University of Manchester researchers’ collaboration with the Partnership for Research in Occupational, Transport and Environmental COVID Transmission (PROTECT) project informs policy and practice aimed to reduce risk from Covid-19 transmission

Narrative

INTRODUCTION

At the start of the pandemic in 2020, the National Core Studies (NCS) programme was established by the UK government to increase research in key areas to guide strategic, policy and operational questions about Covid-19. Six national studies were set up with the key aim of answering the most critical questions for policy makers.

Partnership for Research in Occupational, Transport and Environmental COVID Transmission (PROTECT) was the National Core Study set up to research understanding of the transmission of Covid-19 in the workplace, on transport and in public places. It was made up of six themes. PROTECT was led by the Health and Safety Executive (HSE)’s Chief Scientific Adviser, Professor Andrew Curran . Professor Curran is also an honorary professor at The University of Manchester and is co-director of the Thomas Ashton Institute for Risk and Regulatory Research which is a strategic partnership between UoM and HSE.

PROTECT was delivered by a collaboration of government, regulatory and academic institutions including The University of Manchester. The study began in October 2020 and was funded by HM Treasury until March 2023. Professor Curran met regularly with Chief Scientific Advisors from other government departments including the Chief Medical Advisor, Chris Whitty. The project represented a huge collaborative effort from all involved and was an example of highly adaptive and reactive research. Individual stakeholders such as HSE and other government departments were able to benefit from research results in real time as throughout the process important outcomes were fed into to advise policymakers.

The University of Manchester led on theme three of PROTECT, ‘sector specific studies’ which aimed to understand the specific risks of transmission faced by different industrial sectors. Research in this area conducted by University of Manchester researchers focused on understanding transmission risks in occupational groups and sectors such as public transport sector, food processing, construction and other sectors. In addition, the team investigated why some local authorities had sustained high levels of Covid-19 infection (‘areas of enduring prevalence’) compared to similar areas. A Greater Manchester Case Study around enduring prevalence later followed.

Our researchers also contributed to several other PROTECT themes, including Theme 1 ‘Outbreak investigations’, theme 2 ‘transmission modelling, theme 4 ‘tools and methods’ which aimed to develop tools and methods to better understand transmission of Covid-19 in different environments and Theme 6 ‘Knowledge synthesis’ on a project called ‘Keeping the UK Building Safely (KUBS)’ which aimed to improve understanding of the construction sectors efforts to build ‘covid secure’ workplaces.

WORK UNDERTAKEN BY UNIVERSITY OF MANCHESTER RESEARCHERS

Exploring the relationship between types of occupation and Covid-19 risk

Our research explored relationships between different types of occupation and the risk of Covid-19 outcomes such as infection, severe disease and Long Covid, using various sources of data, including infection data from the ONS Coronavirus Infection Survey, the VirusWatch study, and mortality data for England and Wales. We found evidence that there were increased risks for some occupational groups and that this varied over time. For some occupational groups, such as health care workers, high elevations in risk for infection and mortality were seen early in the pandemic had largely disappeared by the later waves. In contrast, in the educational sector relatively high infection risks (but not mortality) were observed throughout the pandemic. The findings were fed into government departments and featured into the Industrial Injuries Advisory Council (IIAC) independent report presented to UK Parliament in November 2022 on ‘Covid-19 and occupational impacts’.

UoM Team: Matthew Gittins, Sarah Rhodes, Jack Wilkinson, Martie Van Tongeren

Examining perceptions of risk and mitigation in the public transport sector

Our research aimed to look at the perceptions of risk of transmission amongst various stakeholders (workers, passengers, employers and regulators) within the public transport sector along with what mitigations were being put in place and the perceived effectiveness of these strategies.

Our study concluded that evidence and knowledge gained during the pandemic should be used to develop clear and effective strategies to allow for coherent and rapid responses to any future pandemics / health emergencies. Recommendations included:

•Establishing or maintaining industry forums to respond quickly to appropriate issues in the future; 

•Collaborative development of clear messages, between policymakers, regulators, companies, unions, and passenger groups;

•Encourage leading by example from those working within the public transport industry in adhering to guidance about risk mitigation;

•Considering the complex dynamics in workplaces when developing messages to worker groups that will interact in many ways;

•Developing clear lines of accountability for compliance with guidance, particularly for passengers and workers;

• Longer term planning of public transport services should consider wider agendas (for example, sustainability and net zero) and greater cross agency co-ordination.

At various stages of the work the team provided findings and recommendations directly to the Department for Transport (December 2021 and January 2022) and provided feedback to those who took part in the research namely: experts (policy makers, academics etc), organisational leaders (across different modes of public transport), workers and passengers. Our research was cited in IIAC Independent Report "Covid-19 and Occupational Impacts" presented to UK Parliament in November 2022 and Industrial Injuries Advisory Council paper "The Occupational Impact of COVID-19 in the Transport and Education Sectors” presented to UK Parliament in November 2024.

UoM Team: Anna Coleman, Karen Davies, Nicola Gartland, Sheena Johnson, Martie Van Tongeren

Understanding the drivers of ‘Enduring Prevalence’

In 2021, the UK government’s Scientific Advisory Group for Emergencies (SAGE)reported identified that there were areas of enduring prevalence of Covid-19 across UK. Our team was asked to investigate the reasons for certain areas in England (e.g. areas in the North-West, North-East and East-Midlands) to have enduring high prevalence of infection during the pandemic.  Our researchers interviewed 19Directors of Public Health across England, both in areas identified as having high enduring prevalence and in areas that did not, to better understand the drivers behind enduring prevalence.   

Our research showed that the Directors of Public Health considered that deprivation, employment and housing were the key drivers of COVID-19 prevalence, along with vaccination rates. Work related factors such as job insecurity and absence of sick pay were also perceived to influence behaviours and increase the risk of virus transmission. 

The research was fed back to SAGE and was widely disseminated at a range of local, regional, national and international forums, conferences and events, including presentations to HSE and UK Health Security Agency (UKHSA).   

UoM Team: Chris Armitage, Anna Coleman, Nicola Gartland, Angelique Hartwig, Sheena Johnson, Cath Lewis, Janet Ubido, Martie Van Tongeren

Greater Manchester Case Study on ‘Enduring Prevalence’

Following the initial work on enduring prevalence, the team conducted a Greater Manchester Case Study both to investigate workplace responses during the course of the pandemic, changes as a result of government policy such as the removal of restrictions and including the April 2022 report ‘Living with Covid’. They also investigated how Greater Manchester workplaces were supported by Public Health and Environmental Health teams during the course of the pandemic.

This research was widely disseminated, including presentations to HSE and UK Health Security Agency (UKHSA Seminar Series; UKHSA Clinical Peer Review Group). We also held dissemination events with Directors of Public Health; GM local authorityCovid-19 leads.

UoM Team: Michael Benson, Anne Clayson, Bernadine Farrell, Mark Johnson, Sheena Johnson, Cath Lewis, Claire Mann, Janet Ubido, Martie Van Tongeren, Eliza Varga, Arpana Verma

Understanding the construction sectors efforts to build ‘Covid-Secure’ workplaces

Our researchers conducted the Keeping the UK Building Safely(KUBS) project to improve our understanding of the construction sector’s efforts to build ‘COVID-secure’ workplaces. Evidence collected by the KUBS project was used to support the sector to reduce transmission of the COVID-19virus and keep building safely and productively as the UK economy unlocked. Reports produced informed industrial guidance and policy.

During the first phase of the project, the team gathered data rom surveys and interviews with four principal contractor organisations and identified six key themes in the industry’s response to reducing COVID-19transmission, highlighting practical challenges facing the sector in the transition to a full ‘reopening’ of the UK economy.

The second phase of KUBS was conducted at a late point in the pandemic and with a wider range of staff from all levels within construction. Research concluded that the full extent of the economic consequences of the pandemic was yet to be known, but early data suggest that the path to recovery would be slow – particularly in the context of global uncertainty arising from the conflict in Ukraine. For people in the UK, inflationary pressures, and the associated increases in the cost of living is likely to lead to greater demand for social housing and by implication, on the house building/refurbishment sector more generally. 

Through engagement directly with the government, industry and other stakeholders, the research team disseminated research findings and advice, produced accessible and usable communications outputs such as evidence briefings, guidance documents and risk assessment tools, and made research publications and reusable datasets findable and accessible to other researchers to maximise impact.

UoM Team: Neil Bourne, Ruifeng Cao, Clara Cheung, Sharon Clarke, Bill Collinge, Angelique Hartwig, Amanda Howells, Sheena Johnson, Richard Kirkham, Claire Mann, Patrick Manu, Qingyao Qiao, Sabrina Saba, Martie Van Tongeren, Akilu Yunusa-Kaltungo

Impact date	2020
Category of impact	Health and wellbeing, Policy, Awareness and understanding
Impact level	Benefit