A Primary Care Scientist’s view of 2020

I have sat on the SAPC executive for 4 years now, and I have the honour of being the joint lead Primary
Health Care Scientists (PHoCuS) with Dr Julia Hiscock, University of Bangor. Primary Care Scientist is a
catchall term for the >50% of the Academic Primary Care (APC) workforce who are not general
practitioners. This group includes academics involved in both education and research. We are diverse,
with different professional backgrounds e.g. allied health professionals and nursing, social sciences
(e.g. anthropologists, psychologists, sociologists), statistics and data science, clinical trials
methodology, health economics and implementation science.

In my view, APC is at its strongest when it is collaborative and interdisciplinary. The ideal of ‘Team
Science’ is gaining traction within biomedical researchi - but for those of us working in APC research it
is old news as our laboratory is the glorious, if somewhat messy, world of primary care. Which segues
nicely into the first months of 2020….

The University of Leeds team (@AU_PrimaryCare) was due to host the SAPC 2020 Annual Scientific
Meeting (ASM). We started the year with all the major planning complete and a growing sense of
excitement at showcasing APC’s team science. In January, news reports emerged about a place called
Wuhan in China, and a disease not all that dissimilar to the 2003 SARS virus epidemic. Now named
‘COVID-19’, this was pandemic not an epidemic, and cancelling the ASM had become inevitable. In
three short months it was clear that tackling COVID-19 would require a society response the like of
which has never been seen in our lifetime. I need not tell you of the heavy burden faced by our clinical
colleagues in the NHS, local authorities and the care home sector. Others have written eloquently and
at length about the impact of this disease on the coal face; as social scientist I have watched from my

As joint-national lead for PHoCuS I want to reflect on COVID-19 and its impact primary care scientist
workforce. Along with clinical colleagues, we have seen transformative change in the University
sector. In four weeks most Universities have gone from ‘business as usual’ to entirely remote working.
The magnitude of change has been staggering, but perhaps even more so against the backdrop of
clinical colleagues are increasing their NHS commitments. Non-COVID research within the NHS has
mostly ceased. We are increasingly seeing non-clinical academics stepping into roles previously
occupied by their clinical counterparts in order to secure taught course delivery. We are teaching
remotely. We are home-schooling children. We are worrying about our older relatives and our clinical
friends on the front line.

As a senior leader in a University, I have heard many of my non-clinical colleagues expressing feelings
of helplessness, and expressing doubts about the value of what we do. We are in lockdown, with one
of the only portals into the world is through (social) media. The language of government and the media
is at risk of becoming divisive, with strong narratives emerging around clinicians as ‘heroes waging a
war’ against COVID. However, wartime analogies cannot be used selectively - I refuse to think of
people who have died from COVID as ‘casualties’ or ‘collateral damage’. Rather my point is much more
basic: the COVID pandemic may be caused by a virus, but it will be spread/stopped by people. Success
will be determined by the everyday actions of ordinary people.

The solutions to COVID will be found by drawing on APC’s long tradition of team science. In addition
to stepping into the gaps emerging within taught courses, primary care scientists are undertaking
rapid reviews to guide clinical practice. We will be undertaking epidemiological modelling of data to
inform public health. We will be helping critically evaluate new diagnostic tests. We will contribute to
the clinical trials infrastructure to rapidly test new vaccines and drug treatments for COVID. We will
be peer reviewing the scientific robustness of the research designed to address COVID problems to
prevent biased findings from leading us down evidential rabbit holes. As restrictions lift around
research, we will be integral to efforts to learn lessons about how to respond to a viral pandemic. This
will be mixed methods science in full flow. This will be multidisciplinary working that attracted many
of us to working in APC in the first place. Many things may need change in this new normal, but this
this shouldn’t be one of them.

Sue Richards
Professor of Primary Care Research and SAPC Executive member locked-down in a small market town
near Leeds
28th April 2020

i https://acmedsci.ac.uk/file-download/38721-56defebabba91.pdf