Britain probably leads the world in self-criticism. So maybe we don’t always notice when the country leads the world in something a bit more useful. During the pandemic a lot has been done badly here – the modelling, testing and lockdown policies have been harmful, clumsy, and chaotic – but it’s worth reflecting on what we have done well, especially in science.
Last week the New York Times, which has made a habit of sneering at Britain, noticed that we have sequenced far more viral genomes than any other country. About half the world’s covid viral sequences were done here. That enabled us to identify the new contagious variant early and gave researchers a huge wealth of information about the virus and its mutations, buried in which will be insights into how to beat it.
We did that with two policies. First, a national obsession with genome sequencing going back decades that left us with a rich infrastructure. Fred Sanger invented DNA sequencing in Cambridge; the Wellcome Trust’s Sanger Centre made the biggest single contribution to the Human Genome Project; Biobank is the world’s most ambitious population DNA database; Genomics England has led the world in honing the techniques of genomics and tracking down the mutations that cause rare diseases and some cancers.
Second, there was a smart injection of a relatively small sum at an early stage in the pandemic. In March the government spent £20 million to set up the Covid-19 Genomics UK Consortium (COG-UK) pulling together centres of clinical and sequencing expertise all over the country. It’s this that has enabled us to out-sequence the rest of the world, map the mutations in the virus and trace its evolution and spread. Many countries are scrambling to imitate it.
True, this knowledge has not stopped the virus, but Britain has done well in treatment too. The Recovery trial, also set up in March, has proved invaluable in assessing what works and more importantly what does not work in treating patients. While other countries threw everything at dying patients and learned little, Recovery made it easy for harassed doctors to enrol every patient in a controlled, continually evolving trial in which treatments are added and dropped.
Recovery is what told us dexamethasone helps in patients on ventilators and hydroxychloroquine does not. A similar trial led by Imperial College and Utrecht University has now shown that the immune-suppressive drug tocilizumab also saves the lives of those in intensive care.
The most life-saving British contribution is in vaccines. Sarah Gilbert’s Oxford University team pioneered the idea of vaccines that stimulate a T-cell response to develop a universal flu vaccine before collaborating with AstraZeneca to pull off a covid vaccine in record time. Then, the Medicines and Healthcare Products Regulatory Agency did something it has been itching to do: test a medication for safety in parallel not sequence and get a result in record time, leaving the European Medicines Agency floundering in its wake.
Much can still go wrong, and these successes have yet to prevent the spread of the virus. Others are now catching up, and in some cases are ahead. Britain has played little part in some big recent bioscience breakthroughs, including gene editing and messenger-RNAvaccines.
But the government cannot be faulted for its ambition in bioscience. In September it launched a new Genomics UK strategy, with a plan to use this pandemic’s demonstration of what we can do well in bioscience to apply the knowledge in treating patients, as well as to attract biotech innovators to the UK. The strategy aims to begin delivering the long-promised goal of personalised treatments, as well as predicting individuals’ risks of chronic diseases.
There is an interesting wrinkle here. For decades Britain has been unable to solve the problem that it is better at discovering things than applying them. More Nobel prizes than any other country bar America but no Google, Sony or Siemens to show for it. But in bioscience the gap between discovery and application is smaller here than elsewhere, and we have just shown we can leap it with elan. Most genomic data sets in the world are entirely research based. Ours are better coupled to clinical care. If the next 50 years is going to be dominated by innovation in biotech as the last 50 were dominated by IT, then Britain is well placed.
If there were league tables of culture, Britain would be mid table at best when it comes to philosophy, music, literature, art, physics and chemistry. But it is the Man U or Liverpool of biology and always has been: the circulation of the blood, evolution by natural selection, the structure of DNA, genome sequencing, in-vitro fertilisation, DNA fingerprinting, cloning: the list is extraordinary for a country with 1 per cent of the world’s population. Go Bio-Britain.