I am currently opposed to a COVID-19 challenge trial for, among others, four very important reasons:

A thread https://twitter.com/nataliekofler/status/1283938159651430402

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

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.

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.