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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

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 7y 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 7y ago
Your opening begs the question. Medical ethics are not an objective thing set in stone.
motohagiography 7y ago
I signed up because given the almost certain likelihood of random exposure at some future point, and the consequences of unwittingly infecting others, a controlled exposure was a net reduced risk. Caveat: I also commute by motorcycle, ride horses, sail, shoot, eat bacon, enjoy cigars, have been known to skydive, and swipe right on profiles that say, "no drama." So YMMV.

ageitgey 7y 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 7y ago

Your opening begs the question. Medical ethics are not an objective thing set in stone.

motohagiography 7y ago

I signed up because given the almost certain likelihood of random exposure at some future point, and the consequences of unwittingly infecting others, a controlled exposure was a net reduced risk. Caveat: I also commute by motorcycle, ride horses, sail, shoot, eat bacon, enjoy cigars, have been known to skydive, and swipe right on profiles that say, "no drama." So YMMV.