Ross Clark

Is dexamethasone a major Covid breakthrough?

Is dexamethasone a major Covid breakthrough?
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Just how a big a deal is today’s announcement that the steroid anti-inflammatory drug Dexamethasone has been shown to be effective at lowering the death toll of Covid-19 patients?

At first sight, this is a modest breakthrough. The drug was shown to reduce the death rate among patients on ventilators by a third and among those on oxygen by a fifth. Overall, it reduces 28-day mortality from the disease (the study doesn’t look at patients who may have died after that period) by 17 per cent. Notionally, had the effect of the drug been known at the beginning of the outbreak, it would have meant that we could have reduced the Covid-19 death toll from 42,000 to 35,000. That is still a hefty death toll, and the drug can hardly be described as a ‘gamechanger’, as everything tends to be called nowadays. But it would obviously have been welcome. The study, oddly, has not been published: just the conclusions.

However, what Dexamethasone lacks in drama it makes up for in convenience. It is an old drug, available for generic manufacture. It is very cheap and there should be no delay in administering it to patients, anywhere in the world. It makes the threat of a second spike a little less frightening. But more than that, it is a reminder that we don’t necessarily have to wait for a vaccine in order to find ways of ending the vast economic damage which has been wrought by Covid-19 – it may well be that therapeutic drugs can tame it long before a vaccine does. Look at HIV/Aids – in the 1980s we believed we were four or five years away from a vaccine. In reality, a vaccine still hasn’t arrived nearly 40 years later, yet we do have effective retroviral drugs which can effectively delay the disease indefinitely.

Other drugs may well turn out to have a beneficial effect, too. The Oxford University Recovery trial, which discovered the beneficial effects of Dexamethasone, is already looking into four other drugs – trials of a fifth, Hydroxychloroquine, have been stopped as it showed no effect. All eyes will now be on the other drugs in the trial – HIV drug Lopinavir-Ritonavir, antibiotic Azithromycin, anti-inflammatory drug Tocilizumab, and plasma extracted from patients convalescing from Covid-19.