Meet the behavioural scientist guiding us through Covid-19

Two years ago, Professor Linda Bauld was appointed the University’s first female holder of the Bruce and John Usher Chair of Public Health. Today, she is one of the UK’s leading expert voices helping us understand the virus and its public health consequences. We caught up with her to find out more about her role during this crisis.

Linda Bauld, Bruce and John Usher Professor of Public Health
Professor Linda Bauld

While many of us have been testing new culinary skills or catching up on home improvements during lockdown, weekends for Professor Linda Bauld look very different. As one of Scotland’s leading public health experts, Professor Bauld, alongside Usher Institute colleagues, has been working tirelessly to shape our understanding of the virus as a regular media commentator and an independent academic advisor, while conducting her own research to further knowledge of the virus.

“As time went on during this health crisis it became clear that the public really wanted to hear different voices about what was going on and understand what the evidence was saying. It’s my role to follow what’s happening in relation to this pandemic, comment on and possibly critique decisions being made, and communicate the science,” she says.

Clear communication from government, particularly the Scottish Government, has played a key role in the public’s compliance with lockdown measures, says Professor Bauld. And now with hopeful signs that the spread of Covid-19 is slowing both in Scotland and the UK, Professor Bauld has been a prominent advocate for Scotland to start easing its lockdown measures soon.

“It’s not tenable to restrict your populations indefinitely,” she says. “There is growing evidence that we may have a reprieve, but the virus could come back so the strategy needs to focus on gradual easing of lockdown and trying to reinstate key services. We need to restart the parts of the NHS that have been paused or diverted. We must try to open up bits of our economy slowly because the long term damage is already going to be very significant and could be a lot worse if we don’t try to carefully move things forward in the next few weeks.”

But not everyone is ready to resume their lives, Professor Bauld observes.

“We’re seeing from the surveys that there are some groups - not just people in the “shielding” category - but more generally, who have actually been comfortable with being locked down. They find it easier socially, or there have been positive aspects for them despite all the negatives, and some of that group will be reticent to take advantage of the new freedoms that may be offered to them. They will want to be safe, but nothing in life is 100% safe, so it’s about harm or risk reduction, and that’s a very scary concept for some people.”

Smoking and Covid-19

As a behavioural scientist with a keen interest in health prevention, Professor Bauld is well placed to understand how people respond to public health measures. Her research and advice over the past 20 years has influenced behaviour around alcohol and tobacco use in Scotland, notably undertaking the first study of the UK’s national stop smoking services. Now, her extensive expertise in tobacco use has led her to examine the link between smoking and Covid-19, especially as data has thrown up some unexpected questions around smokers’ susceptibility to ill health from Covid-19.

“Smoking is still the leading preventable cause of death in the world. We have seven million deaths a year and 200 people die every day from smoking. It’s going to dwarf Covid by any stretch of the imagination. But it’s appropriate to look at the two together” she says.

“What we normally see with other respiratory conditions is that smokers are very badly affected – that is what you would expect. For some weird reason that is not the case with Covid and we don’t understand it. The data from multiple countries shows smokers are under-represented in case numbers, and they are also under-represented in the numbers of people who go into hospital with Covid. But when they are in hospital, even though they are in smaller numbers, they’re much more likely to die or to have bad outcomes.

“We’re working with University College London on a rapid review of all the evidence and conducting a big representative survey in Pakistan, which has some of the highest rates of smoking amongst men in the world. We’re also looking at what advice is needed for governments in Africa and South Asia on this topic.”

Team effort

Professor Bauld’s work is part of a considerable team effort at Edinburgh’s Usher Institute to respond to the virus. Led by Professor Aziz Sheikh the Insitute brings together expertise in health services research, health informatics, data science and social science to work towards the data-enabled transformation of health.

Usher Institute academics, including Professor Bauld, Professor Devi Sridhar, Professor Mark Woolhouse and Professor Aziz Sheikh, among others, have been at the forefront of the Covid-19 response in Scotland and further afield, contributing to policy, providing comment in the media, gathering data, and leading or collaborating on significant research projects to further our understanding of the virus.

“Some of us have almost completely diverted our attention to this issue,” says Professor Bauld. “We had to. It’s unprecedented in our professional careers so far. We have had to really shift our focus and I think it’s appropriate for an institute that has the oldest chair of Public Health in the UK and the oldest Chair in General Practice, and that is very focused on population health to respond to this,” she says.

Something Professor Bauld was keen to set up, alongside Professor Sheikh, was a webinar series featuring academics from around the world, initially as a tool to help governments and policymakers learn from other countries.

I think it’s even more important for academics to engage with colleagues from overseas.

“One of the unique features of Covid-19 is that it’s a truly global pandemic,” she explains. “If you look at previous public health crises, previous epidemics have been somewhat limited, geographically. I think it’s even more important for academics to engage with colleagues from overseas. The webinars have been incredibly successful. We’ve had hundreds of people register each week, and hundreds more watching the live stream on YouTube. And I get emails from people from different countries who I’ve never met. I’ve found that really helpful, so that’s been brilliant.”

Professor Bauld remains a little sceptical that Scottish society will be more receptive to future public health interventions after our experience of this pandemic, but there are some indicators of hope.

“I saw some interesting data from Australia looking at what’s happening with flu right now, during their winter. The rates are far lower than anyone expected, and do you know why that’s the case? Because people are washing their hands, and they’re using tissues, and they’re doing the stuff that they were taught to do during the Covid outbreak. I do think that the public understand public health better and listen to advice but whether they will be supportive of broader health policies? We will see.”

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