The CaHRU team have been responding to COVID-19 with a series of new studies and proposals seeking to further our understanding and improve our response to the pandemic. The first two studies in progress focus on the ambulance and Emergency Medical Services (EMS) response to pandemics and COVID-19 in particular.
The first is a one-year study led by Dr Ffion Curtis, research fellow at the Lincoln International Institute for Rural Health, which aims to conduct a systematic scoping review of the literature on interventions, outcomes and experiences of the ambulance service response to pandemics. The study team includes 
Despina Laparidou from CaHRU, Dr Withanage Iresha Udayangani Jayawickrama and Dr Dedunu Weligamage Dias both international visiting fellows at CaHRU from the University of Colombo’s Postgraduate Institute of Medicine, together with Marishona Ortega, prof Niro Siriwardena and Rob Spaight and Dr Emma Horncastle from East Midlands Ambulance Service NHS Trust. The team wish to better understand how ambulance services respond to pandemics, what the outcomes of such a response are and, importantly how ambulance services are experienced by patients and staff during pandemics. The study will determine what interventions (e.g. infection control, PPE) are implemented within EMS, what outcomes are reported relating to EMS interventions and what qualitative evidence there is describing the experiences of EMS staff and patients during pandemics.
The second study is the EMSC3 study, ‘Identifying and explaining clusters of acute physical and mental health conditions in the East Midlands of the UK and Ontario using ambulance call condition data – Satscan analysis and evaluation of health care system effectiveness (Emergency Medical Service Call Condition Cluster Study). The multidisciplinary international team led by Prof Niro Siriwardena, CaHRU, University of Lincoln includes: Dr Harriet Moore from University of Lincoln School of Geography; Profs Frank Tanser and Mark 
Gussy from the LincolnInternational Institute for Rural Health Care; Prof Graham Law and Dr Elise Rowan from CaHRU; Dr Gina Agarwal and her team from McMaster University, Ontario, Canada which includes Dr Melissa Pirrie, Dr Ricardo Angeles, Dr Iwona Bielska, Brent McLeod of McMaster University & Hamilton Paramedic Service, and Richard Ferron from Niagara EMS; and Prof Kamlesh Khunti of Leicester Diabetes Centre at the University of Leicester. The aim of the study is to investigate the epidemiology of 999 ambulance attendances for ambulatory care sensitive conditions in East Midlands, UK and Ontario, Canada. The team will achieve this by identifying spatial clusters of single and multiple common ambulance acute service-sensitive conditions (diabetes, asthma, mental health, COPD, 
angina and epilepsy), using call condition records from the East Midlands Ambulance Service NHS Trust, and equivalent services in Ontario involving state-of-the-art spatial analysis (with SatScan software). The analysis will begin with a focus on acute respiratory conditions, particularly focussing on people with underlying or multiple comorbidities (e.g. chronic heart, lung and kidney disease or diabetes) and calls for suspected COVID-19. The study is on the UK Health Research Authority list of approved COVID-19 research.
A number of other bids are in development including a further proposal on the ambulance response and another investigating post-COVID-19 rehabilitation.
By Prof Niro Siriwardena