On May 6, the World Health Organization (WHO) published criteria for an ethically acceptable COVID-19 human challenge trial. By Oct. 20, the U.K. announced the world’s first of such a trial. To study the efficacy of vaccines on an accelerated timeline, the scientists overseeing the study will deliberately infect healthy volunteers with SARS-CoV-2, the virus that causes COVID-19. Some argue that giving healthy volunteers a largely untreatable virus is both risky and unethical. Others, myself included, argue the opposite: to refrain from conducting these tests in order to stop a virus implicated in widespread human suffering that rarely kills the young and healthy would be unconscionable. To be clear, I’m not asking for people to volunteer to be infected. But it is long past time for us to allow others to make that choice for themselves.
Globally, COVID-19 has exposed significant weaknesses in our testing protocols for vaccines and therapeutics. These protocols derive from good intentions and are, in part, a well-meant reaction to previous ethical disasters. However, this situation is different. The spread of COVID-19 has been wide, but the risk of death is low. The internet allows us to be exponentially more informed, especially in regards to the risks we choose to undertake. Most importantly, we have far greater ethical safeguards today to prevent the exploitation of people as study subjects. Traditionally rigid safety standards should no longer allow COVID-19 to wreak physical and psychological havoc on humanity when more can be done to find a successful vaccine.
As of Nov. 7, 1.25 million humans have perished from COVID-19. More will follow. Additionally, rates of depression and drug overdoses are increasing, and unemployment continues to ravage our communities. This virus has left no facet of our lives untouched. All the while, 38,659 people worldwide have volunteered to be deliberately infected with SARS-CoV-2 through 1Day Sooner, an organization lobbying for human challenge trials in the U.S. and around the globe. I am one of them. If people voluntarily decide to take this risk for themselves, who are we to stop them?
The ability to deliberately infect human volunteers would expedite the development of an effective vaccine. According to the WHO, not only would this improve the rate of vaccine development, but it would also increase the likelihood that the vaccine that is approved is the most effective. Challenge trials can even yield more information about COVID-19 infection and transmission in the process.
Can we guarantee that nobody will be subject to deleterious long-term effects, or even die? No. But we do have some numbers to quantify the risks. For example, the U.K. challenge trial permits only those aged 18 to 30 to participate. For reference, the Centers for Disease Control and Prevention’s “best estimate” of the current infection fatality rate in the U.S. for people aged 20 to 49 years old is 0.02%. Only 0.0785% of those between the ages of 18 and 29 become hospitalized. Most importantly, those statistics include people with underlying health conditions, whom the U.K. challenge trial and any other would likely exclude. The individual risks of hospitalization, death and unknown chronic effects pale in comparison to the societal and global benefits of participating: fewer cases, fewer deaths and a quicker return to normalcy.
Instead of waiting for people to get sick, take me and other volunteers up on our offer to do it deliberately. Yesterday, 8899 people died of COVID-19 worldwide. As 1Day Sooner argues, if we could have avoided just 25% of those deaths with a vaccine, we would have prevented over 2,225 deaths in a single day. We permit people to volunteer to donate organs while they are still alive; we permit people to consent to being given experimental drugs that no human has ever taken before to test their toxicity. It follows that we should allow individuals to volunteer to be infected with a virus that very often results in a mild infection for overall healthy individuals with no underlying diseases.
Challenge trials won’t completely end COVID-19 once and for all. For one, we could only know that the vaccine in question would work among the young and healthy. But a vaccine for some people is better than nothing. Vaccinated youth could return to work, and more vulnerable populations would benefit from reduced community transmission.
Within reason, I believe what I do with my body is my choice. I want to have the right to decide whether or not my contribution to the effort to end the pandemic is worth the risks. Today, we stand against a bureaucracy resistant to change and all too willing to allow needless suffering in the process. We must fight back against this injustice. There is no doubt that COVID-19 is a dangerous illness. All of us have lost our livelihoods to this disease; many of us have lost our loved ones.
There is much uncertainty right now regarding our futures and this virus. But we must not allow this fear and uncertainty to get in the way of what could be done to find a vaccine sooner. The statistics show that there is indeed risk involved in these trials. But it is time we acknowledge that, in light of the benefits, the risk isn’t so high for trials to be seen as completely unreasonable. In this grey area, we should leave individuals free to make the choice for themselves.
Nima Shariatzadeh (18Ox, 21C) is from Houston.