估计表明，由于大流行期间的科学进步，已避免或避免了数百万死亡。在一个纸入卫生研究政策和系统we addressed questions about how advances were so rapid, and why national death rates varied so much.
Rapid development of the first effective therapy
Trials were conducted to find new uses for existing (ie, re-purposed) drugs that had already been shown to be safe to treat other illnesses. In the UK, the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial was designed so it could efficiently test a range of existing drugs simultaneously. These included dexamethasone, a widely used corticosteroid.100天内, much quicker than usual, RECOVERY identified dexamethasone as the first treatment in any country proven to improve survival from COVID-19.
英国的卫生研究非常协调，因为卫生部国家卫生研究所（NIHR）嵌入了整个NHS中的每个医院信托基金。通过确保遵守少量与共同相关的紧急国家优先事项，这加快了进步。此外，这意味着该国的所有170多家医院信托都培训了医疗人员的研究能力，因此after reorganisation if necessary, they could participate in the RECOVERY trial. There was also accelerated ethics approval, and enhanced data access and sharing.
一旦证明了减少死亡的有效性，这些发现就以类似记录的快速时间发布。皮质类固醇相对便宜且广泛使用。
第一次疫苗的快速开发
我们还分析了英国，美国和德国在英国的共同开发疫苗的开发如何比以往任何时候都快。上述健康研究系统的某些功能在加速进度中起着作用，但其他功能更为重要。
在这3个国家 /地区，到2019年底，长期研究在创建开发疫苗的新平台方面取得了长足的进步。莎拉·吉尔伯特及其同事牛津大学的詹纳学院（Jenner Institute）开发了一个新平台。他们后来与阿斯利康合作。
A different new platform had emerged from long-term research onmessenger ribonucleic acid（mRNA）。美国大学的研究包括KatalinKarikó和Drew Weissman在宾夕法尼亚大学的重要工作。这导致了专门创建的现代公司的进一步发展。医学学术学院的Uğurishin和ÖzlemTüreci还在德国的Mainz University在德国的Mainz大学进行了研究，后来创建了Biontech，后来与Pfizer合作。
幸运的是，对于人类而言，一旦发现并于2020年1月上旬鉴定出新的SARS-COV-2病毒基因组并发布了新的三个新平台。
现有健康研究系统的许多部分，包括监管机构和试验能力，重点介绍了疫苗研究。拥有前所未有的资源集中，包括财务 - 尤其是在美国Operation Warp Speed，团队能够取得如此迅速的进步。有时，关键阶段是安全地进行的。
High quality trials capacity developed in preceding years in countriesincluding Brazilalso played an important part in testing vaccines developed by both Oxford/AstraZeneca and in China.
Many died, but fewer where evidence informed policy
可悲的是，尽管取得了这些成功，但许多人在接种疫苗之前已经死亡（此后少数人），而治疗只能节省一定比例的重病患者。土著和其他少数民族社区的死亡率通常更高，在全球范围内，无法获得疫苗和新药。
According to世界表, by the end of 2021 just 10 people per million population in New Zealand had died of COVID, and just 86 per million in Australia. In contrast, and despite the scientific progress, 2,172 per million had died in the UK, 2,536 in the US, and 2,882 in Brazil. Canada and Germany were in the middle of the spectrum, but with much lower death rates than the UK.
the agile response of highly skilled and experienced researchers in close partnership with policymakers through the Emergency Response Priority Research workstream has ensured health decision makers have had the best possible local evidence on which to base operational decisions.
Many factors such as location helped explain the level of success in controlling the virus. A major factor was that many lives were saved by political leaders adopting evidence-informed non-pharmaceutical interventions including lockdowns and mask mandates to control the virus in their jurisdictions, but these policies were introduced at different speeds and levels in different countries.
At crucial times, policymakers in巴西, the英国，和我们(especially under President Trump) are reported to have given insufficient attention to the scientific evidence on how best to control the virus.
A culture of decision-makers working with researchers to use evidence to produce and communicate policies is a key aspect of health research systems, and was a feature of successes in Australia, Canada, New Zealand and initially Germany.
澳大利亚看到了广泛的努力，以建立研究人员与政策制定者之间的现有联系，尤其是在新南威尔士州, where, an evaluation claimed: “the agile response of highly skilled and experienced researchers in close partnership with policymakers through the Emergency Response Priority Research workstream has ensured health decision makers have had the best possible local evidence on which to base operational decisions.”
我们两个人指出大流行, that despite some challenges with producing and using evidence, “Compared to many countries, Canada holds evidence in high regard.” Prime Minister Justin Trudeau emphasised the importance of investing in scientific research to inform decisions.
科学，科学家和科学传播者一直处于政府的最前沿……从新西兰消除Covid-19的斗争。
在新西兰，卫生研究系统战略强调将研究结果转化为政策和实践的重要性。总理贾辛达·阿尔登（Jacinda Ardern2020年报告:“科学，科学家和科学传播者一直处于政府的最前沿……从新西兰消除Covid-19的斗争。”
Globally, despite all the successes of research systems, the pandemic created many challenges that need to be addressed, especially for non-COVID, early career, female and minority researchers.
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