The Observer view on Britain's Covid-19 response
Being British has been a discomforting experience for the past six months. A nation that had prided itself on the strength and resilience of its healthcare system has been laid low by the Covid-19 pandemic, which has claimed nearly 50,000 lives in the UK. Most other western nations have suffered fewer deaths and endured comparatively little national trauma. Not surprisingly, the UK government’s handling of the crisis has been heavily criticised, mostly for its tardiness and incompetence. Britain was too late in going into lockdown and it abandoned its ability to test for the coronavirus when it should have been ramping up capacity. The prime minister has blustered and vacillated over key policies from the wearing of masks to the timing of the easing of lockdown restrictions.
Given this sad background, it has been startling to note recent headlines and comments made across the world about the country’s Covid-19 response.
“The Brits are on course to save the world,” claimed the US economist Tyler Cowen in Bloomberg Opinion, while the American journal Science was at pains to quote leading international scientists who have heaped praise on our researchers’ anti-Covid work. “UK megatrial outshines other drug studies,” ran one of its headlines.
The focus of all this attention is the Recovery trial programme set up by Oxford University scientists Martin Landray and Peter Horby. It has taken advantage of the vast numbers of stricken Covid-19 patients who have flooded Britain’s hospital wards in order to carry out careful, randomised trials that have revealed the efficacy of treatments provided by doctors. Thanks to this work, a cheap steroid drug called dexamethasone has been shown to reduce deaths by a third in seriously stricken patients and is now used across the world as standard care for seriously ill patients. At the same time, the antimalarial drug hydroxych
loroquine, heavily promoted by Donald Trump and others, was revealed to have no effect as a treatment of Covid-19. It has now been dropped from clinical use for Covid-19 patients. These successes contrast with the failures of other countries, in particular the US, to assess carefully what treatments will actually improve the health – or save the lives – of patients.
Landray and Horby deserve considerable credit for their pioneering efforts. Their Recovery trial programme was set up in only a few days as hospitals prepared themselves for the waves of seriously sick patients that would soon swamp their wards. Normally, it takes months to organise a large randomised drug trial. But, as both scientists have acknowledged, there have been many other individuals and organisations who deserve acclaim for their involvement in Recovery. For a start, there are the 3,000 doctors and nurses, often sleep-deprived, stressed and anxious, who helped collect precious data in the grim setting of their hospital’s intensive care units while also struggling to save patients’ lives. Around 12,000 individuals with serious Covid-19 infections were recruited to Recovery; many of them have died. Their involvement underlines the tragic impact of Covid-19 and the importance of Recovery in pinpointing drugs that should help to reduce future loss of life. Britain had one other advantage, of course. It possesses the centralised National Health Service. Many other nations have health services that are fragmented and so cannot launch sufficiently large-scale trials. By contrast, Britain was able to combine data from hospitals that have ranged from the Western Isles to Truro and from Derry to King’s Lynn and so tease out data that will continue to pinpoint lifesaving treatments while highlighting those that are worthless. In addition, the National Institute for Health Research, created in 2006 and which provided Landray and Horby with their programme’s £2m funding, has played a critically important role in this affair. If nothing else, Recovery has demonstrated starkly the importance of possessing a strong, well-funded, national programme for treating patients and for assessing their needs on a sound scientific basis.