One year since the emergence of COVID-19 in the UK and the production of data-driven analysis informing government and public service delivery continues at pace.
In Wales, the swift creation of the One Wales approach galvanised expertise and brought together organisations at the heart of decision making. With approved access to data already held in the SAIL Databank, along with access to new timely data, it was immediately possible to produce vital analysis to form the basis of national planning throughout the pandemic.
To date, the One Wales team have looked at the prevalence, transmission and impact of the virus and more recently the uptake of the COVID vaccines – with the results informing government thinking both in Wales and at UK level.
Central to the One Wales analysis has been the presence of a new population wide cohort, the foundation upon which much of the questions could be answered. Jane Lyons is a Research Officer and Data Scientist within the Population Data Science team at Swansea University and the lead behind the Welsh Multimorbidity e-Cohort (WMC).
Prior to the emergence of COVID-19, the WMC was designed to aid analysis on the implications of multimorbidity (the presence of two or more concurrent long-term health conditions) by measuring its prevalence, trajectories and determinants, as well as helping to identify clusters of diseases that result in the greatest healthcare need and death.
Once the pandemic struck using the WMC study design enabled the One Wales team to produce rapid assimilation to help with the COVID-19 research response.
What makes up the Welsh Multimorbidity e-Cohort?
The WMC is a data resource that enables researchers to carry out statistical and machine learning approaches to answer research questions. It works with anonymised and encrypted data from SAIL and brings together Welsh Demographic Service Dataset (WDSD) and the Annual District Death Extract (ADDE) mortality registry data from the Office for National Statistics to create a Welsh population cohort of 2.9 million individuals with follow up from 1st January 2000 to 31st December 2019.
Using WMC to aid the One Wales analysis
Speaking of the use of the WMC and the One Wales effort, Jane said:
“Learnings and study designs from the WMC were utilised for rapid assimilation of available data resources to help with the COVID-19 research response for Wales. Two population cohorts called C20 and C16 were created to provide near real-time intelligence. The C20 cohort includes all individuals in Wales on the 1st January 2020 with follow up until death, first break of Welsh residency or study end date (updated monthly). The C16 cohort includes all individuals in Wales on the 1st January 2016 with follow up until death, first break of Welsh residency or 31st December 2019. C16 is designed to provide counterfactual and contextual comparative data on population health service utilisation and mortality rates. The C16 and C20 cohorts are used by our team to determine the demographic, socioeconomic and clinical risk factors for infection, morbidity and mortality related to COVID-19 as well as measure the impact of COVID-19 on healthcare utilisation.
“To date analysis has included the work to understand the paths of transmission of COVID-19 in schools, how health care utilisation has changed since the pandemic, identifying the risk of infection to healthcare workers, vaccine uptake and safety, and also work to estimate mortality outcomes for adults with COVID-19 in Wales.
“None of the WMC or COVID-19 work would have been possible without a fair team science approach and a huge collaborative effort across multiple organisations and institutions, which has widened networks and enhanced relationships. The researchers working within the One Wales team have worked together to ensure the research can be possible and outcomes delivered.”
“We are extremely grateful that permissions from data custodians and information governance panels have allowed this near real-time research to be carried out to help understand the spread of the infection and the effectiveness of intervention measures.”
One Wales brings together colleagues from both within Swansea and across Wales under the direction of the Welsh Government Technical Advisory Cell (TAC) and includes the following groups and organisations: the Secure Anonymised Information Linkage (SAIL) Databank, Administrative Data Research (ADR) Wales, NHS Wales Informatics Service (NWIS), Public Health Wales, NHS Shared Services Partnership and the Welsh Ambulance Service Trust (WAST). All research conducted has been completed under the permission and approval of the SAIL independent Information Governance Review Panel (IGRP) project number 0911. This unity of expertise from across Wales has resulted in an agile and responsive approach to tackling data analysis and intelligence generation based on both the constant and newly developing priorities for tackling COVID-19 in Wales.