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How a single meeting in Oxford saved millions of lives

The Royal Box stands and applauds Oxford University and AstraZeneca scientist Professor Sarah Gilbert (front row) as the first match on Centre Court on the first day of the 2021 Wimbledon Championships began this week. (Photo by AELTC/Joe Toth / POOL / AFP) / RESTRICTED TO EDITORIAL USE (Photo by AELTC/JOE TOTH/POOL/AFP via Getty Images)

July 1, 2021 - 7:00am

On 30 January 2020, just a month after a “novel coronavirus” was identified in Wuhan and while there were still only 82 cases confirmed outside China, an emergency meeting was held in an Oxford department.

The Nuffield Department of Medicine (NDM) is a heavy hitter when it comes to global health. It has about 3,000 employees, a thousand or so in Oxford itself and the rest scattered around tropical medicine units around the world — crucially, including places like China, Vietnam, Thailand. Jeremy Farrar, the head of the Wellcome Trust, worked with Nuffield in Vietnam. Others, such as Peter Horby, a professor of emerging infectious diseases, had also worked in Hanoi. Experiences with previous coronavirus outbreaks, SARS and MERS, was fresh in the minds of several of them.

That meeting on 30 January happened after Horby went and told Richard Cornall, the head of the NDM, that the coronavirus was likely to be devastating. Professor John Todd, a professor of precision medicine at the Wellcome Centre for Human Genetics, an NDM subdivision, was there that day. “Peter went to Richard,” he told me, “and said we need to claw together all the existing expertise in structural biology, immunology, vaccine production, project management, administration.” That meeting led to a huge mobilisation of resources and expertise, from very early on in the timeline. Among those present was Sir John Bell, former head of NDM who would go on to advise the government during the pandemic.

This is relevant because now, looking back, the Oxford medical departments, and most notably the Nuffield, have had a huge and outsized impact on the course of the pandemic. Last week, I wrote about Ivermectin. It’s an antiparasitic drug which may or may not work to improve outcomes for Covid patients.

What’s interesting, though, is that — as I said — there is a major clinical trial looking into whether it works or not. The PRINCIPLE trial, as it is called, is recruiting thousands of patients to properly examine the drug’s impact. It’s an innovative design: patients who are suffering symptoms can recruit themselves onto it and will receive either normal care, or normal care plus ivermectin which they will get from their GP. It is also looking at the use of favipiravir, an antiviral, and a corticosteroid, budesonide (often used to treat asthma) for Covid. PRINCIPLE is run by the NDM’s sister organisation, the Nuffield Department of Primary Care Health Sciences.

It is not the only major trial to come out of Oxford. RECOVERY, which established that the cheap steroid dexamethasone substantially improved outcomes — and showed that tocilizumab and remdesivir could save lives as well — was set up by the NDM and Nuffield Department of Population Health. It is estimated that by March, the use of dexamethasone had saved about 22,000 lives in the UK alone, and perhaps a million lives globally. “Oxford knows how to run large-scale trials,” says Todd. “The secret to a large-scale trial is to keep it simple.”

And the Oxford-AstraZeneca vaccine, which will probably be the biggest lifesaver of all — a low-cost, effective, easily stored and manufactured vaccine — was developed by scientists at the Jenner Institute, a part of NDM.

By the time of the January meeting, Sarah Gilbert of the Jenner Institute had by that stage already started work on a vaccine — a Chinese scientist having already made the Covid RNA sequence available. But she needed a million pounds immediately to sign up with a manufacturer to get the clinical trials underway; Cornall, recognising the urgency, offered to underwrite the funds out of the NDM, rather than wait for grants. The vaccine trials, led by another Oxford medical scientist, Andrew Pollard, got under way soon after.

That meeting also led to the use of Oxford’s Diamond Light Source particle accelerator to work out the structure of the spike protein when a synchrotron in China broke down; NDM’s connections with Chinese scientists allowed them to step in at short notice. The department has also been hugely involved in sequencing the variants: Todd mentions a sequencing machine breaking down on Christmas Eve, and a staff member driving from Oxford to Cambridge’s Sanger Institute at 9pm to use one there. “People were working 16-hour days,” he says.

The point is not to say that the Nuffield Department of Medicine did this single-handedly. Universities around the UK and the world have been hugely involved in the fight against Covid — Todd mentions UCL and Edinburgh, and many others did great work. But it is worth noting that there was a particular concentration of expertise in the NDM at that point early last year, and that single, emergency meeting allowed it to spot the problem early on, and, by the most conservative of estimates, to help save millions of lives.


Tom Chivers is a science writer. His second book, How to Read Numbers, is out now.

TomChivers

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Norman Powers
Norman Powers
3 years ago

This is a slightly odd article that reads more like a press release by Oxford than a piece of independent journalism.
Organizing clinical trials of treatments? Great, yes, we need those. What we also need is academics to stop trying to systematically erase anyone who wants to talk about those very same treatments, or compare their risk ratios to those of vaccines, but Oxford doesn’t seem coherent enough to take a consistent stance on that. Why do we even rely on universities to run these simple trials to begin with? Shouldn’t that be the government’s job?
Universities have been by far the biggest villains of COVID, not heroes. It is universities that push fraudulent modeling that makes COVID look far more serious than it actually is. It is universities that systematically flood the literature with pseudo-science yielding endless contradictory claims, it is universities who hide and say nothing when scientific malpractice is uncovered. It is universities behind the replication crisis, it was a university that argued to the Telegraph that “the conclusions about lockdowns rely not on any mathematical model but on the scientific consensus”. Nuffield said nothing.
Were there any consequences for the virologists who signed Daszak’s letter? There were not. Were there any consequences for scientists who defined COVID as testing positive for COVID and then claimed the tests don’t have any false positives at all? No, there were not. Thus any claims about how many lives they’ve saved have no actual scientific validity because we don’t know how many people truly died from COVID to begin with.
I do strongly suspect that if universities didn’t exist, COVID would have been something we read about from time to time in the health section of newspapers and not more than that. There’d have been no lockdowns, no mask mandates, no social distancing, no travel suspensions, no mass quasi-mandatory vaccine program. The belief that all those things are needed comes directly from academics desperate for “novel” claims that they can build their careers with, not the raw data itself, as becomes clear when you sit down and start reading the literature.

Last edited 3 years ago by Norman Powers
Lesley van Reenen
Lesley van Reenen
3 years ago
Reply to  Norman Powers

Yes catchy title, but I wonder how they arrived at ‘saved millions of lives’.

Norman Powers
Norman Powers
3 years ago

By comparing modeled counterfactuals to reported data, but neither have sound foundations, so in the end it’s all meaningless. They might have saved millions of lives or they might have hardly any. Dumpster diving through research papers is a constant exercise in face-palming. People will still be arguing about it a century from now, probably without getting any closer to an answer.

Lesley van Reenen
Lesley van Reenen
3 years ago

I guess the author did not read the comments on the recent Ivermectin article? There is a significant study flaw with the Principle trial, in that people are recruited when they have had symptoms for up to 14 days, but the virus peaks on day three—and it’s too late to use an antiviral after the peak of virus replication. This was observed way back in Jan by Penny Ward, visiting professor in pharmaceutical medicine at Kings College London and is backed up by anyone using or prescribing it….. take it immediately symptoms set in, if not prophylactically.
Also I thought that Dr Pierre Kory of the FLCCC in the US initially highlighted the benefits of corticosteroids in Covid treatment. If memory serves this is related to the fact that they figured out that the pneumonia being experienced was identical to organizing pneumonia …. And corticosteroids is the treatment for organizing pneumonia. Can anyone comment on this?

Last edited 3 years ago by Lesley van Reenen
Galeti Tavas
Galeti Tavas
3 years ago

When I read of these kinds of unknown, vast, organizations, I hope they are the good guys working ethically and morally to make things better for humanity….. But my mind always flashes images of old James Bond Movies, and underground labs with white coated scientists running around with clipboards as seconds tick by….
Bill Gates stroking a white Persian cat….

Galeti Tavas
Galeti Tavas
3 years ago

https://www.youtube.com/watch?v=TG6BuSjwP4

Bret Weinstein, (interviewed here when Unherd still was anti the insane covid response by Government) is now days a rabid anti conventional covid man.

He talks of the potentially vast danger of mRNA vaccines (they target ONE bit of ONE protein spike, and thus with mass vaccination wile the virus is present means an adaptation is very possible – compared to conventional vaccines using whole viruses, which means immunity is done on many parts of the virus.)

So watch https://www.youtube.com/watch?v=TG6BuSjwP4o at 1:53:1 to see his thing on vaccine risks, and why he refused them.

He pushes Ivermectin….

Matt Spencer
Matt Spencer
3 years ago
Reply to  Galeti Tavas

Have you got anything more credible than f***ing youtube there mate?

Glyn Reed
Glyn Reed
3 years ago
Reply to  Matt Spencer

https://www.hartgroup.org/ivermectin-works/
See the peer-reviewed paper by Dr Tess Lawrie.

Jonathan Ellman
Jonathan Ellman
3 years ago

30 January 2020, and yet the government took no action until March 2020. This was not a success for the scientific community.

Prashant Kotak
Prashant Kotak
3 years ago

The politicians take no action, and it’s the fault of the scientific community?

Jonathan Ellman
Jonathan Ellman
3 years ago
Reply to  Prashant Kotak

I think the sci-com had the clout to inform the govt. of the urgency.