Pandemic Resilience – The next pandemic is coming

00:00:00: Do you remember the winter of '22?

00:00:12: The pediatric intensive care units were full of babies and small children who could barely

00:00:17: breathe.

00:00:20: This was because the measures taken to combat the coronavirus pandemic in the past two winters

00:00:26: meant that many children had not yet suffered their first RSV infection.

00:00:31: As a result, there were many children who became ill and therefore more than usual were

00:00:36: seriously ill.

00:00:38: An example of how quickly pathogens can spread.

00:00:42: And this is precisely the expertise of Dr. Barrett Langer, acting head of the Department

00:00:47: of Epidemiology and head of the Clinical Epidemiology Research Group here at the Helmholtz

00:00:53: Center for Infection Research.

00:00:56: In this episode of Infect, our host Julia Deman talks to Barrett Langer about how we

00:01:01: can prepare ourselves for when the next pandemic will pose new challenges to our personal health

00:01:07: and the healthcare system, our society and politics.

00:01:11: Pandemic resilience.

00:01:15: I'm sitting here in the library of the age that I, with the epidemiologist Dr. Barrett

00:01:22: Langer.

00:01:23: Hi, Barrett.

00:01:24: Hi, Julia.

00:01:25: Many of us still have the corona pandemic in mind.

00:01:29: What about you?

00:01:30: I still have it very much in mind, yes.

00:01:33: After the pandemic is before the pandemic, what about pandemic resilience?

00:01:39: What does that actually mean?

00:01:41: So pandemic resilience is just a term to make clear that in a society you need to set up

00:01:48: your infrastructures and all of the structures that you have in a way so that you are able

00:01:54: to manage epidemic developments that are happening and to target interventions that you want

00:02:01: to use in a way that they are not as harmful as they might be.

00:02:06: So you are a physician and an epidemiologist.

00:02:10: What exactly is your field of research and which tasks do you have here at the HCI?

00:02:18: So as you say, I both have clinical experience in infectious diseases and I'm also an epidemiologist.

00:02:24: And my research group focuses on the dynamic and the burden of respiratory infections.

00:02:31: And we do that by doing evidence synthesis, so meta-analysis of ongoing research.

00:02:37: We also use large epidemiological studies, both population-based but also clinical studies,

00:02:44: to understand how infections actually spread, what under detection you currently have, how

00:02:50: infection fatality might be, and also to understand the effects that both pharmaceutical but

00:02:56: also non-pharmaceutical interventions might have.

00:03:00: And then we also develop dynamic models that are able to predict but also analyze the spread

00:03:09: of infections.

00:03:11: You mentioned population-based or clinical cohorts.

00:03:16: What is that and why exactly is it important for us?

00:03:20: So in our department, we are managing and leading and conducting several large population-based

00:03:28: studies.

00:03:29: And we call studies population-based when we try to go as close to the actual makeup

00:03:34: of the population that we have, for example, here in Germany.

00:03:40: The way we do that in Germany, for example, is that we have population registers that

00:03:44: lie with the individual city.

00:03:46: And we, after having all the ethical and data protection approvals, we are allowed to get

00:03:53: data from these registers, random data basically, from these registers and then approach these

00:03:59: people to please be part of our study.

00:04:03: And what that means is that even though people of course still take part voluntarily, we

00:04:08: then have studies that are as close as you can be to the population, for example, of

00:04:15: Hanover or of Germany or of even larger regions.

00:04:18: And then what you can do is in these populations, you can actually follow people to understand

00:04:25: how diseases are developing but then also how interventions work on these diseases.

00:04:31: And we, of course, here at the HSI, we do that mainly for infectious diseases.

00:04:36: And I think there are two cohorts or cohort studies which are important here for you.

00:04:46: What is this?

00:04:47: So we have several.

00:04:48: I have two main examples.

00:04:50: Yes, you are totally right.

00:04:52: So one is the NACO study.

00:04:54: This is basically the largest population-based study there is in Germany.

00:05:00: It is a study that works in or that is conducted in 18 centers across Germany.

00:05:06: And we are managing one of these centers in Hanover.

00:05:09: Overall it has recruited 200,000 participants.

00:05:13: And this is really a study that is not only meant to understand infectious diseases but

00:05:18: also chronic diseases and really tries to go very, yeah, understand participants' journey,

00:05:27: let's say, across a large number of years in very, very much detail.

00:05:34: And then we have a second, a bit smaller cohort that we are managing from the HSI.

00:05:38: which is the Moospat cohort that we build up during the pandemic,

00:05:43: basically as a seroprevalence study to understand what under detection

00:05:47: and infection fatality of SARS-CoV-2 is.

00:05:50: It works, it has around 34,000 participants in eight regions in Germany.

00:05:56: And we noticed even during the pandemic that this was a cohort that works really well.

00:06:01: We are very grateful to participants to give us blood, to give us information,

00:06:05: to fill out questionnaires.

00:06:07: But we were not, because we had to build it up when the pandemic started,

00:06:13: we were not really able to give the results, the parameter you need,

00:06:18: really in a timely manner, for example, for modeling that is then needed by decision makers.

00:06:24: And this is why during the last two years we have redesigned this cohort

00:06:28: into something that we now call an epidemic panel.

00:06:31: And this is really meant to be adaptive to any pathogen that might come in,

00:06:36: to be as rapid as you can be.

00:06:38: So we really try to be able to start any surveys that we want to start within weeks

00:06:43: and to be really able to give out continuous reporting of the estimates that we find.

00:06:49: So for example, over this winter, for this cohort,

00:06:51: we have given out weekly estimates of positivity for RSV influenza SARS-CoV-2

00:06:57: in the population just continuously over the last 12 weeks or so.

00:07:03: So you told me now what you do, but how exactly does your work life look like?

00:07:11: How does an epidemiology department work?

00:07:14: So as I've already said, we are quite a big epidemiology department.

00:07:18: We have four research groups.

00:07:20: We have a research group that is based in the laboratories.

00:07:23: So we also have laboratory work,

00:07:25: and these colleagues are mainly developing diagnostic essays

00:07:28: that we then use in our population-based or other studies.

00:07:32: We also have research groups too, actually,

00:07:34: that are very focused on building and developing and then evaluating digital tools

00:07:40: in both that we can use in, for example, the studies that I just mentioned,

00:07:44: that work on the mobiles of participants, for example,

00:07:48: but also in infectious disease surveillance across the world.

00:07:51: This is, for example, the SORMA's tool that has been rolled out across different countries.

00:07:57: And we then have research ongoing that is very based on, say, statistical analysis,

00:08:04: on modeling, that of course works a lot in front of the computer.

00:08:08: So what we have in the department is a very hybrid way of working.

00:08:13: We really try to have larger meetings where everyone is there.

00:08:17: We try to have presence days where everyone is there.

00:08:20: But we still have also a lot of virtual meetings,

00:08:23: and so it works kind of in both ways.

00:08:27: And then the fifth thing we have is we also have, of course, the study center

00:08:32: where our participants are seen in Hannover, not in Brunschweig.

00:08:35: And this is then, of course, something that also only works in presence with quite a good center.

00:08:41: So you do not just do research and your leading research department.

00:08:47: You also do some, let's say, political activities, research political activities.

00:08:56: And when I hear all that, it sounds like, well, you're a machine that works day and night,

00:09:05: but you're a human being.

00:09:06: I can see that sitting in front of me.

00:09:09: So yes, you have to eat, sleep, and yeah, you need some balance in life.

00:09:17: What's important to you in your private life?

00:09:20: So I think balance is not so difficult for me because I have a family, I have two kids,

00:09:25: and those immediately provide balance when you come home,

00:09:28: because then other things are important, of course.

00:09:31: And so as a family, what we like to do is we like to travel,

00:09:35: and we like to take trains a lot, so we don't have a car.

00:09:38: We only go with trains to everywhere.

00:09:41: Sometimes we even do interrail, and this is something that I like a lot.

00:09:45: So you said you're also a mother, and I think you're a good example for combining children

00:09:52: and career.

00:09:52: How do you manage that with your work here at the Edge that I?

00:09:58: So the Edge that I is quite supportive in that.

00:10:02: So for example, not only me, but also the other colleagues who are leading research groups

00:10:07: in my department, they also have care and family responsibilities,

00:10:12: and not all of them work full-time, and that is something that is possible,

00:10:16: and that we manage within the department, but that is also supported by the Edge that I,

00:10:21: and I think that is a really good thing.

00:10:23: And of course, on the question of how do you manage that personally,

00:10:27: everyone will have a different answer, but a lot of it is just trying to manage your time

00:10:37: as best as you can together with your partner, but also having a lot of help.

00:10:42: And support by my family, my wider family as well.

00:10:46: Thank you for your time and the interesting facts of your research,

00:10:51: and the insights into the research of an epidemiologist.

00:10:57: Thank you so much.

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