Vaccine challenge trials NOW!
Friday, May 1st, 2020Update (May 5): Here’s a Quillette article making the case for human challenge trials. I think there’s an actual non-negligible chance that this cause will win—but every wasted day means thousands more dead.
I’ve asked myself again and again over the last few months: why are human challenge trials for covid vaccines not an ethical no-brainer? What am I missing that all the serious medical experts see? And what are we waiting for: for 10 million more to die? 20 million? So it made me feel a little less crazy that the world’s most famous living ethicist agrees.
I loved the way James Miller put it on my Facebook:
This is the trolley problem where the fat man wants to jump knowing his chance of death is below 1% and our decision is whether to stop him.
Like, suppose someone willingly sacrificed themselves so that doctors could use their body parts to save 10 million people. We might say: we would’ve lacked the strength to do the same in their place. We might say: we hope they weren’t pressured or coerced into it. But after the deed is done, is there anything to call this person but a hero, or even a martyr? Whatever we feel about the fireman who sacrifices his life in the course of saving 10 kids from a burning building, shouldn’t we feel it about this person a million times over? And of course, I deliberately made this vastly more extreme than the actual situation faced by young, healthy volunteers in a covid challenge trial, who in all likelihood would recover and be fine.
Regarding the obvious question: so would I volunteer to take an unproved vaccine, followed by a deliberate covid injection? Sure! Unfortunately, I might no longer be a candidate: I’m now nearing middle age and pre-diabetic, I help watch two young kids, and I live with two immunocompromised parents. But on the principle of walking the walk: if it were a vaccine candidate that I considered promising (and there are now several), and if it were practical to isolate me away from home for the requisite time, and if I could actually be of use, then absolutely, jab me.
On a somewhat related note: Last night I watched the Ender’s Game movie with my 7-year-old daughter Lily (neither of us had seen it; I’d read the book but only as a kid). Not surprisingly, the movie was a huge hit with Lily; she’s already begging to see it again. As for me, my first thought was: what a hackneyed sci-fi premise, that the entire human race is under attack from some alien species, and that all human children grow up in the shadow of that knowledge. Nothing whatsoever like the real world of 2020! My second thought was: what a quaint concept, that faced with a threat to humanity, the earth-authorities would immediately respond “quick, we need to find and train and cultivate super-geniuses willing to break the rules, and put them in command!” Only in the movies, never in real life! Except in, y’know, WWII, where that mindset was pretty crucial to the Allied victory? But 75 years later, yes, it reads to us as science fiction.
To inject a tiny note of optimism, I’m hopeful that we will eventually see some fruits of genius commensurate with the threat, whether in the realm of treatments or vaccines or contact-tracing apps or PPE or something else that no one’s thought of yet. Right now, though, the sad fact is this: as far as I know, the only indisputable work of genius to have arisen in response to the covid crisis has been the Twitter account for steak-umms.
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