1 00:00:00,330 --> 00:00:07,260 So can you say your name and your title? On Sunday, Douglas on a research group leader in the Jenner Institute. 2 00:00:08,190 --> 00:00:12,989 Okay, thanks very much. So starting from your earliest interest in your subject, 3 00:00:12,990 --> 00:00:17,640 can you just give me a kind of three or four sentence account of how you got to where you are now? 4 00:00:19,440 --> 00:00:20,970 I'm looking in three or four senses. 5 00:00:21,600 --> 00:00:30,520 So I first did a short project with the Gender Institute when I was a medical student, which would have been 2006 or 2007. 6 00:00:30,590 --> 00:00:35,100 Yeah. So it just gave the thought that, you see, we were done and you were going to be a doctor. 7 00:00:35,100 --> 00:00:40,470 Is that when you applied for medicine? Yeah, that's right. Yeah. So I was a clinical medical student in Oxford. 8 00:00:40,710 --> 00:00:55,650 I graduated in 2007. I then did a short project alongside my clinical foundation training four month projects in the journal, 9 00:00:55,740 --> 00:01:05,670 which turned into a three year Ph.D. on the development of vaccines against the blood stage of malaria. 10 00:01:07,320 --> 00:01:12,360 That was 2009 to 2012. Subsequently, I. 11 00:01:15,130 --> 00:01:22,750 Did some further clinical training in the NHS. I was a NHS trainee, an infectious disease in general medicine. 12 00:01:24,190 --> 00:01:31,569 I did some postdoctoral research and then in 2016 I got a Wellcome Trust Fellowship and came 13 00:01:31,570 --> 00:01:38,710 out to full time research and I've been leading my group in that in the journal since then, 14 00:01:38,740 --> 00:01:41,500 working full time in research. 15 00:01:42,100 --> 00:01:49,120 So as I understand this, two aspects to you is that you are actually interested in the the immune system and allergenicity and how vaccines work. 16 00:01:49,810 --> 00:01:57,610 But you also have this interest in how you actually manufacture them to a point where you've got a product that can be delivered to the world. 17 00:01:57,880 --> 00:02:06,340 Yeah. So that my original primary interest is also translational and clinical research. 18 00:02:06,610 --> 00:02:14,560 So developing new malaria vaccines and then subsequently I've moved towards developing a new candidate rabies vaccine as well. 19 00:02:16,750 --> 00:02:26,680 And the interest in money, my interest in manufacturing, I guess, has come from from two things. 20 00:02:27,610 --> 00:02:31,599 The primary one was really an accident of fate. 21 00:02:31,600 --> 00:02:36,110 And it was it was the need to solve a problem in my rabies vaccine programme. 22 00:02:37,090 --> 00:02:46,090 So my rabies vaccine candidate is, is based upon an adenoviral vector very similar to Chadox1 COVID vaccine. 23 00:02:47,830 --> 00:02:57,940 And I had said in a grant application that I would take a technology that had been developed by someone else in the DNA previously, 24 00:02:57,940 --> 00:03:06,310 which could make bats make these up in the virus vaccine stable at room temperature for, you know, storage and distribution outside fridges. 25 00:03:08,020 --> 00:03:13,959 And I'd said I'd do this with this rabies vaccine and I would do it to clinical grade, 26 00:03:13,960 --> 00:03:23,170 such as good manufacturing practice with GMP compliant, easy, because really rabies vaccine is mainly needed in hot places, basically. 27 00:03:23,290 --> 00:03:29,290 Exactly. Yeah. And I was quite naive about what it would take to do that. 28 00:03:29,290 --> 00:03:39,909 But it turned out that to do that, we needed more vaccine and higher concentration and in a different mixture of salts and 29 00:03:39,910 --> 00:03:46,540 sugars from what's our clinical biomanufacturing facility or a small in-house pilot, 30 00:03:46,660 --> 00:03:50,590 clinical grade manufacturing vaccine manufacturing facility led by Cath Green. 31 00:03:51,010 --> 00:03:55,540 We needed we needed more vaccine, a different vaccine from from the way they had made it before. 32 00:03:55,720 --> 00:04:02,770 And so to try and do this project, to make this temperature stable, rabies vaccine, 33 00:04:04,120 --> 00:04:10,540 which ultimately didn't work, or at least the temperature stable bits of it, I had to redevelop. 34 00:04:11,030 --> 00:04:14,650 I had to develop a new way of making out in the virus for the placebo. 35 00:04:17,020 --> 00:04:24,810 Can I just pause it? So through 2017, 2018, 2019. 36 00:04:26,490 --> 00:04:35,100 I developed a new wave of for our CBF to make clinical grade adenovirus vaccines and previously the way the way 37 00:04:35,100 --> 00:04:41,639 they had done it was really only suitable to make a few hundred or a couple of thousand doses of a vaccine. 38 00:04:41,640 --> 00:04:51,480 It wasn't scalable, it was very manual and the way we developed was suitable to be scalable. 39 00:04:51,600 --> 00:04:57,090 We were only planning to do it at small scale and for the rabies project we only did do it on a small scale, 40 00:04:58,230 --> 00:05:02,580 but we did it in a way that could go to larger scale. 41 00:05:02,790 --> 00:05:03,780 They have a big need it. 42 00:05:05,220 --> 00:05:20,040 And we also did it using materials and equipment that was very standard, you know, off the shelf, single use disposable things, 43 00:05:20,040 --> 00:05:26,530 which makes it much easier to set up in a new facility because you're not you're not trying to fit the manufacturing to a, 44 00:05:27,090 --> 00:05:32,129 you know, whatever stainless steel, you know, equipment they already have installed. 45 00:05:32,130 --> 00:05:44,910 You can just buy the off the shelf disposable things. So we we set the process up to be end to end and standard single use things and. 46 00:05:47,900 --> 00:05:55,210 Whip it, and if I'm frank in large part because we need to make it quite simple so the CBF could execute it. 47 00:05:55,220 --> 00:06:04,310 We kept a very simple way, avoided doing, you know, some things which might have made more vaccine or better and sexier, 48 00:06:04,310 --> 00:06:08,630 but we compromised on something to keep it simple. 49 00:06:11,540 --> 00:06:24,470 So the CBF had successfully run that process and made enough vaccine for a few thousand doses in I think 2019 for our rabies vaccine. 50 00:06:26,210 --> 00:06:34,200 And subsequently I have been a co-investigator on a large grant, 51 00:06:35,170 --> 00:06:40,760 the Oxford part of which was what was led by us on Sara Gilbert called the future vaccine manufacturing research job. 52 00:06:41,010 --> 00:06:47,360 Yeah, and that was really, really important. 53 00:06:49,070 --> 00:06:53,450 So tell me a bit about them, and I think that is important. So how did that help come to be? 54 00:06:53,510 --> 00:07:00,920 So that started in 2017. I think I'm right in saying that something like didn't write it down, but yeah, something like that. 55 00:07:01,190 --> 00:07:05,090 So I mean, why does that seem to be necessary? 56 00:07:07,470 --> 00:07:13,590 So to be honest, I don't know the the sort of political background to it in great detail. 57 00:07:13,980 --> 00:07:17,460 But around that time the the was. 58 00:07:19,200 --> 00:07:24,900 Significant investment public funds in vaccine manufacturing. 59 00:07:25,560 --> 00:07:35,400 And two things. One, one was the set up of the Vaccine Manufacturing Innovation Centre or the MCC, which was going to be built in Holywell. 60 00:07:36,150 --> 00:07:38,370 And we should probably come back to that. 61 00:07:39,870 --> 00:07:47,640 But that was a £67 million investment of public funds to build the facility, you know, bricks of bricks and mortar and bus largely. 62 00:07:49,680 --> 00:07:57,630 And the second was investment of about £17 million in these two vaccine manufacturing research hubs. 63 00:07:58,350 --> 00:08:04,350 So the had one being at UCL. So there was one at Imperial. 64 00:08:04,350 --> 00:08:12,510 Imperial, and there was one of the one we're involved in is actually technically led by UCL because it was an imperial one and a UCL, Oxford one. 65 00:08:17,130 --> 00:08:29,880 So my understanding is that those things were driven by something called the UK Vaccines Network, which I think Chris Whitty may have led. 66 00:08:29,880 --> 00:08:35,460 But I think others of my colleagues would be able to give you the history of more pumps. 67 00:08:35,610 --> 00:08:47,640 Adrian Hill And I know Sara Gilbert was involved and so anyway, there's this future vaccine manufacturing research Hall, 68 00:08:48,630 --> 00:08:54,840 Oxford in UCL, I think about seven and a half million pounds and. 69 00:08:57,040 --> 00:09:05,590 There were four strands of work being done in Oxford, some of which I ended up doing two, 70 00:09:07,270 --> 00:09:13,120 essentially because they matched what I'd been doing on the rabies programme. So one of them was to continue to develop. 71 00:09:14,220 --> 00:09:20,850 Better ways of making on the horse vectors. And the other was better ways of making them temperature stable. 72 00:09:22,410 --> 00:09:30,850 And. It's probably worth mentioning that that funding was, I believe, overseas development aid funding, 73 00:09:31,270 --> 00:09:42,970 and it was very much targeted development in developing manufacturing methods that would be suitable for vaccine production in developing countries, 74 00:09:45,910 --> 00:09:46,840 which is what we did. 75 00:09:47,290 --> 00:10:01,179 And I think that probably is one of the best investments the UK has ever made, perhaps in terms of both benefit for low and middle income countries. 76 00:10:01,180 --> 00:10:08,860 LMI sees benefit for the UK itself because if we hadn't had that funding, we would not have an oxford-astrazeneca vaccine. 77 00:10:11,020 --> 00:10:17,140 So the reason I say that is that we had. 78 00:10:18,460 --> 00:10:28,960 I think I think the future vaccine manufacturing research I only really got on the way and in 20 know those parts were all I'd had 79 00:10:28,960 --> 00:10:35,980 one postdoc working on it it was called Sophia Fellowship and she so she had finished off what we'd started doing for rabies, 80 00:10:35,990 --> 00:10:39,770 the basic first version of our manufacturing process. 81 00:10:40,300 --> 00:10:44,320 Finished off in 2018, early 2019. 82 00:10:44,330 --> 00:10:47,200 What was the first bits of what we did in The Hub? 83 00:10:47,740 --> 00:10:56,380 And then Sophie, I wanted to move on to something else, and I hired a new post-doc who's called Carina Jo. 84 00:10:57,790 --> 00:11:04,090 She's Indonesian. She just finished a PhD in Australia and I. 85 00:11:05,930 --> 00:11:13,610 Felt that what we should focus on to improve our manufacturing process was the what's called the upstream process, 86 00:11:13,610 --> 00:11:19,460 which is how much vaccine is made by the cells that are making them making the vaccine virus. 87 00:11:21,620 --> 00:11:26,330 The the other bit, the downstream process, which is how you purify the virus away. 88 00:11:26,900 --> 00:11:32,330 I thought what we had was was okay and actually what was limiting how much we could get was the upstream. 89 00:11:33,800 --> 00:11:40,660 So I went looking for a postdoc with the relevant experience to do that. 90 00:11:40,760 --> 00:11:50,239 And Carina had quite a bit of experience in culturing mammalian cells, 91 00:11:50,240 --> 00:11:58,400 the type of cells we used to make the vaccine in a sort of industrial biotechnology type setting. 92 00:12:00,110 --> 00:12:05,330 And so she arrived in, I think, August 2019. 93 00:12:05,780 --> 00:12:16,099 And more or less the first experiment she ever did was to try some different culture media with the cells, 94 00:12:16,100 --> 00:12:19,340 which we'd always used, quite old culture media. 95 00:12:20,840 --> 00:12:24,930 And she said all these various more modern ones, we should we should try. 96 00:12:24,950 --> 00:12:27,139 And to be honest, I was a bit doubtful about it. 97 00:12:27,140 --> 00:12:37,100 I wanted, but I thought probably we'd get better results by doing it the way that Johnson and Johnson make that happen, 98 00:12:37,100 --> 00:12:40,740 of course, vectored vaccines, which is using a much more complicated technique called perfusion. 99 00:12:43,130 --> 00:12:47,960 But Carina said was, let's try this new modern medium. 100 00:12:48,620 --> 00:12:56,390 And she did it. And she brought me the results in, I think late November or early December 2019. 101 00:12:56,720 --> 00:13:00,770 And they were really good. I didn't really believe they were so good. 102 00:13:00,770 --> 00:13:08,419 I didn't really believe they could be real. So it was less replicate, less repeat the experiments. 103 00:13:08,420 --> 00:13:20,360 She went away. Not a all. I came back in January and she brought me the the repeat data and I think late January or early February. 104 00:13:20,360 --> 00:13:25,860 And it was just as good. So what was the medium? 105 00:13:26,250 --> 00:13:30,900 It was simply making making cells grow faster, reproduce more quickly, 106 00:13:30,930 --> 00:13:37,950 making the cells happier at a higher density as well, and ensure it was what it was doing. 107 00:13:38,160 --> 00:13:46,590 So the. The, you know, dogma in the field about the virus. 108 00:13:47,280 --> 00:13:52,290 Vaccine manufacturing for a long time has been at a certain level of cell density. 109 00:13:52,500 --> 00:13:56,000 The cells stopped making the vaccine efficiently. 110 00:13:56,160 --> 00:14:00,350 And it's not just not just dogma. There's lots of evidence to show that was the case and that was what I was doubtful for. 111 00:14:00,590 --> 00:14:11,790 It would work. But it turned out that it hasn't been done a lot believe hadn't been sort of retested since all of the media had been developed. 112 00:14:13,200 --> 00:14:18,110 So. We got pretty lucky, to be honest. 113 00:14:18,440 --> 00:14:22,070 You know, incredibly lucky. The thing that worked. 114 00:14:23,660 --> 00:14:34,270 And so. What they enables is what's called a Fed balance process, 115 00:14:35,050 --> 00:14:44,590 which is essentially the plain vanilla of the global biopharmaceutical manufacturing industry. 116 00:14:45,580 --> 00:14:53,320 It's very similar to the way that monoclonal antibodies, which, you know, the most common biopharma group of products in the world, 117 00:14:54,160 --> 00:14:59,800 are made and you just put cells into a big part of either reactor and you grow them. 118 00:15:00,640 --> 00:15:10,330 You add some extra supplements to keep them happy when they get tired and sitting and you take out your products at the end and it's much more 119 00:15:10,510 --> 00:15:17,350 is much simpler than the alternative way of making out the virus in a large scale would have been regarded as the industrial gold standard, 120 00:15:18,110 --> 00:15:27,939 which was the fusion which JNJ had developed, JNJ had been working on on Novartis manufacturing for a change, 121 00:15:27,940 --> 00:15:31,990 and companies they had bought have been working on manufacturing since the nineties. 122 00:15:32,890 --> 00:15:37,360 I had it really fantastically, you know, brilliant process, you know, very, very elegant. 123 00:15:37,360 --> 00:15:40,940 Good. They've done great work on it, but. 124 00:15:42,270 --> 00:15:47,820 You know, I don't think they've been developing it. And nobody nobody had been developing a process on it. 125 00:15:48,000 --> 00:15:57,000 If we're honest for something, the scale of the pandemic and change process was relatively complicated. 126 00:15:58,530 --> 00:16:04,780 So in that sort of brings us to early February 2020. 127 00:16:05,580 --> 00:16:09,330 Right. By which time. And we already knew it. 128 00:16:09,330 --> 00:16:18,210 So it would be just I'm always just asking everybody this question. Can you remember when you first heard that there was a pandemic in the offing? 129 00:16:19,620 --> 00:16:27,870 I can't remember the very first time I ever heard about the virus, but I was certainly aware of it in January. 130 00:16:29,550 --> 00:16:38,220 And I can remember having a conversation with Sara Gilbert and just in passing in the office and Jan saying, Oh, 131 00:16:38,220 --> 00:16:44,340 you know, there's this virus in and in Wuhan and you're making any vaccine, you know, because I was there as remote. 132 00:16:46,260 --> 00:16:53,250 And I if I'm honest, I had never been very honest, very, very been very honest. 133 00:16:53,430 --> 00:16:57,150 I'd never been very interested in you know, it was it wasn't my thing. 134 00:16:57,180 --> 00:17:02,340 Emergent pathogens and outbreaks. And I was. 135 00:17:04,210 --> 00:17:07,870 I have been during the Ebola pandemic, for example. 136 00:17:07,870 --> 00:17:12,030 I had been quite. Sceptical. 137 00:17:12,050 --> 00:17:16,760 You know, there have been lots of Ebola outbreaks and it has not caused a pandemic. 138 00:17:17,120 --> 00:17:23,839 You know, we we I think a lot of the things which people are worried about, 139 00:17:23,840 --> 00:17:30,390 or at least in the media, there's been concern about epidemics that actually have fizzled out. 140 00:17:30,620 --> 00:17:36,859 And they've been proven to be viruses that maybe didn't have the potential for for causing such serious problems. 141 00:17:36,860 --> 00:17:44,090 And that's not not to say that I didn't regard a pandemic from some virus as an existential threat. 142 00:17:44,870 --> 00:17:53,870 I had had a clinical tutor in in medical school, Alan Townsend, who I remember impressed on me. 143 00:17:53,870 --> 00:17:56,860 Very, very. You know, it really stuck in my mind. 144 00:17:56,870 --> 00:18:04,220 He was viscerally scared about the potential for a flu pandemic and how that would overwhelm the NHS. 145 00:18:05,150 --> 00:18:08,540 I'm not really stuck with that, but I. 146 00:18:10,150 --> 00:18:18,190 My sort of prior belief hearing about this virus in Wuhan was that it would probably fizzle out like we talked about before. 147 00:18:19,120 --> 00:18:24,820 And so that initial conversation was there. It was on. I don't think either of us really thought it was going. 148 00:18:25,180 --> 00:18:31,580 You know, she was working on it because I'm sort of thing. But I don't think either of us really thought it was a serious. 149 00:18:31,630 --> 00:18:35,020 It was. What changed that for me? 150 00:18:35,920 --> 00:18:40,719 I read an article in the New York Times on the 2nd of February. 151 00:18:40,720 --> 00:18:43,720 I don't know what pulled the graph. The really. 152 00:18:45,020 --> 00:18:58,520 Got me scared. I pulled the graph out of it and I got a slide showing up and it was a graph of the R value of all on those 153 00:18:58,520 --> 00:19:05,120 with no values versus the infection fatality rate percentage of people who would die after getting infected. 154 00:19:05,840 --> 00:19:17,239 I showed the estimate for became SARS-CoV-2 you know with wide ranges of uncertainty on both of those based on the early data 155 00:19:17,240 --> 00:19:28,970 from China and it showed by comparison those those numbers for the original songs and for Mars and for Ebola and for flu and. 156 00:19:30,430 --> 00:19:43,740 It was very apparent for that from the plausible ranges of R an inflection of style fatality rates included at the centre of the range, 157 00:19:43,820 --> 00:19:45,639 the most likely number, 158 00:19:45,640 --> 00:19:53,770 but certainly the less favourable ones as well, included things which were very, very, very scary and worse than anything the world had seen. 159 00:19:55,600 --> 00:20:02,410 And. You know, worse than, you know, any flu pandemic in living memory. 160 00:20:04,320 --> 00:20:09,610 And. To me, that was all that was needed to. 161 00:20:14,810 --> 00:20:19,090 It became like my little brother. 162 00:20:20,440 --> 00:20:24,880 And, you know, it was apparent from the. 163 00:20:25,860 --> 00:20:28,890 This was something the world needed to take very, very seriously. 164 00:20:31,620 --> 00:20:38,230 And. If I'm honest, I'm uncertain how. 165 00:20:43,220 --> 00:20:47,630 Governments were not on maximum alert at that point. 166 00:20:47,660 --> 00:20:57,740 I think there was sufficient data in early February in The New York Times to merit, you know, treating this as a huge, huge global emergency. 167 00:20:59,720 --> 00:21:08,810 And I wasn't sure what to do for a few days because it wasn't my area of research. 168 00:21:09,120 --> 00:21:14,660 I realised then that actually it didn't take very long to sort of, you know, 169 00:21:14,680 --> 00:21:23,120 I the chimpanzee adenovirus platform we have here, we've used it for literally hundreds of things in preclinical work. 170 00:21:23,120 --> 00:21:27,290 And, you know, it's, it's, it's simply molecular based. 171 00:21:27,380 --> 00:21:36,890 You can put a new antigen from whatever pathogen you like, put a new antigen into it, and you can get an immune response. 172 00:21:37,820 --> 00:21:48,710 It's very simple. And I knew, you know, whichever whichever antigen we done and I think there have been ten or 12 of them in clinical trials. 173 00:21:50,510 --> 00:22:00,070 It's safe and you got an immune response. And I knew also that Sarah had done nothing worse. 174 00:22:01,490 --> 00:22:05,180 And that was protective in monkeys. 175 00:22:05,850 --> 00:22:13,550 I got an immune response and people and I knew also that for Ebola vaccines, 176 00:22:15,140 --> 00:22:23,750 it actually proved there's a big, huge question of how was it going to be possible to make a vaccine? 177 00:22:25,180 --> 00:22:31,590 That was that was critically important. And in February of 2020, in deciding what should be done, you know, 178 00:22:32,190 --> 00:22:38,510 how likely it was that a vaccine could be developed quickly enough to make it worth doing lockdown, for example. 179 00:22:38,550 --> 00:22:42,510 So there's no point looking down if everyone's going to get it anyway. 180 00:22:42,840 --> 00:22:46,450 It has to be on an accelerated. And. 181 00:22:48,210 --> 00:22:52,290 On you, for example, in. For Ebola. 182 00:22:56,560 --> 00:23:00,670 That being really the opposite experience for HIV. 183 00:23:00,710 --> 00:23:06,520 You know, some some some diseases. It's very hard to make a vaccine against HIV, for example. 184 00:23:06,520 --> 00:23:12,220 There's umpteen different ways of protecting a monkey. But it's nobody's got an effective HIV vaccine for people. 185 00:23:13,690 --> 00:23:19,720 But the experience for Ebola have been the reverse. It was relatively challenging to protect monkeys. 186 00:23:20,170 --> 00:23:29,080 But then when Ebola vaccines actually deployed in West Africa, more or less anything, you know, it wasn't that hard to protect. 187 00:23:29,860 --> 00:23:35,440 And the reason for that was that the the animal challenge model was very, very stringent. 188 00:23:36,970 --> 00:23:41,120 I don't know how true this is, but some someone someone told me the animal challenge model was, you know, 189 00:23:41,140 --> 00:23:49,570 developed for bioterrorism purposes, you know, to to mimic, you know, a baseball stadium being sprayed with Ebola in huge quantities. 190 00:23:51,610 --> 00:23:56,980 Whereas in reality, in the in the real world, if you're exposed, you, you know, you're exposed to very tiny amounts of that. 191 00:23:57,160 --> 00:24:01,690 So it was actually actually pretty easier to protect people and. 192 00:24:04,170 --> 00:24:10,710 For, you know, generally speaking for acute infections, which. 193 00:24:14,290 --> 00:24:18,369 You know, the natural history of infection is that it resolves you know, 194 00:24:18,370 --> 00:24:22,600 the normal outcome of infection is that people develop immunity and they get better. 195 00:24:23,020 --> 00:24:30,250 And we you know, we knew that was going to happen, that 90 plus percent of people that got this infection for that. 196 00:24:30,820 --> 00:24:35,170 All you're trying to do with a vaccine is emulate what natural infection does. 197 00:24:35,830 --> 00:24:38,020 And that's not hard to do. 198 00:24:40,470 --> 00:24:47,160 There's obviously lots of complications and reasons that might prove problematic, but fundamentally, a lot can usually be done. 199 00:24:48,030 --> 00:24:54,540 And it's fundamentally different from something like HIV, where the natural immune response doesn't protect. 200 00:24:55,200 --> 00:25:04,980 So my feeling in February 2020 was that the technology platform we had had a very good chance of being effective. 201 00:25:07,130 --> 00:25:09,590 I wouldn't put a percentage on that, but, you know, 202 00:25:09,590 --> 00:25:16,460 I would have I would certainly have taken a bet of 5050 having some effect against severe disease and death. 203 00:25:19,990 --> 00:25:29,920 And the real problem, you know, I knew there the vaccine had already been made by the you know, we already had it. 204 00:25:30,640 --> 00:25:34,540 So the challenge is, how did you get it out of the lab and into the real world? 205 00:25:36,220 --> 00:25:43,490 And I actually would probably personally in a world with no vaccine regulation. 206 00:25:45,590 --> 00:25:53,880 And an uncontrolled pandemic. Personally as a as a well and, you know, relatively well informed person was there. 207 00:25:53,890 --> 00:26:00,130 I would probably have taken the vaccine blind in February or March 2020. 208 00:26:00,670 --> 00:26:10,149 I would have been confident, with no evidence that the the risk benefit balance of having had the, you know, no new evidence specific plant vaccine. 209 00:26:10,150 --> 00:26:14,620 But what I know about the virus vaccines before and vaccines against all the coronaviruses, 210 00:26:15,340 --> 00:26:20,560 I would have been convinced that the risk benefit balance of having some of the vaccine made in the lab, 211 00:26:20,740 --> 00:26:28,480 you know, was that the manufacturing standards that we apply in the lab, that would have been more beneficial and risky to me. 212 00:26:29,200 --> 00:26:36,310 But that's clearly not how things work for and shouldn't be, how things work for, for deploying vaccines for these millions of people. 213 00:26:37,390 --> 00:26:41,290 So the real the real challenge is, is not making the vaccine. 214 00:26:41,950 --> 00:26:50,410 It's, you know, the groundwork on making the vaccine to create the technology platform not been done over the preceding ten years. 215 00:26:50,770 --> 00:27:01,870 You know, that was hard, but it wasn't hard in February 2020 was hard in February 2020 was how to do a rapid clinical trial and. 216 00:27:03,460 --> 00:27:07,510 Actually even that I felt might be very, very fast. 217 00:27:08,260 --> 00:27:17,980 We had a sort of slightly skipping ahead, but we had an extraordinary meeting in early March 2020 when we were designing the Phase one clinical trial, 218 00:27:18,910 --> 00:27:24,520 and we were designing the Phase one trial, which was, you know, the idea was to vaccinate something like 40 people. 219 00:27:27,250 --> 00:27:31,180 We normally for a phase one trial with small numbers like that, we don't do controls. 220 00:27:32,290 --> 00:27:37,359 We don't give people placebo because you're just looking for safety. 221 00:27:37,360 --> 00:27:45,190 And then in response, yeah, and you measure an immune response and it's not possible in a phase one to measure efficacy against infection. 222 00:27:46,060 --> 00:27:54,879 But we have this extraordinary experience of designing a Phase one trial with with controls and thinking, well, it was quite possible. 223 00:27:54,880 --> 00:28:02,140 And the government wasn't looking down at that point that if we vaccinated people in April, you know, 224 00:28:02,560 --> 00:28:08,290 20, 30% of the people in the trial might be exposed to the virus in the course of a couple of months. 225 00:28:08,740 --> 00:28:14,740 And actually, statistically, that would be sufficient to give an efficacy rate on those tiny numbers. 226 00:28:16,780 --> 00:28:21,820 So the. It was. 227 00:28:23,230 --> 00:28:28,330 I felt that because we had the prior safety experience on and given the similar, 228 00:28:28,330 --> 00:28:35,380 very similar vaccines to lots of people because the clinical need was huge. 229 00:28:35,470 --> 00:28:41,560 You know, if you've got a 10% risk of dying, if you're an older person and you've got this this virus, you know, 230 00:28:41,570 --> 00:28:48,910 how much safety data do you need to know to know that some protection from a vaccine is better than whatever the risk is from a vaccine? 231 00:28:49,000 --> 00:28:55,420 You know, if the stakes are very, very high in terms of risk of the infection, you know, 232 00:28:55,420 --> 00:29:01,450 if you've got if you've given the given the vaccine 2000 people and followed them up for a month, 233 00:29:02,470 --> 00:29:10,150 and, you know that, you know, you're, you know, considering vaccinating a population with a 10% risk of death if they get an infection. 234 00:29:10,810 --> 00:29:13,120 Well, actually, that's probably sufficient safety data. 235 00:29:14,080 --> 00:29:23,020 So it seemed in this very unusual context that it might be possible to provide adequate data to motivate, 236 00:29:23,110 --> 00:29:29,410 you know, adequate data to support deploying the vaccine in high risk populations, 237 00:29:30,160 --> 00:29:36,580 you know, health care workers very, very rapidly, because both safety, you know, 238 00:29:36,580 --> 00:29:41,950 we knew the platform was fairly safe and we might get an efficacy result very, very quickly. 239 00:29:42,070 --> 00:29:46,840 At the speed with which we got an efficacy result was a function essentially of how quickly 240 00:29:46,840 --> 00:29:53,440 we could get people vaccinated and how many cases of the virus there were in the population. 241 00:29:55,360 --> 00:29:59,440 The only reason we didn't get an efficacy result sooner was because of lockdown. 242 00:29:59,830 --> 00:30:04,570 Yeah. So this wasn't enough circulating infection and I. 243 00:30:06,050 --> 00:30:09,270 Talk about a bit more about lockdown in a minute maybe. 244 00:30:10,220 --> 00:30:17,900 Clearly, it was good that it happened, but we would have had an efficacy results and in summer 2020, 245 00:30:18,890 --> 00:30:21,340 had there been a large wave of infection on lockdown. 246 00:30:22,580 --> 00:30:35,480 So I felt like in February 2020 that, you know, technologically, the button Oxford's vaccine technology was getting off target crocodiles. 247 00:30:36,740 --> 00:30:44,180 I knew that the university was Andy Card in particular experience of running large trials during 248 00:30:44,180 --> 00:30:50,820 the swine flu pandemic university and the clinical trial capability to to run trials quickly. 249 00:30:50,840 --> 00:30:56,600 You know, if the journal is good at anything, it's good at getting things into people quickly and efficiently. 250 00:30:57,950 --> 00:31:03,319 The general run, the fastest phase one trial in the world for an Ebola vaccine candidate. 251 00:31:03,320 --> 00:31:07,540 Didn't develop like the vaccine in that case, but. 252 00:31:08,920 --> 00:31:10,930 We're quite good at getting things done quickly. 253 00:31:11,000 --> 00:31:18,540 The UK regulators are very effective as well in getting things turned around fast in an emergency like London, 254 00:31:19,510 --> 00:31:27,820 and I thought it would be possible to progress very rapidly from a phase one into thousands of people. 255 00:31:29,260 --> 00:31:33,940 So I thought the technology in the clinical trial actually probably wasn't that problematic. 256 00:31:34,020 --> 00:31:38,739 They were they weren't going to be the rate limiting thing and getting vaccine out into the world, 257 00:31:38,740 --> 00:31:42,639 the right limiting thing and actually potentially a fatal flaw for universities 258 00:31:42,640 --> 00:31:47,380 programme as a whole was the fact that we had no idea how to manufacture a large scale. 259 00:31:47,980 --> 00:31:57,580 You know, we if you'd asked me what's going to happen in, in, in February 2018, if in February 2020 you'd asked me what's going to happen, 260 00:31:58,870 --> 00:32:02,919 I'd have said I thought probably the most likely scenario or quite unlikely 261 00:32:02,920 --> 00:32:09,010 scenario would be that we might find out in summer that the vaccine worked, 262 00:32:09,700 --> 00:32:15,370 but we wouldn't have any of it to give to anyone what happens in normal times? 263 00:32:16,430 --> 00:32:24,190 How would you normally get a vaccine scaled up for something like like no childhood diseases or one of those? 264 00:32:25,750 --> 00:32:31,659 So what would happen normally is that you would do a phase one trial and then you would stop and 265 00:32:31,660 --> 00:32:35,890 you would look at the results from the phase one trial in a few tens or maybe a hundred people. 266 00:32:36,700 --> 00:32:40,540 And if not looked okay, then you'd do a phase two trial, a couple of hundred people. 267 00:32:41,710 --> 00:32:47,440 And often those are done with only small scale manufacturing capability. 268 00:32:48,400 --> 00:32:55,390 And then in industry, you know, phase three trial is relatively unusual for phase three trials to be done in academia, 269 00:32:55,420 --> 00:32:59,620 or at least unusual to be done by academics without an industrial partner. 270 00:33:03,640 --> 00:33:07,170 Typically what happens is that a phase three trial will happen, 271 00:33:07,900 --> 00:33:17,450 that a large scale manufacturing process will be developed to produce the vaccine for the phase three trial by the commercial partner usually, yes. 272 00:33:17,470 --> 00:33:17,800 Yeah. 273 00:33:18,670 --> 00:33:34,450 And it you know, I can't think of an example of a phase three trial, you know, happening with public funding, with academically manufactured vaccine. 274 00:33:34,450 --> 00:33:45,250 When I in it, you know, the Norway's an industrial partner and the idea there is that, you know, a, 275 00:33:45,610 --> 00:33:51,490 you know, phase three trial is going to cost depending on who you believe, at least tens of millions. 276 00:33:53,560 --> 00:33:59,320 And you should, you know, to no point investing in it's not going to be possible to make it at scale. 277 00:34:02,080 --> 00:34:11,740 B, if you do the trial and then you change the manufacturing afterwards, then you have a comparability. 278 00:34:11,770 --> 00:34:15,820 People get very worried about comparability when manufacturing processes change. 279 00:34:16,090 --> 00:34:20,049 How do you know that what's coming out of the new manufacturing process is exactly 280 00:34:20,050 --> 00:34:23,500 the same as the the vaccine that gave the good results in the clinical trial? 281 00:34:24,250 --> 00:34:32,500 So people like to have the final process pinned down for phase three and but then actual investment 282 00:34:32,500 --> 00:34:40,480 in really making millions and millions of doses would only happen after the phase three. 283 00:34:41,330 --> 00:34:46,990 The result? Sometimes people would invite you if they were confident. 284 00:34:47,800 --> 00:34:54,230 A company was confident. I think they might invest in actually building a new factory in parallel with a phase three trial. 285 00:34:56,270 --> 00:35:01,700 But you certainly wouldn't be churning out millions of doses during the phase three trial. 286 00:35:03,170 --> 00:35:06,350 So that's the usual way of things. And. 287 00:35:09,630 --> 00:35:13,980 That clearly wasn't going to work in this case. 288 00:35:15,270 --> 00:35:19,110 On the other, things about the usual way of things is incredibly slow. 289 00:35:20,070 --> 00:35:28,140 So pharmaceutical manufacturing happens on to this GMP, good manufacturing process regulation. 290 00:35:29,400 --> 00:35:39,510 And there's a deeply ingrained culture of quality and quality to you and me might mean, 291 00:35:39,900 --> 00:35:43,380 you know, something as good something as fit for the purpose for which it's intended. 292 00:35:44,400 --> 00:35:48,630 But in that environment, I think this is what a lot of people would rightly expect. 293 00:35:49,050 --> 00:35:52,830 It's a very, very risk averse environment. And. 294 00:35:54,370 --> 00:35:58,299 For me, coming from a clinical background, I sometimes find that quite challenging. 295 00:35:58,300 --> 00:36:10,480 The I, the there's very high value placed on avoiding any potential risk arising from a manufacturing problem and. 296 00:36:12,040 --> 00:36:16,209 Less value placed on the home. 297 00:36:16,210 --> 00:36:28,070 The results if making. The manufacturing so controlled actually makes it so expensive and slow that no drug gets to 298 00:36:28,070 --> 00:36:36,500 patients or it's impossible to develop the drug or it gets to patients years later in it. 299 00:36:36,670 --> 00:36:44,540 In a clinical medical context, you accept that for every everything you prescribe to a patient, all the risks and benefits. 300 00:36:46,640 --> 00:36:53,960 It's not a zero risk culture, but the culture and in biopharmaceutical manufacturing is. 301 00:36:57,000 --> 00:37:02,130 Close to being a zero risk culture. I love that because of a fear of litigation. 302 00:37:03,360 --> 00:37:03,959 Yes. 303 00:37:03,960 --> 00:37:12,960 And I think also, you know, there's a basic feeling people should know, you know, nobody should die because of a defective vaccine, the 21st century. 304 00:37:13,410 --> 00:37:27,990 You know, that is an unacceptable thing. My personal feeling is that the. 305 00:37:29,640 --> 00:37:35,010 Aspects of that culture of quality and risk aversion are. 306 00:37:37,910 --> 00:37:45,680 Far more onerous than is proportionate to the actual true risk. 307 00:37:46,790 --> 00:37:56,900 And that, you know, and that's because the culture is dominated by manufacturing specialists and not not by clinicians who think about, 308 00:37:57,200 --> 00:38:05,240 you know, what is a real risk to a person. So the relevance of this to COVID 19 is that the. 309 00:38:07,330 --> 00:38:10,780 That expectation of. 310 00:38:12,600 --> 00:38:14,610 Extremely controlled, 311 00:38:15,210 --> 00:38:25,110 extremely well understood manufacturing processes and no change in those manufacturing processes between a Phase three trial and. 312 00:38:28,000 --> 00:38:33,240 And deployment of a vaccine. Makes it incredibly slow. 313 00:38:34,540 --> 00:38:41,440 To develop new products. And actually looking in February 2020 that. 314 00:38:43,480 --> 00:38:48,010 It seemed to me that the speed with which the manufacturing could be scaled up, 315 00:38:48,520 --> 00:38:55,239 both from the point of view of doing it in a regulatory compliant way and from the from a financial perspective, 316 00:38:55,240 --> 00:39:01,780 the fact that, you know, if you want to make a vaccine and you don't have your own factory, 317 00:39:02,560 --> 00:39:09,190 you need to invest millions of pounds in booking a facility upfront. 318 00:39:10,150 --> 00:39:17,860 And we didn't have millions of pounds. And, you know, it takes months and months to prepare the facility to do the first batch. 319 00:39:19,810 --> 00:39:29,670 I use the analogy with people. It you know, it's a little bit like setting up a new branch of McDonald's or something. 320 00:39:29,680 --> 00:39:35,660 You know, it might take months and months to prepare the facility trains, train the staff and, 321 00:39:36,490 --> 00:39:40,000 you know, invent the recipe if you're inventing hamburgers for the first time. 322 00:39:40,900 --> 00:39:44,890 But once you've got it, you can churn out the vaccine very quickly and. 323 00:39:46,920 --> 00:39:53,190 I was concerned that that set up was not going to happen soon and often. 324 00:39:53,370 --> 00:40:01,260 And I hadn't. I felt it had to be done before we knew, before we had evidence whether all the vaccine was going to work. 325 00:40:02,310 --> 00:40:13,980 So really, within a few days of that reading, that New York Times article, having sort of torn my hair out for a battle, 326 00:40:14,130 --> 00:40:17,970 I remember writing to the Guardian neighbours and saying, Do you want it? 327 00:40:18,000 --> 00:40:23,550 Would you be interested in a piece from the vaccine developer about how to regulate? 328 00:40:24,260 --> 00:40:31,169 Quite a lot of pinch, though I felt there was a problem of awareness that actually it would be possible to make a vaccine. 329 00:40:31,170 --> 00:40:34,460 But the challenges were around regulation, manufacturing. 330 00:40:34,760 --> 00:40:42,420 But I wasn't part of the programme here and I thought it was important people understood that. 331 00:40:43,290 --> 00:40:46,930 The Guardian, unsurprisingly, were not interested in what I had to say. 332 00:40:49,560 --> 00:40:59,220 But I realised that actually all of the people in Oxford who might be able to do something about this problem. 333 00:40:59,550 --> 00:41:05,430 Well, really, I was the only person who had worked on scalable manufacturing of this type of vaccine. 334 00:41:07,990 --> 00:41:13,000 And so I started thinking, you know, what can we do? 335 00:41:13,690 --> 00:41:19,990 And with Katrina's result or coroner's results show it was that we could get. 336 00:41:22,430 --> 00:41:29,120 More vaccine from a very simple process than had previously been thought possible. 337 00:41:30,710 --> 00:41:45,380 And with that, it seemed like it would be not that hard in a sort of purely technical sense, but very, very hard. 338 00:41:45,380 --> 00:41:53,959 And that's been in a sort of GMP compliance sense, unheard of in a GMP compliance sense, technically possible, but regulated, 339 00:41:53,960 --> 00:42:00,740 really challenging to take what we had at the scale of, you know, literally two tablespoons, 30 millilitres was the scale. 340 00:42:01,070 --> 00:42:08,840 Kareena had got her original results. It seemed to be possible to turn that into a commercial scale process, which would be 200 litres. 341 00:42:09,620 --> 00:42:11,600 And on what kind of time scale? 342 00:42:12,860 --> 00:42:23,660 Well, in fact, in February 2020, I started putting together a grant proposal in the UK or I had a UK government research funding, 343 00:42:24,170 --> 00:42:37,219 how to do emergency COVID funding. So I put in a grant and got 2 million for the Phase one trial and I missed the first deadline known to exist. 344 00:42:37,220 --> 00:42:52,450 And I wasn't ready. I put but essentially I put together an application for £400,000 to and the pitch was enabling production of the titles, 345 00:42:52,490 --> 00:42:59,060 enabling production of a million doses by the end of 2021 to vaccinate NHS workers. 346 00:43:00,230 --> 00:43:05,640 That was, that was, you know, that seemed like a wildly ambitious, you know, 347 00:43:05,660 --> 00:43:10,070 no one really was thinking, well, a million doses might be available within 2020. 348 00:43:11,940 --> 00:43:17,800 And we knew, we knew we couldn't do that internally. 349 00:43:17,810 --> 00:43:31,070 So to enable putting together the proposal, I had reached out to the Vaccine Manufacturing Innovation Centre directly. 350 00:43:31,130 --> 00:43:35,660 So that was something that at that point, V-neck was no building. 351 00:43:35,960 --> 00:43:44,990 I was six people in an office on the science park with some plans for building, but they had one guy called John Humphrys, 352 00:43:44,990 --> 00:43:50,870 who was the head of process development, who was going to be part of process development side. 353 00:43:51,380 --> 00:43:54,530 And you know, this was their remit, this mobile they were set up to do. 354 00:43:54,860 --> 00:44:02,839 So I got in touch with them and the boss put me in touch with John and he then put me 355 00:44:02,840 --> 00:44:07,900 in touch with a Dutch company called Halix as a contract manufacturing organisation. 356 00:44:08,070 --> 00:44:11,960 They'll take all the people's problems and manufacture them. A commercial is coming. 357 00:44:12,570 --> 00:44:17,330 They very, very new and I don't think they really done anything yet in that facility. 358 00:44:19,400 --> 00:44:25,820 So that was one direction in which I reached out to try and, you know, find some friends, you know, get some help. 359 00:44:29,110 --> 00:44:33,020 The other was Cath Green, who runs the CBA, 360 00:44:33,060 --> 00:44:41,250 said she was on this mailing list for the UK Bio Industry Association and she sent a message to say if anyone on the list would help us. 361 00:44:42,870 --> 00:44:48,029 So she sent out a message on my behalf asking for help and the scale up. 362 00:44:48,030 --> 00:45:01,050 And we got a lot of responses very, very amazingly fast and pull by a tag which is a big sort of equipment that's l p, 363 00:45:01,080 --> 00:45:12,870 I think equipment and materials supplier multinational but with a base in Portsmouth legal all mainly and they said, 364 00:45:12,870 --> 00:45:25,860 well, we'll run it will run a 200 litre barge will will will take your lot process and we'll take it to 200 litre industrial scale and we'll do that. 365 00:45:26,190 --> 00:45:32,210 You know, we'll put in our people's time and, you know, the materials that are up, 366 00:45:32,220 --> 00:45:35,400 you know, pull materials and all the equipment they would supply them. 367 00:45:35,400 --> 00:45:40,890 So it was a big package of in-kind support worth a couple of hundred thousand pounds. 368 00:45:41,760 --> 00:45:45,389 And at that point, you know, really it was an amazing response. 369 00:45:45,390 --> 00:45:54,299 We got via email because at that point the leading UK platform and if you read the papers, the leading UK vaccine programme was, was Imperial. 370 00:45:54,300 --> 00:45:59,640 No one had really heard about as we were. We hadn't nothing, nothing had been put out in the press. 371 00:46:02,700 --> 00:46:06,900 And then one of the other companies that responded that was called Cobra Biologics. 372 00:46:08,580 --> 00:46:12,390 And also I'd made I'd made contact with Oxford Biomedica just down the road. 373 00:46:12,970 --> 00:46:16,320 So I had these conversations. 374 00:46:16,320 --> 00:46:20,850 I remember pacing around the frosty car park in mid-February, 375 00:46:20,850 --> 00:46:25,500 trying to persuade chief scientific officers from these companies I'd never dealt with before, 376 00:46:25,920 --> 00:46:31,409 you know, working at a scale I had no experience of to do this. 377 00:46:31,410 --> 00:46:40,620 Absolutely. What to them was preposterous to take a lab a lab process, couple of tablespoons and turn it into an industrial process with no funding. 378 00:46:42,150 --> 00:46:51,059 Incredibly fast. And Cobra, Biologics and Halix. 379 00:46:51,060 --> 00:46:59,040 The Dutch company came on board for this initial application to UK R.I. and they said they would provide some. 380 00:47:00,520 --> 00:47:10,740 Basically they would prepare to run the process in their facilities, which is a modest investment of that time, but not actually run it. 381 00:47:12,490 --> 00:47:16,990 Oxford, Biomedica at that point decided they weren't able to be involved. 382 00:47:17,620 --> 00:47:24,120 You know, they were much bigger, you know, listed company and they had their own business, you know. 383 00:47:24,130 --> 00:47:30,460 Well, that's out of all the customers needs to me. And they, they weren't able to get involved in the stage, but we kept in touch with them. 384 00:47:32,680 --> 00:47:43,730 And so. Things really how you know what happened very, very fast around the end of February. 385 00:47:43,880 --> 00:47:47,840 Look, you know, within a day or two of speaking to these people, 386 00:47:48,050 --> 00:47:54,980 I put in the application to UK arrived within a day or two of the UK or I phoned back and you know, 387 00:47:55,460 --> 00:47:59,330 they said, you know, we're not we're not officially taking the decisions on these grounds for a while, 388 00:47:59,330 --> 00:48:11,959 but we're going to we're going to fund get on with that. So by the end of February 2020, we were like, well, 389 00:48:11,960 --> 00:48:19,010 we're scaling up as fast as we possibly can towards a but what's called an engineer and basically a process run, 390 00:48:19,550 --> 00:48:24,629 not a clinical grade, but industrially, industrially relevant scale. 391 00:48:24,630 --> 00:48:29,880 And that was going to be done in Paul's facility in Portsmouth. In my lab. 392 00:48:29,880 --> 00:48:39,060 We were all we hadn't done the sort of purification with this, you know, with with vaccine that come from this new media. 393 00:48:39,450 --> 00:48:42,890 All we'd done was we knew we could get a loan from the upstream process. 394 00:48:42,900 --> 00:48:49,770 So in my lab we were frantically checking, well, can we actually still purify the stuff in the way that we had done it before? 395 00:48:50,490 --> 00:48:56,760 How do you in simple terms, how do you purify the product that you want from a very simple time? 396 00:48:56,760 --> 00:49:08,130 And so it's a series of filters, slightly less simple terms of what's called chromatography step, where the virus sticks onto a filter. 397 00:49:08,340 --> 00:49:13,860 Another thing was pass through. So when you say the virus, I think we need to keep clear all the time. 398 00:49:13,860 --> 00:49:20,400 Are we talking about the hot new virus or the spike protein? We're talking about getting the virus for the good question. 399 00:49:20,670 --> 00:49:24,540 Whenever I say the virus in a manufacturing context, I mean the vaccine. 400 00:49:24,660 --> 00:49:34,540 Yeah. Yeah. In the last. Around. 401 00:49:34,540 --> 00:49:42,310 About that time I remember setting up a WhatsApp group with Garth Green and Adam Ritchie, the project manager. 402 00:49:42,940 --> 00:49:46,280 It was called The Coronavirus versus Corona Virus Growth Rate. 403 00:49:46,510 --> 00:49:55,150 Growth Rates Club, you know, and I'd do the logo for the group first set up was to feel a bit of a geeky joke was barely a joke. 404 00:49:55,580 --> 00:50:01,240 It was two intersecting exponential curves. You know, at that point, the corona virus was growing faster. 405 00:50:01,720 --> 00:50:09,490 But what we had to do was try and find a way to make our virus in the virus grow faster, and that should be possible. 406 00:50:09,760 --> 00:50:13,780 You know, I thought the what should be possible. Technically, it was possible. 407 00:50:13,960 --> 00:50:19,240 It was a question of dying in a way that was regulated, fully compliant and financially practical. 408 00:50:21,520 --> 00:50:27,780 So. Three, three Feb 2021. 409 00:50:28,230 --> 00:50:31,890 A plan for getting the manufacturing to, you know, roughly million dollar scale. 410 00:50:33,230 --> 00:50:41,070 I put that together and it looks increasingly like time to plan all the people support in parallel with I was. 411 00:50:43,280 --> 00:50:48,410 Involved in trying it out of us, trying to, you know, motivate. 412 00:50:48,500 --> 00:50:55,250 I felt like I was trying to motivate colleagues within the university to treat this as a real, real emergency. 413 00:50:56,030 --> 00:51:01,520 I remember writing a briefing note for that at an apartment. 414 00:51:04,190 --> 00:51:12,270 In which I said I. Foods. This was potentially the worst emergency for the country since World War Two. 415 00:51:13,770 --> 00:51:21,580 And something that's. It was highly plausible that tens of millions of people would die. 416 00:51:23,440 --> 00:51:32,860 And in February 2020, look, I don't know the case in the UK and a lot of people are still thinking this thing would be contained in China somehow, 417 00:51:33,100 --> 00:51:45,640 despite the big outbreaks in Italy and Iran saw it, the sort of parallel stream of stuff I was doing, which was really trying to. 418 00:51:47,880 --> 00:51:53,070 Persuade people to treat it as a real threat in an emergency. 419 00:51:54,150 --> 00:51:58,830 And I find it quite distressing, to be honest, that there was no. 420 00:51:59,740 --> 00:52:11,800 The prevalent attitude. I was also, you know, at the same time involved in. 421 00:52:13,240 --> 00:52:20,660 Trying to. Well proposals for what we would want, how our clinical development program would work. 422 00:52:20,840 --> 00:52:24,670 So I was speaking with Sara Gilbert and Cascarino. 423 00:52:27,290 --> 00:52:32,770 Adrian Hill was overseas by. Listening to him on the pod wasn't. 424 00:52:34,970 --> 00:52:41,600 Originally involved. A plans to run a paediatric triathlon and later in the summer. 425 00:52:45,730 --> 00:52:54,850 And I put forward this I and the original plan was going to have the first batch of the vaccine made and. 426 00:52:55,970 --> 00:53:04,040 In Italy and a CBF our own manufacturing facility was manufacturing and other products. 427 00:53:04,040 --> 00:53:09,020 It was busy. And I. 428 00:53:10,600 --> 00:53:16,250 Felt quite strongly that the. Manufacturing should stop. 429 00:53:17,120 --> 00:53:25,790 And the quickest way we could make get a clinical trial started was to make it in our own facility, and that could be done within a matter of weeks. 430 00:53:26,840 --> 00:53:35,690 So and I also felt that it was possible to progress the clinical trial plan quite rapidly. 431 00:53:35,900 --> 00:53:53,050 So. On. The first discussion I'm aware of of a continuous phase one, phase two, phase three clinical trial was a. 432 00:53:55,020 --> 00:53:59,820 An email thread started on the 25th of. 433 00:54:00,420 --> 00:54:10,340 February 2020. And things came together for a. 434 00:54:12,840 --> 00:54:17,209 If it felt like critical mass to me, critical mass was achieved. 435 00:54:17,210 --> 00:54:22,450 And this is not. I think it's important to be very clear. 436 00:54:22,760 --> 00:54:27,930 Sarah. Sarah And tests have been working on this from, from January. 437 00:54:28,480 --> 00:54:31,840 Tom Fantastic. Look. 438 00:54:35,020 --> 00:54:44,530 The critical mass around the plan of real emergency clinical development coupled to emergency 439 00:54:44,530 --> 00:54:49,180 manufacturing development to actually get meaningful quantities of it into the real world. 440 00:54:50,020 --> 00:54:55,210 And actually, the connection between the manufacturing and clinical trials was really very important. 441 00:54:55,220 --> 00:54:58,900 You know, we could only do the clinical trials quickly as we can manufacture the vaccine. 442 00:54:59,110 --> 00:55:04,209 So the idea of, you know, really just in time supply, first of all, apart from trial, 443 00:55:04,210 --> 00:55:10,240 kind of go by manufacturing facility building very fast till phase one and then accelerating the 444 00:55:10,240 --> 00:55:18,670 batch from Italy and then maybe whatever we could do it 200 leads scale using one new process the. 445 00:55:20,360 --> 00:55:23,870 The idea we could make that happen and it could feed into a continuous phase one, 446 00:55:23,870 --> 00:55:28,040 two or three trial, and that would then be an industrial scale process. 447 00:55:28,040 --> 00:55:36,790 Ready? And this would be a program that would involve both the General Institute and the Department 448 00:55:36,790 --> 00:55:44,800 of Medicine and also the vaccine group and the Division of Paediatrics that coalesced in a. 449 00:55:46,760 --> 00:56:01,010 For me in a slide presentation to the group of principal investigators from the Department on the 26th February 2020. 450 00:56:02,960 --> 00:56:05,620 And I'm Adrian Holloway. 451 00:56:06,470 --> 00:56:13,970 I asked Richard Cole if we could have the opportunity to present this as the vaccine development team at the start of the meeting. 452 00:56:14,960 --> 00:56:23,410 And Adrian Dalton from Massachusetts Forum in the morning where he was antipolo and came along for the first time, 453 00:56:23,420 --> 00:56:31,070 I think, and they had come to a Department of Medicine meeting relating to the pandemic and. 454 00:56:32,630 --> 00:56:42,500 But all these slides basically said we thought we could open efficacy results and millions of doses of vaccine by the end of the year. 455 00:56:43,860 --> 00:56:46,939 Well, the timeline on the slide was a bit over optimistic. 456 00:56:46,940 --> 00:56:57,810 I think I was leaving for August, but. It was on the call of a figure law. 457 00:57:00,670 --> 00:57:11,950 Amazing. And I remember having a conversation with Crystal Fraser, who's a eminent infectious disease epidemiologist who was in the room. 458 00:57:12,940 --> 00:57:17,330 And he said. Well. 459 00:57:19,380 --> 00:57:24,960 If what you're saying is right, it is possible to make meaningful quantities of vaccine a lot of times. 460 00:57:25,170 --> 00:57:30,870 You know, that sort of timescale, then all the assumptions on which policy is being made. 461 00:57:32,280 --> 00:57:42,660 You know, the decision to not lock down early. Which was, you know, influence my philosophy tone for the most convenient function or any time soon. 462 00:57:43,540 --> 00:57:49,500 He said, Well, you know, people people haven't understood that I could be long seen or be seen on. 463 00:57:50,890 --> 00:57:54,430 If what you're saying is right, then the policy decisions that are being made a roll. 464 00:58:02,860 --> 00:58:06,030 I was. Pretty profound. 465 00:58:06,150 --> 00:58:25,760 Mm hmm. And surely within within the week after that was the first the first meeting of the COVID vaccine programme, 466 00:58:25,970 --> 00:58:32,360 Joint General and Perpetrator Vaccine Group, then planning a phase one trial, you know, huge. 467 00:58:32,360 --> 00:58:37,760 You know, it's absolutely not to an elbow. We were not at all in the frame of infection control. 468 00:58:37,880 --> 00:58:44,540 You know, people were not thinking about how do we, you know, the idea that the virus itself might be a threat to the programme. 469 00:58:47,550 --> 00:58:53,760 Was not there to begin with. It was we were crammed and, you know, 50, 60 people in a tiny room. 470 00:58:55,080 --> 00:59:00,020 And that was quite a discussion about, you know, a phase one that might produce an efficacy result was going on. 471 00:59:00,090 --> 00:59:10,379 I remember saying, you know something someone reminded me in the pub recently that I had said something about everyday. 472 00:59:10,380 --> 00:59:18,150 The everyday slower that we developed a vaccine could be that thousands of people died, which just, you know, it's like great. 473 00:59:18,150 --> 00:59:25,660 You know, sounds grandiose. But I felt it was true. 474 00:59:25,960 --> 00:59:31,420 I thought we had a very serious responsibility to try and move as fast as we possibly could. 475 00:59:32,520 --> 00:59:38,350 I didn't think, you know, early on I thought I vaccine had a good chance of being efficacious. 476 00:59:38,370 --> 00:59:45,540 I didn't I didn't think it would likely turn out to be the best vaccine against COVID 19 in five years time. 477 00:59:46,530 --> 00:59:50,990 But I thought it might be that we were we were able to do it faster. 478 00:59:53,520 --> 00:59:57,120 So for me, speed was the the critical thing. 479 01:00:03,190 --> 01:00:10,509 So yeah, that's the that's the sort of I've been talking for quite a long time. 480 01:00:10,510 --> 01:00:17,110 I've only really brought it up to the end of February 2020. When how is this? 481 01:00:17,110 --> 01:00:20,230 Is this the sort of thing? Yes, yes, absolutely. Absolutely. 482 01:00:20,910 --> 01:00:24,670 It's very much giving us what what it was like to live through it. 483 01:00:24,670 --> 01:00:27,970 I can see it kind of watching it. You are living through it again. 484 01:00:29,140 --> 01:00:34,490 Yeah. So. So once you'd, um. Got that group together. 485 01:00:36,350 --> 01:00:41,100 I mean, you still needed funding, didn't you? Yeah, I know. 486 01:00:41,300 --> 01:00:46,550 But it was a couple of it was a couple of months till before the vaccine taskforce was set up, wasn't it? 487 01:00:46,760 --> 01:00:52,040 Yeah. So for me, February and March 2020 were. 488 01:00:54,500 --> 01:00:59,520 Without a doubt the most intense and distressing. Traumatic. 489 01:01:01,980 --> 01:01:15,080 Period of my life. Because it felt like watching a slow motion train crash on and it was completely avoidable. 490 01:01:16,520 --> 01:01:28,660 Or it felt like it was should be avoidable to a large extent. And you mean in terms of the government not implementing mitigation strategies earlier? 491 01:01:29,230 --> 01:01:33,220 Well, in terms of how the actual work on the vaccine was going. 492 01:01:36,570 --> 01:01:42,190 I think. Partly a bit. 493 01:01:42,270 --> 01:01:47,809 A bit of both. Yeah. I might ask you about it. Not part of the bit that goes online immediately. 494 01:01:47,810 --> 01:01:58,250 I said, well, both of those fell on the vaccine development program, not not just ours, but globally. 495 01:02:00,220 --> 01:02:03,740 Wasn't getting the level of investment. You know, it was. 496 01:02:04,580 --> 01:02:09,170 You know, if you looked at some cost modelling of pandemics, you know, like premiums, 497 01:02:09,170 --> 01:02:16,090 you know what people have done, modelling the cost of a flu pandemic. It was obvious this was going to cost trillions of dollars. 498 01:02:17,740 --> 01:02:23,510 And it was obvious that an effective vaccine would save many billions of dollars. 499 01:02:24,130 --> 01:02:28,600 And we were making decisions for one of lack of 50 or £100,000, 500 01:02:28,600 --> 01:02:33,190 or we were not taking decisions because they would put at risk that sort of money that we did not have. 501 01:02:34,600 --> 01:02:43,360 That could delay things by a couple of weeks. And, you know, I've mentioned in terms of monetary values, but it was also obvious that, 502 01:02:43,510 --> 01:02:47,710 you know, global death rates were probably going to have been thousands of deaths a day. 503 01:02:49,660 --> 01:02:57,390 So. It was terrible and obviously terrible and my own. 504 01:02:58,800 --> 01:03:08,580 I didn't really feel I think a lot of people thought personally I was mad because I was so agitated about it. 505 01:03:12,290 --> 01:03:17,390 I think my own family were worried about me. My father. 506 01:03:18,520 --> 01:03:21,560 Hunt's. Terminal lung cancer. 507 01:03:22,790 --> 01:03:34,099 And he was on chemotherapy. And in February, in February 2020, he decided to go to you know, he's always wanted to see the Sistine Chapel. 508 01:03:34,100 --> 01:03:44,510 He liked art. So I had this, you know, terrible conversation with my parents, first of all, while they were literally on the tarmac at Heathrow. 509 01:03:45,180 --> 01:03:55,800 And then when they'd arrived at the hotel in Rome saying it was a man was immunosuppressed with lung cancer, you should not be in Italy. 510 01:03:56,520 --> 01:04:01,820 I'm really sorry. I know you want to see the Sistine Chapel. But you've got to come home. 511 01:04:04,130 --> 01:04:08,770 And I thought I was mum, but I did come home in the end. 512 01:04:08,780 --> 01:04:12,680 But, you know. 513 01:04:20,440 --> 01:04:31,900 You know, it was a very difficult time. But coming back to the the voting problems, you know, we did not the level of investment we needed. 514 01:04:32,950 --> 01:04:41,980 And, you know, in February, March 2020, the games that the were in town, as it were, for funding was UK RMI, 515 01:04:42,340 --> 01:04:49,530 which had coughed up a couple of million pounds to 2.3 million, I think was a 400,000 for 4 million on the Fox role. 516 01:04:51,150 --> 01:04:54,160 And that was enough to see us through a phase one trial. 517 01:04:55,000 --> 01:05:10,500 There was. Cepi, the Coalition for Epidemic Preparedness Initiatives Innovation, who had previously given Sarah £10 million to work on a mars vaccine. 518 01:05:29,070 --> 01:05:29,370 Yeah. 519 01:05:29,370 --> 01:05:37,140 And Cepi it proved quite challenging to actually get commitment from them to, to very large scale, you know, the scale of funding that was needed. 520 01:05:37,230 --> 01:05:46,470 So we went, we didn't have any funding of the scale needed to do large scale manufacturing and the whole way through March. 521 01:05:47,190 --> 01:05:51,480 You know, it felt like the world wasn't a week gone by by that point. 522 01:05:52,110 --> 01:05:58,050 We assembled a consortium to scale the manufacturing of, I think about nine organisations. 523 01:05:59,100 --> 01:06:05,370 So in February, Vaccine Manufacturing Innovation Centre Halix Cobra. 524 01:06:05,640 --> 01:06:09,120 Oxford Biomedica who took a while to actually commence. 525 01:06:09,120 --> 01:06:12,540 But they were we were talking with them and informally they were, you know, 526 01:06:12,540 --> 01:06:20,930 participating in a phone calls, I think, and then a couple of sort of suppliers. 527 01:06:20,940 --> 01:06:26,999 And then in March the Serum Institute of India and I'd spoken to Ruchi Biologics, 528 01:06:27,000 --> 01:06:31,560 which is the Chinese contract manufacturer, and they said W you excite correct you. 529 01:06:33,840 --> 01:06:38,870 And. I'm sure I'm forgetting other. 530 01:06:38,900 --> 01:06:51,500 Paul. Paul? Yeah. So, but in, in March, you know, we had this with we were having calls, multiple calls over every week, 531 01:06:53,960 --> 01:07:04,280 coordinated by, by me and Adam, one project manager while Karina was doing a lot of work, essentially. 532 01:07:05,390 --> 01:07:08,150 You know, one part of it was how do we do this 200 later on? 533 01:07:08,180 --> 01:07:13,969 Paul You know, the mechanics of how to go in the cells, how do we get the materials to pull fast and enough? 534 01:07:13,970 --> 01:07:16,730 And, you know, we we compressed and compressed the timescale. 535 01:07:16,730 --> 01:07:22,760 So instead of like doing a wrong by August, we decided, you know, the urgency was increasing. 536 01:07:22,760 --> 01:07:27,260 And we, we decided we'd try and get the 200 metre run done in in April. 537 01:07:29,570 --> 01:07:37,010 So that was one strand of work. And then the other was, well, Kobra and Alex had said that they would prepare for what's called inward tech transfer, 538 01:07:37,010 --> 01:07:45,860 taking the manufacturing process and really running it to GMP standards and increasingly turning towards doing that. 539 01:07:45,860 --> 01:07:51,560 And, you know, and saying, well, we actually we really want to do this for real as soon as we possibly can. 540 01:07:55,040 --> 01:08:06,980 And, you know, can we actually really make a batch for the NHS, you know, within, within summer 2020 maybe and. 541 01:08:12,880 --> 01:08:22,810 We had no money. And so, you know, every week I was on this phone call with CEOs of these different contract manufacturers saying, 542 01:08:23,560 --> 01:08:26,770 oh, we're talking to such and such a fund. We'll have some money next week. 543 01:08:27,050 --> 01:08:31,970 It was like magnanimous, you know? John tomorrow. 544 01:08:31,980 --> 01:08:41,130 But it was never John today. And you know, please, guys, please stick with us. 545 01:08:41,150 --> 01:08:45,740 Please don't give away your manufacturing capacity to someone else who's got the money now. 546 01:08:46,190 --> 01:08:51,170 You know, they were they were saying, well, we're going to have to give them you know, we can't commit to do this for you haven't got any money. 547 01:08:52,040 --> 01:08:57,050 And it's you know, ultimately they've all done very well financially out of it. 548 01:08:58,640 --> 01:09:04,880 It was a good business. You know, there was this unique confluence of the right thing to do altruistically. 549 01:09:06,170 --> 01:09:12,650 And also actually there was a very good business case for coming on board with our vaccine programme in the early days. 550 01:09:12,980 --> 01:09:19,220 All the companies that did have done very well, but we needed real money. 551 01:09:22,040 --> 01:09:27,290 And that only changed in April. 552 01:09:28,520 --> 01:09:36,670 And. A couple of other things that happened during during March which. 553 01:09:39,080 --> 01:09:42,850 I'm maybe worth just touching on in terms of my personal experience. 554 01:09:42,850 --> 01:09:46,200 So. I. 555 01:09:47,010 --> 01:09:53,680 I was. You know, I've become increasingly convinced that it was possible to make a vaccine and that 556 01:09:55,060 --> 01:09:59,830 manufacturing and supply was going to be the limiting factor in actually getting it to people. 557 01:10:01,670 --> 01:10:06,220 And it's increasingly public that there wasn't enough funding harmonising and 558 01:10:06,230 --> 01:10:10,520 the government governments were not engaged with the scale of the problem. 559 01:10:11,650 --> 01:10:16,960 And my. My partner is an economist in the School of Government. 560 01:10:17,800 --> 01:10:26,140 Her boss is the former chief economist for different Department for International Development. 561 01:10:27,460 --> 01:10:35,790 And I sent him an email explaining the situation at the end of February and saying that 562 01:10:36,730 --> 01:10:40,090 I saw a lot of middle income countries were going to be in the back of the queue to get. 563 01:10:42,050 --> 01:10:52,450 A real deal. And he put me in touch with a guy called David Kindler is the UK's number two in the world punk too, 564 01:10:53,720 --> 01:11:00,860 between myself and Kate, my partner with a bit of input, a review from Stefan, her boss and Adrian Hill. 565 01:11:01,760 --> 01:11:06,200 We put together a discussion, you know, essentially a briefing note that said. 566 01:11:07,870 --> 01:11:12,939 If the world invested some of basically it was arguing that it was an incredibly 567 01:11:12,940 --> 01:11:17,349 good investment for governments to put in hundreds of millions of pounds, 568 01:11:17,350 --> 01:11:19,510 like then in March 2020. 569 01:11:22,290 --> 01:11:30,030 I'm told I'm told that and then that there was a need for, you know, market commitments to buy the vaccine before the clinical trial results. 570 01:11:33,720 --> 01:11:40,690 I'm told the briefing note had some influence on. COVAX subsequently being set up. 571 01:11:40,750 --> 01:11:49,580 And. And. This is the international organisation principally to supply you to other middle income countries. 572 01:11:49,700 --> 01:11:53,590 That's right. Yeah. Um, but yeah, that was, you know, 573 01:11:53,600 --> 01:12:00,020 all part of this surreal experience is that all of this kind of the World Bank about spending hundreds of millions or billions of pounds. 574 01:12:01,260 --> 01:12:05,190 And we still have short of tens of thousands of pounds. 575 01:12:08,610 --> 01:12:17,790 But there was this sort of track of, you know, I was having those conversations on people on a believe was talking to Chris Whitty and Patrick 576 01:12:17,790 --> 01:12:26,820 Vallance by the end of March 22 I'd sent a message to I think we had a call with Jonathan Van-tam. 577 01:12:27,250 --> 01:12:34,079 I know one or two emails involving Patrick Vallance and Jonathan Van-tam in March 2020, you know, 578 01:12:34,080 --> 01:12:37,650 basis and look, we can do this but you know the manufacturing problem but we can do it. 579 01:12:37,840 --> 01:12:47,909 We can do it in the UK in parallel with the UK Bio Industry Association and set up a vaccine manufacturing what they 580 01:12:47,910 --> 01:12:53,520 call the Vaccine Manufacturing Task Force and subsequently became an arm of the Government's Vaccine Task Force. 581 01:12:53,520 --> 01:12:58,830 But the manufacturing line was set up first and it was it was led by a guy called Ian McKellen, 582 01:12:59,940 --> 01:13:04,500 and he was a former vice president of manufacturing for GSK. 583 01:13:05,370 --> 01:13:11,100 And I think he contacted me on March the 30th email in a phone call. 584 01:13:11,880 --> 01:13:25,600 And basically they had a. In the first couple of calls we had with them, you know, a massive zoom call and dozens of, you know, 585 01:13:25,600 --> 01:13:32,950 well-intentioned and generous people from all the UK bio industry association member companies, 586 01:13:32,950 --> 01:13:36,549 you know, willing to help one out of groups at all to help without Novartis manufacturing. 587 01:13:36,550 --> 01:13:43,420 We had a group set up to help with money, which was basically to help Imperial. 588 01:13:43,420 --> 01:13:52,660 They had a group set up to do will fill and finish putting the vaccines into vials and a group set up to do a deal with supply chain. 589 01:13:54,120 --> 01:13:58,680 Very, very sensible. Very important. And. 590 01:14:02,090 --> 01:14:09,930 To start with. I think they thought that they were you. If the assumption was that we wouldn't have a a large scale manufacturing plant. 591 01:14:12,650 --> 01:14:16,310 And they said that they were going to take over. 592 01:14:16,520 --> 01:14:23,960 So the first couple of meetings were a bit weird. It was like, you know, what do I actually owe for the plant, you know? 593 01:14:25,610 --> 01:14:35,459 And the. But it turned into a very, very productive and very supportive relationship. 594 01:14:35,460 --> 01:14:38,730 And within a week of, I think, April 7th. 595 01:14:40,050 --> 01:14:43,740 He had asked me to put put together a plan. 596 01:14:43,740 --> 01:14:47,700 Well, what would it take to buy the capacity? You know, I said, 597 01:14:47,700 --> 01:14:54,630 I think we need to buy a capacity in the three of three contract manufacturers we had that were potentially for supplying the kind of three, 598 01:14:54,870 --> 01:15:03,350 three sites that might supply the U.K., like COBRA to buy American to internationally etc. maybe talk about into non-European. 599 01:15:03,360 --> 01:15:14,940 But later up the. The task force was interested in UK supply primarily. 600 01:15:15,930 --> 01:15:23,400 And you know, I had been thinking well by this point, well we just need to book the mine, you know, hire the facilities for the rest of the year. 601 01:15:24,460 --> 01:15:28,950 And. I said this to me and I said, Well, you know, what's it what would it cost? 602 01:15:29,190 --> 01:15:33,840 You know, write a plan. And I wrote a few slides. 603 01:15:34,750 --> 01:15:36,270 It's like it needs to be simpler. 604 01:15:36,840 --> 01:15:44,040 And I ended up basically boiling it down to a single slide where said, you know, we could do this for £65 million for the year. 605 01:15:45,690 --> 01:15:51,960 And I was at pains to say, but we don't you know, you don't need to put all that money at risk to begin with. 606 01:15:52,230 --> 01:15:56,760 You know, you could bail out if the trial results in May or this point, you know. 607 01:15:57,240 --> 01:16:00,330 So actually, all we're really asking for is £12 billion upfront. 608 01:16:00,690 --> 01:16:04,950 It wasn't even though it was a huge amount of money for me, I'd never asked for that much money for anything before. 609 01:16:06,860 --> 01:16:14,250 But it's like, no, you just need to ask for £65 million and a week after that. 610 01:16:17,760 --> 01:16:20,999 We want to, you know, ride in. 611 01:16:21,000 --> 01:16:24,810 And his task force will help you with a plan and play set up a cause. 612 01:16:25,240 --> 01:16:37,980 Harsh on business Secretary Huntoon, sir, we're talking about the clinical trial and the phone and all these presentations on your functional side. 613 01:16:38,490 --> 01:16:43,910 And very soon after that, we had a, you know, commitments of of. 614 01:16:44,750 --> 01:16:49,760 £65 million. But by that time, the government vaccine taskforce had been established. 615 01:16:50,170 --> 01:16:53,630 It was formally only established, I think, on the 1st of May. Oh, right. 616 01:16:54,200 --> 01:16:57,470 Or at least that's when Kate Bingham came on board. 617 01:16:59,900 --> 01:17:05,720 But certainly through April, there was you know, 618 01:17:06,140 --> 01:17:12,590 we were in contact with government through through this being a vaccine manufacturing taskforce and was connected into government. 619 01:17:14,060 --> 01:17:21,080 And, you know, the there were clearly people in the civil service who had been briefed. 620 01:17:21,230 --> 01:17:27,550 You know, it's your job now to make this happen. You know, there was someone to pick up the phone to and go on from. 621 01:17:27,740 --> 01:17:34,220 Do you feel when you heard you've got 65 million? I know. 622 01:17:35,540 --> 01:17:41,089 Please. Obviously, I mean it. But to be honest, there was still there was so much other stuff going on. 623 01:17:41,090 --> 01:17:49,070 I was like, okay, well, what's got those one problem solved? But, you know, you know, I thought the whole thing felt so real. 624 01:17:52,070 --> 01:17:58,010 It was like a one line email pretty much, and then we didn't actually have a contract. 625 01:17:58,160 --> 01:18:02,600 So still it's gone back to going back to all our partners and saying, Well, look, 626 01:18:02,600 --> 01:18:06,950 we've got this promise of the money, but we still can't give you a contract or the actual money. 627 01:18:06,950 --> 01:18:10,010 But believe us, so everything run on trust. 628 01:18:14,770 --> 01:18:19,380 And by that point, civil servants, you know, would have already been some scandal about PPE contracts. 629 01:18:19,400 --> 01:18:23,590 The government was worried about due process in the contracts and so on. 630 01:18:25,180 --> 01:18:30,190 Things took a little bit of time to finally sort out, but by that point, 631 01:18:30,190 --> 01:18:41,950 the negotiation with AstraZeneca was on and prior to that Mark was just like a lot going on and it was a whole nother parallel track of, 632 01:18:42,370 --> 01:18:52,420 you know, something that £65 million was to fund manufacturing at 200 litre scale for the UK primarily and. 633 01:18:53,640 --> 01:18:59,170 I done some months, so I've got a spreadsheet for the 3rd of March, I think. 634 01:18:59,170 --> 01:19:03,270 Got something on Lauren's calls. I didn't show it to anyone at the time. 635 01:19:03,270 --> 01:19:07,250 It was too, you know, felt too preposterous. A lot of people think, oh, 636 01:19:07,280 --> 01:19:13,530 was that's called that is a spreadsheet called billion those scale essentially doing the as well how would 637 01:19:13,530 --> 01:19:19,790 we do this if we wanted to make a billion doses and it was apparent we couldn't do that on 200 metres scale. 638 01:19:19,790 --> 01:19:23,670 I couldn't do it in the UK. And so how many doses? There's 200 litres. 639 01:19:23,960 --> 01:19:27,030 When you say do you want a little scale, that's just the size of the best. Yeah, that's right. 640 01:19:27,120 --> 01:19:29,849 Yes, right. Yeah. That's an important that's an important question. 641 01:19:29,850 --> 01:19:36,509 So 200 litres originally our original calculations were that would make a million doses and that turned out we didn't, 642 01:19:36,510 --> 01:19:42,390 we weren't able to get quite that much, but a few hundred thousand doses. 643 01:19:47,420 --> 01:19:56,780 Yeah, that's right. So, yeah, there was this one was one truck of work that was technically doing as a too early to scale a pole. 644 01:19:57,140 --> 01:20:06,320 It was another track of work, which was, well, how do we, you know, essentially the business side of it and and the business side of UK supply, 645 01:20:06,320 --> 01:20:12,950 you know, how do we make it, you know, come to a deal that will allow it to be actually made for real for UK supply. 646 01:20:13,380 --> 01:20:19,330 And there was another truck which was well actually covered bigger and can we do something that was globally relevant because like, 647 01:20:19,460 --> 01:20:27,360 you know, I remember so how many of us, 65 is all there in India and there's quite a lot, you know, and. 648 01:20:28,330 --> 01:20:33,270 You know, it looked like. What might be needed would be billions of doses. 649 01:20:34,800 --> 01:20:37,040 But that was just not the, you know, the idea, you know, 650 01:20:37,050 --> 01:20:41,520 and thinking of making a billion doses before any patient had been injected with a product in a trial. 651 01:20:42,450 --> 01:20:51,850 So I'd have been laughed out of town, but. And there was another, you know, another strand of work on how to do that. 652 01:20:52,120 --> 01:20:58,360 And essentially, as soon as the 65 million for the UK was agreed, as soon as the 200 leads a scale plan was agreed, 653 01:20:58,780 --> 01:21:06,070 we'd already have begun staff who had begun talking about well, well we privately called stream two for the UK. 654 01:21:07,190 --> 01:21:16,630 I say we I mean me and Ian McCubbin on the contract manufacturers which was thousand leads a scale within the economy 655 01:21:17,830 --> 01:21:22,630 various people were on the record a lot of points in the UK couldn't manufacture vaccines in the relevant scale. 656 01:21:23,320 --> 01:21:27,580 There was no weather at 1008 to scale for this sort of product in the UK. 657 01:21:28,090 --> 01:21:35,080 But we figured either physically you could fit the thousand Lisa scale thing, you know, equipment in talks for biomedical clean rooms. 658 01:21:37,820 --> 01:21:42,440 And we figured out the equipment actually didn't cost costs of some million. 659 01:21:42,440 --> 01:21:45,660 But, you know, in the scheme of things, it was not done. 660 01:21:45,950 --> 01:21:51,590 At the same time that we were asking for the 200 litres, you know, 661 01:21:52,370 --> 01:21:57,949 we already knew that really what we wanted was 2000 litres, but we didn't think we could make the ask quite. 662 01:21:57,950 --> 01:22:03,050 Yeah. So how did I feel when we got the 65 million? 663 01:22:03,080 --> 01:22:11,389 Great. But it was just so much a little stuff to do. I think perhaps we better stop because you've got something else to stop. 664 01:22:11,390 --> 01:22:11,690 Because you've.