[ Features ]

The UK has been demonstrably and evidentially world class when it comes to the science and research effort to tackle Covid-19 virus and has shown regulatory deftness. Despite our politicians' embarrassing bluster about "world class" track and trace and other ineptitudes, there's so much to be applauded.

In March the government spent £20m to establish the Covid-19 Genomics UK Consortium (COG-UK). This pulled together centres of clinical and sequencing expertise all over the country.

And the UK has real form in this arena. The Wellcome Trust’s Sanger Centre is the biggest single contributor to the Human Genome Project; UK Biobank is the world’s most ambitious population DNA database; Genomics England is a world-leader in genomics to track down the mutations that cause rare diseases and some cancers.

This combination means that the UK has sequenced far more viral genomes than any other country the rest of the world. Few countries can match the UK in mapping the mutations in the virus and tracing its evolution and spread. About half the world’s covid viral sequences were done here. The Covid-19 Genomics Consortium (Cog-UK) has tracked the genetic history of more than 150,000 samples of Sars-Cov-2 virus. "If you're going to find something anywhere, you're going to find it probably here first," says Professor Sharon Peacock, head of Cog-UK, in this article. That's why the UK was the first to identify the new contagious variant, providing researchers with vital information about the virus and its mutations. Cog-UK uses the data to track outbreaks, identify variant viruses, and publish a weekly report.

In treatments of Covid-19, the UK has been at the forefront. The national clinical trial, called The Recovery Trial (which stands for Randomised Evaluation of COVID-19 therapy), was also established in March 2020. It remains the largest trial of treatments in COVID-19, with over 26,000 participants to date. One in every six COVID-19 patients that come into the U.K. hospitals go into the trial.

According to Matt Ridley in The Telegraph, the trial "has proved invaluable in assessing what works and more importantly what does not work in treating patients. While other countries threw everything at dying patients and learned little, Recovery made it easy for harassed doctors to enrol every patient in a controlled, continually evolving trial in which treatments are added and dropped."

The Recovery trial led to the work that investigated whether the cheap steroid dexamethasone was an effective treatment for patients hospitalised with severe COVID-19. The trial compared over 2100 patients who received dexamethasone and usual standard-of-care with more than 4,300 patients who received usual standard-of-care alone. On 16 June, the trial announced the result that dexamethasone reduces death by up to a third for severely ill COVID-19 patients. Dexamethasone is now recommended for COVID-19 patients worldwide, potentially saving many thousands of lives.

The Recovery trial also showed that hydroxychloroquine, the antimalarial drug that was promoted by, among others, the ludicrous former President of the US, did not benefit hospitalised patients.

Writing in Science magazine, Kai Kupferschmidt said: "In a sea of small, single institution studies, Recovery, with 12,000 patients and hundreds of participating hospitals, stands out—and offers lessons for the few other megatrials, organized by WHO and other bodies, which have been slow off the mark." (Rather snarkily, in the same article, a WHO representative observes that the UK had been able to recruit well, "because they have had a lot of hospitalized patients." Fair point, if rather tetchy and maladroit.)

It's not just the Recovery trial. A similar trial, known as Remap-Cap that involves more than 3,900 Covid patients in 15 countries around the world and run by Imperial College London, the UK's Intensive Care National Audit and Research Centre, and Utrecht University, has now shown that the immune-suppressive drug tocilizumab also saves the lives of those in intensive care. It's already being deployed by the NHS.

Of course, the most famous British contribution has been the Oxford/Astra Zeneca vaccine. Sarah Gilbert’s Oxford University team at the Jenner Institute designed the vaccine over a weekend in January and then collaborated with AstraZeneca to bring the project to fruition in breakneck speed.

It is also the vaccine with the greatest potential to help the world. The Oxford-AstraZeneca vaccine makes up the bulk of the 2 billion vaccine doses secured by COVAX, a consortium of 190 world governments formed to help ensure COVID-19 vaccines were distributed fairly around the world—including to developing countries. AstraZeneca has pledged to sell the vaccine at cost to developing nations in perpetuity, a condition insisted upon by Oxford university. Supply deals indicate a single dose will be priced at about $3 to $4.

There was the establishment of The Vaccine Taskforce in May 2020. The brainchild of Sir Patrick Vallance, the UK Government's chief scientific advisor, this created a dedicated, nimble private-sector team of experts embedded within Government. It secured access to six vaccines (from more than 240 vaccines in development) across four different formats.

There have been regulatory firsts. The Medicines and Healthcare Products Regulatory Agency tested these new vaccines for safety in parallel not sequence and got results in record time, observes Matt Ridley. This was something the MHRA had been "itching" to do.

In December 2020, the Pfizer/BioNTech vaccine was approved by MHRA - the first coronavirus vaccine to be approved for mass use in any country. It was a jab for the world, said Anjana Ahuja: "This milestone is a poignant symbol that science transcends national borders: the vaccine was developed in Germany by the children of Turkish immigrants; tested in Germany, the US, Turkey, South Africa, Brazil and Argentina; manufactured in Belgium and first approved in the UK."

The UK was also the first to approve the Oxford/Astra Zeneca vaccine. It has also approved the Moderna vaccine. At the time of writing, no other country has approved three separate Covid vaccines.

And in Coventry, notably, Margaret Keenan became the first person in the world outside of clinical trials to receive a Covid-19 vaccine. In Oxford (natch), Brian Pinker became the first person to receive the Oxford vaccine.

And the UK is taking the fight to anti-vaxxers. The level of support for public take up of vaccination in the UK is strong. Oxford has its Vaccine Knowledge Project, which is led by Andrew Pollard, the chief investigator on the Covid-19 trial.

The Oxford COVID-19 Government Response Tracker (OxCGRT) systematically collects information on several different common policy responses that governments have taken to respond to the pandemic on 18 indicators such as school closures and travel restrictions. It now has data from more than 180 countries.

Britain has long been "better at discovering things than applying them," says Matt Ridley, but in biosciences "the gap between discovery and application is smaller here than elsewhere, and we have just shown we can leap it with elan. Most genomic data sets in the world are entirely research based. Ours are better coupled to clinical care. If the next 50 years is going to be dominated by innovation in biotech as the last 50 were dominated by IT, then Britain is well placed."