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I am currently opposed to a COVID-19 challenge trial for, among others, four very important reasons:
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1) There is no rescue therapy for SARS-CoV-2 infection.
For other challenge trials, done for Malaria for example, there is a reliable rescue therapy. If patients get sick (or very sick) they can be treated and risk of death is low.
For SARS-CoV-2 this therapy does not exist
For other challenge trials, done for Malaria for example, there is a reliable rescue therapy. If patients get sick (or very sick) they can be treated and risk of death is low.
For SARS-CoV-2 this therapy does not exist
2) There is no “challenge virus”. Generating virus for human “consumption” is not an easy task. Generating a virus that might be weaker or less virulent (but still be relevant for testing a vaccine) is even harder.
3) There are serious concerns RE: risks. Even if we do choose “healthy, young” volunteers, there have been reports of long-term cardiovascular and lung function deficits.
Infected young people may not die, but will deal with health consequences for decades.
Infected young people may not die, but will deal with health consequences for decades.
4) I have major misgivings about informed consent and autonomy here. We are dealing with an economic fallout associated with this pandemic. Any compensation for a trial like this could constitute exploitation if those that sign up have been economically impacted by COVID-19.
This point is important because the compensation associated with a challenge trial, which will likely require weeks-long isolation, will be (and probably should be) significant. This could easily be attractive to those who have lost their jobs.
Finally I’ll say this: there is no real guarantee that a challenge trial, at this time, would speed up vaccine development. We ought to think long and hard about intentionally infecting folks with a virus we understand so little about, without a rescue therapy.
We will be condemning those volunteers, if not to death, then to long-term health consequences that we don’t yet fully grasp.
