There is risk but it’s smaller than climbing Everest
A year since reports of Covid-19 first emerged, Rhys Blakely speaks to volunteers who are willing to be infected to help speed up research.
Alex Greer, a chemistry student, runs the Effective Altruism Society at Durham University in the UK. ‘‘It’s about using evidence and careful analysis to do the most good in the world,’’ he says. With this in mind he recently received an offer he felt he could not refuse: would he allow himself to be infected with Covid-19 in the name of science?
Greer, 20, is one of more than 2500 Britons who have volunteered to take part in the world’s first coronavirus ‘‘human challenge trials’’. Due to begin in London next month, they will involve participants being exposed to the virus in a secure biocontainment suite.
The aim is to accelerate research by studying, in away not possible in other settings, how our bodies react to the bug and how well the next generation of vaccines can fend it off.
Dominic Wilkinson, a professor of medical ethics at Oxford University, believes the dangers are acceptable and that volunteering signals ‘‘an enormous amount of altruism and maturity’’.
The project, led by Imperial College, will initially involve a few dozen 18 to 30-year-olds, free of risk factors such as heart disease or diabetes. For this age group studies put the chances of dying of Covid in the region of one in 10,000. ‘‘It’s the sort of risk that women run of dying in childbirth,’’ Wilkinson says.
On top of that there is the possibility of ‘‘long Covid’’, where symptoms linger for weeks or months. ‘‘But a lot of people have caught the disease and had no say in it,’’ Greer says. ‘‘Hopefully by giving my informed consent I can help prevent others being blindsided.’’
At 66, Paul van den Bosch, a Gpwho has worked for Medecins Sans Frontieres (Doctors without Borders), will not be eligible for the first trials but he hopes that older people, a priority group for vaccines and treatments, will eventually be allowed to take part.
‘‘We’ve become a bit obsessed by an injunction to stay safe,’’ he says. ‘‘Our lives are finite and it’s not our job to stay safe all the time. We’re going to die in the end – and if one wants to be romantic about it then, dying gloriously is better than dying of dementia.
‘‘And from a practical point of view, the risks aren’t huge. They’re much smaller than a lot of the things that people do, like climbing Everest [where about one in every 100 climbers beyond base camp dies].’’
Over the past year scientists have developed vaccines at a pace that many doubted was possible. By providing £34 million for the challenge trials the UK government is signalling a belief that the process can be accelerated further still.
This seems plausible: the American company Moderna had created a coronavirus jab by February 24, although it took another eight months to show that it worked. This was done by recruiting 30,000 people for a field trial and giving half the real vaccine and half a placebo. The scientists had to wait for infections to strike naturally. It took until midNovember for 95 people to catch the virus, enough to assess with reasonable statistical certainty that it was effective.
Challenge trials offer a shortcut to that process because scientists can observe infections from the moment the pathogen meets its host. By scrutinising every detail the trials should help to define how the immune systemmobilises to fend off the coronavirus, as well as the duration of vaccine-induced immunity and the measurable signs that a person is protected. The first step will involve working out the smallest amount of virus you can expose someone to and cause an infection. This should help to minimise the risk of severe disease.
The vaccine task force, the government body responsible for building stockpiles, has secured the first three challenge trial slots to test new jabs. A second generation of vaccines is likely to be needed, it says, for boosting protection, tackling mutations and making immunisation campaigns cheaper.
It envisages a ‘‘fast to fail’’ approach, where challenge trials quickly sort out the vaccine chaff. If transmission rates are low this may be the only way the next swathe could be tested.
Jennifer Wright, 29, a physics PHD student at the University of Glasgow, says she has been motivated by the ability to gather otherwise unobtainable data. She would also like to feel as if she had done her bit. ‘‘I’m very sure I would like to take a risk to help out. Some of my friends work for the NHS and they’ve been taking risks all through the pandemic while I’ve been looked after and stayed safe.’’
In the spring Sean Mcpartlin, 22, a philosophy student at Oxford, became involved with 1Day Sooner, the non-profit group through which all the volunteers interviewed for this article have signed up. It held discussions with Imperial but the researchers may end up enrolling volunteers through other channels.
Volunteers for the Imperial trial are expected to be paid about £4000 (NZ$7600) for a two or three-week stay at the Royal Free Hospital in London and probably a year of follow-up appointments.
Mcpartlin has helped by calling wouldbe participants and says they are not very interested in financial incentives, adding it is more about ‘‘the rationale’’.
Around the world, 1Day Sooner has recruited more than 38,000 volunteers and won the backing of several Nobel winners. Mcpartlin has been making sure volunteers know what they’re letting themselves in for. ‘‘The outstanding questions were practical,’’ he says. ‘‘What is the quarantine facility like? Will there be wifi?’’
‘‘ . . . if one wants to be romantic about it then, dying gloriously is better than dying of dementia.’’