Highlight notice - COVID-19 and ethnicity
Research to understand COVID-19 and to prevent, treat and control it will be critical for mitigating the severity of the outbreak. Rapid progress in addressing this epidemic depends upon a coherent and integrated response from researchers, industry, the healthcare system and the public.
To address this need, NIHR and UKRI have launched a rolling call for rapid research proposals that address emerging priorities and have potential to deliver public health impacts within 12 months. This call has a number of highlight notices against it to seek research proposals on specific topics, including this notice on COVID-19 and ethnicity.
This highlight notice supports NIHR’s single, national prioritisation process for COVID-19 research, to prevent duplication of effort and ensure that the resources and capacity of health and social care systems are not exceeded. We are maintaining a live list of COVID-19 studies that have been given urgent public health research status by the Chief Medical Officer/ Deputy Chief Medical Officer for England
There is emerging evidence of an association between ethnicity and COVID-19 incidence and adverse health outcomes.1,2 There are also concerns that healthcare and other key workers who belong to black, Asian and minority ethnic (BAME) groups may be particularly at risk.
These issues are of critical importance and urgently need to be addressed but are not straightforward, because there may be multiple factors driving this association (such as genetic, socioeconomic, behavioural, cultural and religious and environmental) and many potential confounding factors including comorbidity.
We need research to further our understanding of potential differences in risk for ethnic groups, which groups are at greatest risk of a range of adverse outcomes, and, based on that understanding, what can be done about this to reduce morbidity and mortality. This call is in addition, and designed to complement, existing work already being done by academic groups and Public Health England.
We welcome research proposals in two areas:
- Impact of COVID-19 and association between ethnicity and COVID-19 in the general population.
- Impact of COVID-19 specifically on people working in health and social care from BAME backgrounds.
Research could include:
- Studies to improve our understanding of genetic risk factors and how these manifest clinically, including in terms of immune responses to COVID-19 infection.
- Secondary analysis of existing datasets to understand underpinning reasons for a disparity in outcomes for certain ethnic groups: underlying health conditions, multiple long-term conditions, lifestyle risk factors, deprivation, access and inequalities. The aim is, if possible, to identify modifiable risk factors.
- Understanding and optimising behavioural responses to public health measures, including how to influence individuals and communities to make the behavioural or lifestyle changes necessary to reduce risk.
- Mental health and how communities are responding to the crisis. This can include exacerbation of pre-existing mental health conditions and concomitant consequences, combined with support or interventions to improve health outcomes.
Research on the impact of COVID-19 on people from BAME backgrounds in the health and social care workforce may also include:
- Description and analysis (quantitative and qualitative) of occupational risk by ethnic group and by professional role, including risk of exposure to the virus, infection rates and related harms.
- Work related challenges to wellbeing, physical and mental health as a result of the COVID-19 environment, including coping mechanisms (positive and negative), and support and interventions that are sensitive to religious and cultural needs, as appropriate.
Guidance for applicants
Applicants should where possible take advantage of existing resources and data that may have been created for other purposes, including population cohorts or clinical trial data which includes details of ethnicity.
In all cases, engagement and involvement in research of patients, service users, carers and the public are vital. Research needs to be timely, and reporting milestones should enable the enaction of evidence-informed policy to mitigate poor outcomes among groups in the short-term.
The committee will look across the range of proposals to ensure there is no duplication and may request that academic groups join together where similar work is suggested to improve the scope, expertise and outcomes of the research.
How to apply
This highlight notice will be supported through the joint UKRI-NIHR COVID-19 rapid response rolling call. Details of this call, including eligibility and how to apply, are available on the NIHR website.
Applicants must apply by first completing the NIHR form for prioritising COVID-19 studies. Applicants requiring funding should then follow the link to the full funding application form and submit this by 9am on 11 May.
All applications will be reviewed by a group of appropriate subject matter experts. To enable simultaneous consideration of as many relevant applications as possible, we strongly recommend that applications be submitted by 9am on 11 May 2020.
We will aim to notify applicants of outcomes in early June. Applications relevant to this highlight will still be eligible for submission after this, but will be assessed in relation to those already funded.
Any queries should be directed to ccf-nCoV@nihr.ac.uk.
Applicants should not wait for badging from the Urgent Public Health Group before submitting a full application for funding.
1See for example: ICNARC report on COVID-19 in critical care 10 April 2020.
2Available datasets have low completeness for ethnicity data, may not use the same ethnic categories and limited population data are available to provide denominators to calculate rates. Poor ethnicity recording is a known issue with similar datasets. There are some possible solutions for this, such as data linkage and use of specialist software to assign ethnicity.