The Centre for Epidemic Preparedness & Response acts as a focal point for multidisciplinary research and knowledge sharing on epidemic and pandemic preparedness and response at LSHTM. Our growing network of members are helping to facilitate learning around preparing and preventing future pandemics through their research. Read about our research in action below.
Go beyond the pathogen
Vaccines and medical treatments will always play a critical part in our response to outbreaks of disease, but COVID-19 has shown us the importance of nonbiomedical factors too – social context and human behaviour, economic implications and political fallout. Our job is to go beyond the pathogen, drawing on multidisciplinary and interdisciplinary thinking to connect more dots and see the bigger picture.
Going beyond the pathogen in action:
- Strengthening Public mental health in Africa in response to the COVID-19 Epidemic (SPACE) programme
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Dr Muhammad Alkasaby - Research Fellow in Mental Health, UK Public Health Rapid Support Team (UK-PHRST).
Dr Muhammad Alkasaby explaining the research project examining MHPSS integration into outbreak response More info: Strengthening public mental health in Africa in response to COVID-19
The UK Public Health Rapid Support Team investigated challenges and opportunities for mental health and psychosocial support (MHPSS) in the COVID-19 Response in Africa led by Centre member, Dr Muhammad Alkasaby, as a part of 'Strengthening Public Mental Health in Africa in Response to Covid-19 (SPACE)' Programme funded by the UK-PHRST.
One key focus of the project is the strengthening of national and regional leadership to apply evidence-based guidance in effective MHPSS preparedness and response for outbreaks.
The study examined the extent to which MHPSS activities were included in the national response to the COVID-19 pandemic in African countries by working collaboratively with Africa Centres for Disease Control and Prevention (Africa CDC), WHO Regional Office for Africa & the Regional Office for Eastern Mediterranean, West African Health Organization (WAHO), the East, Central and Southern Africa Health Community (ECSA-HC).
The findings identified limited political commitment, financial and human resources and training to respond to mental health and limited monitoring, evaluation, and reporting mechanisms in addition to low prioritisation of mental health, based on surveys and interviews with 28 out of the 55 African Union countries. As a continuation of this work, the UK-PHRST in collaboration with Africa CDC organised regional workshops in Africa to strengthen the MHPSS in preparedness and response to outbreak. So far, two workshops took place in West Africa (Liberia), and East Africa (Kenya), and there is a plan to organise other workshops in Central, Southern and Northern Africa.
Find out more about the recommendations
Outputs:
Challenges and opportunities for mental health and psychosocial support in the COVID-19 response in Africa: A Mixed-Methods Study Summary Infographic: Challenges and opportunities for mental health and psychosocial support in the COVID-19 response in Africa: A Mixed-Methods Study UK-PHRST Strengthening public mental health in Africa in response to COVID-19
- The effectiveness of case-area targeted interventions with vaccination on controlling epidemic cholera: A prospective observational study in Democratic Republic of Congo
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Ruwan Ratnayake - Research Degree Student in Infectious Disease Epidemiology and Mathematical Modelling
Research Degree Student Ruwan Ratnayake talks about their research project examining the effectiveness of vaccination on controlling cholera - COVID-19 testing at the MRC Unit the Gambia at LSHTM
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The MRC Unit The Gambia at LSHTM ran the country’s only COVID-19 diagnostics centre until June 2020 when the National Public Health Laboratories began testing, following technical and equipment support from LSHTM’s laboratory team. They rapidly built three facilities to increase the number of hospital beds across The Gambia and provide crucial clinical care for COVID-19 patients. Teams produced 3D-printed personal protective equipment (PPE) and cloth face masks in collaboration with local businesses and supported the Gambian Ministry of Health’s preparations for the national COVID-19 vaccination programme.
Experts at the MRC Unit The Gambia at LSHTM created a rumour-tracking app to identify and combat misinformation about COVID-19 circulating amongst the populations in The Gambia and neighbouring Senegal.
Listen to the LSHTM Viral Podcast Episode: Tracking COVID-19 rumours in Africa
Informing global health policy
Centre Co-Director, Professor Martin Antonio was the founding Director of the WHO Collaborating Centre for New Vaccines Surveillance which provides technical support to countries in the African Region to improve on surveillance of Invasive Bacterial Diseases (IBD). The Centre informs policymakers on new vaccine introduction to combat IBD. The Medical Research Council Unit The Gambia (MRCG) was designated a World Health Organization Collaborating Centre for New Vaccines Surveillance (WHOCC NVS), in recognition of the contributions of the Molecular Microbiology Group within the Vaccines and Immunity Theme at MRCG for the control of epidemic meningitis outbreaks in West Africa.
Professor David Heymann, a medical epidemiologist and Professor of Infectious Disease Epidemiology at LSHTM and member of the strategic advisory committee at CEPR, is currently chair of the Strategic and Technical Advisory group on Infectious Hazards (STAG-IH) that is advising the World Health Organization (WHO) on current and future infectious disease hazards including the COVID-19 pandemic.
Break down barriers
We’re living in a hyper-connected world but there are still barriers in the way when it comes to collaboration. Part of our mission is to re-think ways of working and to challenge preconceptions and prejudices so that we can share knowledge and ideas quickly and effectively across different disciplines, countries and cultures.
Breaking down barriers in action:
- Epiverse-TRACE: Building and connecting a community of co-creation for the future epidemic response
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Anna Carnegie - Community Manager for the Epiverse Initiative at LSHTM and MRC Unit The Gambia at LSHTM
Anna Carnegie talks about the Epiverse TRACE initiative's work to creating a community of epidemic responders. - Ebola Response Anthropology Platform
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The Ebola Response Anthropology Platform was established to help health workers develop culturally sensitive interventions to change behaviour in local communities and stop the spread of the Ebola virus disease. Researchers rapidly mobilised to conduct clinical trials of Ebola vaccines and treatments. Students cleansed Ebola patient record data for the World Health Organization (WHO) to ensure sites of outbreaks were recorded accurately.
Research efforts supported international Ebola response planning, including calculating what resources were needed, where and when by, in order to halt the exponential growth of the outbreak.
Move the needle
We’re here to help redefine how people and societies prepare for and respond to future outbreaks of disease. We’re one organisation in a global network but we’re determined to make a real impact quickly. That means understanding all the lessons of the COVID-19 pandemic, championing new processes and practices and working together with our partners to create an outbreak playbook for the pandemic era.
Moving the needle in action:
- Genomic surveillance of SARS-CoV-2 in Uganda, South Sudan and Burundi
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Professor Matthew Cotten
Professor Matthew Cotten discusses his work around genomic surveillance of COVID-19 across Uganda, South Sudan and Burundi. - Testing, quarantine and isolation - modelling the risk of onward transmission from air travellers
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Dr Sam Clifford, Billy Quilty
Dr Sam Clifford discusses research on the risk of onwards transmission from air travellers during an infectious disease outbreak. Outputs
Strategies to reduce the risk of SARS-CoV-2 importation from international travellers: modelling estimations for the United Kingdom, July 2020 | Eurosurveillance Effectiveness of interventions targeting air travellers for delaying local outbreaks of SARS-CoV-2
- Outbreak analytics and COVID-19 response
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LSHTM was involved in the early stages of the COVID-19 pandemic in estimating key features of epidemiological dynamics, from fatality risk to superspreading, and examining potential response strategies for a range of countries. As the pandemic progressed, their work helped reveal the potential threats posed by COVID-19 variants and benefits of vaccination programmes on reducing impact, contributing scientific insights to multiple governments and health agencies.
Listen to LSHTM Viral Podcast: Using mathematics to help control COVID-19
- Rapid local sequencing led by MRC/UVRI and LSHTM Uganda Research Unit
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In Uganda, our researchers evaluated SARS CoV-2 rapid diagnostic tests and PCR kits and generated the first Ugandan SARS-CoV-2 full genomes through rapid local sequencing.
This helped Uganda to understand the disease and monitor and control virus transmission. They also secured test reagents and personal protective equipment on behalf of the WHO in support of the national testing effort.
Modelling work continued apace throughout the pandemic, providing key projections and regular data analysis in scientific papers which also contributed to evidence for the UK government’s policy making.Outputs
Main Routes of Entry and Genomic Diversity of SARS-CoV-2, Uganda
- Innovative vaccine research to prevent Ebola Virus Disease in Sierra Leone
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LSHTM researchers involved in phase 1 and phase 3 clinical trials aimed to find out whether long-term immune protection against Ebola Virus Disease can be achieved using a two-dose vaccine regimen Zabdeno (Ad26.ZEBOV) and Mvabea (MVA-BN-Filo). The trial have now completed in 443 adults (43 in stage 1 and 400 in stage 2) and 576 children aged 1–17 years. The trials were conducted across three clinics in Kambia district, Sierra Leone. Long term follow-up of the study participants is ongoing.
The vaccine uses a modified adenovirus as a delivery vehicle for broken down and inactivated components of various virsues in the in the Ebola virus family. These include the Ebola virus itself, Sudan virus, Marburg virus, and the Tai Forest virus.
Once this payload of proteins, glycoproteins, and nucleoproteins is delivered to the immune cells of the body, they can use it as a template to begin to make antibodies that will protect the patients from real infection and disease.
The vaccine regimen was well tolerated, and no safety concerns emerged from the trials in adult or in children. At 21 days after the second dose, 98% of all participants had induced antibody responses to the Zaire ebolavirus species.
The vaccine doses were administered with a 56-day interval between the two doses. When booster vaccination with Ad26.ZEBOV was given to adults 2 years after the initial vaccination, it induced a strong response within 7 days, thus indicating that the vaccine recipients’ immune systems can generate a good ‘memory’ response.
The trials were the first to provide data on this vaccine regimen and the data were used by Janssen Pharmaceutical Companies (Janssen) to apply for licensure. The vaccine regimen was granted Marketing Authorisation by the European Commission in July 2020 and Prequalification from the World Health Organization (WHO) in April 2021. Researchers in this study, including our management member Dr Kate Gallagher, are a part of the EBL3001 study group, focusing on furthering Ebola vaccine research.
Outputs
Safety and long-term immunogenicity of the two-dose heterologous Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen in adults in Sierra Leone: a combined open-label, non-randomised stage 1, and a randomised, double-blind, controlled stage 2 trial Safety and immunogenicity of the two-dose heterologous Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen in children in Sierra Leone: a randomised, double-blind, controlled trial