Communication and impact

Right from the beginning, Professor Sharon Peacock strove to make everything about COG-UK as transparent as possible. Realising that the 24-hour news cycle 'means everybody's hungry for news all the time', Peacock engaged several people to help her communicate the work undertaken by COG-UK. This needed very careful handling to make sure the public understood the nature of what COG-UK was doing and not to stigmatise certain areas or people where the sequencing identified particular outbreaks and new variants. Providing clear and accurate information was also important to making sure that COG-UK got credit for what it achieved (Peacock transcript).

In the early days, COG-UK relied heavily on the press office at the Sanger Institute while it built up a communications team of its own (Harrison and Jermy transcript). Communication was not only important for highlighting the work of the consortium to the outside world but also internally as it helped to foster a sense of community in its dispersed members around the country.

SAGE Reports

A lot of the early communication was handled by Dr Andrew Jermy, who was asked to come in and help COG-UK by the third week of March 2020. He came on board after being invited by Professor Dominic Kwiatkowski to help coordinate writing reports for COG-UK to share with the Scientific Advisory Group for Emergencies (SAGE). For Jermy, Kwaitkowski's invitation came at a perfect time because at that moment he and his wife were 'staring into the abyss' because the day before he got the call all the school exams had been cancelled, which was a vital part of his wife's business (Harrison and Jermy transcript).

Jermy recalls that in the first few weeks everything felt very undefined as to what was needed. At the first Zoom meeting he attended with COG-UK, he remembers 'everyone started talking, and I took furious notes, and then I started writing up a report.' This report was subsequently submitted to SAGE at the end of that week. It was the first of eighteen reports that Jermy prepared for SAGE. Essentially, he says the work involved him 'taking notes on who was doing what, what we were planning, and how quickly things were growing.' He also had to 'work out what we could say and what we couldn't say, and go from there. It was very chaotic in those early reports, those early weeks.' The early reports mainly summed up what COG-UK had managed to pull together so far (Harrison and Jermy transcript).

Jermy reflects that a lot of the work that he did at the start was providing evidence to justify why the money had been invested in COG-UK. He points out 'in those early months of the pandemic it was difficult to argue that the genomics were having a quick impact, it took a while to get enough data about what was happening in the community and start to get genomics happening quickly enough in terms of particular outbreaks. So it was very much trying to accentuate the positive messages where we could find them in those first six months' (Harrison and Jermy transcript).

As time went on, report writing and analysis meetings became a regular part of Jermy's routine. Occasionally, people came up with 'something that was mature enough that it could go into the week's report. But quite often at the end of these meetings, I really felt like I was stitching together threads of air to turn it into a report.' Each report, he recalls, 'was literally three days worth of furious work, and then simmering over a weekend and submitting on the Monday'. Jermy remembers 'there were a couple of times we said we're going to miss this week, we'll wait for something else to come up next week, we're not going to send a report this week'. The reports shifted over time from being weekly to then being every fortnight and finally monthly. This was in part determined by the fact that it took time for a lot of the analysis to be done (Harrison and Jermy transcript).

While Jermy had written quick reports for Nature, he never had to write advice documents before, so writing the SAGE reports was a new experience for him. But then, as he points out, 'most people were doing things that they've never done before in extraordinary circumstances at the time.' According to him the work 'was definitely a responsibility, we had to be very careful not to over-claim what genetics could say.' He recalls, 'We spent quite a lot of time saying, “unfortunately we don't have enough data at this time to really inform you about that based on what the genomics are saying.” A large part of that is because to really understand what is happening within, for instance, an individual outbreak or to an institution or a town or whatever, you need to understand a lot about the background of the different viral lineages or variants that are moving around in the community so that you can understand whether you have a particular outbreak in that institution, or whether it reflects the community.' Part of the problem was that it took a long time to get the 'genomic data up to the level' where they could provide information that was useful for policy-makers. This happened towards the end of summer 2020 (Harrison and Jermy transcript).

According to Jermy, the SAGE reports set an important precedent for when public health authorities took over the reporting of genomics and new variants. The importance of the reports is also underlined by Dr Ewan Harrison who worked closely with Jermy in the early days. He argues, 'In many ways the UK government was probably the first government in the world that was presented with what was happening genomically in the pandemic…. I don't think any other government had that data that early.' One of the first issues, Harrison says COG-UK's data flagged up relatively early to SAGE was that a lot of the first COVID-19 cases had been imported into the UK by British people travelling back from Europe (Harrison and Jermy transcript).

Once the reports were submitted, SAGE was left to work out how to communicate that to the chief medical officers and the government. Some idea of the impact the reports had is captured in the interview with Professor Matthew Holden, an advisor to Public Health Scotland. He notes that 'One of the challenges with genome data is demonstrating its utility and COG did an exceptional job on that'. Crucially whenever he spoke to people in Public Health Scotland about Scottish data, he and colleagues were generating an awareness of what COG-UK was doing. He says, that meant 'we were able to join up what they were hearing at the UK level with what was coming out at the Scottish level. Without that I think it would have been harder for me to get the traction on the ground to convince people and demonstrate the benefits' (Holden transcript).

Coverage reports

From September 2020, COG-UK began publishing coverage reports which provided information on the geographic coverage of sequencing across the UK. These reports were to a large extent propelled by Dr Catherine Ludden to ensure COG-UK sequencing capacity was equitable across the country. They also grew out of her frustration of not knowing exactly what proportion of positive COVID-19 cases the consortium was sequencing in each region. As she says, 'I knew how much we were sequencing but didn't know the proportion of positive cases sequenced for each region. Someone said we've done 100 in Liverpool, what does 100 mean? I was quite passionate about getting our coverage reports out so we knew what was the proportion of cases that we were sequencing in a certain week. For instance, we could know if we got 10 per cent in the northwest but 50 per cent in the East of England, which went completely against my belief of equity of access to sequencing. That helped me to tailor towards where we needed capacity and how to do better' (Ludden and Blane transcript).

In order to help the process, Ludden worked with Elias Allara, a public health doctor trained in epidemiology and medical statistics, seconded from Health Data Research UK to help COG-UK. Together, they designed a system to automatically generate regular reports showing what coverage had been achieved since the start of the consortium, what was sequenced and how this progressed week by week. The system also tracked turnaround times it took to get samples sequenced, which was calculated from the time the sample was collected and couriered to when the genome data was finally uploaded. It was designed to capture the turnaround times for both hospital (pillar 1) and community (pillar 2) samples (Ludden and Blane transcript). COG-UK published a total of 42 Coverage Reports.

Public and consortium engagement

Alongside the generation of the SAGE and coverage reports, COG-UK quickly set out to build a website to help publicise what it was doing. Originally this was created with the help of Mark Thompson, Steve Palmer, Paul Bevan and other people in the communications team at the Sanger Institute. This was then updated in February 2021 with the help of Georgie McManus, a freelance medical writer who joined COG-UK's communication team in November 2020. The original website had primarily been designed with academics in mind, whereas the new version had a greater focus on the lay audience and media. McManus points out this was important, because when she became involved 'a lot of people were confused about what COG was actually doing and who was COG, who are the institutions that are involved and how they all work together. Another issue was to make it more user friendly and having all the information very accessible and understandable for the general public' (McManus transcript).

Another person who joined the COG-UK communications team about the same time as McManus was Dr Elaine Westwick. Coming on board in January 2021, one of the first things she did was write a blog post about the visualisation tools developed by COG-UK (Westwick). This appeared together with other blog posts written by other COG-UK members which explain various aspects of the work done by the Consortium. A number of the blog pieces were written by Peacock. At the end of 2020 she wrote a blog about the early history of COG (Peacock Dec 2020) and then another at the end of 2021 (Peacock 2021). She also wrote one for the second anniversary (Peacock 2021). One of her motivations for writing these pieces she says 'was really to try to keep the facts straight, so that people don't rewrite history' (Peacock transcript).

In addition to displaying its work through the website, the communications team organised a series of virtual events (https://www.cogconsortium.uk/news/page/3/?category=events). These events not only helped give a sense of community to the consortium but also provided an opportunity to showcase the science behind COG-UK and how it helped inform clinical care, public health interventions and policy decisions. All the events were videoed and put on the website. One of the events was COG-UK Together. Held in October 2021, this event provided a chance for many COG UK members to meet together for the first time both physically and virtually to discuss their work and highlight what had been achieved around the country.

Media attention

Having a good communication structure in place proved particularly helpful for dealing with the avalanche of media interest when news broke about the Alpha variant in late December 2020. Peacock remembers 'When the news of the Alpha variant broke, the small communications team in COG were absolutely battered by that. People were constantly asking for information' (Peacock transcript). McManus, who was in charge of organising media interviews, also has a similar memory. She points out that in the early days, she received 'quite a few media requests' but that 'picked up hugely after the Alpha variant was announced'. At that point, she describes the media requests as going 'ridiculously off the scale.' As she puts it 'My inbox just went bing, bing, so frequently updating'. For her, it proved to be one of the busiest periods throughout her time at COG-UK. While she was able to take off Christmas day, she had to be on hand throughout the festive season to manage 'the crazy amount of attention all of a sudden'. She had to manage numerous requests for interviews from both UK and international news outlets. This necessitated her sourcing the right person, which required some thought because she was conscious that people in COG-UK only had a limited amount of time (McManus transcript).

A lot of the interviews were done by Peacock. At the start Peacock says this was not easy because 'I don't consider myself great at being a media spokesperson'. Also, she points out 'I didn't go into science because I wanted to be well known.' But the level of media attention in December 2020 was such that she felt she 'had to step into the public arena'. In part, she did so 'because people needed factual information that was accurate, but also because I wanted COG-UK to be seen for what it was achieving. I didn't want people to misunderstand who was generating that information, that we needed the credit for that' (Peacock transcript).

While Peacock had done some media work before, she had never done anything on 'this scale before'. Overall, she found 'the media interest quite difficult to handle'. As she comments, 'No matter how much you train for the media, it doesn't train you for the really difficult political questions'. One of the challenges was that sometimes her words were quoted out of context. She remembers 'That happened to me around the Alpha variant with me being quoted as saying it would sweep the world. It's true that it did and that I thought that, but the fact that you say 1000 words, and only five get taken out of context is really annoying. I'd be rung every five minutes by the press. They've given up now but it was a real intrusion in my life. My phone was constantly ringing'. Because she became quite a well-known she also got some 'very unpleasant emails' and like many other people involved with COVID-19 work 'got death threats' (Peacock transcript).

Peacock was also very conscious of the need to 'get the balance right, because I wasn't ever sure whether people would think I was on an ego trip or whether I was doing this for COG.' For this reason, she and the communications team tried 'to encourage regional labs into the media, because we're very conscious of the fact that Cambridge was sometimes the central focus.' Another issue she flags up was they had to be sensitive to the fact that COG-UK represented a group of scientists fulfilling a public health function (Peacock transcript).

Women in COG

From June 2021, the communications team organised a regular forum to showcase the lives and work of women in science. Known as 'Women in COG', the forum grew out of Peacock's desire to promote the accomplishments of women during the pandemic who were not always as visible as that of their male colleagues and to inspire girls considering a career in science. The project kicked off with a series of videoed conversations with women from within the network and beyond. Hosted on the COG-UK website, these conversations feature the specific research of different people and discussion around their careers as a woman and advice to the younger generation considering a scientific career. Some idea of the impact this project had can be gauged from Stephanie Hutchings, a trainee clinical scientist, who was very excited by the number of speakers who were engaged in the interviews. She really appreciated hearing about how they managed their careers. As she says, 'As somebody a bit earlier on in my career it really helps me to think you can still lead that balance, and you can still be a leader within this field' (Hutchings and Pymont transcript).

The project culminated in the publication of a book Snapshots of Women in COG in January 2023. In the foreword, Peacock points out that women were 'vital to the many successes of COG-UK, whether in sequencing laboratories, bioinformatic tool development, data analysis, public health, operations, communication, administration or leadership.' She continues, 'Women have shown endless resourcefulness and tireless devotion to making a genuine difference in the world, whether in our daily duties or in working to create positive spaces for women to thrive. Collectively, the experiences and discussion shared in the book paint a positive picture of women who have developed careers, moved into positions of leadership and responsibility, and received a good deal of support, despite having to overcome some outdated attitudes and barriers along the way'(COG-UK Jan 2023).

References

COG-UK Women (Jan 2023) Snapshots of Women in COG: Scientific excellence during the COVID-19 pandemic.Back

Peacock, S (17 Dec 2020) 'A short history of the COVID-19 Genomics UK (COG-UK) Consortium', COG-UK Blog.Back

Peacock, S (2021) 'History of COG-UK', COG-UK Blog.Back

Peacock, S (2022) 'Two years on', COG-UK Blog.Back

Westwick, E (25 Feb 2021) Visualisation tools to help understand SARS-CoV-2 mutations.Back

Interview transcripts

Note: The position listed by the people below is the one that they held when interviewed and may have subsequently changed.

Interview with Professor Matthew Holden, Director of Impact at St Andrew's University, Whole Genome Sequencing Advisor to Public Health Scotland.Back

Interview with Stephanie Hutchings (Trainee Clinical Scientist in Infection Sciences), Hannah Pymont (Qualified Clinical Scientist, Trainee Consultant Clinical Scientist in Microbiology), Public Health Laboratory, Bristol.Back

Interview with Dr Ewan Harrison (Deputy Director COG-UK and UKRI Innovation Fellow, Wellcome Sanger Institute, Senior Research Associate, Department of Medicine, University of Cambridge) and Dr Andrew Jermy (External Communications Advisor COG-UK).Back

Interview with Dr Catherine Ludden, Director of Operations, COG-UK and Beth Blane, Logistics Manager for COG-UK, Research Assistant in the Department of Medicine, University of Cambridge.Back

Interview with Georgie McManus, Former Communications Coordinator, COG-UK.Back

Interview with Sharon Peacock, Professor of Public Health and Microbiology in the Department of Medicine, Cambridge University and Executive Director of the COVID-19 Genomics UK (COG-UK) Consortium.Back