Colin completed his doctorate in respiratory epidemiology in 2003. “Epidemiology is the branch of medicine looking at the distribution, patterns, and controls of disease and other factors that might relate to a population,” he says. “It looks at information about populations and tries to understand the patterns of disease and where best to intervene.”

In 2009, he was awarded a chief scientist post-doctoral fellowship at the University of Edinburgh’s Usher Institute. “One aspect of the fellowship was to explore the use of routine data in combinations to understand respiratory and infectious disease epidemics, expanding from primary care information to include other inputs such as rich data sets around hospital care and some public health information such as vaccination data, notifiable diseases, and so on.”

In his first year, swine flu—the H1N1 virus—came along. A swine flu vaccine was created early on, and this intervention formed part of the study. “I carried out some rapid work funded by the United Kingdom’s Department of Health, and we were able to put a number on how effective the vaccine was in preventing swine flu in Scotland,” says Colin.

“Other groups had looked at this, and we were the fastest off the block—but it still took us six to seven months to get the permissions and data needed. So, by the time we had the evidence, the first substantial wave of the pandemic had passed and—almost anecdotally—we could see the vaccine had had an effect.”

The funding body then asked, what if there was another pandemic? How would they approach the work differently and—with some funding—could they prepare for a new threat?

Early Assessment of Vaccine and Anti-Viral Effectiveness (EAVE) was the result. “We undertook our study by asking, if we had another pandemic, what data would we need and how would we go about getting it? We put data sources and permissions in place, then put the study into hibernation in preparedness for the next pandemic.”

Colin came to New Zealand in 2017. “My wife is a Kiwi, and a fantastic opportunity arose at a start-up faculty, which doesn’t happen very often, so I jumped in with both feet!”

He did, however, maintain his links with the EAVE project. When COVID-19 appeared, the project’s funders suggested it might be time to trigger the protocols.

Early on, the team was able to come up with a way of forecasting so they could give the Scottish government a 28-day forecast based on case numbers rising and falling.

“That paper was published recently in Lancet Digital Health,” says Colin. “The forecasts were very accurate and used by the government to tailor public health interventions.”

Studying the safety and effectiveness of the vaccines has also been part of the EAVE II study. “Our Lancet and Nature Medicine papers on the effectiveness and safety of the vaccine were exactly what the original EAVE study was created for, and there was very rapid evidence that the vaccine was effective and safe.”

In New Zealand, Colin is working with the Institute of Environmental Science and Research (ESR) on several COVID-19 studies, including mathematical modelling on the potential effect of vaccination programmes for opening New Zealand’s borders. “We are also looking at outbreak surveillance, using a mix of publicly available information and survey information kept by ESR, and applying machine learning methods to accurately predict what might happen.”

Colin is a keen advocate for the production, and use, of data for this type of work in New Zealand. “I would love to be able to repeat what I did in Scotland here in New Zealand. The big difference is that we don’t have access to primary care data, which is the basis of EAVE II,” he says.

He points to OpenSAFELY, a secure analytics platform for electronic health records in the UK’s National Health Service (NHS). “It’s a federated system where data remains in situ. There’s no creation of links or mass extractions of data. Researcher algorithms come to the data set, and you use technology to do analysis in a way that protects personal data while allowing researchers access.”

OpenSAFELY is now delivering analyses across more than 24 million patients’ full pseudonymised primary care NHS records.

“We need to be able to be timelier with our research so we can understand information in the now and set up closed feedback loops to help,” says Colin. “We want the analysis to be used, and high-value feedback to be created, to deliver urgent results during the global COVID-19 emergency.”