Professor Paul Klenerman (Class of 1981)
Paul Klenerman is Professor of Gastroenterology in the Nuffield Department of Medicine at Oxford University and has been researching diseases including HIV and Hepatitis B and C for over 30 years. Now, he and his team are working on COVID-19. Paul was at CLS, starting in Old Grammar, from 1972-1981, going on to study medicine at Cambridge and Oxford, including a PhD into immune responses to HIV. Having taken up fencing at City, Paul went on to be British Sabre Champion – and to represent Great Britain at the 1984 Olympics in Los Angeles.
How would you describe your job if we met you at a wedding?
I work in infectious diseases and immunology. I study viruses and vaccines… at the moment my work is totally focused on COVID-19. More usually, it has been other viruses, particularly Hepatitis C and other aspects of immunology, relating to viruses and immunology.
At what age did medicine first interest you as a potential career?
I sort of drifted into medicine because I thought it was interesting. I certainly didn’t have a burning desire to do infectious diseases. I didn’t even know what it was. I just kind of wanted to have a go.
Everything I’ve done has been more or less a fluke. I’ve ended up in infectious diseases because I bumped into somebody on the stairs when I was looking for a job and they said, ‘Why don’t you try this.’ It was at the time of the HIV epidemic, and people said, ‘Why don’t you apply for some funding to do a PhD?’ And I thought that sounded like a good idea. The PhD, frankly, didn’t work at all but I discovered something interesting in the immune response and it all led from there.
Everything has been a bit like that: a series of flukes, many of which have led to dead ends and others have been really interesting.
At schooI, I liked all the sciences – I didn’t actually do Biology A-Level though – and I liked the idea that, in medicine, you could apply the sciences to something.
I think people should just approach their career choices with an open mind; do something they think they might enjoy and see where it takes them.
The job I am doing now didn’t exist when I started medicine. You can’t predict too far into the future.
Can you remember your first day at school?
My parents had been offered a free place to a fee-paying school for me by Barnet council, under a scheme that no longer exists.
I was a fish out of water on my first day. I’d come from a primary school where there were no rules – or not many – and I’d spent my time doing art and playing football. So I found the whole thing very bewildering at first.
But City was really friendly and fun and encouraging. People weren’t jostling for position. I remember a very brilliant speech by the head boy when I first got there. He was also a free place student. He talked about all the opportunities he’d been given and how the school had changed his life….
There was a very encouraging approach which, I suppose, has influenced my attitude towards life – just to see everything as an opportunity.
The timescale for medical research during the pandemic must be on a more urgent footing than usual?
The Covid-19 work has been prioritised massively; funding has been accelerated very quickly to allow researchers to get on with it and people are getting their findings and information out there very quickly online. There’s usually this lag between research and publication – but a lag of even a couple of weeks in the current context is quite a lot.
Will the rapid response to this crisis change your methods for all future projects, too?
Yes, I hope so. We have that discussion a lot. We’ve seen how quickly people can come together as a unit. We’d like to be able to carry that through in looking at things – maybe in a slightly more measured way – on other projects.
What can you tell us about the research you are doing?
There’s four bits to it. One is to develop antibody tests, which are really important to understand who has already been exposed to Covid-19 and therefore who is protected. If you want to get out of lockdown and make predictions about how to protect people, that test is crucial.
Another strand is to try and find predictors of why certain people get sick and others don’t.
A third strand is to see how we can intervene to treat the sickest patients, in intensive care.
The fourth is about a group of cells that I’ve worked with for a long time – T-cells: what kind of role can they play? If patients have previously had related viruses, is their reaction to Covid-19 better or worse?
Is there something that we can do in terms of lifestyle or diet that will in itself boost our own immune systems?
I get asked this a lot and I wish I had a better answer! It’s quite easy to identify things that make your immune system weaker. Deficiencies of minerals and vitamins can depress your immune system. But it’s hard to actively improve your system by actively taking in more vitamins and minerals. I wouldn’t say the door was closed on that but there’s not that much evidence so far.
Exercise definitely boosts a process called autophagy which is involved in cleaning up cells and making sure they function well. Boosting that certainly improves people’s life spans and it looks as though it could improve the quality of your immune system.
The other thing to say is that one of the big risks in society at the moment is obesity and Type 2 Diabetes and that sort of metabolic stress on the body can impair immunity – so avoiding those conditions is really important.
What might the timescale be for a successful, tested vaccine for Covid-19?
Everybody has said about a year minimum… that would be incredible because normally it takes many years, not just to test it but to develop and organise trials. The Covid-19 sequence was first described in January so to have a vaccine ready to go to trials in Oxford in April or May is very very quick.
To confirm whether a vaccine will protect humans against Covid-19 is the slow bit, because you have to wait for them to get infected or not. That depends on how much infection there is around. The better job we do with social distancing the harder it is for the vaccine to be tested.
Just for context, I was involved in a Hepatitis C vaccine study… we waited for people to get infected or not and it took at least five years for that trial to read out…
I don’t think you can speed that part up. Only by making the number of people in the trial as big as possible – and this trial is much much bigger than normal.
If I were 16 now, what kind of personal qualities would I need to do your job? What do you like about it on a day-to-day basis?
I like the blend of creativity and just being able to explore ideas and then apply this to real problems. The blend of science and medicine I find very attractive.
A lot of it is about curiosity: there’s so much we don’t know. There’s a lot of medicine we can deliver without knowing
everything but if you want to make advances we need to look under the bonnet a bit more. I like the creative side: people look at science and think it’s all about learning formulae and answering test questions but it’s actually more about using your imagination and trying to think about how things might work, thinking laterally and making connections.
Does the phrase, ‘We are listening to the science’ that we hear a lot these days frustrate you, when science actually has lot of fluidity and difference of opinion…
It’s a very good question. There is some underpinning science but a lot of what people have been talking about when it comes to these political decisions are predictive models which all have pros and cons.
So I think it is a little bit frustrating that it’s viewed as, ‘We know all the answers’. People want to hear that – but we don’t know all the answers because we don’t have all the data. The scientists involved in this are fantastic but they can only predict or understand things in a limited way at the moment because there’s some big gaps in our knowledge.
Which teachers at City inspired you?
I liked all of them! My Chemistry teacher Mr Britten – that was my favourite subject at the time. He made it all quite fun. We had brilliant maths lessons with Mr Heard – he was fantastic. The text book he’d written made everything so much simpler. The sports teachers Mr Crompton and John Allen…
Did the fencing began at school?
Yes. They just brought it in as an option and I thought I’d give it a go. I was enthusiastic, I did whatever was on offer. I did swimming, water polo, rugby, football… Fencing was just something else to do.
They were very encouraging. I didn’t win a single fight in the first year. But when I was about 15, a couple of years into it, I had a lucky run and made the final of the Under-20 championships, against all these 18- and 19 year-olds. I just fluked my way to the final. I lost in the final but I’d had a taste of that buzz so I was encouraged to do a bit more.
I ended up going all round the world; I was in Buenos Aires for the world championships in 1982 just as the Falkland Islands were taken and the task force started heading out ahead of the conflict. We were in the Plaza de Mayo where they were burning the Union Jack. We left as soon as we had finished competing!
How was the Olympics?
Amazing. I’d been to world championships, but it felt different to that because you were with all these other inspiring athletes in the Olympic Village. We were there with Tessa Sanderson and Daley Thomson.
We were eliminated in the fairly early stages… But, it’s easy to say, but it’s really about the taking part. It would have been great to win a medal but it would have been a turn up for the books!
Which other extra-curricular activities did you enjoy at City?
Water polo was absolutely brilliant. John Allen started it from scratch. He set it all up and it was really good fun. We won national championships. We all went on to play water polo at university too. It was a wonderful thing to do.
Do you remember your last day at school?
At the end of the Oxbridge term. After A levels we did an extra term and a series of exams for Oxbridge qualification. The last day was a general paper which I found incredibly difficult, but they let me in. There were only a few of us left at that point out of the whole year.
What was your first experience of work?
In my year off before University, apart from fencing, I took on a job in medical research, taking samples across London in my beaten-up Mini. That was 1982.
In fact, most of the discussions we have now around Covid-19 research are still all around how to get the samples and process them. If you don’t organise that bit right you can do the best science in the world but you won’t learn anything because you won’t have the right material.
Your research involves contact with patients as well as lab work…
I’m not real frontline NHS staff; I’m not taking blood off Covid-19 patients - but I do spend time on the wards, so having the chance to make the connections between the patients’ illness and the science that might lead to a new vaccine or treatment is really amazing. I’m really privileged to be able to do that.