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Strange that, until this point, the virus has been deemed dangerous enough to shut down whole swathes of the economy for a year, but not dangerous enough to ben

Strange that, until this point, the virus has been deemed dangerous enough to shut down whole swathes of the economy for a year, but not dangerous enough to bend the rules of clinical trials to find a vaccine faster. If we had done this sooner, we might have got the vaccine out before the mutant strains appeared over the last couple months.

whatshisface 6y ago
The trolley problem solution that gets chosen in real life situations really seems to be a consistent "last person who touched it broke it" policy.
- dehrmann 6y ago
  Politically, it's the winning solution.
- jdminhbg 6y ago
  > The Copenhagen Interpretation of quantum mechanics says that you can have a particle spinning clockwise and counterclockwise at the same time – until you look at it, at which point it definitely becomes one or the other. The theory claims that observing reality fundamentally changes it. > The Copenhagen Interpretation of Ethics says that when you observe or interact with a problem in any way, you can be blamed for it. At the very least, you are to blame for not doing more. Even if you don’t make the problem worse, even if you make it slightly better, the ethical burden of the problem falls on you as soon as you observe it. In particular, if you interact with a problem and benefit from it, you are a complete monster. I don’t subscribe to this school of thought, but it seems pretty popular. https://blog.jaibot.com/the-copenhagen-interpretation-of-ethics/ https://blog.jaibot.com/the-copenhagen-interpretation-of-eth...
fabian2k 6y ago
I don't know enough about this trial to decide yet whether it is ethical or not. But there are in any case some differences to a full trial for a vaccine. This is a trial with young people, for a real vaccine trial you also need to know if it works in older people and the mortality is so much higher then that it would be clearly unethical to perform this trial.
- fallingknife 6y ago
  How can it be unethical if everyone is a volunteer? Also, has there ever been a case of a vaccine that only works on one age group?
  - Closi 6y ago
    I personally find this study totally ethical, but I guess the counter-argument would be “How risky is an experiment allowed to be before it’s considered unethical, even if people are volunteering?”. Like let’s say we wanted to verify if some liquid was a poison, and we thought it had a 50/50 chance of killing someone, and we offer someone £500k to drink it, is that ethical? Probably not. I mean ethics are always subjective, but I don’t think that’s right. Does it make it ethical if it will probably save two lives? Uhh, I’m still uncomfortable with it... So after that point you are just arguing about how risky the experiment is allowed to be before it becomes unethical, and what benefit it will have for other people in relation to that risk. Again, I agree with you and the trial because the risk seems low enough and the reward seems high enough - this is just the counter argument.
- renewiltord 6y ago
  > or a real vaccine trial you also need to know if it works in older people No, it really doesn't. Most vaccines don't. Maybe one could argue that a COVID-19 vaccine should. But if you had a vaccine that worked on everyone under the age of 60 but worked zero above that, it would still be a 'real' vaccine and we'd be using it everywhere for the cohort it works for. In fact, I can't even imagine what train of thought leads to this statement.
jedimastert 6y ago
> dangerous enough to bend the rules of clinical trials to find a vaccine faster Bending ethics regulations because of emergencies is a really dangerous precedent, and a bell I'd rather leave unrung. We don't need to bend the rules when things get bad, we need to have better rules. Subtle but massive difference
tiahura 6y ago
To further your point: "Moderna’s mRNA-1273, which reported a 94.5 percent efficacy rate on November 16, had been designed by January 13 [2020]. This was just two days after the genetic sequence had been made public in an act of scientific and humanitarian generosity that resulted in China’s Yong-Zhen Zhang’s being temporarily forced out of his lab. In Massachusetts, the Moderna vaccine design took all of one weekend. It was completed before China had even acknowledged that the disease could be transmitted from human to human, more than a week before the first confirmed coronavirus case in the United States. By the time the first American death was announced a month later, the vaccine had already been manufactured and shipped to the National Institutes of Health for the beginning of its Phase I clinical trial." https://nymag.com/intelligencer/2020/12/moderna-covid-19-vaccine-design.html https://nymag.com/intelligencer/2020/12/moderna-covid-19-vac... It's almost impossible to imagine the devastation that could have been averted if the vaccine was released in March 2020.
- tialaramex 6y ago
  Or, as several countries did, you could actually pursue elimination and "avert the devastation" without miraculously creating millions of doses of untested vaccine, injecting them into your population and then crossing your fingers that nothing goes wrong.
- onychomys 6y ago
  That's only because we know in hindsight that it works, though. Phase 1 and 2 trials are important, even though they take time, because there's no guarantee that a vaccine candidate will be safe and effective. See, for example, a couple of Merck candidates that ended up failing [0]. If the Moderna one had been released in March 2020 and injected in millions of people and then they all got sick anyway, it would have been a disaster. [0] https://www.nbcnews.com/health/health-news/merck-discontinues-two-covid-19-vaccine-candidates-n1255503 https://www.nbcnews.com/health/health-news/merck-discontinue...
  - dehrmann 6y ago
    I agree with the importance of safety testing, but I suspect we could have had vaccines 3 months earlier with challenge trials. March was obviously not realistic, and we "had" the vaccine in the same way you have a winning bet in roulette before the wheel stops spinning. Or that Schrodinger still had a living cat.
renewiltord 6y ago
I'm going to say what you're carefully tip-toeing around. It isn't strange. It's normal. When you watch people's actions and not their words, you see what they truly believe. The Trolley Problem is most definitely solved in real life. For instance, we can see that we allow rescue divers to die so that trapped children may be saved. The trolley problem has been solved: some number of cave divers' lives are worth less than some larger number of trapped childrens' lives. Should we risk soldiers' lives going to Afghanistan so we can stop Osama Bin Laden and discourage hypothetical future violence against us? Yes, of course. Trolley problem solved. Try it again with COVID-19 and you learn something. The truth is that we don't really care all that much about some elderly dying (rightly so). We care so little about their lives that we wouldn't even risk a thousandth as many people to save them. That's how it goes. Revealed Preferences tell us all we need to know. There is a dollar sum for a life. Some lives are more valuable than other lives. And there is a banal variant of utilitarianism that flows through us all. We are not fools. No species that risks nothing gains anything.
- s1artibartfast 6y ago
  I think your point is accurate, but more nuanced. you have to include accountability (e.g. blowback against the person who pulls the lever) Inaction is the most attractive option because the decision maker is can avoid blame. We could have taken an aggressive stance against covid, done challenge trials, mobilized manufacturing, used more controversal restrictions on movement. OR We could have taken a more laze fair approach, letting the elderly lock themselves down and die in greater numbers. Instead, we got some middling third option where politicians try to minimize accountability, and we get both very high deaths and very high economic disruption

whatshisface 6y ago

The trolley problem solution that gets chosen in real life situations really seems to be a consistent "last person who touched it broke it" policy.

dehrmann 6y ago
Politically, it's the winning solution.
jdminhbg 6y ago
> The Copenhagen Interpretation of quantum mechanics says that you can have a particle spinning clockwise and counterclockwise at the same time – until you look at it, at which point it definitely becomes one or the other. The theory claims that observing reality fundamentally changes it. > The Copenhagen Interpretation of Ethics says that when you observe or interact with a problem in any way, you can be blamed for it. At the very least, you are to blame for not doing more. Even if you don’t make the problem worse, even if you make it slightly better, the ethical burden of the problem falls on you as soon as you observe it. In particular, if you interact with a problem and benefit from it, you are a complete monster. I don’t subscribe to this school of thought, but it seems pretty popular. https://blog.jaibot.com/the-copenhagen-interpretation-of-ethics/ https://blog.jaibot.com/the-copenhagen-interpretation-of-eth...

fabian2k 6y ago

I don't know enough about this trial to decide yet whether it is ethical or not. But there are in any case some differences to a full trial for a vaccine. This is a trial with young people, for a real vaccine trial you also need to know if it works in older people and the mortality is so much higher then that it would be clearly unethical to perform this trial.

fallingknife 6y ago
How can it be unethical if everyone is a volunteer? Also, has there ever been a case of a vaccine that only works on one age group?
- Closi 6y ago
  I personally find this study totally ethical, but I guess the counter-argument would be “How risky is an experiment allowed to be before it’s considered unethical, even if people are volunteering?”. Like let’s say we wanted to verify if some liquid was a poison, and we thought it had a 50/50 chance of killing someone, and we offer someone £500k to drink it, is that ethical? Probably not. I mean ethics are always subjective, but I don’t think that’s right. Does it make it ethical if it will probably save two lives? Uhh, I’m still uncomfortable with it... So after that point you are just arguing about how risky the experiment is allowed to be before it becomes unethical, and what benefit it will have for other people in relation to that risk. Again, I agree with you and the trial because the risk seems low enough and the reward seems high enough - this is just the counter argument.
renewiltord 6y ago
> or a real vaccine trial you also need to know if it works in older people No, it really doesn't. Most vaccines don't. Maybe one could argue that a COVID-19 vaccine should. But if you had a vaccine that worked on everyone under the age of 60 but worked zero above that, it would still be a 'real' vaccine and we'd be using it everywhere for the cohort it works for. In fact, I can't even imagine what train of thought leads to this statement.

jedimastert 6y ago

> dangerous enough to bend the rules of clinical trials to find a vaccine faster Bending ethics regulations because of emergencies is a really dangerous precedent, and a bell I'd rather leave unrung. We don't need to bend the rules when things get bad, we need to have better rules. Subtle but massive difference

tiahura 6y ago

To further your point: "Moderna’s mRNA-1273, which reported a 94.5 percent efficacy rate on November 16, had been designed by January 13 [2020]. This was just two days after the genetic sequence had been made public in an act of scientific and humanitarian generosity that resulted in China’s Yong-Zhen Zhang’s being temporarily forced out of his lab. In Massachusetts, the Moderna vaccine design took all of one weekend. It was completed before China had even acknowledged that the disease could be transmitted from human to human, more than a week before the first confirmed coronavirus case in the United States. By the time the first American death was announced a month later, the vaccine had already been manufactured and shipped to the National Institutes of Health for the beginning of its Phase I clinical trial." https://nymag.com/intelligencer/2020/12/moderna-covid-19-vaccine-design.html https://nymag.com/intelligencer/2020/12/moderna-covid-19-vac... It's almost impossible to imagine the devastation that could have been averted if the vaccine was released in March 2020.

tialaramex 6y ago
Or, as several countries did, you could actually pursue elimination and "avert the devastation" without miraculously creating millions of doses of untested vaccine, injecting them into your population and then crossing your fingers that nothing goes wrong.
onychomys 6y ago
That's only because we know in hindsight that it works, though. Phase 1 and 2 trials are important, even though they take time, because there's no guarantee that a vaccine candidate will be safe and effective. See, for example, a couple of Merck candidates that ended up failing [0]. If the Moderna one had been released in March 2020 and injected in millions of people and then they all got sick anyway, it would have been a disaster. [0] https://www.nbcnews.com/health/health-news/merck-discontinues-two-covid-19-vaccine-candidates-n1255503 https://www.nbcnews.com/health/health-news/merck-discontinue...
- dehrmann 6y ago
  I agree with the importance of safety testing, but I suspect we could have had vaccines 3 months earlier with challenge trials. March was obviously not realistic, and we "had" the vaccine in the same way you have a winning bet in roulette before the wheel stops spinning. Or that Schrodinger still had a living cat.

renewiltord 6y ago

I'm going to say what you're carefully tip-toeing around. It isn't strange. It's normal. When you watch people's actions and not their words, you see what they truly believe. The Trolley Problem is most definitely solved in real life. For instance, we can see that we allow rescue divers to die so that trapped children may be saved. The trolley problem has been solved: some number of cave divers' lives are worth less than some larger number of trapped childrens' lives. Should we risk soldiers' lives going to Afghanistan so we can stop Osama Bin Laden and discourage hypothetical future violence against us? Yes, of course. Trolley problem solved. Try it again with COVID-19 and you learn something. The truth is that we don't really care all that much about some elderly dying (rightly so). We care so little about their lives that we wouldn't even risk a thousandth as many people to save them. That's how it goes. Revealed Preferences tell us all we need to know. There is a dollar sum for a life. Some lives are more valuable than other lives. And there is a banal variant of utilitarianism that flows through us all. We are not fools. No species that risks nothing gains anything.

s1artibartfast 6y ago
I think your point is accurate, but more nuanced. you have to include accountability (e.g. blowback against the person who pulls the lever) Inaction is the most attractive option because the decision maker is can avoid blame. We could have taken an aggressive stance against covid, done challenge trials, mobilized manufacturing, used more controversal restrictions on movement. OR We could have taken a more laze fair approach, letting the elderly lock themselves down and die in greater numbers. Instead, we got some middling third option where politicians try to minimize accountability, and we get both very high deaths and very high economic disruption