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tv   Martin Landray  Al Jazeera  July 5, 2020 11:32am-12:00pm +03

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one of 50 vehicle robbery incidents reported in the u.s. in the last few months turkey is increasing naval cooperation with the u.n. recognize government in libya defense minister who see sokka made the remarks while inspecting a turkish ship off libya's coast last year turkey signed a maritime deal with the tripoli government there's been tension with france and others in the mediterranean turkish soldiers have been fighting with a government of national accord against the wall of belief or have to in japan tokyo's governor looks set to retain her post in sunday's election jus in part to her handling of the pandemic yuriko cokie is the 1st woman to lead the japanese capital and is viewed by some as a potential successor to the prime minister shinzo abbott. got more news here not 0 right after talk to outta here. on counting the cost of pandemic decimates jobs pushing many expect stream promising could have green recovery save the global economy senegal flagpole has been trying these crews accused of overfishing us meat
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processing products make or for banks and then. charging the cost on al-jazeera from the order. coded 19 is changing the world as we know it. when infections soared earlier this year governments worldwide implemented strict social distancing measures that have slowed the global economy dramatically so far they've been more than half a 1000000 deaths with 10000000 people infected worldwide but the huge financial cost of the pandemic has forced many countries to ease restrictions and reopen their economies. the united kingdom one of the world's largest economies has among the highest cope with 19 infection and death rates. british scientists like many others are working around the clock to find
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a vaccine. with one of the country's most renowned institutions the university of oxford fighting the pandemic on multiple fronts. professor martin landry he's one of the scientists leading the recovery trial it's the world's largest randomized clinical trial of potential cause with $1000.00 treatments. he's not looking for a cure as such he's focused instead on finding readily available drugs that can be used immediately to reduce the number of deaths. will there ever be a cure for cope with 19 or even a vaccine or will we all just have to learn to live with the virus find out more as professor martin landry talks to al-jazeera. professor martin landau thank you for. talking to al jazeera thank you very much for having me you're currently running the world's biggest trial of possible coronavirus treatments why is that such an important area of research when so much
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of the focus elsewhere is on the vaccine as being the way out of this crisis well it's quite clear to me we need both vaccines and treatments we need vaccines to prevent the disease but with some way of getting a vaccine not sony discovering one that works but discovering one that we can use in millions or possibly billions of people we need treatment because people are sick today people are dying from covert to today and tomorrow and next month and even if we have a vaccine there will still be some people who don't get it for whatever reason and they also will need treatment so we need both it's a tween strategy is not a competition we need we need both of course in the end as you pointed out yourself there is no guarantee that we'll ever get a vaccine well that's certainly true there's a lot of hope there's some really good work going on it's incredible speed at the moment but it's entirely possible that none of those will turn out to be scalable effective vaccines as we've seen with hiv i mean h.i.v. people are looking for a vaccine for whatever it is now 30 or 40 years and we still don't have one but the
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success we have in h i the is a series of drugs each of which really reduce the risks by a vanity small amount and you put them together and now patients take 3 or 4 drugs together big effects i think it's much more likely that we'll find a series of treatments that will reduce the risk of the important things it's a risk of dying if you're admitted to hospital the risk of going to ventilator improve your chances of getting out of hospital quickly but it better effect each of those by say a 5th so if you took you know currently 20 or 25 percent of people who get admitted to a hospital. die or die in the hospital because you sat by a 5th that would be massive. well let's get into the nitty gritty of your trial it's called recovery which is a clever acronym standing for randomized evaluation of code 19 therapy tell us about the trial well the trial is is seriously large we were quite clear that we needed
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a trial that could pick up these modest effects it's running across the u.k. 175 hospitals n.h.s. hospitals up and down the whole of the u.k. . cove it is a disease can affect anyone any age and so this is a trial that's open to anyone and we're studying currently 5 or 6 treatments which are we think have some promise or where people have raised expectations that they might be effective treatments and frankly we really need to know and you're looking at them in combination rather than looking for that sort of single silver bullet well with a long looking for single book silver bullet some of them where you are being used in isolation so patients just get one treatment some of them are being used in combination so people can get 2 or 3 treatments statistically it's quite a complicated design concept it is actually quite easy the question is if your doctor is by the bedside of a patient who's got coded how should they treat them and that's for that what the child's a jessie and to better understand the possible outcomes here you talk about reducing deaths perhaps by a 5th i mean that's pretty modest isn't it on its own it's pretty modest but if one
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say said well last week of the week before there were 20000 deaths in the united states just to pick an example from covidien if you do stop by a 5th that would be 4000 lives saved in a week that's the united states you look in brazil or you look in india or you look in other parts of the world then these could be really massive effect and if you put one 5th with another 5th and another 50 if you find 2 or 3 treatments like this then we've started to talk about seriously large effects even on a one by one basis are you doing with those early results and at what point do you start if these things are effective being able to roll them up. well there's 2 questions here one that we've chosen drugs in this 1st phase which we could if they turn out to be effective can be rolled out very very rapidly so these are drugs that because there is essentially off the shelf there off the shelf drugs i mean take dexamethasone steroids and that's in every hospital in the world so if that
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works that could be extremely effective and rolled out instantly but doesn't work we need to know that so we don't use it but we won't get all results at the same time because not all drugs were started in the trial at the same time not all patients are suitable for all drugs. and of course the this phase of the epidemic in the u.k. is subsiding somewhat good thing but that means that some of the results will be a little bit later coming and that's fine and the point here is prevention or reducing symptoms or both well this is particularly focused on the group of patients who are sick enough to get into hospital and then when for patients who are in hospital the questions are pretty. straightforward will they need a ventilator and will they die and those are really the things that we're trying to affect with these treatments in other words reduce the need for a ventilator reduce the need for a ventilator improve survival reduce the time that people are in hospital all of
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those would be important both for the patient and for the health system that has to cope with these enormous numbers of patients what we need is evidence we have to have evidence to get that evidence as quickly as we can to make sure that the evidence is your bust as possible which is what large randomized trials do and then make our policies on the basis of some evidence we cannot just be using these treatments arbitrarily willy nilly just because it seems like a good idea sometimes the rush to do something is not the right response what one needs to do is is to understand what the disease is doing understand the treatments find effective treatments and use those over treatment is not effective or worse still is harmful abandon those. one thing i'd say in the u.k. which has been extremely helpful is that by and large we haven't gone down that route of making the hoped for drugs like hydroxy quark law queen and others
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just sort of available for doctors to prescribe because they want to do something what we've done instead is to create this very large randomized trial covering every hospital in the country and say if you've got a certainty about how to treat these patients you can randomised into this trial and we can get the answers actually quicker than anybody really robust dances is either take or is a cross and we move on does it make your job harder having politicians making these sorts of pronouncements that muddy the waters while you as the scientific community are dealing with actual facts looking for actual solutions i focus on my job my job is to create the evidence i don't i don't feel that my job is either supermoto or or. or otherwise one particular treatment or another i actually don't feel particularly responsible for would a will a particular drug work what i feel really responsible for is understanding in
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discovering whether the drug works so people can come up with ideas they need testing and then my child test those ideas it does to some extent will serve to highlight though how political covered 1000 has become globally on top of being a global health emergency you've got countries and governments vying against one another not just in the search for vaccines and. therapeutics and so on as you are doing but also vying against one of the for who has the highest death toll who was least prepared and so on. governments may say they're acting in the public interest but increasingly the worry must be that they're beginning to act in their own interests covering their tracks trying to make it look like they were doing something when actually they were well yeah these global politics in that i'm qualified to comment on global politics but what i would say that it is something
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that your community your scientific community in this country is directly exposed to almost every day in the conflict between you know out of advisors and the government and the advice that the government chooses to take or not what i'd say that covert has done is that health and science and education who traditionally see been seen as luxuries or even. costs to the burdens on the economy. what kobe has demonstrated is that unless you get the science and the health care and the education right you do not have an economy and i think that that's one of the most fundamental shifts that we've seen over the last 3 or 4 months you know that suddenly health and health science is absolutely necessary if one is to have a functioning economy and i think that that's not a local issue or
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a national or regional issue that is an international issue and i think it's something we all have to grasp does it worry you that in this country that equation now seems to be shifting yet further ahead to the primacy of the economy again over health and lives the importance of restoring the economy over the importance of getting these sorts of solutions in place or clearly economy and health are very closely intertwined as i've just said i think that what's become so all of us is that one can have wishful thinking about economy but if one doesn't deliver the health then the economy would just fall over and so health in the science i think has been one of the real strengths actually this country in particular if one looks at the vaccine research and the clinical trial or search you know the recovery trial is the largest randomized trial in the world the w.h.o. have a trial is about a 3rd of the size and involves many different countries but in the last 10 weeks or
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so we included over 11000 people in every hospital up and down the country that is something that the u.k. should be incredibly proud of and the information that we generate from that the results we get from that and not only inform how we treat n.h.s. patients here in the u.k. but how patient should be treated internationally and so i think that's for normally valuable is something we should be proud of her said before if you don't. the health right and you know the science right you have no economy whatever you might wish well on that point there is the moral imperative as well that whatever solutions are found to be a vaccine bit therapeutics be it a combination of the 2 that all countries on earth get them and all people on earth have equal access to them not just the rich countries at the expense of the poor and even within societies ensuring that all groups within society have equal access what will you be doing is there anything you can do with your research to ensure
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that that moral imperative is met. well within the u.k. the trial is open to anybody who's admitted to hospital so let's start at that point so the proportion from black and ethnic minority communities that in the recovery trial very nicely mirrors the proportion of all patients who go into hospital with cove it how do we manage that well we've made we've translated things into the relevant languages we have in every hospital in local communities we've been very transparent about everything that we're doing . and we have a local research nurses and clinical staff who really understand their communities so that's one thing we can do the 2nd thing we can do is to generate evidence is relevant to everybody and that is exactly what we're doing is it relevant to a diverse range of people in the u.k. but a diverse range of people internationally and the 3rd thing is to be really clear
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when we have results is to get the hours out and we know that there rambus so we have to make sure we get therm conclusions to get that those out as quickly as widely and comprehensively as possible so that people can act on those results at speed wherever they might be i mean this is the sort of thing we hear a lot of at the moment in the race for a vaccine the developing world clearly concerned that they will be left at the back of the queue it is an absolutely unthinkably immense job is that getting this stuff to the whole world that's 4 and a half 1000000000 doses of the vaccine may be needed your drugs as well how do you scale up to that extent how do you get it to the refugee camps in bangladesh how do you even get it to all communities in a country like the united states the inequality is laid bare the moment no national health service well covert is laying bare the those inequalities there's no doubt
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about that and those inequalities don't get solved. taking a uniform blanket approach and very often what they require is a tailored local approach to the local community or local community can be a particular refugee camp or it can be an entire country or it can be a region of the united states but you have but you have to think about delivery at those those local levels but when it comes to supply chain that's not entirely a local problem that's about manufacturing distribution price that's where the world the work of world bank welcomed gates. the e.u. and so on become so important in the fundraising that they're doing not thinking about how do we get a neat little publication in some journal but actually how do we get a treatment that actually is delivered to patients across the world where they need it that journey is a much more complicated journey and a much more expensive journey but we have to start on that journey now even if we
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don't know which vaccine works even if we don't know which treatment works and so i would say if for example. manufacturing over a particular vaccine or a particular drugs is done and then the results come through and it turns out that they are not as effective as we'd all hoped we should not be quick to criticize that that's preparedness and the nature of preparedness is that every now and again you don't need it the point about preparedness is when you do need it it's there when it's there now and so it's not a surprise that we have to invest in a number of both jugs and vaccines all candidates and their supply chains and our law practice of delivering these to those local communities wherever they might be we have to invest in that now in order to be prepared for when the scientists and the and the research. comes up with something that we have clear evidence and it does seem to be something like an unprecedented level of cooperation of the moment
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among the global drug companies already pointing in the right direction yes i would . say that it's been noticeable who how well particularly the big pharmaceutical companies of the justice i mean i sit on the outside of this. but i think it's you know interesting that you know she's an acoa already manufacturing drugs for the oxford vaccine which happen which we don't yet know whether that's in effect going to be effective vaccine other companies have votes donated to us it is a map as a drug to recovery trial you know there's a number of examples where industry big pharma is helping in seriously. proactive and almost philanthropic ways in order to deliver an improved health globally now of course exceptions to that. where people think more narrowly about their particular drug and their particular market share in there and so on and so forth but i would say that there are a number of the big key players where are you looking governments in charity in
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health sector or pharma that if it acted extraordinarily well and helpfully and that that's been really rewarding i'd say another big problem one assumes to the idea of global uptake of water for drugs become effective or and are made available is the idea of the anti vax as the people who for whatever reason don't want to take it for themselves or believe that a vaccine or a particular drug might be harmful to children there's also a plethora of conspiracy theories around that these things might become infused with microchips tracking their movements and so on i mean i mean is there a danger and as these conspiracy theories grow online that whatever solutions are made available on taken up in sufficient numbers to provide the sort of immunity across the global population that's required well we you know we always have those challenges and i think. i think the 1st thing we can do is be really certain about
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ourselves and our own evidence it's it's hard to wimpy other people over when in fact the evidence that you have to back up your case. is not as convincing as even you would like so you the 1st thing is to actually get to get the good evidence i think at the same time as the education in the impact and we're back to communities again merely. about working with communities and communities are there particular sectors of society there particular patches of worlds particularly politic political dimension but we have to get and work with it with communities in the success is always being when you actually work with communities different communities have different leaders the leaders not always the highest paid person who sits at the top of the tree but they have different leaders in terms of influences and i think one needs to think about that very carefully what it takes us back as well doesn't it to the idea of political message you can getting that absolutely right and building the public trust and confidence yes i mean it's one thing to think about is that you know to take vaccines or drugs it doesn't really
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matter who's vaccine or who's drug or who's clinical trial demonstrates that. the drug works or the vaccine works and the trial demonstrates success of a search is successful that's not what's important because it's actually a global challenge and the fact that there are you know dozens of people trying to develop vaccines many people trying to think about trials. actually you know we need some winners and we don't really mind where they come from. having said that i think that just going back to randomized trials of drugs. they have seen this in previous outbreaks we've seen this even in this outbreak when it was in china and we began it begins to migrate around the world a phenomenon that everybody wants to do their trial and we've not careful we end up with dozens or actually literally hundreds of small trials which never recruit very many people they're not particularly well done and they really don't have any hope of providing an answer and so one of these bits of coming together is actually
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prioritizing which are the most likely treatments and most interesting treatments the most the treatment you could quickly get out to many many people prioritizing those into a few seriously large trials and if you do that you can get answers remarkably quickly you get an answer every couple of months dozens and dozens hundreds and hundreds of small studies because this drug that i quite like this drug or i've got a test for that drug or whatever else it might be is not the way forward we have to have some prioritization few big studies deliver answers and move on are you worried professor about the prospect of a 2nd wave here in the u.k. possibly much sooner than anybody had feared because of the speed with which the lockdown has been lifted which many in your community many scientists like you are saying is simply too fast the defense mechanisms are not there to guard against
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a rise in the infection rate. i mean i fully understand the balance between economy . people's need to do something i see the mental health of being alone at home and the health issues that go with the coronavirus having said that it seems quite clear to me that the moment we have no still have no treatments so we're no further forward than we were in january and we still have no vaccine so we no further forward today from where we were in january that's all moving very very fast but it's not going to be you know we're not going to have those sorts of answers you know today and tomorrow and so it's quite clear that the more people you bump into the more people and the greater the risk of in fact you know you just have an effective test trace and isolate system and may not have for some time to come so you know the test treat and vaccinate are the fundamentals and i would add to that actually supports a more support emotionally mentally and and economically. because we have to make
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these. people have to live. but we have to ensure that we balance that against. against the challenges of the kind of r.s.v. is there yet and finally this lots of talk about inquiries that may or may not happen in the aftermath not just here but all over the world to find out what went wrong there are real lessons to be learnt though this is a global pandemic not the 1st and it won't be the last other certainly learn a lesson to learn is you know. if all goes goes through life and and doesn't learn any lessons i think there's a merely positive lessons to learn never been so some areas of extraordinary success some areas of collaboration and real delivery yet to speed and scale we just haven't seen yet i normally work in cardiovascular disease it would normally take me year and a half 2 years to just recruit the number of patients into the study that we've just done in the last 3 months let alone get results probably another couple of years beyond that to get results and the costs will probably be $10.00 times
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greater and so actually with the right approach to the governance to the delivery to the cartelization it's made a massive difference so there's some really positive lessons to learn which we should not lose and of course there are some things that we should have done better you know we should learn from those too but right now the challenge is we still have coronavirus we still have no treatment we still have no vaccine and we the testing is only just being rolled out i think all of that was changing very fast but that should be off of your focus so i'm sorry just to pick up on that we should we really ought to be going out quite so readily and living our lives i'm very nervous about going back to normal. i'm nervous about going back to normal in the way we lead our lives i'm actually nervous that we go back to business like it was before all of business like it was before i think actually one of the things
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about this is it's a time to reset. our values our way of life but also so many of the things which we did as a matter of routine and orthodoxy and tradition which the virus is this and dealing with it obviously showing we can actually make changes which are substantially for the better we need to learn from those 2. professor martin andre thank you for talking to al-jazeera thank you very much indeed.
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