Eight new projects will explore how the virus spreads in schoolchildren, healthcare workers, in medical settings, on surfaces in public spaces, and in strictly-Orthodox Jewish communities.
Funded by UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR), these new research projects on coronavirus transmission, which have been awarded a total of £5.3 million, will help inform policy decisions about COVID-19, including infection prevention strategies and containment measures.
Children appear to be less likely to test positive for coronavirus (SARS-CoV-2) infection than adults and their symptoms are generally milder. More data are needed to fully understand the role children play in transmitting the virus and help schools operate safely.
Two of the newly funded research projects will investigate the role of schoolchildren in spreading coronavirus. One group of researchers will map coronavirus transmission in schools in Bristol, to help them deal with the practical challenges of preventing and coping with an outbreak of COVID-19.
The second project will investigate how quickly and efficiently coronavirus might be spread by schoolchildren, to identify how symptomatic or asymptomatic children transmit the virus and how long they are infectious.
Healthcare workers have a high risk of exposure to coronavirus. One element of this risk is their exposure to the virus in tiny droplets of liquid – or aerosols – that are generated during some medical procedures. Another of the newly funded projects will assess the amount, type and infectiousness of aerosol generated during a variety of procedures, to help determine how best to organise care.
Transmission of coronavirus in healthcare settings is likely to have had a considerable role in the spread of the pandemic in the UK. Two studies will assess how transmission in healthcare settings compares with that among the general public.
The first will analyse UK-wide data on hospital cases of COVID-19 to understand how important transmission and infection control in hospitals was to the first ‘wave’ in the UK, whereas the second will study healthcare staff to determine how healthcare exposures affect transmission risk compared with other factors outside the workplace.
Another newly funded study will work with healthcare staff, in this case collecting blood samples from doctors and nurses who have been infected with coronavirus to determine how the immune system responds to infection. The researchers hope their findings will help understand how we develop antibodies that fight the virus and could be used to inform a vaccination plan for healthcare workers.
Research to date has shown that coronavirus can survive on some hard surfaces for up to three days. Surfaces that are touched by lots of people, such as holding rails on public transport, are a particular concern. A multidisciplinary research project will test different surfaces and coatings that may kill coronavirus, to develop new approaches to prevent transmission in public spaces.
The Orthodox Jewish community has experienced a high number of COVID-19 cases. Another of the newly funded projects will work with one of these strictly-Orthodox Jewish communities to understand how community structures, such as household size, may contribute to transmission, including the role of children.
Professor Chris Whitty, Chief Medical Officer for England and Head of the NIHR, said:
Understanding which factors are important in COVID-19 transmission and therefore how the disease spreads is important for targeting measures to control the pandemic.
These eight new research projects funded by NIHR and UKRI will help us to understand transmission in a number of key groups and settings.
Professor Fiona Watt, Executive Chair of the Medical Research Council, part of UKRI, said:
We still don’t know enough about how and where SARS-CoV-2 is spread. This range of studies seeks to determine the risk of transmission in real life settings, including schools and hospitals.
The results will not only help us understand when to take extra precautions when necessary, but could also allow us to return to more social behaviour in settings where the risk is deemed low.
This group of projects forms part of a rolling call for research proposals on COVID-19, jointly funded by UKRI and NIHR in response to the pandemic. The research funded to date includes projects on treatments, vaccines and the spread of the virus, as well as specific calls on COVID-19 and ethnicity, and the wider impact of the virus on mental health.
About the projects
COVID-19 mapping and mitigation in schools
Professor Caroline Relton, University of Bristol – £2.7 million
Limiting transmission of coronavirus in schools is a major challenge owing to a number of factors related to transmission of the virus and the school environment, such as the fact that children with COVID-19 are often asymptomatic and children in schools interact with a large number of other children and adults.
This project will undertake a number of tests of current or past COVID-19 infection in staff and pupils over a six-month period. The researchers will then use staff and pupil postcodes to identify the areas of Bristol with most infection, so that they can be offered targeted support for infection control, and use an app to help everyone reduce the infection rate at school and outside school.
The researchers will also assess the impact of returning to school on pupil and staff mental wellbeing, what schools are doing to support pupils experiencing difficulties, and which activities are most helpful.
The study findings will create new knowledge and tools to help schools deal with the practical challenges of preventing and coping with an outbreak of COVID-19.
Tracking transmission by schoolchildren
Professor Shiranee Sriskandan, Imperial College London – £267,000
Infections carried in the nose and throat can spread rapidly between children, and between children and adults. The novel coronavirus can infect children without causing symptoms, meaning that spread of COVID-19 among children has been very difficult to study.
The researchers will invite schools, nurseries and their families to participate in this study to investigate how quickly and efficiently coronavirus might be spread by schoolchildren, both within the school community and in households. The researchers aim to identify if symptomatic or asymptomatic children transmit the virus, whether the likely modes of transmission are by contact or are airborne, and how long children can carry infectious virus.
The results will help understand transmission of SARS-CoV2 between children and between children and adults, to clarify principles to prevent transmission, target control measures if an infection occurs and develop interventions to limit spread.
Aerosolisation and transmission in healthcare settings
Professor Nick Maskell, North Bristol NHS Trust – £433,000
Aerosols are generated when tiny droplets of liquid are suspended in the air. Aerosols can carry viruses, like coronavirus, and can be generated during some medical procedures.
This study will assess the amount and type of aerosol generated when medical procedures are performed, and how infectious the aerosol is. The researchers will use specialist equipment to measure real-life aerosol generation in five priority specialties: dentistry, orthopaedics, respiratory, critical care and ophthalmology.
The findings from this research will show how best to organise operating theatres, medical procedures, outpatient clinics, wards and use of protective equipment, in order to protect patients and staff while maximising the ability of the NHS to undertake life-saving procedures.
Transmission of coronavirus in hospitals versus in the community
Dr Gwen Knight, London School of Hygiene and Tropical Medicine – £127,000
Coronavirus spreads in many different types of environments, including within healthcare settings.
These researchers will use mathematical and statistical techniques to harness UK-wide data on hospital cases to understand how important transmission of coronavirus in hospitals was to the first ‘wave’ of COVID-19 in the UK, the impact of interventions such as quarantine for discharged patients, and what we could do in the face of any future resurgence.
Understanding how much transmission happens in hospitals or in the community will help control ongoing spread. In addition, knowing what factors make certain hospitals hotspots means that these factors can be targeted to limit transmission.
Contribution of the workplace to risk of infection among healthcare workers
Professor Peymané Adab, University of Birmingham – £441,000
Healthcare workers have a higher risk of getting COVID-19. However, risk factors outside the workplace are also important. For example, being from a minority ethnic group and home circumstances can increase risk of catching coronavirus. It is not clear how these aspects compare with workplace risks, or which work exposures are most risky.
These researchers will recruit about 5,000 staff with different job roles and departments from three large West Midlands hospital trusts. These will include workers who had a COVID-19 test because of symptoms and some workers with no symptoms. Workplace exposures and other characteristics will be compared among healthcare workers who tested positive for coronavirus and those who had negative tests.
The findings will help us to better understand the risk of infection among healthcare workers and to develop guidelines to reduce risk.
Infection rates in healthcare workers and how the immune system responds to infection
Dr Ana M Valdes, University of Nottingham – £720,000
The severity of COVID-19 infection varies substantially among different groups of people. These differences may be down to how the virus provokes an immune response in the human body.
Researchers in Nottingham and London have been collecting blood samples from more than a thousand healthcare workers on a weekly basis during the pandemic, encompassing people who have had a severe infection, those who have had mild symptoms and people with no symptoms.
Their new study will assess how many and which doctors and nurses have been infected with coronavirus and how the immune system responds to infection.
Samples will be analysed for antibodies against the virus, to understand what antibodies are produced against the SARS-CoV-2 virus, how the levels change over time and whether antibodies against other coronaviruses confer immunity against COVID-19. The analyses will also consider how individual characteristics, such as sex and ethnicity, affect how a person’s body fights the coronavirus.
Information from this study will be helpful to develop a plan on how to vaccinate healthcare workers effectively, and strategies to prepare for a potential surge in COVID-19.
Transmission of coronavirus on surfaces in public places
Professor Peter Wahl, University of St Andrews – £271,000
A key mode of transmission for coronavirus is through contact with surfaces in public spaces that are touched by lots of people – for example, door handles in schools and holding rails on public transport. Previous research has shown that coronavirus survives for a significant amount of time on materials commonly used for touch surfaces, such as stainless steel and plastic.
This research – a partnership between material physicists and virologists – will test different surfaces and coatings for their effectiveness in killing coronavirus. In particular, the research will build on existing knowledge about the antiviral properties of copper.
The findings could be used to actively inhibit and delay transmission from surfaces in public areas, helping to prevent further spread of infection and future outbreaks.
Coronavirus transmission in an Orthodox Jewish community
Dr Michael Marks, London School of Hygiene and Tropical Medicine – £249,000
Orthodox Jewish communities have a higher average number of children per household, and greater interconnectedness of households.
This study will investigate the role of children, cross-protection from other types of coronavirus, asymptomatic transmission, household structure, and pre-existing conditions on transmission and burden of COVID-19 in this community.
The researchers will use data and samples from a survey of 500 households to develop mathematical models for transmission of coronavirus and estimate risk in different settings.
The findings will help understand if community structures such as household size and social mixing patterns contribute to transmission in high risk communities and the role of children in transmission.