits part of the complement system component of the immune system. (Main picture above – Dr Biswa Mishra with research nurses Amy Slack, Sheila Munt and Joy Dearden.)
Dr Antonina Zhelyazkova (front, who’s played a key role in the RECOVERY study) with clinical trials pharmacist Kamala Ramatar, research practitioner Jenny Philbin and research nurse Denise Hadfield
The team have also randomised patients into the REMAP-CAP (Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community Acquired Pneumonia) and RECOVERY-RS (Respiratory Support: Respiratory Strategies in COVID-19) trials. REMAP-CAP is a trial for the most severely ill people with COVID-19 who are being treated in ICU, while RECOVERY-RS considers different methods of ventilator support for patients. Due to the urgent nature of the unfolding Covid-19 situation, and the novel nature of this disease, many of the trials the team are working on are designed to be dynamic and able to adapt quickly to new findings in related studies.
The largest Covid-19 related study at Oldham is ISARIC (International Severe Acute Respiratory and emerging Infection Consortium). This is a global study collecting data on all hospitalised cases (or suspected cases of Covid-19), and provides a range of freely available, standardised clinical data that will inform the management of patients, and the public health response. Oldham staff have collected data on more than 600 people for this valuable public health study.
Dr Andrew Drummond, Principal Investigator for the ISARIC and GenOMICC studies at Oldham; and Dr Redmond Tully, Principal Investigator for the RECOVERY and REMAP-CAP studies at Oldham
Research Midwives have also been involved in looking at the potential impact of this pandemic on pregnant women. 23 patients have been recruited to the surveillance studies UKOSS (UK Obstetric Surveillance System) and PAN-COVID (Pregnancy And Neonatal outcomes for women with Covid-19).
None of this would have been possible without the fantastic cooperation of clinical staff and support services. Staff from clinical areas have been endlessly helpful, enthusiastic and accommodating – all at a time of high stress and unparalleled demand. Nursing staff have assisted with communicating with patients in challenging situations due to isolation, PPE and language barriers. They have undertaken study related training, and administered study medication to participants.
Support
Doctors have recruited to trials after specialist training, and have helped to identify patients, consider drug interactions, interpret tests and collect data.
Staff in the microbiology department have almost certainly never been as busy as in recent months, however they have remained eternally helpful, a fantastic source of information and always willing to support any research effort wherever possible. They have assisted with preparing and storing samples from trial patients, often out of hours, and even providing training to research nurses to use specialist equipment.
The research pharmacy team have worked incredibly hard to ensure that these new trials open safely and quickly to ensure the maximum benefit to our patients.
Working on all these studies has involved a vast amount of data collection, and organisational work and essential administration duties.
However these patients are anything but just numbers to the research staff. They have followed every one of their journeys through Covid-19, and have been touched by their stories. They have followed whole families who have been affected by this disease; cheered their recoveries, and felt saddened for those who died.