Intended for healthcare professionals

Letters Covid-19: RECOVERY trial

Rapid mobilisation of research in response to covid-19: a paradigm for the future

BMJ 2020; 369 doi: (Published 29 May 2020) Cite this as: BMJ 2020;369:m2155
  1. Martin James, clinical professor1,
  2. Gary A Ford, professor of stroke medicine2,
  3. Thompson Robinson, professor of stroke medicine3,
  4. Rustam Al-Shahi Salman, professor of clinical neurology4
  1. 1Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW, UK
  2. 2University of Oxford, Oxford, UK
  3. 3University of Leicester, Leicester, UK
  4. 4University of Edinburgh, Edinburgh, UK
  1. martinjames{at}

As clinical researchers in stroke we applaud the rapid mobilisation of research into covid-19 in response to this new global threat.1 Nearly 100 urgent research studies in covid-19 have been approved over the past few weeks, many of them complex trials that would have taken months or years to start before the pandemic.2 This has been made possible, in part, by streamlined and proportionate regulation and approvals.

But our admiration is tempered by frustration. Year after year, stroke kills around 40 000 people in the UK3—most of whom are older people with “underlying health conditions”—and five and a half million people worldwide.4 Globally, stroke is the second leading cause of premature death, a situation expected to prevail for another 20 years or more.5 When we talk to patients with stroke and their families, they immediately grasp the urgency of stroke research and share our frustration at the disproportionate regulation that slows the approval and conduct of research into the disease.6

So we commend the rapid response to this global emergency from regulators and funders in support of our counterparts in public health research. Our call is to go further—to see the same streamlined approach taken to research into the other major threats to worldwide health. Let two of the lessons that nations learn from covid-19 be critical reappraisal of the regulatory burden on research and audit into all the leading causes of death and disability, proportionate to the threat that these diseases represent. At least some of the heartbreak of covid-19 could be turned to good if it prompts a dramatic reduction in regulation, such that clinical research into all the big killers—communicable and non-communicable—can flourish unhindered.


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