Urgent research and surveillance on COVID-19 using the new OpenSAFELY secure platform across 55 million patients' full linked primary care records

Our group is delivering analyses across 27 million patients' full pseudonymised linked promary care NHS records, soon expanding to 55 million. This unprecdented scale is needed for rapid results during Covid-19.OpenSAFELY uses a new model for efficiency and privacy: we have built a secure analytics platform inside the data centres where GP records already reside, and linked to all relevant Covid-19 outcomes data.This is not a proposal for theoretical future delivery. All permissions are signed, all data has flowed, our first analyses are complete. We have achieved this with no external resource.We urgently need funds to sustain, accelerate and expand our work across diverse collaborative analyses. This application covers the platform, and three workstreams:1) Observational epidemiology to identify patients at higher risk of admission, ventilation and death from Covid-19, to inform management, seclusion advice, service planning, and underlying mechanisms (e.g. higher risk among BAME groups); to rapidly assess specific hypotheses arising around treatment/prevention including ACEi's, ARBs, ibuprofen, inhaled corticosteroids, antiocoagulants, and other treatments.2) Deliver innovative transmission models that combine disease-dynamics approaches with near-real-time hyperlocal data on prevalence and population at risk, to predict local spread and service need, and (for example) to design and evaluate exit strategies from lockdown.3) Measure and mitigate the indirect health impacts of Covid-19 on, for example, cancer presentations and referrals, cardiovascular management, vaccinations, etc, using research and observatory approaches to identify urgent necessary actions.