Treating COVID-19: Reckless cowboys vs. the ivory tower academics
Published: 18 Jul 2020
The “COVID-19: Updates from Singapore” weekly webinar series is a forum for leading clinicians, scientists, public health officials and policy makers to share insights from their fields of study. The fifteenth edition of the webinar was held on Thursday 16 July at 7pm.
Professor David Paterson, Director at the University of Queensland Centre for Clinical Research and an Infectious Diseases physician at the Royal Brisbane and Women’s Hospital, was the guest speaker for this week’s session. Speaking in response to the misleading information on COVID-19 treatment that comes with the deluge of data, Prof Paterson discussed the trials and tribulations of COVID-19 treatments and provided a critical review of current clinical trials that have recently been carried out.
TitledThe Misbegotten Battle Between the Ivory Tower Academics and the Rogue Cowboys, Prof Paterson began the webinar by comparing two groups of people on a spectrum that have emerged from this COVID-19 pandemic. On one end of the spectrum – the ‘rogue cowboys’, comprise those who believe that patients are doing poorly with basic supportive care only and that unproven interventions are worth a try. On the other end – the ‘ivory tower academics’ who believe that unproven interventions are dangerous. He suggests that the cause of this tension regarding the treatment of COVID-19 exists because of the absence of multiple, large, randomised trials to prove the efficacy of certain treatments. Therefore, this leads to many treatments being guided by personal philosophies instead.
Prof Paterson summarised the COVID-19 treatment involving drugs that have been widely discussed and politicised by some governments, such as Remdesivir, Lopinavir/Ritonavir and Chloroquine. From this, he posits that the contention over treatment options existed because the American research infrastructure was incapable of rising to the challenge of providing large numbers of pragmatic, randomised trials in the midst of a pandemic. Yet, Prof Paterson remains confident that existing health systems are able to properly facilitate the enrolment of future patients with COVID-19 into randomised controlled trials. He urged for higher enrolment rates for COVID-19 patients into clinical trials to booster existing research data. He mentions that there is significant opportunity to learn and consider how ethics, governance, drug delivery study and funding can be optimised so as to enhance patient experience in the long run because the COVID-19 pandemic is proving to be a long-drawn battle.
It was suggested that clinicians who are involved in looking after patients suffering from other infectious diseases should also take this chance to search for opportunities to develop low-cost, pragmatic randomised controlled trials, learning from this experience to build solidarity and help patients move forward.
WATCH: COVID-19 Updates from Singapore: Webinar 15 | Prof David Paterson
Join us next week on 23 July 2020 as we hear from guest speaker Professor Richard Horton, Editor-in-Chief of ‘The Lancet’, who will be speaking on “Learning from COVID-19 to Build a Resilient Future”. Register now at https://medicine.nus.edu.sg/cet/webinar/.
