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17 June 2020updated 23 Jul 2021 9:45am

A quiet discovery: dexamethasone, the coronavirus treatment that works

We have always known that progress in the face of this pandemic would come not with a bang, but with a whisper.

By Ailbhe Rea

The first treatment proven to save lives from coronavirus is now being given to NHS patients, following a “huge breakthrough” by scientists at Oxford University. 

Dexamethasone, a common steroid that costs only £5 for an entire course of treatment, has been shown to cut the risk of death by a third for Covid patients on ventilators. It was also found to cut deaths by one fifth for patients who require oxygen but do not require ventilation. 

The drug is safe, inexpensive and widely available: good news for the NHS, which already has a stockpile of 200,000 courses of the drug, enough for even a second peak of the virus in the UK, and good news for poorer countries, who will have access to a proven treatment for the sickest coronavirus patients at no significant expense.

Tom Whipple, the Times‘ science editor, has an interesting analysis piece this morning outlining why this is a particular success of the different approach taken by British scientists towards treatments for the virus. While other countries have thrown the kitchen sink (or pharmacy cabinet) of potential treatments at Covid patients, rushing drugs through for “emergency use”, in the UK more than 10,000 patients were drafted into a formal trial of possible treatments.

Thanks to the Oxford Recovery Trial, we now know that dexamethasone works for the very sickest Covid patients, while hydroxychloroquine, the anti-malarial approved by Donald Trump, doesn’t. Other drugs used to treat Covid patients in other countries may also have worked, but without the structure of a formal trial, we will never know for certain.

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It’s yet another success for Oxford University, which has, across its different research groups and departments, been one of the leading academic institutions in the global effort to fight this pandemic. It is also worth acknowledging as a policy success for the government, vindicating their approach of stockpiling potential treatments for the virus before there was a guarantee of their success in trials.

This drug is far from a panacea. Even in the sickest patients, it cures a minority of those on ventilators. It is not proven to work in coronavirus patients who do not have breathing difficulties; it will not be given to patients outside of hospital, and, as the government’s chief scientific adviser, Patrick Vallance, emphasised yesterday, it does not mean an end to social distancing.

But we have always known that progress in the face of this pandemic will come, not with a bang, but with a whisper. We were never going to go from nothing to a sudden, miraculous cure. Rather, we were told from the beginning of this crisis that progress would most likely be made by trialling the drugs we already use for other diseases, and making breakthroughs little by little as to how they can best be used, possibly in combination with each other, to treat this new virus. Anyone who has had direct experience of losing someone to Covid-19 will appreciate what a tangible difference this will make to some families in the weeks, months and maybe years ahead. It’s a whisper, but the first life-saving treatment for Covid-19 has been found. These are the moments worth noting, and celebrating. 

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