CRUSH COVID: new research collaboration

The purpose of the CRUSH COVID project is to detect local outbreaks in Uppsala County at an early stage and thereby succeed in stopping transmission at as early a stage as possible.

“It’s important for Uppsala University to contribute research on an issue that’s so important in society, and to be able to do it jointly with the regional authorities,” says Mats Larhed, Vice-Rector of the Disciplinary Domain of Medicine and Pharmacy at Uppsala University.

The Public Health Agency of Sweden predicts that, over the coming autumn and winter months, COVID-19 will spread in the form of local (cluster) outbreaks. The infection is currently being detected only when patients need to seek medical care, or get a test, because of their symptoms. Since one to several weeks have often, by then, passed since the person became infected, both tracking transmission of the virus and preventing it from spreading even more are difficult.

Detect local outbreaks

The purpose of the CRUSH COVID project is to detect local outbreaks at an early stage and thereby succeed in stopping transmission at as early a stage as possible.

“We’re currently seeing a rise in the number of cases in Uppsala County. This research project can provide valuable knowledge of how we can effectively fight the spread of infection,” says Johan Nöjd, an Uppsala Region doctor specialising in infectious diseases.

In CRUSH COVID, researchers at Uppsala University will use information technology (IT) to combine data from several sources to facilitate early identification of geographical areas with signs of increased transmission. Anonymised data from the 1177 Care Guide helpline, for example, are combined with virus measurements in wastewater and information on the number of people needing inpatient care owing to COVID-19. Another key data source will be symptom data from the COVID Symptom Study (CSS) in Sweden.

Tove Fall, Professor of Molecular Epidemiology and senior researcher in both CRUSH COVID and CSS Sweden, reports on progress and plans.

“We’re now working intensively to compile information from several different sources. This should enable us to identify signals of increasing infection transmission at an early stage. We’ll then evaluate how well the method works. If it proves successful and beneficial, it can then be used in other regions as well.”

Researchers in different fields

Uppsala University participants in the CRUSH COVID project carry out research in general medicine, molecular and medical epidemiology, IT, environmental microbiology, statistics, and media and communications. The Uppsala Region provides experts in testing strategy and infection tracing, and in the statistics of testing.

Since COVID-19 is a novel disease, there are few scientific studies about which testing strategies are most effective and best in slowing down the spread of infection (“flattening the curve”) in the community. Among different demographic categories, there are also marked local variations in the proportion of people who get themselves tested in the event of suspected symptoms.

The survey results make up a supplementary database for the Uppsala Region’s Infection Control Unit, enabling the staff to prioritise where, and in which population groups, to expand testing for ongoing COVID-19 infection. In CRUSH COVID, evidence-based evaluation of which actions and targeted measures appear to be most effective will also take place.

“We need to understand how to focus the testing to find as many cases, and as early, as possible. CRUSH COVID will enable us to target measures earlier on to stop the upward trend. That way, we hope to minimise the impact of the pandemic and get valuable information on how to combat it and future pandemics too,” says Mats Martinell, Senior Medical Advisor at the Uppsala Region’s Testing Unit, who is the researcher in charge of the project.