 Right, hello and welcome back everybody. So if we now have three presentations Focusing on the changes, COVID related changes to the longitudinal studies We are covering understanding society, birth, guy holds and the English longitudinal study of aging First up we have Mina Kamari from the Institute for social and economic research Mina is a professor of biological and social epidemiology She's a leading expert in biomarkers and genetics and has worked to apply insights from these areas to better understand aging, cardiovascular disease and health inequalities using the right hold to study of British civil servants and also Mina is the topic champion for how from biomarker content and research in understanding society and leads research on the social biological interface and genetic epidemiology as an investigator for the study So over to you Mina So I'm just going to, as Mary just said, I'm the topic champion for health and biomarker data in understanding society So I'm going to lead you through understanding society and then just give you some an overview of what we did with the COVID-19 and talk a little bit about next steps So what's understanding society? I suspect a lot of you might know, we've already discussed it in the last session understanding society is a survey of representative individuals of the UK population and we collect information from all of the residents in approximately 40,000 households and the residents and their offspring or the children of all the poor sample and what we do is we interview everybody in the household every year and a basic design is similar to a number of international has some panel studies such as PSID So you can do international comparison using the data and I think as we talked about in the last presentation you can benchmark to understanding society if you have some of our questions so we work as a nice control if you want that So the study we get in 2009 and it builds on the BHPS which started in 1991 and we collect information from a range of different aspects of life and I'll go through those in a little while So there's lots of research possibilities with the study because you're measuring the same thing over and over again and across the life course and because we're a household study you can investigate the role of the household context on a number of outcomes and behaviours and look at intergenerational change so it's a great survey if the policies come through when new and exciting things happen like Brexit boats and Covid's and pandemics and that sort of thing So you can see how people were before these things happened and how they are afterwards The sample is actually four different populations So we've got our general population sample which is 26,000 UK households We've got an ethnic minority boost so at wave one we had an ethnic minority boost which was made up of the five main ethnic groups and then as I said we've incorporated the British Household Panel Survey which is a study that started in the early 1990s We also have a set of participants, a set of households that we use as a test bed for questions and methods that we often incorporate into the main study and so we have a total of nearly 40,000 households from waves one and two We do have a new wave six in 2015-16 We added an immigrant and ethnic minority boost which was the new migrants Eastern European groups that we didn't have before and that's in the data from wave six So as I said we collect information from everybody in the household So we interview all the participants of our household aged 16 and above We also run a short self-completion from a youth panel So that's data collected from people aged children aged 10 to 15 years old And then we also ask parents and guardians information about the children in the household So we collect information I think at age three, five and eight from parents about the children So that means we've got information from everyone, the entire life of course And I think I'm going to just highlight the children data because it isn't used a lot And I think it might be that people don't always know that we've got that information from the participants from the children So this is the fieldwork schedule Sorry, it's slightly out of date We need to update it So basically we will be depositing wave 11 from this study this year when BHPS is at wave 30 So 30 years of BHPS data And you can see that we will be in wave 12 of the main understanding society So there's lots of information collected We've got lots of kind of quite old data now in the sense that some of our participants took part in 1991 And what we did was we kind of combined it so that you can in one file have that information Because we used to have everything sort of separated We've done quite a lot of work on combining the data files so that it's not too difficult to get at them So these are the main topics in this study So in addition to health we're interested in social services We're interested in education, employment, income, civic participation, politics and lots of engagement And so we've got a really detailed look at the lives of our participants And because there's so much we're trying to cover We don't ask everything at every wave, it's too difficult So we have a call set of questions that we ask people every year and then a rotating set of questions And when I first joined the study we used to describe understanding society as a juggernaut In the sense that we had a four year cycle of designing questions, administering, collecting the data over two years and then depositing the data But we've changed that slightly so that if something does happen like a pandemic we can add content quite quickly And sort of respond to events in people's lives and also events in the world In terms of health and well-being we have collected lots of questionnaire data So asking our participants about chronic conditions We talked about measures of mental health in the last talk And the reason that we ask the general health questionnaire we administer it every year And we do that and we've kept it as the general health questionnaire as our measure of mental health It's a measure of psychological distress because it was there in the BHPS So we've got these lifelong 30 year histories for some people of GHQ annually At Waves 2 and 3 we asked the participants if they wanted a nurse to come and visit them And for a set of participants we have 20,000 people that we have heights and weights for blood pressure And we also measured lung function and for 30,000 participants we have collected blood samples from them and measured 21 different analytes And we also extracted DNA from that sample and we have GWAS and EWAS data And recently measured some protein data from those blood samples So we've got really detailed biology from a substantial number of our participants There are a range of health and well-being modules and data collected These are the modules that we data collected from the children and young adults So we've got some of these things are collected throughout From Waves 1, 4, 6 and 10 we have things like sleep and the children have given us a lot of information about body image And happiness and different aspects of their life As I mentioned we've got information about the children's mental health, their strength and difficulties, questionnaire We asked them about their self-esteem, screen time use, bullying We've got information about parents' relationships with each other and their relationships with their children So there's a wide variety of health and well-being related information In understanding society that you could use and it's a sort of common usage It's there for people to use In terms of adult well-being as I said we collect GHQ every year We ask about life satisfaction and satisfaction in different domains of life We are used to understand the nation's well-being And so we administer the Edinburgh Warwick positive well-being question and we do that periodically And in terms of the children's well-being we ask about happiness in all different aspects of their life And about themselves so their own appearance, how they're happy they're at school How happy they are with their friendships within the family And we've got the strength and difficulties questionnaire So you can get a total from that or understand different sub-scales of that in terms of the children's mental health The question that we repeated which allows us to measure change over time We don't ask everything at every wave And as I said we've changed protocols slightly so that we can ask these eventually good questionnaires And I'm going to talk and this is sort of an example of how that works So some things are asked every wave, some things every other wave Some things much more randomly than that and sometimes we've had to bring things in when we've realised that we need information about it Like for example here the geek economy and we'll incorporate that into the questionnaire every wave So you can go to the and the other thing that we do is we consent our participants to lots of links So we are consented to link to his data but we don't have that data yet We're still trying to link to his data and make that available But there's lots of links for tax data, DVLA data And the other thing that we do is we can scrape websites So we consented for DVLA but I think we ended up scraping for driving and other types of information And as I mentioned we are always working on trying to find new ways of collecting information I've done some work on how we can ask our participants to collect their own bio-mages for example And the team have been working on whether we can use mobiles and apps to collect other types of information So we're always working and trying to develop and sort of thinking through how we can enhance the data set So this is the website, you can go and find lots of information about the survey there and how we do things And it tells you how you can access the data, we deposit the data in the archive And so it's all there if you want to go and get in So as I said we went from a four year cycle in understanding society Devising, administering, depositing data, which used to take about four years to a four week cycle when the pandemic happened So the pandemic happened in March 2020 and we had administered a web survey to the participants in April 2020 Mina, I'm really sorry, I only have a couple of minutes left Oh no! It's an interesting bit I had too many slides, so I will, what should I do? I can tell you, I can move on to, should we move on to this? So I can just start talking a little bit about what we did So in fact I won't talk about results at all then, shall I just tell you about the study and where you can go and get the data? I'm not sure what's best to do Yeah and if people are interested in results maybe just put it in a Q&A and we can come back to it when we have the Q&A session In those sessions? Sorry everyone So let's have a look So we collected, I should have practiced this too We collected data and sort of monthly, April, May, June and July from our participants So it was web based and we supplemented the April collection with a telephone interview And we deposited almost as soon as we'd collected and cleaned the data into the archive And then we went bi-monthly because we're still actually in the field So we're still collecting from the main stage in understanding society We did this on top of our usual work And then we went bi-monthly so we didn't collect in August last year and we've collected again in September, November, January and March this year All of this has been web based questionnaire and supplemented occasionally with telephone interview And then last month in May we asked participants if they would give us a blood sample for antibody data And so we had a really good response for that and we will be depositing that this month with the questionnaire data from May We're going into the field finally in July and we will be depositing in September We don't have plans to continue to keep doing this This year we will be depositing Wave 11 as I said So we have maintained some main data collection So you can sort of look to see where we are in terms of what's been happening in our main collection on top of these additional COVID questions that we asked people So I will finish there because I had too much in my talk But if people want to ask me anything in the Q&A please do so Absolutely, as Mina said put all of your questions in the Q&A and we can go into more depth around the methods and the results as well Thank you, we are moving on now to the British cohort studies So this is presented by David Banser, David is an epidemiologist with broad interest in population health and particular interest in health inequalities, obesity and physical activity levels He contributed to the scientific development of the 1958 British birth cohort study by planning future data collections, preparing funding applications and helping to maximise its scientific potential And he's from the Centre for Longitudinal Studies So over to you David Thank you, can I check, can you hear me and see my screen? Great, thank you for the introduction and nice to hear about what's happening in USAR because it sounds very busy and very exciting during the COVID period First of all thank you to our funders, the ESRC and our host institution IEUCL So what do we do at CLS? We won major national longitudinal studies which I'll be talking about today I'll be talking about the data that we do have currently and some of the future plans that we have going forward We provide this data to the research community, much like USAR, this is free of charge and available on the UK data archive Researchers can also input on the type of data we collect in the future so we have consultations on this And we also conduct research and multidisciplinary research in both substantive areas related to health and methodological areas like survey and statistical analysis So these are the four cohorts that we have at the moment So we have three, these are national birth cohorts, the sample size is around 16, over 16,000 So individuals born in a particular week in 1958 were enrolled in the study and they've been followed up throughout their lives And now in their 60s we have this data across life And we have a similar model for the 70 cohort, they were born in 1970 And for the Millennium cohort which was born around the Millennium, I'm still being followed up These are the study called next steps, they are birth cohorts in the sense that they were born in around the same birth years But they were followed up started in adolescence, but again we have longitudinal data Here's another visual depiction of the data that we have for each of the studies, their year of data collection and their birth year So for the oldest, the 1958 cohort NCDS, we have data in birth, in childhood, adolescence and across adult life And the same for the other cohorts starting at different ages So what do we have? We have mental and physical health outcomes at multiple different ages in multiple different cohorts We have which data on the social and biological exposures which might be correlated with or potentially causally affect health We also have an ongoing, we're involved in ongoing harmonization programs with closer colleagues to try and facilitate cross cohort analysis And make comparisons of health and associations with health like health inequality across multiple different generations These include things like physical activity, diet, cognition and SCS measures like overcrowding, education and psychological health measures also Here is a simple overview of the kinds of data that we do have in the cohorts It's an awful lot to talk about, but the points for this talk I suppose is that we have which data on health, physical, sorry I'm going to have to drink a water Perhaps I've developed a dry cough during this talk, it's not good We have health data, we have data on the determinants of health including socio-comic factors and parental and home factors as well It's an awful lot in each of these studies Here's a little snapshot of the types of papers that come out using these data Some of them looking descriptively at the prevalence of health or the correlates of health like physical activity Some of them conducting senile work on things like influences on low birth weight, here smoking Other papers looking at the consequences of early life health problems, the determinants of health here Looking at breastfeeding, and then papers looking at long run trends This is a paper I worked on with colleagues using the cohorts and the health survey for England together to look at long run changes in health and equality There's an enormous amount of science that can come from these papers that's happened in the past and will happen in the future I hope this slide just gives you a brief, if somewhat random snapshot of that So that's what's happened in the past, what about the future? So we have ongoing data collections which are either happening at the moment, so the 58 cohort This is ongoing data collection, which we had to postpone for a period due to COVID, which we are restarting The biomedical data collection We have plans with the 70 cohort, collecting data age 51 The next steps cohort age 32, and with the millennium cohort age 22 There's an awful lot more data coming in the pipeline in the future Just to provide some information on the biomedical data that we have So we have specific biomedical data collections in the 58 cohort around 45 years These are on the UK data service and 46 years in the 70 cohort also on the UK DS These give us almost scientific opportunities Both things that we hypothesize when we design these data collections Also, unforeseen opportunities for single cohort analysis Life course, determinants of health analysis And also cross cohort analysis, examining trends in health over long run periods And trends in the determinants and the consequences of health also The data collection in the next biomedical NCDS, likely to be arriving in 2023 So this is the last BCS 70 biomedical data, age 46 We have detailed questionnaire data on household, finances, health, well-being and cognition measures We have nurse measures, anthropometry, height and weight, body fat Physical function measures, grip and balance, measures of blood pressure The blood samples and accelerometry data for 7 days We also have measures on diet, using an online diet questionnaire And again, these are all available on the UK DS I have an update on the our linked data I can't get rid of this banner, I'm afraid But this is a slide which gives a visual depiction of our linked health record data So an update here is that like many studies we've been trying And trying to work through the process of having our studies linked with health admin data But I'm pleased to report some progress So we do at the moment actually have some data on the UK DS With linked hospital episode statistics Here for England, NCDS, BCS and next steps With coverage over around 10 years Admitted patient care, critical care, A&E and outpatient care And I think these data haven't been used a great deal at the moment So lots of exciting opportunities Potentially low-hanging scientific fruit for folks that are interested You can click on the link and you can find out more With other data either available or forthcoming In difference to these and different sub-regions of Britain Another update is genetic data So the 58 cohort has already been genotyped And the millennium cohort study was recently genotyped And so these two studies you can access their genetic data Using our new data access system Which typically takes around or less than one month to a response And is available via a simple form And the link is divided in the slides So we have a new system now Which we hope is proportionate and not too burdensome For either the applicants or for the panel reviewing it Genetic data in the 70 cohort is expected later this year In collaboration with colleagues in Bristol And we are planning for genetic data in the next steps in 2023 So another point to mention is with NCS Because we have this family data You have an interesting opportunity to With genetic data on trios The cohort members, their mothers and their fathers So potentially using this information To try to account for things like assortative mating Or to look at things like genetic nurture effects on outcomes I think in the genetic epidemiology space We've seen studies like UK Biobank Really dominate the research landscape Biobank is a great study But it also has important limitations Including its very distorted response rates So we hope going forward that these kinds of studies Will be used in genetically informed health science And social science going forward And we hope to facilitate that by eventually providing Polygenic scores for multiple phenotypes For each of these different studies We think it's a very exciting space for research Across health and social sciences Here's a link to a project I've recently got funded on this So a testament to the idea that some funders will fund this Some of the time Another update is our COVID data So without going into the rationale I think it's fairly self-evident that we need Longitudinal data We need nationally representative data Ideally to inform on the consequence of the COVID pandemic Both for health and social consequences So we have a neat series of studies With five different longitudinal cohort studies Which were surveyed at the same time Adding to the CLS studies was the 1946 cohort Giving us a long age span of data collection We have data collections via a web questionnaire In May 2020 So building on in this pandemic And then later on in this seemingly never-ending pandemic With wave two in September 2020 And wave three in February to March 2021 With similar data to that collected in USOC Family, employment, homeschooling, mental health Questions on long COVID And qualitative type questions also These data are available for you to download And look up on UKDS Another update is forthcoming data on Suriology measured from blood samples So these data should be available by the end of this year With a set of antibody and blood samples Taken from CLS studies Along with many other studies Which are funded by the national core studies As well as the self-reported data You can soon be able to look at Objected in measured serology for COVID-19 Using these two different types of assets And a final update if I have time I hope I do is three new cohorts That's right folks, we wait for decades The new cohorts arrive and then suddenly We have three more or less the same time Very exciting time I have one slide on each And more information is on the CLS website The first is the early life cohort feasibility study Which is a two-year ESRC funded project Starting this year With the best feasibility of a new UK-wide Birth cohort study So it will recruit thousands of new babies So a birth cohort design Collecting information on families And their development Provided this is successful There will be a large and main study Taking place in 2024-25 So around 25 years after the millennium cohort study We should hopefully be having another large Nationally representative birth cohort But here is another birth cohort study as well It's called the Children of the 2020 study A new nationally representative birth cohort study Of babies in England Which is funded by the Department for Education So this is set up to answer important scientific And policy questions regarding the family Early education and childcare Determines of early school success But like many of the cohort studies It can potentially be used Quite well in health research as well Collecting those kinds of data also So it will be recruiting around 8,000 families Of the staff of 2022-22 With initially a plan for a five-way Longitudinal survey of this birth cohort From nine months onwards The final new study is called the COVID Social Mobility and Opportunities Cosmo study So this is much like next steps Perhaps it's starting off with recruitment Happening in year 11 at school So that's age 15-16 And it will investigate the educational And employment inequalities Brought about by the COVID-19 crisis And it's UKRI funded And led by researchers and colleagues At the UCL Centre for Education Policy And Equalising Opportunities And a certain trust in collaboration with CLS So it'll be the largest study of its kind With around 12,000 young people to take part With data collected following this age And it will explore the disruption That's taken place to school during the pandemic As well as long-term educational And career outcomes So a very exciting time in terms of The data that we already have in CLS The new data that we're planning to collect On the studies that we already have And three new studies occurring as well That's the end of my talk Thank you Thank you very much, David It's super exciting to hear about those Three new go-hards especially So yeah, looking forward to see How they developed So we're now going to look at The English Longitudinal Study of Ageing And what has happened on it During the pandemic We have Chen Franca-Adare From NATSEN Chen Franca is a Senior Research Analyst In the Longitudinal Team within NATSEN And he has experienced In Longitudinal Panel Studies And Online Mixed Mode Fieldwork Designs At NATSEN, Chen Franca has worked On a range of research projects Including ELSA, Online Time Study NATSEN Panel and Technical Education Study And he completed an MSc in Research Methods At Citi in 2019 So over to you, Chen Franca Hi, Mari Hi, Mari Thank you very much for the introduction Thank you So in this presentation I will be discussing about The English Longitudinal Study of Ageing And what happened in the ELSA Universe In 2020 I will mostly focus on the COVID-19 Sub-Study But towards the end of the presentation I will also give you a quick overview Of what's in the pipeline for ELSA In 2021 So before we start With the COVID-19 Sub-Study I just want to give a quick overview Of the ELSA project For those of you who are not familiar With the study and with its design So ELSA is the Longitudinal Study of Ageing It began in 2002 It is a Longitudinal Study The focus is on people above the age of 50 Living in private households in England Partners are often interviewed With the core members So with the main person recruited to the study The original sample for ELSA Was recruited from HSC In between 1998 and 2001 So those are study participants Those are people who completed the interview With the ELSA review of England And then the sample was refreshed Several times with new courts From HSC participants The last court was added to the sample In wave 9 So the ELSA research team Is formed by five collaborating institutions So I've listed them here We've got UCL, IFS, Nuts And the University of Manchester And the University of East Anglia Those five organizations Form the ELSA research team Start to talk about the COVID-19 study First of all Let's say the main research objectives Were excited about finding The effect of the pandemic On the age and population of England And what the dynamics of the lockdown were As we know, COVID-19 Have different effects for the age and population So they were asked to shield They were asked to self-isolate More than other groups So it was important to collect data About their experiences and outcomes So ELSA also offered Opportunities for cross-sectional analysis But also longitudinal analysis And in particular I believe the ELSA will offer Good options to analyze COVID-19 data with previous waves But also with future waves of the study So with data that will be collected In the future COVID-19 data was also harmonized With other longitudinal studies In the UK International studies of aging For example, share the collected COVID-19 data in the same period In the European Union And I also wanted to mention That ELSA was founded by the SRC By the UKRI COVID-19 rapid response Moving to the questionnaire The ELSA COVID-19 study covered Different range of topics So we have the COVID-19 As a module about COVID-19 So experience of symptoms, illness and so on But also if they were shielding Self-isolating and the experience Of lockdown from a medical point of view Then we got other health issues And for example There is an interesting section About access to hospital and primary care There is a mental health section That includes a number of different scales In terms of demographics We mostly ask questions about housing So exactly how many people Were living in the house Age, relationship and so on There are some questions about Financial circumstances Work, so changes in work patterns And others Social connection and isolation For example, we have a really interesting Set of questions about Digital inclusion for this age group In the first wave of the study But there were also extensive Questions about caregiving The longitudinal dimension We were asking both wave 1 and wave 2 And then health behaviors Like for example sleep and sedentary life But also smoking and drinking Talking about the sample The ELSA COVID-19 sub-study Was an issue to people Who were part of the ELSA sample So in the first wave We issue ELSA members That were eligible for an interview In wave 10 Also those who refuse Face-to-face modes For example, differently From the standard ELSA interview We didn't allow any proxy interviews So it means that we Only issued study participants That were considered mentally capable To carry out an interview on their own So in total In the first wave we issued about 9,500 study participants Sample members, sorry And 7,800 were Core members In the second wave we issued In the first wave But then we also removed those Who had refused participation In the COVID-19 sub-study And those who were found Not eligible for an interview So either because they moved out of the UK Or because they passed away Since the previous interview So in total we had A number of cases We issued 9,100 cases And 7,465 were Core members Looking at the fieldwork design The fieldwork structure Essentially had a mixed-mode strategy So Web and Cati And the sequential design So we started with Web And then we released Cati to those Who were unproductive To Web We had three main methodological objectives So the first one was the coverage Of the offline population And here is why we had the Cati mode And then The prioritization Of a cost-effective solution So Web interviews are Relatively inexpensive So we tried to push everything to Web first Before starting Cati fieldwork And the last element Was the compensation for Web Non-response So we used the responsive design After a couple of weeks of fieldwork We run a model Of non-response We divided unproductive study participants In a number of batches By likelihood of completing online And we released to the Cati interviews The batch That were less likely Early and then the batch That were more likely to complete online Later during fieldwork In total, so we had those Two waves of the study The first wave In June and July last Eight weeks, the second wave In September for seven weeks So it was a bit shorter Nevertheless, we got a similar split In the modes So in about both waves we had an 83% Web completion And a 17% Cati completion To be honest We were a bit surprised about these numbers Because we were expecting a larger number Of Cati interviews So it was a positive result for us Another positive element was the response rate Because the sample was really responsive To this COVID-19 study So we had a response rate Of about 75% In both waves And we also had a similar composition In the similar response rate across the two waves For key age groups So we didn't see many differences Between those who take part in the first wave And those who took part in the second wave In terms of sample composition Looking at those who were Looking at the wave to response rate It was positive that 92.4% Of the people who were productive In the first wave Also had a productive interview In the second wave So overall, we had 6472 Sample members Who were productive in both waves Of the study So another element I wanted to discuss Is the ways that are available On the archive data sets So our statistical teams produced For different waves For cross-sectional and for longitudinal Waves The cross-sectional waves in each wave Are for core members And then we have another set of waves For core members and their partners So this one is the first time in ELSA That we developed Waves for the partners as well So generally Core members only receive A cross-sectional wave Moving to the longitudinal waves Most of them as you can see from the slide Have been produced upon The wave-9 cross-sectional wave Adjusting for non-response In the COVID-19 study So in the first wave We have a wave between ELSA wave-9 And the first wave of the COVID-19 study In the second wave ELSA wave-9 And the second wave of the COVID-19 study ELSA wave-9 and both waves Of the COVID-19 study And then we have a wave that only looks At the completion of both waves Of the COVID-19 study You can see by the numbers Of the number of cases Including initial longitudinal waves That they're only for core members So we then produce longitudinal waves For partners Only one element that I wanted to mention Before we move to the next slide Although the study is representative Of the age of 50 In this case for the COVID-19 study We are looking at datasets They're representative for people Above the age of 52 And this is because we didn't have Any refreshment court after wave-9 So we didn't have core members In the age group 52-52 So talking about resources You are able to find The ELSA COVID-19 sub-study Data and documentation on the UKDS archive So the idea of the study Is 8688 We have released End user license dataset And we are in the process of producing A special license dataset Covering The interview date grouped by week Early reports are available On the ELSA project website This includes a methodological report For wave-1 Where essentially we are talking about Just field work From A standard copy interview To a web-cut system And During the year, so in this year We will also be working on a second methodological report Focusing on wave-2 And looking at some Experiments that we run Especially around incentives And survey length And also we will be assessing Some sample compositions between The copy waves The first way of the study And the second way of the study To analyze individual level changes In survey participation In the ELSA project website You can also find some training videos There is a video, for example The covers, the weighting process And So, yeah There was pretty much everything From the COVID-19 study The elements that I wanted to mention Will discuss what's on the pipeline For ELSA in 2021 So, we are running We actually ended field work For a serology study So this one was made of This one required some on-key test kits Been sent to sample members We issued Test those kits to people With a productive interview In either the first or the second wave Of the COVID-19 study And we're still eligible for the interview We are in the process of archiving the data And This study is essentially part of the UK Longitudinal linkage collaboration Looking at COVID-19 antibodies I think that David from CLS mentioned This study as well Then Talking about wave 10 So the ELSA field work Was due to start in 2020 But we shifted it to 2021 Because of the pandemic The ELSA research team Is currently piloting CAPI And remote interviewing solutions And we believe that main stage Fieldwork will start Later in 2021 Another element that I wanted to mention Is about nurse visits So in wave 8 and wave 9 They were split between the two waves But now with the ELSA COVID-19 Because of the pandemic We will be carrying out all the Nurse visits in wave 11 So finally There is also an additional WebCathy wave But we are not sure about The actual design So we are not able to give you more details At this stage Thank you very much You're welcome