The pioneering Oxford University scientists who took on the “high stakes endeavour” of combating Covid-19 have shone a light on the lifesaving work that sees them recognised on the Queen’s Birthday Honours list.
Researchers Sarah Gilbert, Andrew Pollard, Peter Horby, Martin Landray, Catherine Green, Teresa Lambe and Adrian Hill may not yet be household names, but all played integral roles in the development of a coronavirus vaccine and discovering new drug treatments.
The approval of the Oxford/AstraZeneca jab in December came after experts worked at breakneck speed to turn the tide of a pandemic that had already taken a heavy toll.
Normally it takes years for an effective vaccine to be developed and made ready for market – but from the start of last year it became a race against time.
“The pace has been quite incredible because we’ve tried to compress about 10 years of vaccine development into 11 months,” said Professor Andrew Pollard, director of the Oxford Vaccine Group, who is knighted for his services to public health.
“Science is not normally such a high stakes endeavour,” added Professor Catherine Green, head of the Clinical Biomanufacturing Facility at the Nuffield Department of Medicine, who is made an OBE for services to science and public health.
Speaking to the PA news agency alongside her colleagues, she said: “Our projects are spread out over lots of years – but I think it was the focus on teamwork, community and understanding that we were in this not only for the UK but also for the whole world.
“So just wanting to do our best, with no guarantee of success, but wanting to do our best throughout gets you through.”
Professor Sarah Gilbert, who holds the Said Professorship of Vaccinology at the Jenner Institute and Nuffield Department of Clinical Medicine, and is made a dame after helping mastermind the new vaccine, said: “We didn’t really think that far ahead when we were developing the vaccine, it was all about going from day to day and it has been absolutely phenomenal the way the vaccine has been rolled out in so many different ways, it has been very, very impressive.”
The Oxford/AstraZeneca jab – called ChAdOx1 nCoV-19 – uses a harmless, weakened version of a common virus which causes a cold in chimpanzees.
Prof Gilbert said the technology had already been used in 12 different clinical trials, including another coronavirus vaccine against Middle East respiratory syndrome (MERS).
“We did then have to accelerate everything and plan to go further than we ever had before with this type of vaccine,” she said.
Teams at the Jenner Institute and the Oxford Vaccine Group, as well as pharmaceutical giant AstraZeneca, all pulled together “to get everything done as fast as we could”, Prof Gilbert said.
It was a time-consuming process made more difficult by experts having to negotiate Covid-19 restrictions.
Prof Pollard said the work “meant incredibly long hours and no breaks”.
“We’ve sort of reached the point now where there’s a few hours to have a break at the weekends. So we’re making progress,” he added.
“It was hard because we were also trying to abide by social distancing and lockdown regulations,” Prof Green said.
“A lot of people weren’t able to come to work, there was a lot of electronic communication, we had to get very good, very early at Zoom calls.
“You do the work when the work needs to be done in a crisis, you then try to take the breaks when you can because tired people make bad decisions.”
Teresa Lambe, associate professor at the Jenner Institute, who has an honorary OBE from the Foreign Office, said: “Working at such an intense pace has taken its toll. There was a period of time where I didn’t really know what day it was, I didn’t see my family a lot.
“My children forgot my name and called me ‘daddy’ on occasion but it’s been worth it because without the hard work I’ve put in and the team’s put in, we wouldn’t be where we are today.
“We wouldn’t have a vaccine that is available to the world and we wouldn’t have done it in such a short time frame.”
Their remarkable efforts have seen the approved vaccine go into the arms of tens of millions of people around the world.
Prof Green said: “I’ve hugged my mum, it was the best feeling – she’s double vaccinated, I’m double vaccinated, just a quick one. It just matters.
“Physical contact really matters – us being able to get back to the social animals that we are, that’s the point of the vaccine.
“If we can get that done here, we can get it done for the world. We all need to be able to hug our loved ones again.”
With everyday life having been transformed so much by the virus, it can be difficult to remember a time when much of the world was clueless to Covid-19.
Peter Horby, professor of emerging infectious diseases and global health at Oxford University, was there from the beginning, remotely involved in drug trials in Wuhan, China, in January 2020 – the epicentre of the global outbreak.
“I was talking to my colleagues in Wuhan from January 2, and they are quite experienced clinicians and they were telling me ‘this is a disaster’,” said Prof Horby, who is knighted for services to medical research.
“So it was clear to me very early on that this was quite serious, at the very least it was going to be a serious problem for China and the region, possibly the world.
“I think what really made me think this was different (was) because we were seeing a lot of healthcare workers getting infected, so my colleagues in Wuhan were treating the hospital director who had been admitted to his hospital with severe Covid, we don’t see that with many infections.
“We saw it with Sars (severe acute respiratory syndrome) so that really rang alarm bells.”
As the virus spread across the world, hospitals gradually flooded with patients, and with the prospects of a vaccine a distant hope, scientists got to work looking for new drug therapies.
The international Recovery trial would go on to make a crucial breakthrough, identifying dexamethasone as an effective treatment.
“Very early on we didn’t have much of a choice of drugs,” Prof Horby said.
“There were some repurposed drugs, so drugs that were licensed for other indications (diseases) that in the laboratory in the test tube had some modest antiviral effects, so they were worth trying, but we also knew from the clinical picture from patients in China there was the inflammatory process, so that was why we used the anti-inflammatory drugs like dexamethasone, which wasn’t controversy free.
“There were many people saying it was potentially dangerous to try anti-inflammatories in people with an active infection, but I am glad we tried it.”
After 20 years working on emerging and dangerous infections, Prof Horby knew that moving “extremely quickly” was key.
“The worst thing you can do is wait for certainty because by then it’s too late,” he said.
“So we just knew we had to make decisions. So we went out there and made those decisions and made sure the trial was up and running quickly, that we made it simple enough that it could be implemented at the front line amongst very stressed healthcare workers and that we could do it at scale, so we could get a very large number of patients who could give us a definitive answer.”
Martin Landray, a professor of medicine and epidemiology at Oxford University, another Recovery trial architect, said he had “never worked at that speed before”, adding: “With the possible exception of when I was a junior doctor in the early 90s in Birmingham, when I do remember working 50-plus hours over a weekend, dealing with sick patients.”
Knighted for services to public health and science, he said it had been an “incredible journey”.
“I’d never worked in infectious disease before, Peter Horby had never done a trial in the UK before.
“We met in early March. Nine days after writing the protocol, the trial was up and running, less than 100 days later we got the first treatment and here we are today, in fact, 40,000 patients have been recruited to the trial. I would never have imagined that.”
Their hard work paid off, with NHS England saying in March this year that using dexamethasone to treat coronavirus patients may have saved a million lives around the world since its discovery.
Prof Horby said he and colleagues were left “over the moon” by the success of the inexpensive and widely available steroid.
He added: “It wasn’t only that it reduced mortality very significantly, it was such a cheap drug available throughout the world and we knew doctors and nurses could reach into the pharmacy cupboard any time of the day or night and get some dexamethasone. It was a fantastic result.”
But medical progress during the pandemic has not been without its ups and downs.
The rollout of the Oxford/AstraZeneca jab in the UK saw Government advisers recommending under-40s should be offered alternatives due to evidence it may be linked to very rare blood clots.
Asked if this had affected morale, Prof Gilbert said: “It is a complicated situation and we have to allow the regulators and policy makers to continually make their risk-based assessments on the best way to use the different vaccines that are out there.
“Our job is to develop a vaccine and provide as much data as we can and then leave it to others to decide how it’s going to be used.”
Fears over links to blood clots also saw some European countries pause their use of the jab.
Prof Pollard said: “I think the real battle here isn’t against the different difficult decisions that every country has had to make as they’ve gone along, it’s really the battle against the virus.
“And one of the things we have to get right, and I don’t think internationally we’ve done that so well, is getting that narrative right, both from, you know, scientific and political level as well as through the media, to make sure that we don’t do anything that will undermine people’s health.”
One pernicious narrative researchers have to face is the spread of misinformation and the arguments of people opposed to the use of vaccines.
But Prof Green said: “We know what we are doing, we know where we are going and part of our job is to get the facts out there dispassionately, we are not here to interpret necessarily, we are here to give good information when that’s appropriate.
“No secrets, total transparency. Let’s us as scientists maybe calm the discussion down. It’s our job to be the sensible heads in the rooms perhaps.”
Asked about how he dealt with criticism, Prof Horby added: “There are times when I stop looking at Twitter. There are always going to be people out there who make ridiculous claims, calling us murderers and things like that. You just have to ignore that and try to focus on what’s important, which is getting the job done in the best way possible.”
Concerns over the emergence of coronavirus variants, and whether these will be resistant to vaccines, is another issue on scientists’ radars.
Prof Pollard explained: “So far we’ve seen quite good protection with two doses of the vaccine against the variants that have been popping up.”
He explained it was important to track the figures on hospital admissions and deaths – what the jabs aim to prevent.
“So far the news has been pretty good on that. But the question about boosters and new variant vaccines and so on – need to work on them and be ready. We don’t yet have the information to say that we need to do that,” he said.
Overall, Prof Pollard said he was “thrilled” and “absolutely delighted” to be honoured.
Prof Gilbert added: “It’s really great to have the recognition on behalf of the whole team and it is so important to recognise the large number of people who worked very hard to get this vaccine developed, manufactured, tested in trials – all of the clinical trial volunteers without whom we couldn’t have tested the vaccine, and now the people working on the vaccine rollout.”
For some experts the lessons learnt during the pandemic are worth highlighting.
Irish-born Adrian Hill, director of the Jenner Institute and Lakshmi Mittal and Family Professor of Vaccinology at Oxford University, emphasised the “power of vaccines”.
Prof Hill, who receives an honorary knighthood from the Foreign Office for services to science and public health, said: “If you invest in vaccines you can do remarkable things.
“The technology is getting better all the time. We have seen new vaccine platforms like RNA come to the fore just in the last year, the sky’s the limit, we should be making vaccines not just against outbreak pathogens, but against other degenerative diseases, against Alzheimer’s disease, against cancer, there really is great potential, we just need to leverage that.”
Prof Lambe said: “I would hope that what we have done in the last year, year-and-a-half isn’t forgotten.
“The sacrifices that we have made, I don’t want the next generation or our children to have to make, so we need to take what we’ve learned and build on it.”
She added: “I am hopeful that the next generation will be able to do what we did better, faster and with a smile on their face and not work as relentlessly as we had to.”
For now, amid all the plaudits and the honours, the inspirational work of so many scientists goes on.
Asked how he and his team might celebrate, Prof Landray replied: “We have a team meeting as always on a Monday morning. And so I think there’ll be a brief moment of celebration, then.
“And then certainly we’ll be back to work… trying to find better drugs for a better future.”