Opinion

Covid pandemic is not over, so brace yourself for more

Now is a good time to consolidate and develop expertise gained during pandemic

A patient with Covid-19 is transferred in St Vincent’s hospital, Dublin, during the first wave of the pandemic in 2020. Photograph: Alan Betson

Cliona O'Farrelly
Sat Mar 19 2022 - 06:00

In case we might have forgotten that SARS-CoV-2, the virus that causes Covid-19, is still around, the nation’s shared disappointment this week with our Taoiseach, on learning that he was to be denied his moment of glory in the Oval Office with a bowl of shamrock and the president of the United States, was a sharp reminder that any of us can get infected.

The virus is everywhere – for many, it is still disrupting family get-togethers, trips, holidays, education and work. More worryingly, it is delaying operations, diagnoses, cancer treatments – it is making some people hesitant to report symptoms, attend hospital, even step outside.

At the same time, many are celebrating the freedom that vaccines promised – we’re out and about without masks, crowding into restaurants, pubs, racecourses, aircraft, buses and homes. The BA.2 variant of SARS-CoV-2 Omicron is more infectious than previous variants, so case numbers are going to soar higher than ever after these few days of holiday, relaxation and celebration.

Luckily, because of the vaccines, most of us will only be mildly sick and many will display no symptoms at all. But because of sheer numbers of infections, hospitalisations will inevitably increase, putting yet more strain on our health system to deliver safe, efficient and comprehensive care to all our citizens.

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Together, as a nation, we need to discuss and decide how best to reconcile these two different approaches to the pandemic and how to moderate these contradictory patterns of behaviour and thinking.

We must find effective ways of identifying, protecting and including the vulnerable, the nervous and the anxious while allowing life, work, education and the economy to thrive. These discussions should be ongoing – for the duration of this pandemic – likely to be active across the globe for several more years – and the others that, unfortunately, are inevitable.

(For example, many microbiologists, pharmacologists and clinicians think that a pandemic caused by antibiotic-resistant bacteria is likely in the relatively near future.)

Because the emergence and evolution of microbes, immunity and pandemics are so poorly understood, so difficult to predict, so complex and so challenging, we must make sure our discussions and decisions are informed by the best of innovation, by creativity, by dynamic computation, by reliable data, by world-class research and by the highest of international standards.

Preparedness centre

The past two years have demonstrated the breadth and depth of pandemic-relevant expertise that resides in this small nation of ours and how well connected we are with related expertise across the globe. Now is a good time to consolidate and develop that expertise into a national pandemic preparedness centre.

We don’t need a shiny new building for this centre. Its first iteration could be virtual. This virtual centre would include the key infectious-diseases consultants, public-health doctors, immunologists, virologists, haematologists, bioengineers, computer scientists, innovators, behaviourists and psychologists on the island who have been responsible for our response to the pandemic and who are constantly contributing new insights, technologies and data on international stages and at international forums.

Through the centre, these experienced experts would provide interdisciplinary training for the next generation of pandemic researchers while undertaking ground-breaking collaborative research in pandemic-relevant fields.

Science Foundation Ireland (SFI) and the Health Research Board (HRB) have already invested millions of euro in Covid-19-relevant research. Among other projects, the HRB is funding the National Covid-19 BioRepository (NICB) led by Prof Colm Bergin of TCD and Prof Paddy Mallon of UCD. The NICB aims to collect clinical, biological and genetic data from Irish Covid-19 infected people with a view to informing better patient care.

The largest SFI investment (which was matched by private donations) has been in the SFI TCD Covid-19 research hub led by Prof Kingston Mills, director of Trinity Biomedical Sciences Institute (TBSI) and Prof Aideen Long, director of Trinity Translational Medicine Institute (TTMI) at Trinity College Dublin.

This is a massive interdisciplinary research collaboration involving leading scientists and clinicians from across the TCD, St James’s Hospital and Tallaght hospital campuses which has already led to important discoveries, widely-quoted publications and improved patient care.

International meeting

On June 9th-11th this year, TBSI and TTMI are hosting an international meeting: Covid-19 Immunology, Vaccines and Lessons for the Future.

In addition to the many active Irish researchers who will be attending, international experts including Adrian Hill, Kate Bingham and Trish Greenhalgh of Oxford University; Eran Segal of the Weizmann Institute in Israel; Akiko Iwasaki of Yale University; Peter Openshaw of Imperial College London; Jean Laurent Casanova of the Rockefeller and Pasteur institutes; and Alessandra Sette of UCSF will make presentations on different aspects of the Covid-19 pandemic.

Against this background of ongoing Covid-19 research, an open public forum on Saturday, June 11th will provide excellent opportunity to discuss the proposed national pandemic preparedness centre. We will need to think about how the centre should be structured, led and funded, the interdisciplinary skill sets to be developed to meet future pandemic challenges, the training programmes for budding researchers as well as leadership programmes for our emerging clinical and scientific research stars.

The outcome of these discussions could determine how well we exit this pandemic and deal with the others coming down the track. Novel and constructive thoughts, suggestions and ideas from all comers would therefore be welcome.

TBSIadmin@tcd.ie

Cliona O’Farrelly is professor of comparative immunology at Trinity College Dublin

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