No stone is being left unturned in the search for clues
‘We are pooling knowledge from every corner of medicine’
in terms of revealing the dynamics of Covid-19 infection and why it presents so differently between individuals.
Sir Mark Caulfield and his team are intent on what they call “rapid, action-orientated genomic research” and “surge preparedness”.
In normal “peacetime conditions” he recognises, “it would take months to mobilise a team this size and mount an initiative like this but we have done this in days and weeks in a brand new hospital”.
Dr David Collier, clinical director of the William Harvey Research Institute Clinical Research Centre and deputy director of Barts Clinical Trials Unit, is helping to train the volunteers for data collection. He has been engaged in research among high-altitude mountaineers over many years and this highly specialised research that could itself start to pay unexpected returns in the fight against Covid-19.
“We are busy pooling and collating knowledge from every corner of medicine and physiology,” he told the volunteers, as he put up a slide of the British Mount Everest Medical Expedition climbers on Everest where he carried out his own research.
“Mountaineers are able to survive and thrive on very low oxygen levels – a condition called hypoxia – and this could also help in our efforts to understand the impact of Covid-19 because of the way the body responds to low oxygen levels.”
No stone is being left unturned in the search for clues to crack the code.
Dr Collier emphasises to the volunteers that intensive care staff now, like his Everest climbers, carry significant personal risk. The real heroes, he emphasises, are the frontline nurses and doctors, and that intensive care and clinical research do not always make ideal bedfellows. He quotes the example of Rupert Pearse, professor of intensive care medicine and head of research and development for Barts Health, whose own research has been delayed by the imperative to care for the sick and to oversee the national priority trials that will in the long run “most likely save lives”.
It is a tricky balance but on their nightly 6pm conference Zoom calls, Sir Mark and Prof Pearse lead a large and hugely diverse team that is coordinating the ongoing effort to decipher a virus.
This initiative to crack the Covid-19 code is at least as important as the Bletchley codebreakers’ efforts to break the German Enigma Code. The complexity of the Enigma – an electromagnetic machine that replaced plain text letters with random letters chosen according to the settings of a series of rotors – lay in the fact that its inner elements could be set in billions of different combinations, meaning it would be virtually impossible to decode text without knowing the original settings.
As the war progressed, the German military added more rotors to the machine, making it even more complex. The Enigma machine was, in effect, being forced to mutate just as Covid-19 will do. The codebreakers now, as then, are trying to zone in on an ever moving target.
“The work at Barts Health,” says Sir Mark, “provides a key platform from which to launch a concerted attack on Covid-19 in a way that will alter strategic planning for secondary and tertiary waves of this pandemic.
“As a world we have to be ready for that eventuality”. He then adds with undisguised pride “Britain is uniquely placed to take a lead in this research.
“As a people we have the character, altruism and inclination to pull together and this will serve us well as we attempt to collect and analyse the data we need. Not only are we world leaders in genome research but our centralised National Health
Service means that we in the UK can act not only to protect our own population but gain insights that benefit mankind as a whole.”
Covid-19, the muscular super-virus sweeping our planet, has all but closed down entire communities, countries and even continents, but it is hoped that the work being done at Barts Health and Queen Mary will play a significant part in the global effort to stop the virus in its tracks.
St Bartholomew’s Hospital – Barts to its friends – has a long and proud history of looking after Londoners. Established almost 900 years ago it sustained the capital through the Plague, the Great Fire and the Blitz.
Now the famous old hospital and its rebuilt and enlarged Trust, has been equipped with an en suite field hospital, The Nightingale, dedicated to treating victims of Covid-19. In its new guise, Barts is rising to perhaps its greatest challenge to date.