9 ms·

In a study like that would half the participants still be in the control group?

refurb 7y ago
Infecting, or at least exposing, healthy, unvaccinated, people with the virus? Pretty sure that would never make it past an IRB review.
- roywiggins 7y ago
  But a large majority will be exposed to the virus eventually anyway, if things keep going as they are. So what's the added risk if you're exposed earlier rather than later?
  - yokaze 7y ago
    That you are exposed while there is no known working treatment yet. Many attempts are in the works out even trials, but nothing proven. In the near foreseeable future, there might be one. One reason to have the lockdowns.
    - usrusr 7y ago
      Is there anything promising at the treatment front right now? My impression is that there was an initial group of candidates for repurposing that have on closer investigation all turned out to be not quite as helpful as hoped.
    - erfgh 7y ago
      No, the reason for the lockdowns was to increase the chance that people will find care in the hospitals. I shudder at the thought of a government locking people up because a treatment might, at some point in the future, be found. It is of course besides the point but I find it extremely optimistic to expect that a treatment can be found that will significantly reduce deaths when deaths mostly occur in patients of very advanced age or with significant underlying conditions.
- BurningFrog 7y ago
  It would have to be done outside the US.
- Wowfunhappy 7y ago
  Vox did a piece on this[1]. Basically, if you're young, the risk of death is about equal to a kidney donation, which is a procedure we allow. Participating in a trial like this could save many more lives than donating a kidney. And, if you live in e.g. NYC, there's a decent chance you're going to get COVID anyway, trial or no. Separately from that... y'know, there are currently lots of health care workers taking care of COVID patients—frequently without proper PPE—and getting sick from it. If we as a society have agreed this is worth the risk, why not a challenge trial to develop a vaccine? I'm honestly a little surprised there's even a debate about this. The choice seems pretty clear to me. --- [1] https://www.vox.com/future-perfect/2020/4/9/21209593/coronavirus-vaccine-human-trials-explained https://www.vox.com/future-perfect/2020/4/9/21209593/coronav...
  - refurb 7y ago
    I'm not disagreeing with your logic. The risk would be reasonably low if the subjects are young and healthy. However, you can still get similar information by just dropping the control arm in this trial. Give a bunch of people the vaccine and exposed them to the virus. Sure it's not as good as having an untreated control arm, but you're also reducing the risk of someone in the control group dying.
    - Wowfunhappy 7y ago
      The data is of very little use without a control. You could compare it to overall Coronavirus death rates, but those numbers are biased in all sorts of ways (for instance, fully asymptomatic cases).
      - refurb 7y ago
        I would disagree with "very little use". Uncontrolled trials are done all the time. You basically collect "nature history" data and compare it to that. In addition, the mechanism of vaccines is very well know. You can vaccinate and measure antibody formation. You could still develop a vaccine without a control and have confidence that it works.
      - 7y ago
- wbl 7y ago
  Do you know the death rate of an american submariner in the Pacific?
- maxander 7y ago
  As with bizarrely restrictive FDA regulations on, e.g., face masks, the famous conservatism of IRB committees is another thing that the COVID19 story should motivate us to re-examine.
- tim333 7y ago
  I don't think they are exposing them in any way different to how they would be exposed without taking the vaccine. It's just vaccinate then let them do normal UK life.
- bb123 7y ago
  I don't think they are going to infect people intentionally. They are giving the vaccine and control to healthcare workers who are naturally very likely to be exposed throughout he course of their work. They will then compare the infection rates between the two groups.
- nsgi 7y ago
  Are you sure? Challenge studies have been conducted in recent years for Norovirus[1] and Whooping Cough/Pertussis[2]. Admittedly, less is known about Coronavirus, but both those two can be dangerous. 1. https://www.ncbi.nlm.nih.gov/pubmed/25210140 https://www.ncbi.nlm.nih.gov/pubmed/25210140 2. https://clinicaltrials.gov/ct2/show/NCT03751514 https://clinicaltrials.gov/ct2/show/NCT03751514
Wowfunhappy 7y ago
Yes, how else could you know its efficacy?

Infecting, or at least exposing, healthy, unvaccinated, people with the virus? Pretty sure that would never make it past an IRB review.

roywiggins 7y ago
But a large majority will be exposed to the virus eventually anyway, if things keep going as they are. So what's the added risk if you're exposed earlier rather than later?
- yokaze 7y ago
  That you are exposed while there is no known working treatment yet. Many attempts are in the works out even trials, but nothing proven. In the near foreseeable future, there might be one. One reason to have the lockdowns.
  - usrusr 7y ago
    Is there anything promising at the treatment front right now? My impression is that there was an initial group of candidates for repurposing that have on closer investigation all turned out to be not quite as helpful as hoped.
  - erfgh 7y ago
    No, the reason for the lockdowns was to increase the chance that people will find care in the hospitals. I shudder at the thought of a government locking people up because a treatment might, at some point in the future, be found. It is of course besides the point but I find it extremely optimistic to expect that a treatment can be found that will significantly reduce deaths when deaths mostly occur in patients of very advanced age or with significant underlying conditions.
BurningFrog 7y ago
It would have to be done outside the US.
Wowfunhappy 7y ago
Vox did a piece on this[1]. Basically, if you're young, the risk of death is about equal to a kidney donation, which is a procedure we allow. Participating in a trial like this could save many more lives than donating a kidney. And, if you live in e.g. NYC, there's a decent chance you're going to get COVID anyway, trial or no. Separately from that... y'know, there are currently lots of health care workers taking care of COVID patients—frequently without proper PPE—and getting sick from it. If we as a society have agreed this is worth the risk, why not a challenge trial to develop a vaccine? I'm honestly a little surprised there's even a debate about this. The choice seems pretty clear to me. --- [1] https://www.vox.com/future-perfect/2020/4/9/21209593/coronavirus-vaccine-human-trials-explained https://www.vox.com/future-perfect/2020/4/9/21209593/coronav...
- refurb 7y ago
  I'm not disagreeing with your logic. The risk would be reasonably low if the subjects are young and healthy. However, you can still get similar information by just dropping the control arm in this trial. Give a bunch of people the vaccine and exposed them to the virus. Sure it's not as good as having an untreated control arm, but you're also reducing the risk of someone in the control group dying.
  - Wowfunhappy 7y ago
    The data is of very little use without a control. You could compare it to overall Coronavirus death rates, but those numbers are biased in all sorts of ways (for instance, fully asymptomatic cases).
    - refurb 7y ago
      I would disagree with "very little use". Uncontrolled trials are done all the time. You basically collect "nature history" data and compare it to that. In addition, the mechanism of vaccines is very well know. You can vaccinate and measure antibody formation. You could still develop a vaccine without a control and have confidence that it works.
    - 7y ago
wbl 7y ago
Do you know the death rate of an american submariner in the Pacific?
maxander 7y ago
As with bizarrely restrictive FDA regulations on, e.g., face masks, the famous conservatism of IRB committees is another thing that the COVID19 story should motivate us to re-examine.
tim333 7y ago
I don't think they are exposing them in any way different to how they would be exposed without taking the vaccine. It's just vaccinate then let them do normal UK life.
bb123 7y ago
I don't think they are going to infect people intentionally. They are giving the vaccine and control to healthcare workers who are naturally very likely to be exposed throughout he course of their work. They will then compare the infection rates between the two groups.
nsgi 7y ago
Are you sure? Challenge studies have been conducted in recent years for Norovirus[1] and Whooping Cough/Pertussis[2]. Admittedly, less is known about Coronavirus, but both those two can be dangerous. 1. https://www.ncbi.nlm.nih.gov/pubmed/25210140 https://www.ncbi.nlm.nih.gov/pubmed/25210140 2. https://clinicaltrials.gov/ct2/show/NCT03751514 https://clinicaltrials.gov/ct2/show/NCT03751514

Wowfunhappy 7y ago

Yes, how else could you know its efficacy?