“The connection between research and practice plays an important role at CAPHRI. Because CAPHRI's research focuses on healthcare and public health, many researchers are directly or indirectly involved in the corona crisis. Our researchers collaborate a lot with (regional) healthcare organisations. When the corona crisis started, they saw up close what the consequences were for (healthcare) practice. A lot of research had to be stopped because of the coronavirus measures. However, the collaborations with these organisations also made it possible to respond quickly and to start COVID-19 related research projects that actually benefit the healthcare organisations during this time. Of course, it requires flexibility for scientists to put their own research on the back burner for a while and temporarily become a COVID-19 researcher, not to mention the adapted working conditions which are not always easy. In short, a lot is going on within CAPHRI at the moment...”

Do you have any concrete examples of this?

“A number of our researchers also work as healthcare providers, as general practitioners for instance, and are therefore on the front line. Examples are Jako Burgers and Jochen Cals, both professors and practicing general practitioners. Jako has regularly appeared in the media lately to provide information about the coronavirus based on his expertise. Jochen has his practice in Sittard, a city that had to contend with a relatively high number of coronavirus infections. He initiated a project to register the national numbers of COVID-19 patients receiving intensive and palliative care from general practitioners outside of hospitals.

In addition, three of our Academic Workshops (‘Living Labs’) play an important role in the rehabilitation care for corona patients in our region. It appears that patients recover quite differently. The aim is for all patients to receive the right rehabilitation care at the right place. This doesn’t only apply to patients who had to be admitted to the ICU because of their poor state of health. Also patients who were able to stay at home with a milder case of COVID-19 often find it difficult to resume daily life.

On behalf of the Ministry of Health, Welfare and Sport, the The Living Lab in Ageing & Long-Term Care is now studying the effects of the relaxation of the visitation guidelines, which have been in force since mid-May, in 26 nursing homes as a test. The main focus is on the well-being and experiences of residents, family members and employees, as well as on how the nursing homes implement the guidelines and the extent to which everyone adheres to them. The initial results (in Dutch) are now in.   

And then there is Christian Hoebe—in addition to being professor of Social Medicine and Infectious Disease Control he is also Head of Infectious Disease Control at the GGD South Limburg—who is leading Limburg through the corona crisis and is frequently featured in the media to provide residents with (scientifically-based) information. He is also a member of the Outbreak Management Team.”

You do your own research in the area of systematic reviews. What is the importance of this kind of research?

“Within CAPHRI, we are working on two major ‘rapid and living’ systematic review projects. Both reviews involve large groups of researchers. In the first review, available prediction models for the early detection and disease course of COVID-19 are assessed. Updates are regularly published in the leading journal The BMJ. I’m also working on the COVID-19 EPI Update, a collaboration between CAPHRI, RIVM, Cochrane Netherlands, UMC Utrecht, and a partner of the WHO Evidence Collaborative. The initial results of these meta-analyses are freely available (open access) through the Maastricht University Library. For example, one meta-analysis shows that elderly people are five times more likely to die from COVID-19. This information is important in order to be able to create evidence-based policy.”

Many (medical) coronavirus studies seem to be poorly designed or sloppy. How can you prevent this in a chaotic time like the present, in which speed seems to be one of the primary demands?

“That’s a difficult balance. It’s very important that scientific information is made available to policymakers as quickly as possible, so that policy can be steered on the basis of the scientific evidence that’s available at that time. The alternative is to sail without a compass. That’s even worse. What many research groups do is provide information quickly at first and then improve the research through continuous updates. This makes it possible to combine good and fast. During this time, social impact is more important than scientific impact. As long as the information is available; scientific publications in high-impact journals are nice, but this can slow things down.”

How do you judge the wide public availability of pre-prints in that context?

“We’ve already seen it before, but now we’re seeing a clear growth in pre-print and post-review journals. MedArchiv and BioArchiv are the most important examples of this. Certainly at the beginning of the COVID-19 pandemic, a lot of information was released quickly. Meanwhile, we see that the peer-reviewed journals also already contain a lot of COVID-19 information, whereby you can clearly see a reflection of the spread of the pandemic throughout the world. At the moment, for example, there are many Chinese articles, an increasing number of European studies and only a few American studies. I think the pre-print journals are now indispensable. Together with The BMJ journal, we have started a PhD programme in evidence-based publishing. One of the PhD candidates is going to study the quality and consequences of post-publication peer review in pre-print journals.”

At a time when all conventions seem to have been thrown out the window for everyone, is it really possible to do science like we’re used to doing it?

“This is definitely a golden age for science. It is precisely now that scientists can make an important contribution to society. Whereas confidence in academics was waning in the time before the pandemic, it seems to be on the rise again. It is up to us not to betray this trust. The standards, of course, remain as high as ever.”

What does your current (average) working week during this corona time look like?

“We still have small children at home. My wife’s working week and mine have completely changed. It's tight planning. At any moment, either I or my wife have to take care of our girls, so we alternate. I usually work from 05.00 in the morning until 13.00 in the afternoon. I like this. I’m very productive. No one bothers me before 09.00. And every afternoon I have free to spend with the girls. As far as they’re concerned, these days aren’t so bad.”

Text: Mark van der Linde