Use trial drugs on all seriously-ill coronavirus patients in hospital – Blair
Therapeutic drugs should be used to treat all coronavirus patients in hospital at serious risk of illness, not just those taking part in a national clinical trial, Tony Blair has urged.
The former prime minister said there is “no safety issue” in giving potential treatments that are safe and meet a minimum level of efficacy to all patients in need.
Mr Blair said that, rather than offering therapeutic drugs “only to those in the Recovery trial”, co-ordinated by the University of Oxford, any “hospitalised patients at risk of serious illness” should be offered drugs that are safe.
In a foreword to a report on coronavirus by his institute, the ex-Labour leader said: “We should give these patients the drugs and track the data from them.
“There will be resistance to this, because it means altering the Recovery trial process, but this is a lesser risk than denying potentially life-saving drugs to those who need them.
“The AstraZeneca therapeutic drug, one of the most promising, is not part of the Recovery trial in the UK, but we should urgently investigate whether we can speed up its introduction, even with limited doses being available.”
The Recovery trial, which includes 176 UK hospital sites, found in June that a cheap steroid called dexamethasone could save the lives of people with severe Covid infection.
It is currently testing whether the antibiotic Azithromycin, anti-inflammatory drug Tocilizumab, convalescent plasma and an antibody treatment called Regn-Cov2 are effective treatments for coronavirus.
Mr Blair also said that, while he was “optimistic” that by the spring there will be vaccines and therapeutic drugs which allow a return to “something like normal”, he was anxious about the coming months.
“We simply can’t afford to put our society and economy into severe restrictions for the winter months.
“The toll in terms of health and the economy will be enormous,” he warned.
However, Professor Adam Finn of the University of Bristol said: “I think it would be useful to point out to Mr Blair and those reading his proposals that the only sound way to work out whether a specific treatment is safe and effective is by doing randomised controlled trials similar to the Recovery trial.
“Simply giving drugs to patients and watching to see what happens does not tell you whether or not they work because you have nothing to compare them with. Likewise you cannot tell whether there is a ‘safety issue’ in any particular group of patients until you evaluate the therapy in question in a controlled randomised blinded trial that is free of bias.
“This is particularly important for novel therapies that have not been used previously to treat other conditions.
“This is not the only politician this year to have expressed opinions regarding unproven therapies and doubtless not the last and there have been some prominent doctors behaving similarly too – but if we are to avoid harming people and wasting time and resources we need to do this properly.
“The statement conveys the urgency of the situation. Randomised trials like Recovery and Solidarity can deliver clear answers extremely fast as long as they are well organised and able to recruit large numbers of patients rapidly – and they both are.
“By contrast giving treatments open-label slows everything down by leading us up blind alleys while playing roulette with our patients’ lives. I hope this message is clear enough to help sort out this muddled thinking.”