Why we should let people be deliberately infected with COVID, by Sean McPartlin
The COVID-19 pandemic has turned the tragedy of talking about scores of dead into a “new normal”. As countries take steps toward lifting lockdown, it seems like much of the world has become used to the death toll, even as thousands continue to die daily. As summer turns to autumn and autumn to winter, we could be met with the deadly double act of the seasonal flu and COVID-19. Despite the tempting catharsis of jumping with enthusiasm back into our normal routines, now is not the time to relax.
But neither should we become cowed and apathetic. Instead, we should meet this challenge head-on. One promising way of doing so is by preparing for what are called “human challenge trials,” where volunteers are deliberately exposed to a pathogen in order to rapidly test the efficacy of potential treatments. 1DaySooner has collected nearly 30,000 volunteers for such a trial. I am one of such volunteers. I see the risk to my person as slight in comparison with therisk borne by the world’s most vulnerable and the individuals who will die due to our hesitation.Employing such a trial in response to COVID-19, though it should be done carefully, offers us a way of speeding-up the arrival of an effective vaccine and as such, saving thousands of lives.
There has been a singular focus on the risks of challenge trials. The risk to young and healthy volunteers is roughly comparable to that of a kidney donation. Meanwhile, one model suggests there could be as many as 20 million deaths from COVID-19 this year even if we take precautions such as shielding the elderly, and slowing the rate of transmission. Even if we predict a less dizzying number of deaths and, therefore, lives saved, challenge trials are immensely valuable. This is true even if they speed things up by one month, one week, or even just one day.
One day doesn’t seem like a lot. However, in 24 hours a great deal can occur. Some species of mayfly will complete their entire life cycle. Circa 150,000 people will die while roughly 385,000 fresh faces will join our ranks. If the median daily death-toll remains roughly where it presently is, then speeding up vaccine development by just one day could well save about 4,000 lives. Numbers can seem too abstract to represent the sheer loss felt by the families of those who will needlessly perish without a vaccine.
Let’s compare two possible futures. Suppose that challenge trials would allow a vaccine to be accessible in Anne’s town on May 1st, 2021 instead of May 2nd, 2021.
In a world without a challenge trial, Anne is vaccinated on May 2nd, not May 1st. The vaccine might take one week to have its effect. On the evening of May 8th, Anne is exposed to the coronavirus at the grocery store. The vaccine has yet to give her immunity, so she develops COVID-19 and dies ten days later, on May 19th.
In a world with a challenge trial, Anne is vaccinated on May 1st. By May 8th, the vaccine has had its effect, so her immune system is fully capable of preventing the coronavirus from gaining a foothold. She lives the rest of her life, with all of its attendant relationships, and resplendent joys.
Hopefully, this story will not come true. But without robust preparation in order to get out of this pandemic, this story may well prove terribly accurate.
Challenge trials are not a new way of combating endemic disease. They have been used, with great effect, in the development of vaccines for typhoid, cholera, malaria, and Influenza. And they should be used in the case of COVID-19. If we do not prepare now, thousands of people could die before their time. We owe it to those people to prepare now. I hope we can come together to meet this challenge, even if it speeds things up by just one day.
Sean McPartlin is a BPhil Candidate in Philosophy at the University of Oxford an Co-Founder of Effective Altruism Ireland. Follow on Twitter: @McPartlin_Sean.
