When I answered a call to help with Covid-19 research I was leading a team delivering phase 1-3 haemato-oncology clinical trials and was working with UCLH haematologists who are world leaders in their fields.
We were part of the clinical team looking after patients participating in trials. When the pandemic took hold it was clear we had a massive challenge ahead. We did a huge amount of work to understand how to keep our vulnerable patients safe, and shielded, and yet maintain their access to lifesaving research they depended on.
For many patients this meant rationalising their clinic appointments and questioning if we really needed to do a scan or blood test. In some cases patient treatment was withdrawn and recruitment to trials was only kept open in exceptional circumstances. All these changes could compromise the validity of the research - work we had being doing for years was in jeopardy. The focus rightly shifted to the difficult task of a risk minimisation strategy for our patients. I recall a very sombre moment when I read an email from our clinical lead describing the difficult decisions that were being made and how it wasn’t what anyone in medicine had signed up for. He had a job he never thought he would have to do. We had to think differently for the sake of our patients. The queries and concerns from our patients were too many to count. Naturally they were worried. Worried about whether they should shield, whether they could continue with the trial, and worried for their families.
The team more than rose to the challenge to get processes and new ways of working in place. Many non-clinical staff were working from home and two of our research nurses were re-deployed, one to intensive care the other to a geriatric ward - settings they had not worked in before. After over a decade out of direct clinical service my line manager was thrust back on to the ward. It was inspiring to see my colleagues take it in their stride working together to make sure the wards are ready for the coming crisis. The hospital tower was transformed by UCLH’s dedicated and brilliant team.
Once lock down initiated the call came for research staff to work on covid-19 research. By this point we had robust plans in place for our haematology patients and to cope with large scale staff sickness. I knew my skill set that UCLH had developed could be put to good use; I wanted to do what I could to help. Firstly I supported the ISARIC WHO study which aimed to characterise the disease. Propelled enthusiastically into the infectious diseases team we went around the wards collecting samples from willing patients. We were used to clinical research but had to pick up all the detail quickly at the same time as learning to protect ourselves and each other from the virus. With so much on their minds and feeling so unwell many of the patients found it difficult to think about research. The whole situation was surreal. If you have ever felt like you are watching yourself in a movie without being able to control the situation you will know exactly how I felt.
The ward atmosphere was always welcoming and helpful. Everyone helped everyone; we were one team, the nurses, the porters, doctors, receptionists you name them. We had to learn on the job. Issues I never even thought I would need to think about were perplexing - What do you do with a consent form for research once it’s been contaminated? How do you get items off a covid ward without contaminating the clean area? Issues like these challenged our thinking.
UCLH was approached to run a clinical trial using a drug called Ruxolitinib. I had experience using this drug in trials for patients with myeloproliferative neoplasms. I was naturally excited to be involved in delivering this research. It was a trial using a drug I knew, with a principal investigator I knew, in a new setting at a time of crisis. I was privileged to be involved. UCLH set up the trial in record time. A process that takes 10 weeks was done in 2. The drug company moved very quickly and so did we. Quality was not compromised; I saw a team pull together like never before putting in the extra hours to make sure the work was done to the best of their ability. We all knew that this trial had the potential to save lives; there was hope and excitement after so much doom and gloom. The exceptional team work coupled with the potential of this trial drives me to be the best version of myself.
But through all that endurance, courage and focus there was still stress, grief, anxiety and worry. I saw a set of emotions in UCLH staff I never imagined I would see in such a short space of time. It made me take stock of how easy my life actually is compared to some.
Every day was different, everything moved so fast, the dynamic situation called for a dynamic workforce, UCLH was just that. If you thought the NHS was always slow and cumbersome think again! There has been a coordinated approach; the covid research team is large with a number of research projects ongoing, requiring close collaboration cross functionally.
I am struck by the change in the way we work. We can work well from home. We can have remote meetings that are highly effective. Multiple different technologies have been employed that have helped us work harder better faster and made us stronger. Will we ever go back? I hope not. It demonstrated that we can do things better, we can be more economical with our time and change in working practise isn’t as hard as we think. As I get older I will hold on to this moment to remind myself that we must not get stuck in our ways.
There is a real sense of community that I haven’t felt in a long time. Everyone at UCLH is already interconnected, but now more so than ever. I felt closer to everyone. I know that there are many people stuck at home that feel powerless. I am lucky to have a job where I can play a tangible part in trying to help and I am grateful I don’t have to feel that sense of impotence.
Homo-sapiens are the most successful animals on this planet due to our propensity to cooperate. It’s easy to forget that fact when you’re entrenched in your 21st century Instagram life. Maybe it takes a planet wide pandemic to wake you up. I hope we never go to sleep again and that we use this experience to change the trajectory of our species.
Craig Jones is Senior Clinical Trial Practitioner, and Team Lead UCLH for Haematology clinical Trials
