A team of Oxford researchers led the world in identifying successful treatments for infected COVID-19 patients and offer a model for the future. By Ben Hirschler.
Britain has not had a good pandemic. A late lockdown, a lack of testing capacity and shortages of protective equipment for healthcare workers have exacerbated problems for a country with one of the world’s highest coronavirus deaths rates.
Yet in one area Britain has excelled. When it comes to assessing which drugs work to treat COVID-19, a small team of scientists from the University of Oxford has led the world. Their success in proving the life-saving benefits of a cheap and widely available steroid—dexamethasone—highlights just what can be achieved by focusing on speed and simplicity.
The record pace at which the Randomized Evaluation of COVID-19 Therapy (RECOVERY) clinical trial recruited thousands of patients in hospitals the length and breadth of Britain meant researchers were able to quickly reach straightforward “yes” or “no” conclusions about the efficacy of different treatments.
RECOVERY, of course, was not the only research project launched to study the new disease. Indeed, there has been a blizzard of experiments, with more than 4,000 studies aimed at testing treatment and prevention strategies registered since the start of January, according to the TrialsTracker website. The problem is that many of these studies have duplicated efforts and the vast majority have been too small to provide definitive answers.
By contrast, the Oxford group constructed a large study with the statistical firepower to answer the urgent questions that doctors were asking—and they acted fast. “If you want to do things at scale and go fast, then you have to keep the process simple,” Professor Richard Haynes, clinical trial lead for RECOVERY, said in an interview with the Brunswick Review.
Early in the pandemic the Oxford researchers realized that doctors would be hunting for treatments as soon as cases started pouring into hospitals. As a result, Haynes’s colleagues Peter Horby and Martin Landray wrote the protocol—or masterplan—for the trial in just two days in early March, and nine days later the team had recruited the first patient. It was unprecedentedly fast for a process that normally takes months. Within eight weeks RECOVERY had enrolled 10,000 patients.
“Speed was vital,” Haynes said. “Surfing is not a bad analogy: Just before the coronavirus wave broke, we were in position, all our sites ready to go, which allowed us to recruit as many people as possible.”
Grim though the situation was, the fact that Britain had a very big epidemic and a high mortality rate among hospitalized patients made it an ideal place to conduct research last spring. And by June, they had concrete results. In addition to proving that dexamethasone improved survival in patients sick enough to need breathing support, they also demonstrated that hydroxychloroquine—the malaria pill controversially endorsed by Donald Trump—and a combination of two common HIV drugs did not help.