Human challenge studies in the study of infectious diseases
What can deliberately infecting healthy people tell us about infectious diseases? How is this useful for developing treatments, and how do we manage the risks?
Over 1,100 experts have shared with us their concerns about COVID-19 and COVID-impacted areas in the immediate and longer term future. This report outlines infrastructure concerns. Experts are concerned about public transport. They worry about the reduction of services and want clearer guidance on how to stay safe while traveling. They also note that after the outbreak people might not return to using public transport, which could have a range of negative impacts on infrastructure. Digital infrastructure is also an area of concern. Experts worry it will struggle to continue to cope with increased demand. In terms of energy, experts worry about volatility in the energy market and that this could affect how much energy the UK is able to import. Finally there are general concerns about the UK's ability to monitor and maintain infrastructure. Such services might have halted or reduced. On top of that, returning workers might be less familiar with the new processes and put their health and safety at risk.
DOI: https://doi.org/10.58248/HS16
Our survey of over 1,100 experts asked them what their most important concerns were in the short (next 3 months), medium (next 3 to 9 months) and long-term (beyond the next 9 months) relating to the COVID-19 outbreak. Their responses were analysed and synthesised. This synthesis comes from survey responses submitted between 3 and 30 April. Experts raised 38 concerns relating to infrastructure. Below are the areas of concerns that experts have relating to this area.
There are nearly 20 concerns relating to transport. In the short-term, experts want to know more about the decision to reduce the number of services running on the London Underground. They want to know what considerations were taken into account, including around increasing road traffic and potential overcrowding in tube carriages. Experts are also concerned about how to maintain social distancing on public transport in the short and medium-term.
Experts note that there is a likely to be a peak of active travel (such as walking or cycling) during the COVID-19 outbreak. This is because people have been advised to avoid public transport. They note that current infrastructure is not designed for an increase in active travel. They suggest that increased traffic on cycle ways, footbridges and footpaths may damage them.
In the long-term, experts suggest that people may not return to using public transport. They are concerned that this would affect transport infrastructure in a number of ways. Firstly, a decrease in demand for public transport could result in these services closing in small towns, suburbs and rural areas. They are concerned that this will have a negative impact on non-driving individuals who already have limited mobility. There are also concerns that road infrastructure is not designed for an increase in traffic. A combination of increased traffic and people returning to driving may also cause more road traffic accidents. There could also be an increase in air pollution. Some experts suggest people should be supported to use active travel rather than relying on cars. They suggest redesigning infrastructure to favour this mode of transport. For example, they suggest re-purposing some roads for cycle ways and footpaths.
Example of a typical medium-term concern in this area: People may be unwilling to use public transport or share cars, so more walking, cycling, single occupancy cars, traffic congestion etc.
Experts note that over the short and medium-term there will be increased demand on digital infrastructure. They are concerned that the infrastructure will struggle to continue to cope with increased demand. They note that the security of telecoms infrastructure is more important during the current period than ever before. This is because more people are reliant on telecoms to carry out their work. They note that national cybersecurity must be monitored as the UK is vulnerable to widespread disruption through targeted cyber-attacks.
In the long-term, experts are concerned that there will not be enough investment in digital infrastructure to match future demand. They suggest that many people will want to continue remote working after the COVID-19 outbreak. However, remote working requires reliable and high-capacity digital infrastructure. They suggest that infrastructure budgets should be reviewed and there should be greater investment in rolling out new technologies. Experts suggest that everyone in the UK should have access to high-speed internet, 5G and reliable cloud computing. This digital infrastructure would allow people to continue working remotely with minimal impact to productivity.
Example of a typical short-term concern in this area: Many vulnerable persons have been further disadvantaged due to lack of adequate digital connectivity or reliable transport systems to access necessary goods, services, and information.
In the short and medium-term, some experts are concerned about energy supply from other countries. They note that there is likely to be volatility in the energy market and that this could affect how much energy the UK is able to import. Also over the short and medium-term, experts express concern that some households may be disconnected from the grid because they are unable to pay energy bills. They note that this not only causes harm to households but also to energy suppliers who will need to deal with reconnecting customers and with households going into arrears.
Example of a typical short-term concern in this area: I am very concerned that the measures that are in place and being administered by energy suppliers will only reach some of the vulnerable customers who are capable of contacting the supplier or have support to do this for them.
Experts raise nearly 20 concerns over the quality of UK infrastructure in the medium and long-term. They note that normal maintenance work will have been halted or reduced. This causes two issues. First, infrastructure will not have been well-maintained during this period. Second, there will be a backlog of maintenance jobs once people are able to return fully to work. Some experts are concerned that a lack of maintenance may mean some infrastructure will go into disrepair. This will mean it will require much more money to make it usable again or it will have to be abandoned.
Some experts are concerned about people returning to premises that have not been used for months. They note that there are risks to human health from starting to use infrastructure that has been unused for months. For example, water pipes may have deteriorated over the period, making the water unsafe for consumption. Experts propose a clear protocol on how to restart using infrastructure and what should be measured to ensure human health is not at risk.
In the long-term, experts suggest that disruptions in supply chains may mean that large infrastructure projects (such as new rail lines or power stations) could be delayed. They note that further investment may be needed to ensure the delivery of these projects. Some experts also noted that the UK needs to consider how to build resilience against contagious pandemics into new infrastructure. For example, they note that public spaces (such as railway stations or city centres) are not currently designed to allow for metres of distance between people. Similarly, materials have not previously been chosen based on how long a virus or bacterium could survive on their surface. They suggest that in the future, the UK may need to build pandemic preparedness into building codes to prevent future outbreaks.
Example of a typical long-term concern in this area: All building systems need [to be] regulated to include infection control strategies, particularly healthcare and care home buildings.
You can read the methodology of this work here. All researchers who contributed to this survey are listed under Acknowledgements.
You can find rapid response content from POST on COVID-19 here.
You can find more content on COVID-19 from the Commons and Lords Libraries here.
What can deliberately infecting healthy people tell us about infectious diseases? How is this useful for developing treatments, and how do we manage the risks?
How do our bodies defend against Covid-19? Read how immune responses differ across people, variants, reinfection, vaccination, and current immunisation strategies.
Research studies involving thousands of people have allowed scientists to test which drugs are effective at treating COVID-19. Several drug therapies are now available to treat people who are in hospital with COVID-19, or to prevent infections in vulnerable people becoming more serious. This briefing explains which drugs are available, the groups of people in which they are used and how they work. It also outlines the importance of monitoring the emergence of new variants and drug resistance.