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Challenge trials. https://www.1daysooner.org/ https://www.1daysooner.org/ If it were considered ethical to do them, we could have known in a few weeks. "Medical
by moultano 6y ago
Challenge trials. https://www.1daysooner.org/ https://www.1daysooner.org/ If it were considered ethical to do them, we could have known in a few weeks. "Medical ethics" claims another million lives.
- tantalor 6y agoGood summary of problems with challenge trials for Covid: https://www.statnews.com/2020/06/23/challenge-trials-live-coronavirus-speedy-covid-19-vaccine/ https://www.statnews.com/2020/06/23/challenge-trials-live-co...
- moultano 6y agoThe point that challenge trials don't determine safety is accurate, but most of the article is again arguing about the ethics rather than the efficacy. Imagine if volunteers were not permitted by ethicists to storm the beaches of Normandy because their safety could not be guaranteed. Our current testing protocol requires letting the virus rampage through the population before the trials will achieve statistical significance, which is surely more unethical than deliberately exposing a small number of people.
- tantalor 6y agoI tend to agree in the case of Covid, but I'll play devil's advocate... Suppose we replace Covid with "car crashes" and vaccine with "seatbelts". This is a good analogy because crashes are rare and we can't cure trauma (like on Star Trek). It would be absurd to deliberately cause car crashes in order to study the effect of seatbelts. For the experimental group, there will still be some minor injuries. For the control group, many will die.
- moultano 6y agoThat sounds more like doing challenge trials for an ebola vaccine, for which I'd expect you'd get very few volunteers. Still though, if there are people willing to risk sacrificing themselves, and the information would definitely save lives, we should let people do that for the greater good. The world's militaries throw away far more lives for far less benefit.
- nabla9 6y agoKnowing the efficacy in few weeks is not going to speed up the vaccine trials (see my other comment).
- moultano 6y agoEven once safety is established, our current protocol requires waiting for wave of infections to sweep so thoroughly through the population that some of the study volunteers are infected by chance.
- nabla9 6y agoThat's incorrect. Both are determined from the same tests and determining safety takes longer. Phase III trials for each of these new vaccines end long after the efficacy is determined. Estimated primary completion dates are in June 2021 (BioNTech/Pfizer) and November 2021 (Moderna). Even after the drug is accepted, monitoring for safety continues.
- mantap 6y agoWe've subsequently learned that even young healthy and initially asymptomatic people can become permanently ill from so called "long COVID". The ethicists were right to say no.
- moultano 6y agoPeople join the military not knowing whether or not they will ever go to war, yet they still join. By doing so they risk death, dismemberment, and all manner of long term disability under the belief that doing so makes everyone else safer. If exposing a few people on purpose is a moral wrong, then surely allowing millions of them to contract it by accident so that a few people in your RCT can become infected by chance is a moral abomination.
- StavrosK 6y agoI don't follow, how is it worse to reach a lot of people in case some of them catch it in an unrelated manner worse than infecting them on purpose?
- moultano 6y agoA traditional trial requires you to wait for the pandemic to spread in order to get enough positive people in your trial for significance. It's effectively like "challenging" random people in the public in the hopes that some of them are in your treatment group.
- tinus_hn 6y agoConsidering Russia and China started using their vaccines months ago we could have had the answer anyway. We just didn’t want to look.