Michelle Donelan: The Government’s new Turing scheme will open up the world to British students

28 Dec

Michelle Donelan is Minister of State for Universities.

When things become too familiar, it can be comfortable to sit back and enjoy their benefits, never stopping to consider whether the old, established parameters still meet the needs of the present day. The thought of losing it becomes a wrench. Even if what is being offered in exchange is clearly better, the original has acquired a totemic nature that goes far beyond its present value.

Such can be the only explanation for the cries of dismay from some quarters that greeted the news last week that the UK government would be establishing a new global Turing scheme for students, following our decision not to continue participation in the EU’s Erasmus+ scheme.

I can understand why some people feel this way. Many prominent commentators, newsreaders or academics may have used Erasmus, or perhaps their children or friends did. It is easier to imagine what you know, than to visualise the benefits of what is being brought in. However, the simple reality is this: if anyone was creating a student exchange scheme for Britain today, would they really settle for Erasmus+?

Why would we wish to limit an exchange programme to the EU, when the fastest growing, most vibrant and dynamic countries are increasingly found in Asia and Africa – not to mention our old allies in North America, Australia and New Zealand? Some forward-thinking universities have already established exchange programmes, and even campuses, outside of Europe, and I commend them for that, but they deserve our full and whole-hearted support, not exclusion from the Government’s principal funded scheme.

It is also the case, unfortunately, that Erasmus’s benefits went overwhelmingly to students who were already advantaged. The language barrier meant that it was very hard for students not already studying a modern foreign language to take part, to flourish at their chosen university and get the most out of the academic experience. A 2006 study found that of those taking part in Erasmus from the UK, 51 per cent were from families with a high or very high income.

In 2014-15, those with parents in managerial or professional occupations from the UK were taking part in Erasmus at a rate 50 per cent higher than those whose parents had working class jobs – and the gap was widening. Of course, no-one would wish to prevent such students from studying abroad; but where Government support is concerned, surely it should be about ensuring all students have a fair and equal shot at studying abroad or going on an exchange.

That’s why the Government’s new Turing scheme will explicitly target students from disadvantaged backgrounds and areas which did not previously have many students benefiting from Erasmus+, making life-changing opportunities accessible to everyone across the country. It will be backed by over £100 million, providing funding for around 35,000 students in universities, colleges, on apprenticeships, and in schools to go on placements and exchanges overseas, starting in September 2021.

The programme will provide similar opportunities for students to study and work abroad as the Erasmus+ programme but it will include countries across the world and will deliver greater value for money to taxpayers. And it will be named after one of our greatest British scientists: Alan Turing, a pioneer of computing and cryptography, a hero of the Second World War and who himself studied abroad as a Visiting Fellow at Princeton.

Of course, none of this is to decry Erasmus+: undoubtedly, those who took part in the scheme benefited from it. However, the fact is that it is simply too limiting for the global Britain that we aspire to. Of the hundred best universities in the world in the QS World Rankings, only twelve are in the EU. If we have stayed with Erasmus+ it would have cost several hundreds of millions of pounds to fund a similar number of exchanges, not have been global in nature and continued to deliver poor participation rates for young people from deprived backgrounds.

In the future, we will see young people from Bolsover and Bishop Auckland studying in the Ivy League; entrepreneurs from Dudley and Derbyshire learning from the dynamic economies of Malaysia, Vietnam and Indonesia; and our best budding engineers from Hastings and Hartlepool inspired by world-leaders at MIT or the Indian Institute of Technology. The Turing scheme exemplifies the spirit of Brexit, opening up our opportunities, our hearts and our horizons to the whole world.

David Davis: My prescription for a Covid Plan B? A strategic dose of vitamin D.

26 Oct

David Davis is a former Secretary of State for Exiting the European Union, and is MP for Haltemprice and Howden.

Remdesivir, the much-touted anti-Covid drug, has failed its tests, and has been shown not to prevent any deaths. Vaccines, touted for September, are now delayed at least until the second half of the winter, will be rationed, and are expected to be only partially effective.

Meanwhile, the various lockdown strategies tried by the government are of variable effectiveness, somewhere between partial and zero in their impact. The Government’s scientific advisers are recommending temporary lockdowns without hard evidence of their effectiveness. Only last week they admitted that the evidence base for the so called non-pharmaceutical strategies are “weak”, but that urgency requires their use.

Lockdowns have enormous economic cost, and have deadly side effects on the general health of the nation. Indeed if the lockdown strategy were a drug, it would have failed to meet the criteria that have now led to the rejection of remdesivir, hydrochlorquine, and countless other more or less promising medicines.

And the trouble with the “temporary” lockdown is that, without a very fast and effective test, track and trace system, backed up by a rapid isolation strategy, the lockdown will go on for months. The harm to lives and livelihoods will be enormous.

So what now? Is there an escape from this nightmare? Is there a game changer available to us that will allow us to create an effective plan B? I believe that there is.

In early May, I wrote to the Health Secretary pointing to two studies showing a strong association between the incidence and severity of Covid-19 with vitamin D deficiencies in the patients.

Vadim Backman, one of the authors of one of those studies, said about healthy levels of vitamin D that “Our analysis shows that it might be as high as cutting the mortality rate in half”.

Now I am a sceptic when it comes to vitamins and supplements. The supplements industry has a few too many salesmen too willing to make bogus or overblown claims for products that have are mostly harmless – but also mostly useless.

But this was a little different. The claims were, and are, coming from highly respected scientists, the vast majority of whom had no commercial interest. And the arguments were scientifically plausible.

Most of us learned in our GCSE science courses that vitamin D was important to calcium uptake for building healthy bones. Deficiency led to rickets and other bone diseases.

But less well known is that since the mid 1980s there have been a series of scientific discoveries that showed that the the role of vitamin D was massively greater than had previously been understood. Every cell in the body had a vitamin D receptor. At sufficient concentrations, the vitamin switches on thousands of genes.

In particular the immune system seemed to be hugely dependent on the availability of the vitamin. It enhances both innate immunity – the original primitive immune system that is the primary defence of young children – and adaptive immunity, the system that creates antibodies to kill pathogens.

Every year that passes sees more and more scientific insight into the role of vitamin D in resisting disease and controlling inflammation. There is hard evidence in particular in the role of vitamin D supplementation in resisting respiratory diseases. It can help suppress colds, influenza and pneumonia, which fact I also highlighted in my letter to Matt Hancock.

When the Secretary of State referred my letter to NICE, the Government’s body that assesses drug effectiveness, they essentially rejected it on the grounds of insufficient evidence. The evidence was, of course, stronger than for there so called “non-pharmaceutical strategies”, but that was not a matter for NICE. And since then, there has been a non-stop stream of supportive evidence.

Before we get to the hard science, there is already a vast amount of circumstantial evidence. Everyone is well aware that the risk of dying from Covid-19 is significantly increased if you are elderly, obese, come from a black or minority ethnic background or have a pre-existing health conditions such as diabetes.

A very large proportion of all those groups are people with Vitamin D deficiency. Of itself, that implies that vitamin D deficiency may be the common cause.

There are clear correlations with latitude and seasonality in the severity of the disease. Basically, the more sunshine, the more vitamin D, the fewer deaths. The exceptions are countries like Spain and Italy, whose cultural traditions (of covering up) lead to very low vitamin D levels, and to higher death rates. The example the other way is the Nordic countries, who are very northerly, but whose diet is either naturally or artificially rich in vitamin D.

So the physiology and biochemistry implies that there is an immunological effect. The evidence all around us implies that there is an effect. But for the scientists we need hard data.

When I wrote to the Health Secretary, I laid out observational studies that had shown a significant reduction in infections, and a dramatic drop in the death rate above a certain blood level of vitamin D.

Since then, the evidence showing that vitamin D might help prevent Covid turning serious in some people continues to grow.

The gold standard of medical research is the randomised control trial. At the start of the pandemic we did not have such evidence, and NICE highlighted this in their June review.

However, since the review, researchers in Spain have published the results of the world’s first randomised control trial on vitamin D and Covid.

The results are startling and clear-cut.

The trial, which took place at the Reina Sofía University Hospital in Cordoba, involved 76 patients suffering from Covid-19. 50 of those patients were given vitamin D. The remaining 26 were not. Half of those not given Vitamin D became so sick that they needed to be put on intensive care. By comparison, only one person who was given Vitamin D requiring ICU admission.

To put it another way, the use of Vitamin D reduced a patient’s risk of needing intensive care 25-fold.

Two patients who did not receive Vitamin D died. None of those on vitamin D died. While the sample size is too small to conclude that Vitamin D abolishes the risk of death in Covid patients, it is nonetheless an astonishing result. Again, it is consistent with earlier studies showing large reductions in mortality.

This is just one element of the growing body of evidence showing a link between Vitamin D and Covid-19 outcomes. Recent analysis by Ben Gurion University suggests supplementation can cut the risk of infection from Covid-19 in half in some of the most at-risk groups. This 1.3 million person study backed up the conclusions of a previous 190,000 person research project in America. The mass of evidence is building and building.

Thankfully, the Government at last appears to be acting on this.

Last week, the Health Secretary confirmed his Department would be looking again at the evidence. He also confirmed that the Government would be increasing the public messaging around Vitamin D supplements. Crucially, he confirmed there are no downsides to taking supplements.

The vitamin D levels in the blood of the British population halve over the winter, which is one reason we catch so many colds then. They started going down in September. So this announcement is long overdue. Nevertheless we still have just enough time to act on this.

Vitamin D is readily available and – at a penny per pill – it is incredibly cheap. Providing supplements to those at risk due to pre-existing conductions, such as diabetes, would cost £45 million: to these, plus to every ethnic minority citizen, about £200 million.

For a little more, we could do what the Nordic countries do, and fortify some basic foods with vitamin D. And for tiny amounts of money, we could repeat the Spanish experiment in every British hospital, elevating vitamin D levels in Covid patients on arrival, cutting down the demand for ICU treatments.

These expenditures are trivial amounts compared to the £12 billion spent on test and trace and the billions being pumped into the NHS to help it through the crisis.

Furthermore, providing supplements for those at most risk would also help reduce other pressures on the NHS through the winter months, as we know Vitamin D can reduce the likelihood and severity of other acute respiratory illnesses, which flare up annually around this time. Imagine the thousands of lives that could be saved even if we just made prescription mandatory for care homes?

If we were really ambitious, we could fortify our food with it. Sweden puts it in milk as a matter of course, as do some of their Nordic neighbours.

In summary, correcting vitamin D deficiency could halve the infection rates in vulnerable groups: in addition it could more than halve the death rate for those who do get infected. At a time when we are considering yet another lockdown, with all the damage that that could cause, this could be a game changer.

Add this to the better techniques in medical handling of serious cases, and the availability of dexamethasone for the most severe. These are already cutting death rates in ICU from about 50 per cent to nearer 30 per cent. Combine it with the better organisation of hospital care which is now underway, and perhaps reinforce that with use of the Nightingales to isolate more infected people (rather than just as overspill capacity).

The pandemic mortality rate, properly managed, would begin to approach the severity of a serious flu outbreak. At that level, we would no longer need the massive economic self harm of national lockdowns. And as that pressure comes off, there may be a chance of the track and trace getting ahead of the disease, and controlling it further with a hyper-localised strategy, similar to the successful German and South Korean ones.

So while the review of the evidence is underway the Government must take the first step towards addressing the issue.

The Government must at very least provide free supplementation to the at-risk groups. This will no doubt save thousands of lives across the winter months and, in Matt Hancock’s own words, supplementation has “no downsides”. The odds of success are seriously better than the government’s existing strategy. Accordingly, the precautionary principle makes this a no-brainer.