What a half-year it’s been. Having kept myself broadly out
of Addenbrookes Hospital for 20 years, I spent 5 weeks in the neonatal intensive care
last December, thankful for some extraordinary NHS care to our premature child
(who is now doing great!). This had put me in a very “clinical/medical”
mindset. I became aware of the COVID-19 disease around Christmas time, my
parents had come over from Italy, and we were looking together at the news
coming out of China, commenting how unthinkable the lockdown of a large city and
the loss of freedoms would be anywhere here in the “West”. Surely something
like this (at some level, we were thinking both the disease and the response to
it) could only happen in China?! My
parents flew over again, late February, and stayed here for a week. A small
(and then not so small) number of cases had being found close to Bergamo, and
treated in highly specialised units in Milan. It still seemed something that
would have no impact on the broad population. However things moved so fast that
the day after they flew back to Milan the whole Lombardy region became red zone,
and within a few days all of Italy was in lockdown, as it essentially remains
to date.
Early March, I realised that what was happening in Italy
would almost for sure very quickly happen in the other European countries,
because we are just so similar in our ways of life and societies, and so
connected. I was also very worried, because the health system in Lombardy is
better than almost anywhere else in the world, and the disease was straining
it. With a delay of roughly two weeks, there was a similar trend of cases in Spain,
Germany and France. Still, at that point, cases in the UK was surprisingly
(given the degree of international mobility here) few. There was in the UK news
reporting a sense of disbelief and displacement, which reminded me very much of
what I had in mind back the previous December, when looking at the news coming
out of China. COVID-19 then did pick
up in the UK, and it was clear from the number of cases and then shortly
afterwards the number of deaths, that the curve of the epidemics was at least
as bad as in Italy and Spain. Is it so difficult to learn from each other’s
experience?
It was quite clear to me that also the measures that would
have to be taken, in terms of emergency lockdown would have to be similar, since
any opportunity for a more reasoned control strategy was not being pursued. I
was not very surprised when on the 20th of March the university, rather
abruptly, decided to lock down completely. Students were encouraged to find
their way “home”, if they could, causing significant distress and confusion. For
the first time in my lifetime the departments closed down to the point that
even faculty were not able to access their labs and their offices. This was
quite shocking. My thoughts during the week heading to shutdown were conflicted,
between the desire to keep everyone safe and infection rates as low as
possible, but also to react to this threat by doing something useful. After
all, Universities contain a lot of creative people, many of whom are great
problem solvers. Shutting down was an extreme reaction, I felt it was not the
optimal solution.
Researchers were being forced out of their labs when perhaps
they could have something useful to do. From then on, research in the
University has only been allowed on projects very strictly related to COVID. This
in practice has meant only very few biology labs, working directly on the virus
biology, have remained active. Other groups hoping to do relevant work, for
example investigating aerosol dispersal or mask materials, have found it
difficult to work. One project that did manage to go ahead has been based in engineering,
aimed at designing robust and cheap ventilators. Everybody else has had to
reshape their work from home.
I could see it was not clear to everyone around me that this
disease was really going to be life changing, in the short, medium and long
terms. I thought it was a good idea to urgently stimulate people to think about
what they could do. So, in the in the days just before the shutdown, I set up
an online bulletin system using a software called Slack. I defined various
initial topics to focus on, and I allowed access to all the academics from
Cambridge and their collaborators. Very quickly we grew to have about 1000
researchers, contributing knowledge and sharing ideas in a structured way. This was very useful, it served for example to
rapidly coordinate efforts around the ventilator designs that various teams had
started thinking about, and also to share instructions on how to make various kinds
of cheap masks, and we shared information about modelling approaches for the
epidemics. This Slack platform served as a remarkable bottom-up community, and is
still useful now two months on - the “mainstream” University offices are using
it to see what researchers think might be possible in various themes and
directions.
Between complex shopping adventures and dipping into various
other jobs normally entrusted to professionals (schooling, babysitting,
housecleaning, DIY) I of course still had to run my day to day job. Luckily for
me, this did not involve online teaching because I had done my course and
examining in Michealmas. I could just focus on talking to my graduate students
and postdocs, and keeping their research going as much as possible, helping
them to transition to things that they could do at home, such as data analysis
and writing up results and preparing plans for the future. I got involved in two new COVID-19 related projects.
In a very minor way, I tried to help the
open source ventilator ovsi.org, which was built in the Whittle lab, part of
the engineering department. My interest in that project is connected to work
that we do with bio/medical technology developing countries, I wanted to see if
simple designs could really be taken all the way to medical instruments. It’s
certainly become clear to us that there are huge challenges in certifying instruments
for medical use, and we are still in the process of understanding how what has
been developed so far I can be licenced and produced locally in a safe and legitimate
way.
I had a more significant involvement and in another project,
together with Prof. Cecilia Mascolo in the computer science lab, where the idea
was to see if the sounds of voice, cough and breathing, recorded in a simple way through smartphones,
could be enough to diagnose the COVID-19 condition, its severity, and perhaps
even distinguish it from other types of airway diseases like the common cold or
flu. This project covid-19-sounds.org is
going well - we are still in the initial
phase of data gathering sound samples.
We are still looking for more people to join! Having promoted the idea through social media
and our personal networks, we also managed to get this concept on many
newspapers and I ended up on mainstream television. We have so far 7000 people
who have donated their sounds, the largest such data set globally, and we're in
the process to see to what extent these sounds can be used to diagnose the
disease using signal detection and machine learning algorithms. If this project
turns out to be successful it could serve as an automated filter, perhaps as
part of an NHS 111 response, helping the health system manage the demand for
advice, and to work out who should go to hospital and who should safely wait at
home. Working on this project has been a great learning experience! For the
first time in a while I've actually myself had data to work on, and I enjoyed working
out procedures for data analysis. I made figures and reports to other team
members – it felt like being a student again! Being active in research at the level of “raw
data” is something I had lost, as many people do, when growing into a group
leader. In my main established projects there are very competent people in the
lab doing almost everything. Suddenly having to face an entirely new challenge
allows everybody to input, including senior people like me!
I am based in Physics but I work on biological systems. One
of the main thrusts of research in my group is around understanding malaria
disease, which includes creating affordable technologies to help tackle malaria
diagnosis in developing countries. I usually begin my talks by reminding the
audience that malaria currently kills around half a million people per year,
every year, mostly children, concentrated in few countries of the world. The
COVID-19 pandemic is causing huge problems to us, with loss of life and
socio-economic problems. And yet -thankfully- it is such a small thing compared
to malaria. (COVID-19 deaths have reached about 285,000 globally en.wikipedia.org/wiki/Template:COVID-19_pandemic_data
accessed 11th May 2020 and are shared between many different
countries). This really brought home to me what terrible impact an endemic
infectious disease can have on everyday life.
We have to invest enough to sort out these problems, it should be within
our ability to find scientific solutions to both these infectious diseases.
The pandemic has already caused lots of changes, many are obviously
simply bad and we hope to revert them. It has sped up, for good or for worse,
many trends that were perhaps about to happen anyway. By changing our daily
life and our habits so suddenly, and by preventing us from doing a whole set of
things, it has opened up for some people a window of free time. For me despite
being busier than ever it's certainly allowed a chance to consider, with a
little bit of detachment, how to use my time and my expertise in order to try
and do something immediately useful.
