MethodCOV

COVID-19 research was faced with the challenge of incorporating social and contextual factors that are related to COVID-19 diseases in a variety of ways. The methodological network's primary goal was to support the research consortia in the Network University Medicine in identifying, collecting, analysing and interpreting basic social and contextual data - both in population-based and patient-based clinical studies - and to provide medical-historical and ethical orientation knowledge in order to draw direct lessons from current developments. Of great importance are socio-demographic, occupational, environmental and care-related as well as cultural and intellectual-historical factors, for which topic-specific working groups have been set up in this project:

Sociodemographics

In order to be able to directly assess the danger of pandemics and target countermeasures to specific groups, fundamental analyses along key population characteristics are important. Basic socio-demographic data such as gender, marital status, education or income play a central role here, as they can be collected as a companion survey in population- and patient-based study designs at low cost in order to create an efficient database for estimating the social distribution of infectious diseases as well as opportunities for specialised thematic studies.

Occupational factors

University hospitals provide medical care to working people, whose work and professional environment have a decisive influence on the risk of infection, progression and rehabilitation or return to work. Work content and processes determine the risk of infection and how effective infection-prevention occupational safety measures are. For example, the time pressure factor causes the neglect of infection-preventive occupational safety measures. The recording and consideration of occupational factors in the COVID-19 pandemic, as well as in possible future pandemics, contributes significantly to the performance of university medicine in research and patient care.

Environmental factors

The role of air pollution in the spread and virulence of SARS-CoV-2 has attracted considerable attention in the international press. Both in Germany and internationally, an accumulation of severe COVID-19 cases in populations with high levels of air pollution has been noted. One of the biological mechanisms of action of air pollution is a weakening of the immune system in the upper respiratory tract, which is mainly due to a disruption of mucociliary cleansing and can therefore lead to increased susceptibility to infection, including SARS-CoV-2.

Care-related factors

Health literacy is unevenly distributed in society. The (non-)utilisation of healthcare services during the COVID-19 pandemic (both COVID-19-related and due to other health concerns) is an important factor in delayed hospitalisation of COVID-19 patients. In addition to the frequency and choice of contact with doctors prior to hospitalisation, non-utilisation despite symptoms is decisive here. Furthermore, by recording utilisation, it is possible to map the indirect health consequences of the pandemic, e.g. through cancelled preventive care and treatment appointments for chronically ill people.

History and ethics

In discussions about dealing with and overcoming COVID-19, medical-historical and ethical questions were raised from the outset with the aim of understanding how society dealt with the pandemic and discussing medical-ethical issues such as the fair care of those affected at an early stage. The current debates on the legal and value foundations of our society make it seem necessary to fundamentally historicise current events and continue the debates on values that have already begun. The current circumstances and options for action should be interpreted in the context of their historical origins in order to be able to directly derive options for action for the future.

Against the background of the overarching goals of the Network University Medicine, this project had three objectives:

1. Methodological expertise was pooled on the social and contextual factors in pandemic research at the university hospitals described above and networked via a virtual exchange platform. In addition, exchange with research institutions outside university medicine was organised.
2. The network's diverse research projects were specifically supported in the collection and analysis of basic social and contextual data. In particular, a set of scalable best-practice questionnaires was compiled in order to record social and contextual factors in a valid, quick and low-cost manner. These questionnaires were made available to the network. In addition, a consulting concept was developed to support the individual research projects in the research network in collecting and analysing data.
3. In addition to short-term support through the establishment of a virtual networking platform that can also be reactivated quickly after the funding period, the project created long-term structures. These structures should ensure that action-relevant research on social and contextual factors can also be carried out in the event of future epidemics or other fundamental crises. The methods network ultimately aimed to create an agile, resource-saving structure that can be reactivated quickly.

Through cooperation with external researchers from the existing "Public Health Competence Network", additional methodological expertise was to be integrated and further opportunities created to publicise key public health research findings.