Liverpool household COVID-19 cohort study

300 Liverpool households are participating in a unique study. The study will enable our researchers to measure the transmission of COVID-19 and other effects of the pandemic.

Core epidemiological study

The core household study is generating key data to improve national understanding of the dynamics and determinants of transmission into and through households and to further explore the characteristics of COVID-19.

The study, led by Professor Neil French, is supported by University of Liverpool and Liverpool School of Tropical Medicine (LSTM) joint initiatives the NIHR Health protection research unit in emerging and zoonotic infections (HPRU EZi) and the Centre of excellence in infectious diseases research (CEIDR).

“This study is focused on Liverpool and supports the national research effort. The data we are gathering are contributing to an improved understanding of transmission, quicker and more accurate diagnostics to help inform government decisions about who should or shouldn’t be tested and isolated,” says Neil.

“We are also analysing patients’ immune systems to help inform the development of vaccines and drug treatments; exploring household behaviour to provide information about the consequences of social distancing approaches; and understanding peoples mental health in response to control measures for the pandemic.”

The study involves approximately 300 households (totalling around 1000 inhabitants) and spans different geographies in Liverpool to ensure diversity in socioeconomic status and household size.

Household members are assessed on recruitment for SARS CoV-2 infection and then on a weekly basis. New infections are mapped and the pattern of transmission defined, with recommendations for infection control emerging in real time. Household interactions are being recorded to inform improved models of transmission – this will help to refine predictions and improve control.

This epidemiological work will measure incidences of disease and household secondary cases, rates of asymptomatic ‘shedding’ (when a virus is released from an infected host), and risk factors for shedding and transmission. In the longer term, the study will look into risks of re-infection.

The core epidemiological study is complemented by multidisciplinary research studies involving consenting households from the cohort.

Understanding the psychological and social impact of COVID-19

A psychological strand of the household study, led by Professor Kate Bennett and Professor Rhiannon Corcoran, seeks to understand the psychological and social impact of COVID-19 on household members.

Professor Kate Bennett said: “Our city region has some of the most disadvantaged neighbourhoods in the country and so is subject to some of the greatest health and care inequalities. To date there has been no research into the psychological, social and community impact of COVID-19 in the Liverpool City Region (LCR) with a direct focus on health inequalities and neighbourhood disadvantage, so this study is much needed.”

The study is assessing various impacts of COVID-19, including:

• Differences between those who contract and who do not contract the disease by neighbourhood deprivation
• The impact of social support on individual wellbeing
• Changes in loneliness over time.

It is also examining how tolerance of uncertainty influences:

• Individual wellbeing
• The individual, community and societal factors that promote or hinder resilience
• How household structure can impact the wellbeing and resilience of individuals.

Risk and its interplay with socio-economic environments

A further study from Professor Mark Gabbay in collaboration with researchers at LSTM will collect qualitative data from some of the cohort households, alongside employers and representatives from community organisations.

Interviews by researchers will focus on risk in the pandemic and its interplay with socio-economic environments and lived realities.

Householders will describe their perceptions of and reactions to risk, discuss barriers to acting on official advice, attitudes and implications as well as needs and hopes for the future. A second phase will explore these experiences further, and examine the impact of social distancing and social isolation measures using photographs taken by the respondents to highlight issues of importance to them in relation to COVID risk.

Community interviewees will detail how risk has altered activity behaviour and social or support structures within the community. Employers are providing insight into risk reduction, impacts on employees and the organisations themselves.

A sub-study is focusing on COVID-19 risk within the Liverpool Muslim community.

A similar qualitative study in Sub-Saharan Africa (Malawi and Cameroon) will run alongside the Liverpool project.

Funders

The Liverpool Household COVID-19 Cohort Study is funded in part by a £100,000 donation to the University’s COVID-19 Emergency Response Campaign. For more information about the campaign and how you can support it, visit the campaign page.