We still need Covid-19 treatments as well as vaccines

Shamil Tanna

It’s a Friday morning in October and Charlotte Summers has been up since the crack of dawn. As a leading expert in respiratory and intensive care medicines, she is one of the clinical researchers responsible for advising on the UK’s national treatment guidelines for Covid-19. But overnight, results of a trial by the World Health Organisation have been published concluding that remdesivir – an antiviral drug global leaders once pinned high hopes on – has “little or no effect” on patient survival.
“We were just about to release the next update as the news came through,” she says. “It’s disappointing, but it’s just as important for scientists to know which treatments don’t work for Covid as those that do in order to help save lives.” As an intensive care physician at Addenbrooke’s Hospital, Cambridge, communicating the facts around Covid-19 is intrinsic to Summers’ work – specifically the message that, in order to tackle the virus, “we absolutely need therapies as well as vaccines.”

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A year ago, Summers had never given a media interview. “Stuff like that you would have struggled to drag me to do,” she says. But as public fear of the new virus set in, she began to feel the tug of responsibility. “It was the recognition that if someone doesn’t publicise the facts, the void gets filled anyway. You can either put experts who know what they are talking about out there, or you can have Fox News with Trump on it saying nonsense like, ‘hydroxychloroquine saved my life.’” (Trials suggest that hydroxychloroquine is not an effective treatment for hospitalised patients.)
Becoming a poster girl for “good information” may not have been part of the plan, but Summers is well-equipped to engage, whether she’s explaining how a ventilator works in a TV news segment, or advocating for improved mental health support for critical care workers through the Intensive Care Society charity, of which she is a board member. Earlier this year, she was selected as one of the clinical advisors to the government’s ventilator programme, overseeing and supporting both the manufacturing of new, rapidly scalable ventilators as well as reviewing and assessing existing ventilators to see if they might be suitable for UK use. She has managed all this while juggling clinical care work and running a research lab; she is director of the University of Cambridge School of Medicine’s Academic Clinical Fellow Programme and Dean of Selwyn College, Cambridge.
Summers is also vocal on the pressure the pandemic poses to working mothers; she has a nine-year-old son. “My husband has been at home full-time because that’s what works best for everyone,” she says. “But imagine if he wasn’t? Covid is having a disproportionate impact on women because they’re the ones juggling childcare alongside other work. And it’s a big issue – it could regress women’s advancement massively.” As the UK moves into winter and grapples with a second wave, she is equally concerned about the increased stress on healthcare workers: “burnout is already a problem, make no mistake.”
Summers splits her time between research and working directly with patients on the hospital ward. This means she might be conducting lab experiments using human cell models one day and working a double-shift as a hospital ward doctor the next – the combination of which she firmly believes makes for better science. “The whole idea is to understand the mechanisms of disease so that we can produce effective therapies that work at the bedside.”

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Before the pandemic hit, her research focused on understanding acute respiratory distress syndrome (ARDS), a life-threatening condition that causes lung failure in around 10 per cent of intensive care patients and 25 per cent of all people who are put on ventilators. The hospital mortality rate is 35 per cent to 50 per cent – “incredibly serious and yet most people have never heard of it.” Her group will continue this work over the coming months, using data samples from previous viral outbreaks such as H1N1 (“swine flu”) to identify subgroups within some of the causes of ARDS – Covid-19 being one. Understanding the different clinical outcomes of different groups of people will allow scientists to develop treatments and target therapies more effectively.
Having had experience working on treatments for diseases like SARS, Summers knew that a crisis was imminent as soon as news of the new coronavirus began to spread from colleagues in China. “In many ways, it was inevitable,” she says. “If you look back through history, pandemics come. And yet, we haven’t managed to come up with any strategies to stop outbreaks for any infectious disease.” Viral pathogens have been number one on the UK government’s risk register for many years, but she suspects that political agendas have distracted some of the attention needed to prepare.
In spite of all this, she is optimistic about what can be achieved. “It’s the absolute ultimate team science, isn’t it?” she says. “Not ‘single white man wins Nobel Prize’, but everybody pushing aside egos to collectively do something for the betterment of humanity – and that’s fantastic.”
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