The big idea: should governments run more experiments?

Article by Stian Westlake: “…Conceived in haste in the early days of the pandemic, Recovery (which stands for Randomised Evaluation of Covid-19 Therapy) sought to find drugs to help treat people seriously ill with the novel disease. It brought together epidemiologists, statisticians and health workers to test a range of promising existing drugs at massive scale across the NHS.

The secret of Recovery’s success is that it was a series of large, fast, randomised experiments, designed to be as easy as possible for doctors and nurses to administer in the midst of a medical emergency. And it worked wonders: within three months, it had demonstrated that dexamethasone, a cheap and widely available steroid, reduced Covid deaths by a fifth to a third. In the months that followed, Recovery identified four more effective drugs, and along the way showed that various popular treatments, including hydroxychloroquine, President Trump’s tonic of choice, were useless. All in all, it is thought that Recovery saved a million lives around the world, and it’s still going.

But Recovery’s incredible success should prompt us to ask a more challenging question: why don’t we do this more often? The question of which drugs to use was far from the only unknown we had to navigate in the early days of the pandemic. Consider the decision to delay second doses of the vaccine, when to close schools, or the right regime for Covid testing. In each case, the UK took a calculated risk and hoped for the best. But as the Royal Statistical Society pointed out at the time, it would have been cheap and quick to undertake trials so we could know for sure what the right choice was, and then double down on it.

There is a growing movement to apply randomised trials not just in healthcare but in other things government does. ..(More)”.