Director of The Pandemic Institute, Professor Tom Solomon CBE, recently took part in an event bringing together academia, industry and government to address scientific and technical opportunities and challenges in the North West region. Here, he shares his reflections on the ‘Preparing for Future Pandemics’ panel session.

To tackle emerging infections effectively requires partnership of academia, health care, civic authorities, industry, and the public. This was one of the key messages from a recent meeting hosted in The Spine, Liverpool, by the Royal Society, the Academy of Medical Sciences, and The Pandemic Institute. The meeting was one of the Royal Society’s Creating Connections events, which bring together leading experts from academia, research-intensive industries, government and others to explore the role of different places in driving innovation and prosperity across the UK. The Royal Society, along with the Academy of Medical Sciences are two of the four “national academies”; the latter being the independent, expert voice of biomedical and health research in the UK.

I was fortunate enough to chair the round-table discussion “From Local Leadership to Global Collaboration – Preparing for Future Pandemics”. University of Liverpool Pro-Vice Chancellor for Health and Life Sciences Louise Kenny CBE, began the session describing how the University, Liverpool School of Tropical Medicine, City Council and City Region rapidly came together at the start of the pandemic, along with NHS Trusts and Public Health teams, as the STOP Covid partnership (STrategic One Liverpool Partnership for COVID). Because Liverpool hosts the National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections we had been tracking the emerging problem in China from the end of 2019. In early January 2020 we activated the dormant ISARIC protocol, a national study led from Liverpool and Edinburgh, which aims to investigate emerging infections as they arise.

Liverpool City Region Combined Authority, led by Mayor Steve Rotheram, has the UK’s largest concentration of infectious diseases translational public sector research, development and innovation, which delivers £2B of infectious disease R&D annually. AstraZeneca’s vaccine manufacturing site in Liverpool, which produces 20 million doses of flu vaccine annually, is a critical part of the local and national vaccine ecosystem. Mark Proctor CBE is General Manager of AstraZeneca’s R&D and Operations site in Liverpool; he led the Global Supply Team responsible for setting up and launching the Oxford/AstraZeneca SARS-CoV-2 vaccine, in the UK and internationally. He described how major vaccine manufacturers that normally compete all came together, collaborating brilliantly to scale up manufacture and distribution of Covid-19 vaccines. The pragmatism and speed with which regulators worked was also key to the success of the programmes. Supply chain and data management proved to be tricky issues, and need to be thought about now, in advance of the next pandemic.

Iain Buchan, the William Henry Duncan Chair in Public Health at the University of Liverpool, spoke about the Covid-19 Mass Testing pilot in Liverpool, a collaboration between the university, the city council, NHS, public health authorities, and the British Army. This demonstrated early in the pandemic that if you tested people who have no symptoms, you would find many were infected, and could self-isolate to reduce the spread. In this way cases were brough down by 20% in Liverpool, and hospital cases by 43% initially and 25% overall. The results led to rapid changes in national and international policy on who should be tested. Iain also spoke about data-driven reopening of mass events – the Liverpool “First Dance” weekend, and the need for better linkage of data in the future, especially between the NHS and UK Health Security Agency. He showed how a civic intelligence system created in Summer 2020 underpinned mass testing, events and multiple Covid-19 recovery projects, and how a Civic Data Cooperative can mobilise data in this way, with public support.

From early in the pandemic, great sway was put on the “need for a vaccine”; but a focus on the need to “vaccinate the world” might have been a better target, to avoid some of the health inequalities that became so apparent. This was an area of special interest for our fourth speaker, Dr Jahangir Alom BEM, an Emergency Medicine doctor who is a member of the UK Young Academy, and was Clinical Lead for the NHS Staff Vaccination Programme. Black communities had the lowest vaccine uptake, despite being the most vulnerable in terms of infection and mortality rates. A range of factors contributed to this including overcrowded housing, multigenerational families, and a lack of trust. The national government was trusted less in the pandemic than were local authorities, and devolving decision making to the local level proved critical. Working with local religious and other community leaders is key to trying to improving vaccine uptake.

Following these introductory comments there was a broad-ranging discussion among the 40 invited participants representing regional and national interests. The importance of relationships was again emphasised. The Liverpool response worked well because most of the partners knew each other and had worked together for years. Education of the public is also critically important. In Liverpool novel approaches in the community using story-tellers and artists are proving helpful. Science education in schools needs a rethink to ensure it is equipping the public with the knowledge they need to understand what is happening in a health crisis. Although the WHO announced an end to the Covid-19 global public health emergency in 2023, it is critical that systems are maintained ready for the next emerging infection threat. This is the aim of The Pandemic Institute in Liverpool, which has already applied some of the lessons learnt in the pandemic to help tackle mpox (formerly called monkeypox) and the growing measles epidemic. During a lunchtime address at the Creating `Connections event, Liverpool City Region Mayor, Steve Rotheram emphasised the importance of academic-industry partnerships in the region, exemplified by The Pandemic Institute; he underscored his commitment to investing in research and development to strengthen the local and national economy.

Professor Tom Solomon CBE, Director of The Pandemic Institute