What pandemic trials got right

Saloni Dattani: I don’t have a foundational text that drew me to clinical trial reform. I learnt about the topic during the Covid-19 pandemic. It was surprising how efficient some pandemic clinical trials were and, despite it being an emergency situation, it seemed to me that a lot of these processes could have been applied more widely. The RECOVERY trial, for example, tested around a dozen drugs within two years and quickly identified treatments estimated to have saved over a million lives. The COVID-19 vaccine trials ran much faster than usual, thanks to parallelized phases, rolling regulatory reviews, Operation Warp Speed, and other reasons I outlined in a piece forecasting when the vaccines would arrive. Some pieces I found memorable from the time were a book chapter on the history of clinical trials in the US and how AIDS activists reshaped the FDA, and an episode with Martin Landray, who co-led the RECOVERY trial. I’d also read Stuart Ritchie’s book Science Fictions, on bias and poor research practices in science, and Ben Goldacre’s Bad Pharma. Both made me wonder about ways to improve scientific rigor while limiting bureaucracy, which I wrote about in a piece later on.