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Okay. So could you start by saying your name and what your current position is?

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Hello. My name is Dr. Raha West. I'm an anaesthetist, but I'm currently doing a PhD in Perioperative Cancer.

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So that's cancer during cancer initiative, during surgery.

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I've just started doing PGD for a year,

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but before that I was in anaesthetists at Buckinghamshire Healthcare NHS Trust and I was there for about six years before I left to do my PhD.

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Okay, so going back to the very beginning,

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can you just take me through the steps in your career before you reached your position at Buckinghamshire Healthcare Trust?

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Well, to go to the very beginning, I graduated from University of Leicester in the year 2000 and then I did so I did

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the initial training in medicine and then I did a bit of surgery before I thought,

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Oh, I really want to do anaesthetic.

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So I went into anaesthetic training in 2006 it was in Brighton and after I finished Senior Officer Post what it has,

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what it called then is something else now.

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I took time out of training to, to do research, so I landed a job at St George's Intensive Care in tooting exclusively a clinical research fellow job.

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So I was running two commercial trials and it was I feel like it was the best job I've ever done.

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But of course I have to go back and, you know, continue my anaesthetic training.

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I was in north central London, so around UCL Royal Free Hospital and then I met my current husband who works in Oxford.

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So I thought I have to go to London in Buckinghamshire.

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So I went to Buckinghamshire as a senior initiatives in 2016 and when I was there, so I work in theatre,

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I also do a lot of intensive care and I started doing the growth and research again when I was there in 2018.

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I was, I, I, I applied and it was successful to become the Clinical Research Network Research Fellow.

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So I now have affiliation with the Thames Valley in Salisbury, then Clinical Research Network,

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and I'd just be going strong into the research because you know, as a doctor, yes, I you know, my day to day ambition or aim is to save life.

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But I also I felt with research I can stretch it further because it's like an opportunity for me to do more to help people,

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because everything we do as a doctor in rely on the knowledge we know what the previous people have found out and things change.

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They're going to do pathology of disease. T So no ongoing investigation to find out are we doing the right thing?

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Which is what attracts me to research and I'm very, very passionate about research and integrated that into in the clinical care.

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So can you give me a couple of examples of the research questions you've been you were exploring before 2020?

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So I looked at research and any any gaps before 2020.

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I didn't really have any one specific channel, if you like, like for example,

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when I was doing a the in 2008, I was doing the clinical research fellowship.

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We were looking at a study in intensive care how best to sedate, patient and intensive care.

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People get sedation so they can we can rest them and they can, you know, don't don't feel pain,

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you know, of all the potentially invasive stuff they have to face in ICU.

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So we were looking at a type of sedation that could be best in intensive care and then look at things like, you know, infections, sepsis.

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I also at one point look at obstetric research in maternity on during caesarean sections on the best drugs to make your womb contract.

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So you don't believe. So they looked into that as well.

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And then now just thinking it's sort of like where the wind takes me at a time where I feel, oh, that needs answering, you know, before 2020.

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What looks good as well. I've even been so in when I was at books.

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I was reading a study where we want to look at a patient quality of life after, after hospital, after, after surgery.

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So I'm the principal investigator. That means I'm responsible for the conduct of the study at my hospital.

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Of course, you know, the study is from a in a multicenter multi hospital.

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So I'm just responsible for for my hospital. And that was a very good experience I've even been involved with basically, you know, anything like that.

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Oh, that's interesting. I want to I want to help more.

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Basically, I was at Stoke Mandeville, where you were based, which hospital.

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So I was, you know, I was based at Stoke Mandeville and so I was at both.

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So it's under one umbrella of health care and it's just trust.

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So let's finally arrive at 2020. Can you remember where you were or what you were doing when you first heard about the pandemic beginning in China?

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Interestingly, so in the early treatment in January 2020, we had the room was a room back then.

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Coincidentally, I'm actually from Malaysia, so my brother in January had a serious motorbike accident and he was critically

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ill in intensive care and we really thought he wasn't going to survive.

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So I had to go. I had to fly home to Malaysia end of January to support my parents and I really thought my brother was going to die.

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And of course that's when it hit me. It's not a Roomba, you know, there's this thing called COVID 19 because of course,

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to fly to Malaysia, this all the precautions it was it was it wasn't a red country.

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It was amber. I remember a fly to Singapore airport.

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But you have to fill in a lot of questionnaire, temperature check, very you know,

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you have to wear masks at the airports and every like couple of metre checkpoint, they were checking your temperature.

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And that was that was I know generally early in February, obviously in England.

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But then we thought it was just a rumour, you know, we don't know. It's not going to come to us.

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It's just a moment. But I had to go home because my I thought my brother was going to die.

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So it was a very strange experience because now suddenly it's become reality.

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The, you know, the hospital you can only visit because, you know, you have a, you know, important reason like, you know, critically ill relative.

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And if you go to the mall is completely deserted. People don't go out in public.

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And everywhere you go, people were wearing masks on the streets.

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And I thought, you know, wow, this is real.

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And, you know, and then went so of course, then when I came back to England, so my brother survived.

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Thankfully, I came back to England sort of meet February.

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I went into quarantine. I think I was I quarantined for two weeks just on there's no guideline there what you have to do.

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But the department felt that's the safe things to do, you know, because there's no lateral flow tests back then.

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Now. Yes. So just be quarantined as long as you're not symptomatic.

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I came back of from to work, but I feel a little bit if I if I can be honest,

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I felt a little bit uncomfortable because while I was there everywhere, you know,

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people are being, you know,

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wearing masks and then people actually go to crowded area like the mall were completely deserted and so much things in place.

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Like like I said, this airport has so many check up point for temperature.

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But when I arrive in Heathrow, people don't even ask where I just came from.

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So I just felt really uncomfortable and I thought, oh dear, you know, should I be worried?

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So but it is you. I just get on and.

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And then. And then come March. Yes.

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And they hit us, I think it was about 24th of March.

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I might be wrong, but you just hit that. That was when the lockdown started.

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Yeah. That there had been cases. There were cases already before then.

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I think one or two cases and obviously Italy had already demonstrated by then this.

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So I was sort of, you know, made aware of it way before we were worried about it here because I seen it with my eyes,

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you know, like like at the hospital, you know, some hospital.

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How did you immediately dedicate a hospital just for COVID?

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And people were you know, it wasn't a lockdown just yet, but people were just taking a lot of precaution.

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They don't go out and, you know, and all that.

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So and when I yeah, when I was came back, you know, I got a bit worried because we just, you know,

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didn't think it will, you know, come here and then did you start to see cases coming into intensive care was.

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Yeah, yeah. We start to see the cases. It wasn't it was a it was a quite a stressful time, a difficult time being on the front frontline.

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I personally almost feel hopeless because patients coming in exponentially with COVID and it feels like you're getting very,

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very sick and you feel hopeless. Like everything you do with all the knowledge you have, with all the experience you have,

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you still can't help some of them because there was no consensus of what and how you should treat patients.

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So we don't know. You know, we did our best to the best of our knowledge.

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But because we've not been exposed to experience this virus before, we don't know what will work, what's not going to work.

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You know, it's what we do is going to cause more harm, you know?

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You know, so so it was a very difficult time.

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And of course, because the patient, I mean, coming with COVID just keep getting more and more and then more and more of them go to intensive care.

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And a lot of them, you know, they didn't survive. And when you know, when you I'm in my forties,

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so and even in your forties and you have someone younger than you coming in and being previously healthy,

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coming in and then when they die, it really, really is difficult.

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And you asking why? You know, they wouldn't unwell, you know, they didn't have, you know, severe lung problems before they were like me.

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Why did this happen? So so that it was, you know, I personally feel hopeless because yes, you know, I work very hard.

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I do my best to save my life.

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But I can't is to some degree because I need to find answer.

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And then, of course, the recovery trial was, for me, a godsend.

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Yeah, well, let's let's hang on just a second, because the other thing the other aspect of this, of course,

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was that you were having to try to protect yourself from infection and your colleagues, which must have made things even even more difficult for you.

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Yeah, this is a thing that while everybody else locked themselves safe away from the virus at home,

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we have to leave our family, our young children, and face the virus.

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Everybody else, you know, can lock them. So we cut.

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We have to face the virus. And as an anaesthetist and, you know, working intensive care, you are sometimes this, you know,

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so close to the patient's face and their mouths and their cough, because you have to do what you have to do to save their life.

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So you have to you have to intubate them pretty easily.

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Luckily, of course, you know, so so this whole you know,

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the trust quickly implemented a full PPE to protect staff and the PPE is not the most comfortable thing and once you in the PPE,

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so the way the intensive care work will stay, they sort of completely sealed it.

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So like almost if you imagine like an alien movie where people must be very scary for patient as well,

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people wearing you know, these huge with everything's covert you can just see their eye.

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And once you read that you entered what I call the zone, you've seen it in there for about four or 5 hours and it's very, very hot.

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And you sweat it. I sweat from, you know, places that I can sweat from.

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And because when you comes out, when you take everything else, you are soap.

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But, you know, so it's very uncomfortable. I mean, you can't drink, you can't eat.

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You know, you get very thirsty. The masks make me feel very thirsty.

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And I'm, you know, secreting sweat while, you know, also, you know, it was a very I didn't I don't know,

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looking back, I just didn't think I would experience that in my lifetime.

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But I did. Yeah.

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And like I said, it must be also scary with patients who see this sort of must know because I have I'm very smiley.

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One of the things my patient likes about me is my warmth and smile, you know, looking after them,

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you know, when you are in a lot of pain or when you are, you know, very unwell.

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It's just nice to have, you know, a doctor or a health care professional that's very chi.

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You know, it's my I didn't know a lot of my patients said, you know, you're very smiley, you're like the angel sort of thing.

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People see that now because my face is covered with just my eye, although some of them say,

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I could tell by your eye you are smiling, which I thought, you see.

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No, it's nice, but it must be also scary for patient because they are isolated, you know, they can't have their loved one with them because.

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So it's a very scary time. And of course I got COVID in April.

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Oh, so quite soon. Within a month I was when I got it, my son also got COVID.

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He didn't eat for days and he lost a lot of weight. How old is he?

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He was at the time. He was 12.

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So I got cold feet in April quite early on, of course, you know, in the house, we we we took all the precautions of a no fool protections.

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But, you know, it's not I'm nothing. You sign it and I got COVID and I was quite ill, but I didn't need to go to the hospital.

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I didn't want to leave the house because it was bad. So I had I had temperature for ten, the high temperature for ten days.

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I was shaking. It's such an odd feeling to be in that, to feel that high temperature and you shaking and you sort of start seeing things.

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But I said to my mother was not a doctor, so I said to him, I do not want to go to Russia because if I go to the hospital,

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I would never see you is a that's very irrational thinking.

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But when I was ill, that's what I felt.

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I know I'm a not a very rational thing to say, but as a patient, that's what I felt.

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So I said to my husband, only send me to the hospital if my breathing slows down or become very, very fast, or if I'm not myself.

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Otherwise, I'm going to stay at home, you know, be in my own bed.

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But I still I still run to a clinical trial from my bed because I have to look after my team.

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Yeah. So. It was. A unique time of my life, if I may say that.

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Oh, so let's get to the trial. The trial had started even before you you fell ill.

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How did you first hear about the recovery trial? Was there a kind of general call for help sent out randomly all the hospitals?

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Yes, there was a call for help sent out.

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So I when I came back from Malaysia and then I finished my quarantine and then the head of my department said to me, because he knows I'm you know.

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I'm passionate about research. And so he said that this trial called recovery.

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Would you mind looking into it? It's what he said. I said, yes, of course.

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So not only I looked into it, I felt like this is the answer for me.

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I felt like, you know, remember I said, you know, I felt hopeless.

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I felt like I needed more to to help my patient.

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And suddenly there's a trial to try to, because at the time, there was so many uncertainties about the best treatment.

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And so I thought this is crucial, this trial, because this could potentially help us save life from from the virus.

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So what was the trial setting out to do? So the trial sets out to do so.

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It's the it's called an adaptive platform. And what that means is that the trial set to investigate various drugs that we

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already use for something else or to white called repurposed and reused them to see,

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of course, based on experts opinions and some other prior evidence to check what drugs could help save

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patients who to patients separate and under what to to to to help people avoid the ventilator,

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to avoid going to intensive care and to not, you know, save life.

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So that's two. So imagine a platform so the drug can go on the platform, you know, get tested.

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And then once you find an answer yes or no, it can leave the platform.

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While in the meantime, when you find more evidence or more suggestions from the expert group, the drug goes on the platform.

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So we are constantly, continuously looking into various drugs to see which one works,

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which one can helps, how much can it help, what can helps and what does it work?

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You know, because of course, around the time there was a lot of I know people who thinks, oh, like, like, you know, this can work.

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Like hydroxychloroquine was, you know, save like but how would you know unless you do a clinical trial,

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a proper clinical trial that has been, you know, properly thought of approved, you know, so it was very important.

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Like, you know, I remember, you know, the, you know, at one time you couldn't even have if it had settings six drugs on the platform.

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And these are all very different drugs and some of them I have not even heard of,

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but I have to learn very quickly to know that use using out because at the end of the day the response the responsibility of my patient who I,

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you know, entrusted with the trust, it's my responsibility. So I need to know, you know, every detail that I can about the risks.

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Is it going to be safe? Is it going to be safe for this patient before, you know, I recruit them?

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It was it was a very fast learning curve for me because it's a very fast paced trial.

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But I remember thinking so when I look at it, I thought, yeah, this is crucial.

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We must do this and we must do well because what how we you know, how we do it, patient people, life depends on it, I felt.

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But when I look everywhere in the hospital, people are so busy as in healthcare, professional nurses, doctors are so busy, people are so stretched.

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And I thought, Oh, this is not going to be easy because people are so busy saving lives.

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The last thing they want to do is more things. So, you know, but I remember saying to my receptionist, let's just do it.

188
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They don't put a minimum of what you need to to recruit.

189
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So let's just see and, you know, work hard, as you know.

190
00:21:37,530 --> 00:21:41,009
So, yeah, so we, you know, we have a very small team to begin with.

191
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It's just me and my research nurse and then.

192
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But the thing about the trial is it's everything has been stripped back to just answer the racist question which of these struck can save a life?

193
00:21:55,140 --> 00:21:58,230
The protocol was concise. It was clear.

194
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So it was easy for us, the researcher and also for health care professionals to understand this study

195
00:22:05,610 --> 00:22:11,610
is not complicated at all and like to for the research staff to be involved.

196
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They've made short training videos. I mean, videos are a lot easier to watch rather than people's I mean, admitted to them pages and pages of words.

197
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So we watched a video and then we have the understanding, you know, and then we good to go.

198
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So and then but like I said, we have to feel like we have to raise awareness.

199
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People are very busy. They don't have time to read papers. So we put posters everywhere, even into stuffed toilets to say, we're doing this.

200
00:22:38,910 --> 00:22:42,629
This is why we doing this, this is why we need to do this. People are dying.

201
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We need to save life. So, yeah, because the the trial was designed as such that it's been stripped down to the bare essentials.

202
00:22:54,720 --> 00:23:00,330
It was easier for us to promote the trial among the busy clinicians.

203
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And, and we did design also so that it can be incorporated in our day to day clinical care.

204
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So it was very pragmatic and it was easy for patients as well.

205
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So if you just start from the moment where a new patient is admitted with a diagnosis of COVID, what would you do at that point?

206
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So yeah, so it was one of my team will go speak to the patient and said, you know,

207
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it's been confirmed that you have COVID 19 and we're doing this study to try to look at various medication to see if we can save life.

208
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It might not benefit you. It might be might not, but it should benefit other people.

209
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And I think at that time, I mean, one of the unique thing about the pandemic was everybody was in it together.

210
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So it's like, I want to save life.

211
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The research team want to save lives, the health care professionals want to save lives.

212
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Patients also want to do something. So when you go to them and said that this study.

213
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You are eligible because you have covered. I'm not sure if it's going to work on you or not, but you will help other people.

214
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Would you be happy? Most people said yes because people want to have that sense of contribution because we are in it together.

215
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So. So. And then, you know, defined up.

216
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And then you randomise them. So you randomly.

217
00:24:32,160 --> 00:24:38,760
The system randomly allocates this just how clinical trial works, you know, so to avoid bias because otherwise,

218
00:24:38,760 --> 00:24:43,620
you know, so randomly allocate patients to treatment and then they have the treatment for ten days.

219
00:24:43,620 --> 00:24:47,400
And then we look at, you know, how do you get on with your COVID?

220
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Or they might be randomly assigned to just get the standard level of care as well.

221
00:24:52,380 --> 00:25:00,510
Yeah, yes. Yes. Well, because, of course, you have to compare the drug, you know, drugs, I mean, to the routine things that we do.

222
00:25:00,780 --> 00:25:08,880
Yeah. And how far were you just running the trial in your own hospital or did it extend throughout the health authority?

223
00:25:09,240 --> 00:25:16,200
So I was running the hospital at Mandeville Hospital and we cut hospital as well.

224
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Yeah, yeah, yeah. I have a very so I, like I said when I first started was just me and a research nurse.

225
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But we soon realised, you know, we need to form a team to, to spread the work.

226
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Although you know, I was, I was available 24 seven based like for example when I was when I was ill with COVID.

227
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And no, I didn't I think maybe because I was a doctor, I have a very high threshold of according to the hospital, I tolerate a lot more.

228
00:25:49,110 --> 00:25:54,870
I did pass out a couple of times to go to the hospital, but I didn't anyway.

229
00:25:55,980 --> 00:26:04,320
So but I still I still, you know, managed my team from home.

230
00:26:04,650 --> 00:26:10,690
And I mean, you know, say, you know, have you got patients from there any problems?

231
00:26:10,750 --> 00:26:18,780
But I think at one point I feel like if I die, I want to die having helping people.

232
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I know it sounds rather dramatic and it makes me a bit tearful, but that's that is what I felt at the time.

233
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I certainly know because, of course, that was April, because we don't have as much knowledge about where this is going.

234
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There's, of course, that and because at the time we thought, you know, people get coffee can die.

235
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Very easily. Of course. I know. I didn't you know, I did consider that I could die from this.

236
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I know it sounds dramatic by any proof because we don't know much. So I thought I could die from this.

237
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But if I'm going to die, I'm going to die fighting. It's like it feels like going to a war against the virus.

238
00:27:00,980 --> 00:27:05,150
So I want to die fighting. But this is what does it. Oh, you're poorly.

239
00:27:05,150 --> 00:27:09,230
You should just say no. It is just seen as not communicate.

240
00:27:09,840 --> 00:27:15,650
So I want to. I have to, you know, I have to look after the truck so it has safety of the patient in a trial.

241
00:27:15,950 --> 00:27:19,080
So it's so difficult to be emotional because. That's all right.

242
00:27:19,100 --> 00:27:23,060
That's right. Yeah. It's like a war against the virus.

243
00:27:24,350 --> 00:27:28,220
And so most of the patients that you approached agreed to be in the trial.

244
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Yes. I mean, most of the I mean, this is probably the one of the few trial where most patients agreed to be in the trial.

245
00:27:39,320 --> 00:27:41,810
Of course, you know, I did.

246
00:27:42,110 --> 00:27:51,530
I think that the talk about how to promote research in general and promote the trial later I went on the local radio to say,

247
00:27:51,530 --> 00:27:56,210
you know, this is a trial. It being why we doing it, why this is important and why the public should get involved.

248
00:27:56,680 --> 00:28:02,330
And, you know, when people come, sweetie, they get so little informations about the trial before we approached them.

249
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So they have some idea, you know, before you go to see them.

250
00:28:07,430 --> 00:28:11,090
And like I said, you know, the public has been very supportive.

251
00:28:11,100 --> 00:28:15,229
It must be the sense of unity, which is unique to me.

252
00:28:15,230 --> 00:28:22,520
I'm not saying so many people don't unite together, but the the you know, the that time bring people together.

253
00:28:22,520 --> 00:28:30,290
And most people agree to participate in the trial because everyone is aware,

254
00:28:31,070 --> 00:28:35,480
you know, this could be dangerous and people wants to do their part as well.

255
00:28:36,710 --> 00:28:48,590
So so we did very well. You know, we we it was the fastest, quickest trial opens and recruiting to test patients.

256
00:28:48,590 --> 00:28:57,979
So we got the green light. I remember it was the 26th of March, it was a Thursday and Friday, the 27.

257
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We recruited our first patient and then a week later we had 20.

258
00:29:04,280 --> 00:29:12,050
And then in a fortnight we had 70. But I've come to the hospital, you know, the bank holiday weekend in April.

259
00:29:13,370 --> 00:29:16,460
Easter Easter weekend. What is the Easter weekend?

260
00:29:16,940 --> 00:29:22,050
On Saturday, I went in to the hospital from 8:00.

261
00:29:22,070 --> 00:29:26,479
I eat here. I didn't leave until 9 p.m. I went.

262
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I talked to the doctors on call that weekend, I said.

263
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So basically I was building an army because I couldn't do this by myself.

264
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Don't forget, I also have my clinical job. I'm also a doctor in intensive care, which I also do.

265
00:29:39,860 --> 00:29:44,300
So I was building and I decided, yes, I'm going to come in, I'm going to build an army.

266
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I talked to almost all of the medical doctors there. They're all and all I got them all to watch the video to get trained about the trials.

267
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And then me and the army just went and to go and see every patient who has coffee and hospital and we recruit them and we randomised them,

268
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we give them the treatment.

269
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So we, you know, compared to some of the big trusts up north, we are not in a, not a big hospital, we are District General Hospital.

270
00:30:15,500 --> 00:30:22,730
But in the first wave we were the seventh highest recruiter out of 170 each hospital.

271
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That's impressive because I have because I built an army and I have my army.

272
00:30:29,000 --> 00:30:35,690
So but I make myself available for me because, I mean, the well-being of my team is very important to me.

273
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You know, I never take them for granted, like I said. So I did a lot of initiative to to to promote competitive streak I,

274
00:30:46,160 --> 00:30:53,050
I issue certificate because a lot of the team were junior doctors you know they

275
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hungry to get increases experience and they normally don't get a opportunity to be

276
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involved in research so so I said right so you know because also certificate is

277
00:31:03,200 --> 00:31:08,479
always good with these due to not just get to see and then be the name of the,

278
00:31:08,480 --> 00:31:10,340
you know, principal investigator.

279
00:31:11,000 --> 00:31:22,250
So so I have a recruiter of the week certificates A is but didn't and I was fair so if you are not record of the week

280
00:31:22,250 --> 00:31:27,290
there's also engagement of the people who try because sometimes you can try very hard but you might not be able to recruit.

281
00:31:27,290 --> 00:31:32,300
So that's engagement to the trial.

282
00:31:32,540 --> 00:31:37,850
So, you know, the doctor, they were just, you know, it's an initiative which works.

283
00:31:38,240 --> 00:31:42,620
So they like certificates. They work very hard to do to try to recruit.

284
00:31:42,620 --> 00:31:47,900
So basically because the trial is designed as such incorporates your standard care.

285
00:31:48,080 --> 00:31:54,600
So it's not like you have to they'd have to go separately to just to do research, to have they do the award round of medical,

286
00:31:54,620 --> 00:32:02,690
what they see the COVID patients and the consultant, the respiratory, you know, on the COVID team, they all healthy, were amazing.

287
00:32:02,960 --> 00:32:07,790
So they look at how many COVID patients they had taken to see on the wardrobe.

288
00:32:08,360 --> 00:32:12,040
And then they look, you know, what they see, you know, part of the checklist.

289
00:32:12,050 --> 00:32:16,640
So they see the patient or can be, you know, going to recovery, trial or not.

290
00:32:16,640 --> 00:32:22,220
And then we come we said, how many patients do you think is eligible in a for me about.

291
00:32:22,640 --> 00:32:27,620
Oh, yeah, that's okay. That's okay. That's probably not because you know. So yeah.

292
00:32:27,620 --> 00:32:36,780
So it's all incorporated into the standard of care and the individual trainee who has the most patient of the week, you know,

293
00:32:36,830 --> 00:32:44,900
got a certificate and then I do things like, you know, at Christmas, you know, I buy chocolate biscuits for the wards.

294
00:32:45,620 --> 00:32:49,609
It's just something nice things to do for, you know, Christmas or after the blue.

295
00:32:49,610 --> 00:32:58,790
I remember actually Valentine 2021 I bought chocolate biscuits for the what is a personal appreciation you know for

296
00:32:58,790 --> 00:33:07,820
for people for working hard so so yeah so yeah so yes I built an army and in Miami I also I didn't I also thought,

297
00:33:08,240 --> 00:33:17,960
who else can I get in Miami? In Miami. So it's not just doctors, it's not just nurses, people like from the lab, because they have to process blood,

298
00:33:18,200 --> 00:33:24,379
spread the works for them, you know, the pool test as well, because they have to take samples and pharmacies.

299
00:33:24,380 --> 00:33:27,440
Of course, pharmacies is the big, big, big part of it.

300
00:33:27,710 --> 00:33:34,550
I have an amazing can you get real pharmacy on my shoulder with me, you know,

301
00:33:34,730 --> 00:33:41,600
to to guide me so you know it's not a single post an effort at all to guide me to do the trials and and the

302
00:33:41,630 --> 00:33:46,160
drugs that you were putting through the trial where they all things you'd normally have in the pharmacy anyway.

303
00:33:46,160 --> 00:33:49,370
What did they have. Oh, man. No, no, no. There are some of them.

304
00:33:49,370 --> 00:33:54,920
You have to get the mean and some of them are expensive and you have to special order then.

305
00:33:55,220 --> 00:34:02,750
So it's it's not, you know, it's not just something from the coverage, you know, but obviously,

306
00:34:02,750 --> 00:34:09,170
you know, the expert expert group has enabled this this site, what drugs should go on the platform.

307
00:34:09,800 --> 00:34:14,310
They funded the overall central. They had funding for all that did they.

308
00:34:14,370 --> 00:34:18,990
Yeah, exactly. Yeah. He's yeah, yeah, yeah.

309
00:34:19,000 --> 00:34:22,260
So how soon did you start to see what I know?

310
00:34:22,260 --> 00:34:26,970
The study came out with one important result, but two important results quite early on.

311
00:34:27,570 --> 00:34:34,080
Was that something that you felt you could share in the in the importance of that, those findings?

312
00:34:34,170 --> 00:34:39,329
Yes, of course. So so we started a trial. We could have a speech in 27 of March.

313
00:34:39,330 --> 00:34:42,750
And then the the first result next metazoan came in May.

314
00:34:43,750 --> 00:34:54,220
So we were extremely happy because although patients are randomised so as in we can't be too mean what they get.

315
00:34:54,640 --> 00:34:58,450
But so that shot, that shot for dexamethasone.

316
00:34:58,450 --> 00:35:08,230
So I was known as the next finger because every time I press the button to randomise, I got dexamethasone myself, not again.

317
00:35:08,720 --> 00:35:11,470
So she's the next finger.

318
00:35:11,650 --> 00:35:19,090
So of course, this is a completely random, you know, but by chance rather, you know, just by chance, you can still get the same thing.

319
00:35:19,090 --> 00:35:28,360
So, so. So when Dex was one of the first major result that comes to us to save life, I was like, Well, thank God I had index finger, but I didn't.

320
00:35:31,000 --> 00:35:36,219
So we were happy. Happy. We thought, Oh, let's have some, you know, some non-alcoholic bubbly.

321
00:35:36,220 --> 00:35:44,440
So we could have some non-alcoholic bubbly when we heard the results because we felt, you know, we contributed to that for that.

322
00:35:45,520 --> 00:35:50,169
And how quickly was Dexamethasone then incorporated into the standard of care straight away?

323
00:35:50,170 --> 00:36:01,719
Because obviously that is something that's available that we use, you know, as an initiative during tests or, you know, or in ICU.

324
00:36:01,720 --> 00:36:05,440
So it's it's drug we already have to know is cheap.

325
00:36:06,410 --> 00:36:11,750
Which which makes it even better to to to repurpose the drug.

326
00:36:11,750 --> 00:36:22,550
So. And did you did you see could you from your personal experience, see the number of deaths falling and the severity of disease falling?

327
00:36:23,600 --> 00:36:27,650
Oh, it's hard to say, though, because obviously it's all relative.

328
00:36:28,040 --> 00:36:39,139
Like if you see three people die out of what number? So it's you know, I can't say I see people, you know, so it has to be comparative.

329
00:36:39,140 --> 00:36:45,290
So, you know, I'm I'm not sure I can say that, but be the knowledge we have, you know, out of, you know,

330
00:36:45,290 --> 00:36:54,080
thousands of people, you know, significantly a significant number of people have better outcome.

331
00:36:54,470 --> 00:36:59,200
That itself is reassuring for me. Yes.

332
00:37:01,090 --> 00:37:05,050
And how long? So the study has continued meaning? I think the study is still active today.

333
00:37:05,080 --> 00:37:08,080
Is it is it not. Yeah, actually. See I. Yeah.

334
00:37:08,120 --> 00:37:19,810
So I, I so I was the principal investigator from March 2020 and I left a year later.

335
00:37:21,490 --> 00:37:34,330
I left the trial August 2021 because October 2021, I, I went to do a full time Ph.D. in cancer.

336
00:37:37,170 --> 00:37:44,610
Although again, you know, the max sort of after COVID for me personally, after COVID 19, cancer isn't that pressing,

337
00:37:44,670 --> 00:37:53,159
Max pressing, you know, a thing where, you know, one in two people can die from cancer.

338
00:37:53,160 --> 00:37:58,980
So and unfortunately, you know, during the pandemic, cancer had to take a slight step back.

339
00:38:00,570 --> 00:38:03,660
And so it's a it's another pressing issue.

340
00:38:03,660 --> 00:38:07,889
So. So I'm doing my patient that I bureau college London.

341
00:38:07,890 --> 00:38:16,110
So yeah. But doing so during the first part of 2021 as the vaccination was beginning to come become available.

342
00:38:16,680 --> 00:38:26,129
Was the pressure lessened in the hospital or were you still seeing a lot of COVID patients in the I mean, this the first part of 2021.

343
00:38:26,130 --> 00:38:31,230
What? Yes. Yes. And because I guess so.

344
00:38:31,230 --> 00:38:34,500
Because I was involved in two vaccine trials as well.

345
00:38:34,800 --> 00:38:48,230
Oh, yes. It's here in Oxford. So, um, these were certainly like maybe sort of meet week 22 and because the first cohort of each was in the 80 plus,

346
00:38:48,240 --> 00:38:51,960
it was, it was offered a vaccine in early 2021.

347
00:38:53,010 --> 00:38:56,909
So we were sort of meet 2021.

348
00:38:56,910 --> 00:39:07,020
We did, you know, it did down if you like the but but by the by the second and the very second wave of the pandemic,

349
00:39:07,020 --> 00:39:14,640
it was nothing, you know, not not as severe as or as scary as the first wave, because we have some treatment.

350
00:39:15,060 --> 00:39:19,830
We have now knowledge about what we, you know, ups against.

351
00:39:20,190 --> 00:39:23,970
And of course, the vaccine has been in roles.

352
00:39:24,240 --> 00:39:32,310
So, you know, we are seeing a lot less of COVID things are, you know, not as bad as it was in April, May, June.

353
00:39:32,670 --> 00:39:43,650
So the vaccine has certainly made a difference when it was all and roles and and like as a health care professional I felt more protected as well,

354
00:39:44,130 --> 00:39:48,390
having been vaccinated at working facing the virus.

355
00:39:49,140 --> 00:39:55,890
You know, of course it's not 100%, but I felt, you know. I'm slightly for my shield.

356
00:39:56,070 --> 00:40:03,330
You know, it's more than just the hood and the snow surgical gown.

357
00:40:05,100 --> 00:40:16,730
Yeah. So. Yeah he was a very and present president to time is certainly an interesting turning point of my life.

358
00:40:18,170 --> 00:40:24,080
But one thing that was obvious to me was my passion for research.

359
00:40:25,050 --> 00:40:29,130
Because I was willing to die for it.

360
00:40:31,880 --> 00:40:37,320
Mm hmm. And what's your what do you see yourself doing in the future?

361
00:40:37,560 --> 00:40:40,920
Are you going to be working full time when you're free for the next three years?

362
00:40:41,430 --> 00:40:47,310
So I'm currently working full time on my Ph.D. because there's no point delaying it.

363
00:40:47,610 --> 00:40:55,000
And then after my Ph.D., I'm going to pursue the same subject for definition.

364
00:40:55,020 --> 00:40:59,900
So my focus. But the pandemic.

365
00:41:01,100 --> 00:41:09,140
So on a personal level, mix makes it obvious to me where my true passion is, which is research.

366
00:41:09,170 --> 00:41:17,200
So from now on, I'm going to spend the other half of my career, if you like.

367
00:41:17,210 --> 00:41:27,890
I said, I'm almost 50, the other half of my career focusing on on research, based on my experience, based on my talent and my passion.

368
00:41:27,890 --> 00:41:33,490
I think being passionate and a desire to think about something is probably the most important thing.

369
00:41:33,500 --> 00:41:38,150
You might not be that good at it, but you can be better because you want to do it.

370
00:41:39,500 --> 00:41:46,880
In it. You want to wake up at 7:00 in the morning and work for 10 hours straight and not even,

371
00:41:47,240 --> 00:41:50,899
you know, be aware of your surroundings because you're so in the zone.

372
00:41:50,900 --> 00:41:54,440
So that's what I, I feel like with this research.

373
00:41:55,310 --> 00:42:02,420
But the research questions that you're addressing are all I think were very sort of near clinical that near.

374
00:42:02,720 --> 00:42:05,920
Oh, yeah, yeah, yeah, yeah. Exactly. Practice. Yes, exactly.

375
00:42:05,930 --> 00:42:11,930
I mean, all of the research questions that I'm addressing is to do with patient.

376
00:42:13,410 --> 00:42:18,090
You know. You know how how how can it help save life?

377
00:42:18,090 --> 00:42:24,060
How can it you know, how can it effect patients or how safe is appropriate for patients?

378
00:42:24,270 --> 00:42:29,390
So safety aspect is also important to me because, you know,

379
00:42:29,400 --> 00:42:35,670
you can do a lab experience and give some toxic dose or something, you know, and show that, you know, helps cure cancer.

380
00:42:35,670 --> 00:42:39,060
But can you give that to the patient? You call me.

381
00:42:39,480 --> 00:42:46,110
So. So you're but your research is therefore you're going to need to have collaborations with clinical doctors in clinical practice.

382
00:42:47,190 --> 00:42:51,269
Oh, yes, exactly. So it's not a it's not a big data type study.

383
00:42:51,270 --> 00:42:56,970
It's actually. No, no, no. My, my, my, my research is is is patient based.

384
00:42:57,270 --> 00:43:02,100
Clinical based. Yeah, absolutely. Yeah. No, at the moment, no beta.

385
00:43:07,510 --> 00:43:12,070
Well, I think we've covered pretty much everything that I had on my list.

386
00:43:15,990 --> 00:43:20,130
Yeah, I suppose. I suppose the question I could finish with this.

387
00:43:21,300 --> 00:43:25,530
As you said, it was an unprecedented time living and working through the pandemic.

388
00:43:25,710 --> 00:43:33,420
Yes. If, God forbid, it were to happen again, what would you like to see done differently this time?

389
00:43:35,050 --> 00:43:38,990
If he was to happen again. Well.

390
00:43:40,620 --> 00:43:45,600
I know how important research is.

391
00:43:45,990 --> 00:43:49,680
Do you know during the uncertainty time.

392
00:43:49,680 --> 00:44:00,660
So. So. And having had the experience to how to run a massive clinical trial among the very, very busy,

393
00:44:00,870 --> 00:44:09,749
stressful, understaffed environment, a lot of the hard work, you know, has been cut back.

394
00:44:09,750 --> 00:44:15,210
So I know it's almost like. Right. We know how what what went well last time.

395
00:44:16,410 --> 00:44:21,530
We're going to do this and even better. I mean, almost like so.

396
00:44:21,530 --> 00:44:26,960
I mean, the pandemic effects everyone differently.

397
00:44:27,380 --> 00:44:33,350
And I think no, I'm sure not a single person on earth was not effected by COVID 19 one way or another.

398
00:44:34,190 --> 00:44:38,540
But on a personal level, for me, I have learned a lot.

399
00:44:39,380 --> 00:44:48,230
I can even go as far as saying I feel privileged to have the experience because it makes me grow.

400
00:44:48,530 --> 00:44:52,759
It makes me question what I want in life.

401
00:44:52,760 --> 00:45:04,970
And I decided I want to pursue more experience in research and I'm doing a BBG and it was a privilege to experience delivering the trial because,

402
00:45:05,720 --> 00:45:15,350
you know, I had I feel like I had opportunity to do more for patients, for for clinical staff, because we didn't just run the trial.

403
00:45:15,350 --> 00:45:20,120
We also promote research to doctors, nurses and students.

404
00:45:20,840 --> 00:45:24,020
You know, I had trainees I even had medical student in my army,

405
00:45:24,380 --> 00:45:30,500
and they had a policy to be involved in research, you know, where they might not have otherwise.

406
00:45:30,770 --> 00:45:34,820
And most of them enjoyed the experience and so have I.

407
00:45:35,120 --> 00:45:46,820
So, you know, because the recovery trial was built into routine clinical care, and I think that was one of the key that made it extremely successful.

408
00:45:47,180 --> 00:45:51,229
And I felt that should be the benchmark for future trials.

409
00:45:51,230 --> 00:46:00,500
So for my own personal experience, for the future, I like to incorporate that to routine care as much as possible,

410
00:46:00,500 --> 00:46:04,970
to not at burdens to people, to to to health care professional.

411
00:46:05,210 --> 00:46:14,000
I have learned a lot and I'm extremely grateful for the experience and to have survived the pandemic.