4 ms·

One Day Sooner – Covid-19 Human Challenge Trials

17 points by Leary 6y ago

guscost 6y ago
Anyone nearer to the “virus less bad” side of an argument should consider signing up for this (if you’re healthy, of course). It’s a win-win because you get to gamble on quicker immunity.
- sandworm101 6y ago
  >> It’s a win-win because you get to gamble on quicker immunity. Yes. I am very worried that countries are leaning towards "immunity passports". If we tell people that in order to work you must have gotten and recovered from this disease, everyone will suddenly seek to be infected. How many people will sign up for this simply because they feel they need to get this disease in order to return to work? The disease could become a valuable commodity to be sought, even purchased. If the choice is between getting the virus or remaining unemployed for the foreseeable future, I'll roll the dice.
  - xcavier 6y ago
    The WHO is warning there is no proof that having recovered from an infection actually makes you immune
    - sandworm101 6y ago
      >> makes you immune Of course not. Nobody has any such evidence. "Immune" is an absolute term. Even a vaccine doesn't make one "immune" to a disease. So the WHO is absolutely correct in saying that. But if this disease is like the vast majority of similar infections, have had it once likely reduces one's chances of getting it a second time. Of all the viruses that cause disease, only a very few are regularly caught repeatedly.
    - guscost 6y ago
      Well it’s not going to make your more susceptible, that’s for sure.
  - youareostriches 6y ago
    Immunity passports reveal a naive understanding of infection. Thousands of people in South Korea have tested positive even after testing negative. Some of those people continued to infect others. One man in China has tested positive for the virus for over 70 days despite having no symptoms. You can read anecdotes on /r/covid19positive from people who, after exercise, suddenly tested positive and developed more severe symptoms after having previously “recovered” and tested negative. It could very well be that the virus remains reactivatable in some people for an unknown amount of time, maybe even establishing permanent latency like HIV or herpes. Neurological effects are known to occur with this virus and the types of tissue known to be affected continues to expand. In such a scenario, an immunity “passport” would become more of a scarlet letter.
- eli_gottlieb 6y ago
  I'm on the "virus more bad" side, but I'm young and reasonably healthy. When I went to donate blood, they told me my blood pressure was pleasantly low for someone reporting the subjective experience of freaking the fuck out. I'll volunteer.
noodlesUK 6y ago
It’s my understanding that these sorts of challenge trials are only compatible with medical ethics where the participants are unlikely to come to long term harm. This doesn’t seem to be the case with covid. The death rate for this disease amongst young and healthy people is somewhere between 1/1000 and 1/25. If they run a trial with n~=1000 people, they will be likely condemning between 1 and 40 young and healthy people to death, and potentially many more to long term disability. Of course many hundreds of thousands will likely die during this crisis, and the utilitarian view of any benefits this might have will be a net positive, there are serious ethical concerns. I’m not sure if I’d personally feel comfortable being involved in such a trial, especially with the messaging appearing as though it’s low risk.
- ageitgey 6y ago
  How did you calculate the "between 1/1000 and 1/25" death rate for young and healthy people? Are you talking about infection fatality rate or death rate of people being treated in hospital? According to the UK ONS [1] for the week ending April 10, there had been 74 COVID deaths of people aged 44 and younger and 6,139 deaths of people aged 45 and older in the UK. So for that period, people under 45 account for ~1.1% of all COVID deaths despite making up 56% of the total population. If you assume an overall infection fatality rate of about 0.5% (which seems like a pretty good guess from the recent antibody tests in NYC and other studies), 1% of half a percent is a pretty small number. And that's not even factoring in that a lot of the under 44 deaths probably involve co-morbidities and aren't otherwise healthy people. This is back-of-the-napkin math and the IFR is inter-related with the population demographics, so I could be wrong. But it seemed to me like the death rate for people under 45 is quite low. [1] https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending10april2020 https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...
- maxerickson 6y ago
  Your opening begs the question. Medical ethics are not an objective thing set in stone.
- motohagiography 6y ago

17 points by Leary 6y ago

Anyone nearer to the “virus less bad” side of an argument should consider signing up for this (if you’re healthy, of course). It’s a win-win because you get to gamble on quicker immunity.

sandworm101 6y ago
>> It’s a win-win because you get to gamble on quicker immunity. Yes. I am very worried that countries are leaning towards "immunity passports". If we tell people that in order to work you must have gotten and recovered from this disease, everyone will suddenly seek to be infected. How many people will sign up for this simply because they feel they need to get this disease in order to return to work? The disease could become a valuable commodity to be sought, even purchased. If the choice is between getting the virus or remaining unemployed for the foreseeable future, I'll roll the dice.
- xcavier 6y ago
  The WHO is warning there is no proof that having recovered from an infection actually makes you immune
  - sandworm101 6y ago
    >> makes you immune Of course not. Nobody has any such evidence. "Immune" is an absolute term. Even a vaccine doesn't make one "immune" to a disease. So the WHO is absolutely correct in saying that. But if this disease is like the vast majority of similar infections, have had it once likely reduces one's chances of getting it a second time. Of all the viruses that cause disease, only a very few are regularly caught repeatedly.
  - guscost 6y ago
    Well it’s not going to make your more susceptible, that’s for sure.
- youareostriches 6y ago
  Immunity passports reveal a naive understanding of infection. Thousands of people in South Korea have tested positive even after testing negative. Some of those people continued to infect others. One man in China has tested positive for the virus for over 70 days despite having no symptoms. You can read anecdotes on /r/covid19positive from people who, after exercise, suddenly tested positive and developed more severe symptoms after having previously “recovered” and tested negative. It could very well be that the virus remains reactivatable in some people for an unknown amount of time, maybe even establishing permanent latency like HIV or herpes. Neurological effects are known to occur with this virus and the types of tissue known to be affected continues to expand. In such a scenario, an immunity “passport” would become more of a scarlet letter.
eli_gottlieb 6y ago
I'm on the "virus more bad" side, but I'm young and reasonably healthy. When I went to donate blood, they told me my blood pressure was pleasantly low for someone reporting the subjective experience of freaking the fuck out. I'll volunteer.

noodlesUK 6y ago

It’s my understanding that these sorts of challenge trials are only compatible with medical ethics where the participants are unlikely to come to long term harm. This doesn’t seem to be the case with covid. The death rate for this disease amongst young and healthy people is somewhere between 1/1000 and 1/25. If they run a trial with n~=1000 people, they will be likely condemning between 1 and 40 young and healthy people to death, and potentially many more to long term disability. Of course many hundreds of thousands will likely die during this crisis, and the utilitarian view of any benefits this might have will be a net positive, there are serious ethical concerns. I’m not sure if I’d personally feel comfortable being involved in such a trial, especially with the messaging appearing as though it’s low risk.

ageitgey 6y ago
How did you calculate the "between 1/1000 and 1/25" death rate for young and healthy people? Are you talking about infection fatality rate or death rate of people being treated in hospital? According to the UK ONS [1] for the week ending April 10, there had been 74 COVID deaths of people aged 44 and younger and 6,139 deaths of people aged 45 and older in the UK. So for that period, people under 45 account for ~1.1% of all COVID deaths despite making up 56% of the total population. If you assume an overall infection fatality rate of about 0.5% (which seems like a pretty good guess from the recent antibody tests in NYC and other studies), 1% of half a percent is a pretty small number. And that's not even factoring in that a lot of the under 44 deaths probably involve co-morbidities and aren't otherwise healthy people. This is back-of-the-napkin math and the IFR is inter-related with the population demographics, so I could be wrong. But it seemed to me like the death rate for people under 45 is quite low. [1] https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending10april2020 https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...
maxerickson 6y ago
Your opening begs the question. Medical ethics are not an objective thing set in stone.
motohagiography 6y ago