Originally Posted by
Chris_Halkides
In his discussion of the fluvoxamine trial, Derek Lowe
concluded, "It's been said before, but it needs to be said several more times: the clinical response to the pandemic, taken has a whole, has not been good, and we're going to have to take steps not to repeat these mistakes if (or when) another such infectious agent appears. That's another topic entirely, but going into what I refer to as Headless Poultry Mode shouldn't be an option. This trial and the ones listed above have been the real beacons in this area, but the US has not exactly been performing up to where it should in this area."
I think the pandemic has highlighted a weakness in the US health care system in that (with the exception of the VA) it is hard to get commercially driven entities to co-operate in running proper clinical trials of drugs. The UK had a practical multicentre multidrug trial set up within days*. With the NHS committing to support the research essentially all patients admitted were offered the opportunity to recruit into clinical trials. Disproportionately to the population the UK has generated important trial data. Given the patient population size the US could have accelerated evidence based therapies instead far too many patients just seem to have been offered everything including the kitchen sink with minimal effort to collect usable data. Canada has more of a national health service and so has also been able to utilise this for good quality research. Large European nations have been surprisingly poor at producing high quality research on drugs for covid. For all the criticisms it has had at least the WHO produced the Solidarity trial.
https://www.who.int/emergencies/dise...-19-treatments
https://www.recoverytrial.net/
One thing the NIH / CDC / federal government could do is establish a system for rapid multicentre drug trials in the event of another pandemic.
*
https://www.gov.uk/government/news/w...-across-the-uk
Quote:
Almost 1,000 patients from 132 different hospitals have been already recruited in just 15 days and thousands more are expected to join the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial in the coming weeks, making it the largest randomised controlled trial of potential COVID-19 treatments in the world.