Coronavirus

Deliberately Infect Healthy Young People To Test Coronavirus Vaccines, Propose Bioethicists

An idea that could really speed up vaccine development

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U.S. military physician Walter Reed and his medical colleagues famously had mosquitoes bite volunteers in order to establish that the disease was in fact borne by the flying pests. This finding was the basis of successful mosquito control efforts to reduce the incidence of the disease in tropical areas. The volunteers in these experiments were paid $200 to participate and $500 if they contracted yellow fever. These substantial payments, made in gold, would amount to approximately $8,000 and $20,000 respectively in today's dollars.

Now Rutgers University bioethicist Nir Eyal and his colleagues are proposing something like Reed's "human challenge" study as a way to speed up the development of a vaccine against the novel coronavirus that is responsible for the ongoing COVID-19 pandemic. The idea is that vaccine developers can cut more directly to what is essentially a phase three clinical trial. In phase three, vaccines already tested for safety are generally given to a large group of folks who are at risk of the targeted infection and monitored for a considerable period of time to see how many of the vaccinated people actually come down with the disease versus a group of unvaccinated people.

As Eyal explains in Nature, the proposed idea would "gather a group of people at low risk from any exposure—young and relatively healthy individuals—and ensure that they are not already infected. You give them either the vaccine candidate or a placebo and wait for enough time for an immune response. And then you expose them to the virus." So instead of waiting around for the virus to find (vaccinated and unvaccinated) folks in the wild as researchers do in regular phase three trials, you speed things up by bringing the virus to them.

Setting aside the misery of illness, the risk of death rate for folks under age 50 is about 1 in 200. Eyal argues that such a trial would be ethical on the grounds that we allow people to engage in risky activities all of the time such as volunteering for emergency medical services that increase their risks of exposure. In addition, volunteers in the trial who are being carefully monitored for the disease would likely be safer than folks relying on the general health care system to treat them.

The authors argue that such human challenge studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. If both test subjects and researchers volunteer to take this on, let's do it.

NEXT: As Coronavirus Outbreak Hit, Trump Administration Refused To Ease Hand Sanitizer Tariffs

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  1. There will likely never be a vaccine for this Cold virus.

    1. Which virus? COVID-19 or bioethicists?

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      2. Sadly, the Cronyvirus is alive and well. 🙂

        Unicorn…that was truly a classic.

    2. Maybe not, as we have no vaccine for the common cold. I have never had the flu, but I get colds once or twice a year. I also am a carrier for strep (I’m asymptomatic, or at least have been so far, we’ll see as I age).
      My point being that I seem to be immune to most everything except some form of the cold. 15% of colds are a coronavirus of some kind, and I guess the rest are mostly rhinovirus. So, am I susceptible to rhinoviruses, coronaviruses, or both?
      If I die, I’ll try to post the cause, if I can remember my password.

    3. That’s what I’ve been telling people who don’t understand. By the time a vaccine for this could be tested, the epidemics will have passed, and nobody will even be interested in testing it any more, let alone taking it, especially to see if it’s safe — even with the enormous number of vaccinations they have people taking these days, many just barely effective.

      1. Human trials are already underway.

        1. And they’re incredibly brave people. The animal models they tested initial runs of the vaccine against the first SARS virus…did poorly.

          I’d want to be really fucking sure the molecular biologists had their shit in one bag before I tried a vaccine against SARS part 2.

          1. SARS is a lot deadlier than this one, though, and its case fatality wasn’t mitigated nearly as much by being young and healthy.

      2. No. This is a serious virus, much more serious than measles, mumps or chicken pox, all of which we now vaccinate for. Those of us who did not contract it will definitely need vaccinated as will our grandchildren on down for years to come.

  2. Why should I listen to bioethicists? The voluntary nature of this testing is all well and good until they mandate the vaccine based on its “terrific” results in phase 3 of the clinical trial of their hand picked healthy sample.

    1. Um… that’s not how it works.

    2. “Bioethicist” means he’s a *professional accredited expert* on good and evil, and we know that means his morality is better than yours.

      It’s right there in the name. Ethicist. Is that in your name?

      The peasants need to learn their place.

  3. I wouldn’t trust “bioethicists” as far as I could throw them* – but perhaps on the stopped-clock principle they’re onto something.

    *I wouldn’t literally throw them because I’d have to violate social-distancing protocols.

    1. E: Blind hog truffles, too. I have been criticizing bioethics and bioethicists for decades. For example, “Warning: Bioethics May Be Hazardous to Your Health” and I lectured at Princeton on “Freedom vs. Bioethics.” Setting aside one’s usual suspicions about bioethicists, this proposal is a really good idea.

      1. Yes bioethicists with some sort of degree in philosophy should be running clinical trials.

      2. Because what go wrong with intentionally injecting a very contagious and rapidly evolving disease into the bodies of the people so far spared from the worst effects of the disease?

        1. For instance. Asymptomatic people simply don’t spread the disease as much as people who are coughing or sneezing. Now, normally, viruses become less lethal overtime, since the strains which evolve that direction don’t usually kill the hosts, allowing the virus to spread (evolution). Take a group of people who are not killed by the current strain, and don’t spread it as quickly, and one would expect a more virulent strain to evolve in that group, one that causes that group to have symptoms, like coughing, that would increase the spread through that group, and that might be even deadlier to threatened groups if released into the wild.

          1. Maybe I should have gone with my initial distrust.

      3. Also, hogs don’t use sight to find truffles, they use scent 😉

      4. Good for you on both ends.

        1. Both 3’ and 5’ then.

          Yup Ronnie really dropped it here.

      5. Mr. Bailey…You state it is a really good idea. Very well, explain.

  4. Bioethics professor = guy who could not get into medical school, cannot even start an IV and wants to tell the rest of them what to do.

    1. And in this case, phenomenally ignorant. Have they no knowledge of how human phase 3 testing of vaccines is actually done to give fairly reliable results with minimal risk? Hint: antibody titers.

  5. But I think in this study, ensuring a high level of public trust is important, and I would advise researchers not to attract volunteers through high payments.

    So…I’m going to volunteer…with odds of 1 in 200 (per Bailey) that I’LL FUCKING DIE. Because paying poor people would be wrong.

    What type of fucking ethics do these people have?

    1. The same kind as those who won’t allow someone to sell a life-giving organ, or demand a sex worker not get paid in cash instead of in dinner and a movie.

  6. When a bioethicist speaks, I tend to stop listening.

  7. As long as we have proper protocols in selection by sex, gender (real AND assumed), race, national origin, number of same sex parents, abortion choosers, climate change advocates, union membership, #metoo membership, and opposition to purging voter rolls.
    And there have to be equal payments to a random control group not even involved in the study.

    1. And increase the budget for the National Endowment for the Humanities.

      1. On a serious note, what about state funerals for volunteers who die, and benefits for their families?

        1. Orphans only. No families allowed.

          1. Orphans?

            Off to my monocle polishing factory for the ones that survive and, for a fee, my salt mine for the ones that don’t.

  8. “Trump Reportedly Mulling Monstrous Proposal To Deliberately Poison Helpless Babies”

    Sources: Trump asked that stomping puppies be included in project, saying he “love[s] the sound… like Gallagher whacking a watermelon”

    1. As I suspected. Do you have a link I can share on Facebook?

      1. Not yet, you’ll have to wait until tomorrow’s NYT comes out. Then you’ll see it at the WaPo and on CNN and everywhere else.

    2. “Trump Reportedly Mulling Monstrous Proposal To Deliberately Poison Helpless Babies”

      That reminds me, did the Democrats ever get those vital stimulus funds over to Planned Parenthood?

    3. That was funny.

  9. Wrong in the first paragraph. $200 and $500 in gold are worth $15,758.60 and $39,396.50. The US government can lie all they like about inflation, but they can’t hide how much gold was in a $20 coin. And since Mr. Bailey can’t even get simple math right, why would I believe anything else he says?

    1. The volunteers in these experiments were paid $200 to participate and $500 if they contracted yellow fever. These substantial payments, made in gold, would amount to approximately $8,000 and $20,000 respectively in today’s dollars.

      The volunteers in these experiments will be paid $200 to participate and $500 if they contract COVD-19. These substantial payments, made as a digital entry would amount to approximately jack shit respectively in today’s dollars.

      1. *Raises hand* Yes, I’d like to object to the use of “yellow fever”. I’m pretty sure that it is racist as AF, and, as a white liberal checking my priviledge, I feel threatened, and like our safe space has become violated and infected with otherism.

    2. KH: Not your fault, but the article I am quoting was published in 2009. The math works for that date. Stay safe.

  10. Oh, fuck no! Just show that the volunteers produce neutralizing antibody to a second challenge with inactive but antigenic material (i.e. the same vaccine). Or even without a second challenge.

  11. Besides, nobody does phase 3 human trials on preventive agents by deliberately trying to produce the disease in subjects. The closest you might come to that would be testing a contraceptive in people who were indifferent as to whether to have a baby at a given time, or seeing the length of time it takes to get minimal skin reddening in a sunscreen test (and then only testing UV-B effects, not UV-A).

    Of course, except for infectious diseases, nobody has reliable ways to produce the chronic, gradually developing human conditions that you want preventives for anyway.

  12. Too bad we don’t have a class of undesirable people we could invite to be test subjects.

    1. Politicians?

  13. It should be noted that people volunteering for infection with the coronavirus wouldn’t be unprecedented. People have volunteered for worse.

    “Operation Whitecoat was a biodefense medical research program carried out by the United States Army at Fort Detrick, Maryland between 1954 and 1973. The program pursued medical research using volunteer enlisted personnel who were eventually nicknamed “Whitecoats”. These volunteers, all conscientious objectors, including many members of the Seventh-day Adventist Church, were informed of the purpose and goals of each project before providing consent to participate in any project. The stated purpose of the research was to defend troops and civilians against biological weapons and it was believed that the Soviet Union was engaged in similar activities.”

    https://en.wikipedia.org/wiki/Operation_Whitecoat

    1. Sure, but is there a similar group of conscientious objectors who don’t want to personally kill a virus but also want to support the war effort by being infected?

      1. I think it takes more balls to let the military purposely infect you with weaponized biological agents than it does to become infected with the coronavirus. There are people who join the military despite the threat of being shot or captured by the enemy, so I’m sure there are people who would volunteer to do the coronavirus thing under medical supervision. Yeah, it was easier to get Adventists to do it after they were conscripted and the alternative was Vietnam, but there are still people out there who will make sacrifices for others–just because they care, too. I’ve even seen libertarians do it.

        Didn’t Virginia Postrel give away a kidney?

        1. “Yeah, it was easier to get Adventists to do it after they were conscripted and the alternative was Vietnam”

          The article says this program was “between 1954 and 1973” – and I’ve read about similar experiments on COs in WWII.

          There would probably be some social pressure to show that just because they didn’t want to kill enemy soldiers didn’t mean they were cowards. Indeed, as adventurous young men, they may have wanted to seek out dangers comparable to those faced by their non-conscientious contemporaries.

          1. “There would probably be some social pressure to show that just because they didn’t want to kill enemy soldiers didn’t mean they were cowards.”

            That’s exactly what was happening.

            It also didn’t mean they were unpatriotic or war protesters. They used their time in college to train as medics because they wanted to serve, and they dropped out after certification because they knew they would be drafted. They were willing to put their lives at risk to save other people, they just weren’t willing to break the Ten Commandments.

            I maintain that the First Amendment isn’t just part of what makes our government uniquely American but also part of what makes this country great–and not just in the theoretical sense.

            The military’s respect for the First Amendment rights of its soldiers allowed courageous soldiers to serve who wouldn’t have served otherwise. Desmond Doss (Adventist) was the first conscientious objector to win the Medal of Honor, during World War II, but other courageous conscientious objectors have won the Medal of Honor, as well. Plenty of courageous conscientious objectors also presumably didn’t win the Medal of Honor.

            Meanwhile, altruism provides an evolutionary advantage to the members of a species in which it emerges–which is why it adds to the survival of the fittest–and this is probably an example of that. If our freedom allows us to leverage courageousness on the battlefield that our enemies without the First Amendment can’t, that’s a competitive advantage.

        2. And my point was that this is simply not compatible. Asking a conscientious objector to instead volunteer to be infected in order to confirm his enthusiasm for the war effort is not the same as asking young people who else wise have no threat to their health to volunteer for testing does not equal young men ethically unavailable for military service who instead volunteer for medical testing.

          1. Wow. I won’t even try to fix that mess.

          2. Right.

            What we’re asking them to do in testing a vaccine is much easier than asking them to go to war or asking them to let us infect them with biological weapons.

        3. KS: Yes she did. FWIW (and it’s not
          much) part of her convalescence for her donation was spent at our place in DC. Virginia is just f**king awesome!

      2. How about avowed socialists? They don’t want to participate in the “unfairness” of a market economy, and claim to care about doing good for people. Most of them are supportive if not gleeful about the economic shut-down. Seems like an equivalent moral position to COs in wartime.

        1. Socialists should be free to not participate in the market economy if they chose not to do so.

          And conscientious objector status–at least for Adventists–wasn’t about not serving in the military and wasn’t about avoiding service in Vietnam. Thousands of them did serve in Vietnam, and plenty of those who served in Operation White Coat went on to serve in Vietnam.

          “The Seventh-day Adventist Church’s relationship to government military activity has been supportive but noncombative. In 1936, the SDA Church established the Medical Cadet Corps Training Program. This allowed Adventists to remain noncombatant but positive toward the war effort. Sabbath observance remained a concern for the drafted members of the church. Adventist Conscientious Objector perspective differed from the National Interreligious Service Board for Conscientious Objectors, (NISBCO). In 1967, Adventists withdrew from NISBCO because that organization opposed conscription.

          https://en.wikipedia.org/wiki/Operation_Whitecoat#Adventist_view_of_military_service

          They fought for the right to serve on the front lines despite their religious beliefs–not the right to avoid military service because of their religious beliefs.

          1. Desmond Doss was the first conscientious objector to win the medal of honor for actions above and beyond the call of duty–while he was serving on the front line–in World War II.

            https://en.wikipedia.org/wiki/Desmond_Doss#Medal_of_Honor

            It turns out that using the coercive power of government to force people to act according to the government’s preferred belief system is woefully inferior to the government using the best that people have to offer willingly–regardless of those people’s beliefs. It certainly seems to me that turning people away who are willing to put themselves in harm’s way on the battlefield to save other people (or throwing them in prison) would be stupid in wartime, and the Greatest Generation wasn’t stupid.

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  16. “Setting aside the misery of illness, the risk of death rate for folks under age 50 is about 1 in 200. ”

    Sounds high.

    What we don’t focus on enough is bending the curve with treatment and prevention. Betcha a nickel lots of doctors are taking hydroxychloroquine as a *preventive*.

    We should get serious about using drug plasma to treat and innoculate. Get an exponential working in our favor.

    1. Nope.

      That drug has major risks and no proven antiviral benefits.

      1. Do you completely discount the small French study?

        Here is another anecdote: According to Dr. Oz, the data from China was that not a single C19 patient in Wuhan had lupus. Lupus patients take Chloroquine daily as standard medication. An unusual coincidence, I would say.

        Chlorquine “has major risks” is a bit of hyperbole.

        1. Nope it can result in severe toxicity including risk of arrhythmia.

          It is hardly used even as an anti malarial these days.

          Nonetheless there are trials underway to see if it can be useful as an antiviral in this outbreak.

          This is just an open non peer or controlled communication with in vitro preliminary results.
          https://www.nature.com/articles/s41421-020-0156-0

          1. Thanks for the link.

            CQ can be lethal, but safe dosage levels are well understood.

            It is probably not used as an anti malarial because the malaria parasite has developed resistance to it.

            CQ might be effective at reducing the lethality of C19 by suppressing the immune response, which seems counter intuitive. Lethality of C19 might be caused by “cytokine storm”.

            The conclusion from the link you provided:

            “In conclusion, our results show that HCQ can efficiently inhibit SARS-CoV-2 infection in vitro. In combination with its anti-inflammatory function, we predict that the drug has a good potential to combat the disease. This possibility awaits confirmation by clinical trials. We need to point out, although HCQ is less toxic than CQ, prolonged and overdose usage can still cause poisoning. And the relatively low SI of HCQ requires careful designing and conducting of clinical trials to achieve efficient and safe control of the SARS-CoV-2 infection.”

            Seems like it is worth a try. If I were about to die from a C19 infection I would ask for it, assuming I could speak.

        2. Dr. Oz

          I get the joke

          1. Actually, Oz is a very well respected physician. I thought he was just a TV doctor, but the guy is legitimate.

    2. Only a fool would take your nickel bet, doctors have been “hoarding” chloroquine+azrythromycin for a while now. I don’t know if they have been taking it, but they probably have been. Plasma (i.e. injecting antibodies from recovered C19 patients) might be effective but I highly doubt it would be used as a prophylactic.

  17. Any bioethicists out there willing to go on the record that they will be in the first wave of volunteers?
    Not holding my breath that this bunch is anything but hot air.

  18. . . . Propose Bioethicists

    You can tell how ethically horrible an idea is based on the percentage of bioethicists who support it vs oppose it.

    What happened to the ‘value of human dignity’ bioethicists?

  19. Why do I know who the young people won’t be. I’m sure there will not be any from Brown or Harvard. Mostly poor kids who don’t live in NYC or SF or LA or Seattle or Portland. I can even predict what their region and ethnicity probably would be. Sure won’t be any kid whose parents are wealthy investment bankers, hollywood, media, DNC, NPR types. Won’t be Chuck Schumer’s grandkids for sure.

    We are screwing the young people today with massive deficits, student loan debt (caused by baby boomers in academia grifting the system of stupid federal student loans which were never to help the kids anyway). Here Billy and Debbie..here is your bill of $1M each to pay for bailouts..oh and can we test a drug with might kill you to save Bill Clinton so he can keep banging the energizer bunny woke for another 10 years.

    this bioethicist is a bolshevik of the worst sort. I’m betting he is from Eastern Europe anyway…

  20. Basically, every comic book villain was a bioethicist – they just didn’t know it.

    Their job is to justify the morally repugnant under the guise of ‘reason’.

  21. Can Reason authors please stop saying “folks” instead of “people?” I guess I’ll just grin and bear it, but damn it has such a populist ring to it unbecoming of a libertarian magazine.

    1. “Can Reason authors please stop saying ‘folks’ instead of ‘people’?”

      Thank you for saying this — I hate the fake-folksy use of “folks.” Whether it’s “unbecoming of a libertarian magazine,” I’m not sure, but it definitely puts me in mind of a dorky junior-high principal trying to sound up-to-date by using teenage slang from 50 years ago.

      1. BtC: I am guilty – it is a residual rhetorical hangover from my Appalachian upbringing.

    2. Or at least say “folk” which is already plural (or collective anyway).

    3. And while we are picking on word choice, they are writing, not saying “folks”. Of course, I write “said” when I mean “wrote” all the time too.

  22. When I was growing up the word “folks” was almost always preceded by “colored”.

    1. VD: Not in my case. An often heard inquiry upon meeting someone new was: Who are your folks?
      Mountain families had reputations that tended (often unfairly) to follow their members around.

      1. Yeah, I grew up in Kentucky. Had folks from the Hazard-Hindman area. (for the record, the side of the family from Hazard was related to the “blind judge” and we all got rep points from him)

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  25. 1 in 200 can’t possibly be known without wide scale antibody testing.

  26. How about we just infect the bioethicists? Seems like a good compromise.

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