When a new severe pneumonia swept across central China in December 2019 there were early signals that this could be the beginning of a major pandemic. George Gao, the Oxford-trained head of the China Center for Disease Control and Prevention, reported to us about the severe nature of the infection and provided the first sequence of the virus which identified it as a SARS virus. Peter Horby, our Professor of Emerging Infections, was quickly engaged and began studies in Wuhan almost immediately; Jeremy Farrar – now Director of the Wellcome Trust and the scientist who led our Oxford Wellcome Unit in Vietnam through the H5N1 influenza outbreak – was also closely involved, communicating information as the epidemic spread. By mid-January our teams were fully engaged with over 1,000 scientists working on the multiple issues relating to the virus. There were many challenges to address and Oxford scientists were addressing most of them.
It was clear from early on that a good response would require vaccines, therapeutics and diagnostics coupled to good immunology, virology, epidemiology and surveillance as well as behavioural science. The flat structure of decision-making meant that this university could quickly move resources and skills to initiate programmes. In every crucial domain Oxford has led the UK and in many areas has been world-leading.
The University’s strengths in immunology, structural biology and virology have been a major asset. Much of what we have learned about this virus – including our understanding of its natural history and pathogenesis, the nature of the immune response and the structure of its vital proteins – has had a strong Oxford flavour. David Stuart, Paul Klenerman, Tao Dong, Gavin Screaton and many others have all made major contributions in these areas, identifying the role of T cells and innate immunity, understanding antibody responses and finding the structures of major target proteins for drug discovery.
In testing, one of the big challenges has been to establish and validate new capabilities for ELISA testing, to detect and measure antibodies in blood samples. Oxford was first to establish a high-throughput lab, in partnership with Thermo Fisher Scientific. The first Lighthouse Laboratory (high-throughput testing facilities dedicated to the COVID-19 National Testing Programme) was created in a building owned by the University in Milton Keynes, with the help of Oxford scientists such as Mike Hill. Validation of lateral flow tests for antibodies – and more recently for antigens – has been led by a team from Oxford working with Porton Down. Tim Peto and Derrick Crook have been instrumental in developing the diagnostic tools for mass testing now being rolled out nationally to control the disease. UK testing would not have happened so effectively without the input of Oxford scientists, and it now offers a solution to control disease until the spring.
Therapeutics are obviously key to managing the disease; here too the clinical trial expertise in the University has clearly led the world. Martin Landray and Peter Horby set up the Recovery Trial using their expertise in large-scale trials and emerging infections and were able to beat the world to large-scale definitive results. This trial not only eliminated useless therapies but also identified the most effective therapy discovered for this disease, dexamethasone, which saves up to 30% of lives in severely affected patients. They have set a new standard for rapid major trials that should be mimicked globally. Other efforts in Oxford are setting up challenge models for testing therapeutics.
It is not possible to understand how to manage the epidemic in the UK without good epidemiological data, and the definitive study in this area – which has guided all policy – is the ONS study led by our own Sarah Walker. Sarah has worked tirelessly to generate the data that allowed us to track the numbers of people infected and she was among the first to document the very high numbers of asymptomatic infections.
Many parts of the University have been engaged in COVID-19-related operations throughout the pandemic: engineers developed a completely new ventilator and a new LAMP test for diagnosing the disease, and the Blavatnik School of Government has provided the best data on the impact of restrictions on disease.
Finally there was the vaccine. Starting with the MERS vaccine that had been developed by Sarah Gilbert, the team at the Jenner Institute worked aggressively to get trials started. They were the first team to begin trials in human participants and subsequently progressed the trials through phases 2 and 3. The news this week of their successful result speaks for itself and Adrian Hill, Andy Pollard and Sarah – with their teams – deserve huge credit for delivering a vaccine. This will be a vaccine for the world: easy to manufacture, easy to distribute and inexpensive. It is a remarkable achievement for a University programme, the only one globally to have reached a successful conclusion. The absence of any serious disease in any of the vaccinated subjects testifies to the success of the programme.
We should all be immensely proud of Oxford’s contribution to this fight against the virus. We have contributed more than any other university globally, in keeping with our number 1 ranking. Our success also argues for the crucial role universities play in society: adding knowledge, teaching, and contributing to good government policy – but also providing the research and development muscle to get the world out of a very sticky patch. Hopefully government will not forget this as funding allocations are made for the sector and for research, and hopefully our incredibly generous donors will feel proud of what they have enabled.
