World-leading research, dreadful death rate

The UK conducted world-leading COVID-19 research and was the first country to find a treatment that worked, so why did it also have such a high death rate?

Globally, millions of lives were saved because the findings from astonishingly rapid health research were made available internationally. But the death rate in any country depended considerably on local factors, including the use of evidence to inform policies.

That’s the finding from a fresh study comparing the pandemic response from health research systems in seven countries where COVID-19 death rates varied vastly.

“Earlier work to build the health research system into the NHS helped the UK to lead the world in key parts of the research response,” said Brunel University London’s Prof Steve Hanney.

“The problem is that the UK also had a much worse death rate than comparable countries such as Germany or Canada. The UK was very good at developing a vaccine and conducting clinical trials. But when it came to using evidence in policy making, it was much less good. “

By the end of 2021, only 10 people in every million in New Zealand had died of COVID-19 and just 86 per million in Australia, said the study in Health Research and Policy Systems. Yet in the UK, 2,172 per million died. In the US, that figure was 2,536 and 2,882 in Brazil. Canada and Germany were in the middle, but with much lower death rates than the UK.

Yet the UK quickly established the world’s largest trial testing whether drugs for other illnesses were effective against COVID-19. Its Randomized Evaluation of COVID-19 Therapy (RECOVERY) trial was designed to test many existing drugs at once. One was dexamethasone, a common corticosteroid, and another, hydroxychloroquine.

“The RECOVERY trial built on features of the health research system such as research capacity embedded into all UK hospital trusts,” said Prof Hanney. “Very quickly it identified dexamethasone as the first treatment in any country proven to reduce mortality, and that hydroxychloroquine was not effective against COVID-19.”

Far-sighted university scientists in the health research systems in the UK, Germany and the United Sates had spent years developing new platforms so that they could create new vaccines. New companies had been established, sometimes by these scientists, including BioNTech in Germany and Moderna in the US. These companies and the University of Oxford each started developing their own COVID-19 vaccine as soon as the COVID-19 genetic sequence was first revealed in January 2020.

After a few months, large-scale additional resources came from AstraZeneca working with Oxford University, Pfizer with BioNTech, and the US Government with Moderna. The combination of new platforms, a focusing of large-scale resources on this one disease, and accelerated procedures by regulatory authorities resulted in vaccines being developed more rapidly than ever before.

The UK was the first to start using the vaccines. But by the end of 2021, Canada, Australia and New Zealand had higher rates of vaccination than the UK and US.

“Estimates show that millions of additional deaths have been averted, or avoided, as a result of the science leading to the vaccines and the identification of effective repurposed and new drugs,” said Prof Hanney. “Lives were also saved by political leaders adopting evidence-informed policies such as lockdowns and mask mandates, but the speed and intensity of these policies varied greatly.”

Political leaders in Brazil, the UK, and the US (especially President Trump), did not pay enough attention to the scientific evidence, the study said. This contributed to the higher death rates in these countries.

Reported by:

Hayley Jarvis, Media Relations

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