Covid-19: UK lockdown is “crucial” to saving lives, say doctors and scientistsBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1204 (Published 24 March 2020) Cite this as: BMJ 2020;368:m1204
All rapid responses
Maximal cooperation by governments to facilitate rapid “fast-tracking” of an effective and safe vaccine for Covid-19 is crucial to saving lives.
While Iacobucci’s article essentially makes it clear that in any country prompt and energetic action with respect to introducing a lockdown (and other measures) (1) is vital with respect to the early control of a Covid-19 epidemic in danger of running out of control, ingenuity and energy is going to be necessary in other aspects of the pandemic control tool-kit if a solution to the problem of eradicating this threat is to be found.
The relentless progression of the virus across international borders is already developing into one of the most pressing international threats for perhaps a century or more, not only with respect to its already well-recognised adverse effects on health and mortality, but also in relation to its massive potential to destabilise the economies of countries with unpredictable and potentially frightening consequences. The Prime Minister only yesterday referred to Covid-19 as "the biggest threat this country has faced for decades". (1)
That said, it is that very international dimension to the threat that is most likely to lead to the emergence of its nemesis. For this type of threat, there is no precedent, meaning that countries do not have a toolkit from which to pick a hammer. We have only just come to the realisation that this threat must in fact be treated like a threat. There is considerable public debate and unprecedented measures have been taken by several countries. As Winston Churchill once said ‘Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning’.
While considerable research time and wealth is being spent on researching anti-viral medications and other pharmacological strategies, it will likely be the development of an effective preventative vaccine that is likely to prove the most important tool in the Covid-19 prevention tool-kit.
One side effect of the fact that this newly-described virus has now affected virtually if not all countries in the world (2) is that a great many leading centres of research across the globe are now devoting an enormous amount of intellectual force and resource towards solving the problem of developing a vaccine as quickly as possible.
The best results in any academic endeavour will always come from open and generous international co-operation, allowing as it does the pooling of first rate intellectual resources and scientific insights located in different countries. Quoting Butrous, "research collaboration is an enormous and powerful tool which provides mutual benefits to all parties”. (3)
That said, there is a growing dimension of extreme urgency with Covid-19, given the rapidity and relentlessness of its march across the world, the rampantly increasing number of deaths, the increasing levels of fear among populations, and the sense of extreme economic damage that might arise out of the pandemic.
So, there is a palpable sense in the air that “speed might be of the essence”.
A glance through history reveals many examples of medications that were introduced before very serious side effects became evident. For example, the notorious examples of thalidomide, diethylstilbestrol and fenfluramine/phentermine (4) come to mind. Patience, prudence and attention to detail should always be in evidence when new medications, including vaccines, are being developed.
But clear and visible evidence of as much international cooperation as is humanly possible by current governments around the world dedicated towards smoothing the way ahead for potentially effective and safe candidate vaccines will undoubtedly be welcome news to - and indeed expected by - billions of potentially susceptible human beings around the world.
We therefore make a strong plea for governments all around the planet to enter into and foster that that essential spirit of cooperation as soon as possible for as long as it takes to achieve the right results.
1. Russell P. COVID-19: What Next for Lockdown UK? Medscape News UK. 24 March, 2020 https://www.medscape.com/viewarticle/927410?nlid=134641_5170&src=WNL_ukm...
2. Worldometer. Covid-19 Coronavirus Pandemic. 25 March, 2020. https://www.worldometers.info/coronavirus/
3. Butrous G. International cooperation to promote advances in medicine. Ann Thorac Med 2008:3;79–81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700441/
4. Carey JL, Nader N, Chai PR, et al. Drugs and Medical Devices: Adverse Events and the Impact on Women’s Health. Clin Ther 2017;39:10–22. https://www.clinicaltherapeutics.com/article/S0149-2918(16)30922-5/fulltext
Competing interests: No competing interests