How COVID support grants (permanently) changed the work of researchers

Psychiatrist Manon Hillegers has a vivid memory of sitting at the kitchen table watching her own children. Her daughter would be skipping her final exams and her sons, ordinarily athletic boys, were stuck at home. “I was hearing the same stories from my friends and thought: all young people are a high-risk group now. We’re all at risk, because we live in a high-risk, frightening time; we don’t specifically need to have family-related difficulties or chronic illnesses.”

That year, Hillegers, who is the head of the child psychiatry department at Erasmus MC, would go on to conduct research on the mental well-being of young people during the lockdowns. The COVID pandemic turned the lives of most Dutch citizens upside down. However, for scientists like Hillegers, the pandemic simultaneously presented a unique opportunity. When the government announced that it would free up 42 million for research into the most pressing issues related to COVID-19 at the end of March 2020, hundreds of researchers immediately fired up their computers to write their grant application.

In addition to funding for research into the social impact of COVID measures, funding was made available for fundamental studies into the nature of the virus itself and for medical research into types of treatment. Now that the studies have been completed and the scientific findings have been published, five Rotterdam researchers and ZonMw’s Director of Programmes look back on this unique period. How did the projects benefit the researchers and what lessons can be learned from the way the money was allocated?

Ordinarily, a funding round at ZonMw would easily take several months to three-quarters of a year to complete. Any application would initially be put to a committee responsible for advising on whether to take the application further or to refrain from participation. The detailed application would subsequently be reviewed by experts in the field. The submitting party would be given an opportunity to respond to their assessment, after which a ZonMw committee would make a final decision. “This is all done at a leisurely pace, meaning that no one gets overworked and everyone has time to do their job properly”, says Hannie Bonink, who was Director of Programmes at ZonMw at the time.

The modus operandi is designed to ensure that grants are allocated as fairly as possible and that quality prevails over simply knowing the right people. During the pandemic, however, there was no time to observe protocol.

“During the very first phase of our COVID programme (end of March 2020, EV), we set up expert groups to advise us on what genuinely needed to be done urgently and who could do it”, says Bonink. “Normally everyone gets a chance to submit an application, but on this occasion the experts simply said: this needs to be studied and that’s the person you want for the job. By April, we had already made the first payments. It was completely contrary to standard procedure, but we couldn’t afford to take any more time.”

Time constraints also had an impact on the applicants. Of the scientists who responded to the very first request for research proposals, many recall drafting an application in a frenzy over the course of a few days or, in some cases, even hours. Often these applications related to studies that were going to take place anyway, albeit in slightly different forms.

“We had been developing a mobile phone application aimed at very troubled young people for some time”, Hillegers says, citing an example. “The Growit! app was finshed just as the COVID pandemic unfolded and focused on identifying emotional problems. At the same time, it includes a type of intervention to help young people develop resilience through a range of tasks.” Hillegers and her project partners decided to make the app available to all young people, not just the usual high-risk group.

Joost Oude Groeniger, a social epidemiologist at the Erasmus School of Social and Behavioural Sciences (ESSB) had already been working on a long-term study with surveys, including on public trust in government authorities. The final survey was due to be conducted in March 2020. “And then all of a sudden the pandemic happened, with the first lockdown in mid-March. We were handed a unique natural experiment on a silver platter.” Because some respondents had completed the survey shortly before the lockdown, with others completing it shortly after, the scientists were able to measure the direct impact of the lockdown.

As the SARS-CoV 2 virus swept through the Dutch population, Marion Koopmans, head of the virology department at Erasmus MC, pulled out all the stops to find out how the virus was evolving genetically. The findings were directly relevant to the Outbreak Management Team. However, the large scale on which this research could take place was not a matter of course: Koopmans likewise simply had to apply for a grant.

“I don’t even have basic funding for the standard issues that arise for each outbreak. Whether it’s avian flu or monkeypox – all that research has to come from grant applications. Fortunately, I had some money left over and we received support from the Erasmus MC Foundation. That gave us a headstart.” Given that scientists are not all financially well off, the professor is advocating the creation of a structural financial reserve to fund critical research during crises.

Immediately after the start of the first funding round, there was similarly criticism from scientists who did not have time to draft an application at the drop of a hat. Oude Groeniger recalls hearing similar critique from colleagues on social media. “There were complaints from female colleagues in particular, who were saying ‘well, thanks, NWO, that’s all well and good, but it does make things difficult for people with care responsibilities.’ In retrospect, that did make me feel uncomfortable, but at the time there wasn’t any time to give it any thought.”

What Koopmans finds particularly galling is that a year later, the government spent almost a billion euros on Testen voor Toegang (Testing for Access) a widely-criticised research pilot that went ahead thanks to a powerful business lobby. “When you then see how many hoops researchers have to jump through to bring in a tiny fraction of that amount. I genuinely thought it was out of all proportion.”

Jacco van Sterkenburg and Anne-Mette Hermans from the Ersamus School of History, Culture and Communication (ESHCC) encouraged young people to take photos of where and how they were living during the lockdowns: keys in a locked door, a hockey stick collecting dust, crates of beer in a student flat. In-depth interviews about the images particularly showcased the emptiness and loneliness felt by many young people. While he is excited about the results and the partnerships that were formed, occasionally spontaneously, he also has his doubts about the effectiveness of some COVID projects. “The money sometimes seemed to be handed out on an ad hoc basis and I wonder if people genuinely had a clear idea of the relevance of all the research projects. I’ve been to conferences since the pandemic where people presented their findings of multi-year COVID studies. There was little interest in them, as it was all a bit late in the day. It’s especially useful to be able to share interim results that policymakers can actually use.”

This rings true for happiness researcher Martijn Hendriks of the Erasmus School of Economics (ESE), who assessed how effective measures aimed at improving the mental well-being of care workers are. For example, it turned out to be more effective to work towards a desired scenario together instead of brainstorming about specific issues. He discovered the value of quick, interim feedback on results. “We conducted action research, which means measuring the effect of an intervention in the short term, after which you can calibrate the policy in the interim. At the university, we normally do a pre-measurement and a post-measurement with a control group – but this method allows you to contribute to the well-being of employees directly.”

Most of the parties involved agree that the allocation system has its weaknesses. At the same time, COVID support grants have had a particularly positive impact on the research of most of the scientists Erasmus Magazine spoke to.

Hendriks, for example, says he has had more opportunities than usual to disseminate his research findings. Research on coronaviruses and immunity at the Rotterdam virology department received a solid boost, and studies relating to Hillegers’ mental well-being app likewise gained momentum. There are now four scientific publications about the app and a large Flagship grant for follow-up research has been secured. “We will be developing the tools further and focusing on the prevention of mental health problems in young people in the general population. That wouldn’t have happened without the pandemic.”

Hannie Bonink of ZonMw reflects on the hard work they did during the COVID pandemic with pride, although she acknowledges that not everything went perfectly. “Within the organisation, we had a great deal of faith in the fact that we were doing good things together. Normally, ZonMw is seen as a money pot that people can’t get to easily. People do all sorts of things to bring their research to our attention and we ask critical questions: why is this the most important issue? But during the pandemic, it felt like we all had one key interest at heart: doing good research into COVID-19.”