editorial arguing that the pandemic response by the clinical academic community has been poor and ineffective - not a time for fancy science, boots on the ground - and top down / public health style intervention approaches - ?can you find an example of when a disease was properly tackled - ?? - these things can be answered quickly - simulation to show numbers needed considering the typical hospital LOS - without evidence - drugs cause harm: cite the SARS steroids and ribavirin articles - not just about drugs, intensive care: a complex intervention - the processes are super important: wit the decision to build Nightingale - two key delivery issues - ventilators: depends on the early vs late IMV qn - fluid management: current shortage of RRT - bigger question: switching off acute medical services? - nonCOVID harm - general trial points - late endpoints: 30-90d - remap-cap modifying primary endpoint - slow recruitment: remap-cap 227 - specific trials - recovery-support - london hospitals not recruiting - not appropriate design wrt to endpoints - remap-cap - https://clinicaltrials.gov/ct2/show/NCT02735707 - complicated; slow but the right approach; needs to be mandated but with simpler more agile data collection