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Risky Business: lessons from covid-19

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2221 (Published 05 June 2020) Cite this as: BMJ 2020;369:m2221

Read our latest coverage of the coronavirus pandemic

  1. Mun-Keat Looi,
  2. Rebecca Coombes
  1. The BMJ
  1. mlooi{at}bmj.com

Clinical professionals are at the forefront of learning and innovation about, and sparked by, the pandemic. Mun-Keat Looi and Rebecca Coombes report from the first virtual Risky Business conference, held on 2 June

Video 1

The science clinical trials: what we know and the pipeline

“We need to remember what we can do, not what we can’t.”

The opening words from Matthew Shaw, chief executive of Great Ormond Street Hospital, were in relation to the Nightingale hospitals—and captured the mood of the conference. Five months since the UK’s first confirmed case of covid-19 and three since its lockdown began, the world is a different place. But among the chaos, exhaustion, and grief, there is much we have learnt and achieved.

No magic bullet

“It’s unlikely there’s one drug that will suddenly knock out coronavirus and everything will be back to normal,” Martin Landray, co-chief collaborator of the RECOVERY trial, the world’s largest clinical trial of treatments for covid-19, said.1 “But even moderate effects, such as reducing the number of hospital patients dying by just a fifth, is a colossal improvement.”

Video 2

The people: the science of wellbeing

The RECOVERY trial is a platform study, meaning it is considering several treatments within one trial. Starting in mid-March, there were just nine days between the first drafting of the protocol and recruitment of the first patients, including regulation and ethics provisions.

There are no drugs for covid-19 that have been shown to work, with the possible exception of remdesivir, Landray, a professor of medicine and epidemiology at the University of Oxford, pointed out. “The early data for remdesivir looks encouraging for reducing the time for hospital patients to improve and go home, but we still don’t have any evidence that it reduces mortality,” he said.

In the UK the mortality of patients admitted to hospital is extremely …

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