[nudephil (OP)]

Keith sent us this:

All the trials I have heard of involve giving someone a treatment and then "releasing them into the wild". Are there no trials that involve a treatment and then infecting someone with the virus? Participants would be guaranteed medical treatment if need be, etc. This would hasten development of vaccines and other helpful drugs. I, and many others, would volunteer.

What do you think?

[Bored chemist]

I think you would never get it past an ethics committee.

[alancalverd]

Agreed (I sit on an ethics committee).

We have plenty of people with active COVID at various stages from "recently infected" to recovered or dead, adequate evidence of how it is transmitted, and a wide variety of expressions from "active but asymptomatic" to very dead.

It is very unusual to grant research ethics approval to any procedure with more than 0.1% known risk of fatality, and even in those cases there must be a probable benefit to the participant - usually patients with a terminal prognosis. In the case of COVID infection we have an overall 5% risk of fatality, with a much higher risk (probably ~20%) in the definable groups who are likely to benefit most from prophylaxis. The additional scientific benefit would be negligible as there is no shortage of extant  cases at all stages of disease and still a few uninfected controls, though the number is decreasing rapidly as governments play politics instead of tackling the pandemic.   

Sadly, and entirely due to governmental incompetence, the disease is sufficiently widespread and infective that "treat and release" will suffice to demonstrate the effectiveness of any experimental prophylaxis.   

[evan_au]

Would it make a difference to a vaccine trial if:
- They tested the participants to see if and when they developed antibodies
- For those participants who developed antibodies, invite them to participate in the next stage of the trial
        For these volunteers, expose them to the virus.
        They may need to be paid
        They would need to be offered accommodation and food in a comfortable isolation facility for at least 2 weeks (eg a hotel)
        With the promise that they would be tested regularly for virus and general health
        And access to hospital health care should the symptoms become severe

These people will eventually be exposed to the virus (sometime) - they just have the option of doing it under controlled conditions and close medical supervision.

[Bored chemist]

They may need to be paid

Many governments  have outlawed "danger money" because they recognise that its intrinsically a bad thing.
You are asking people to put a cash value on their lives and that's wrong in the first place, but it's particularly wrong when you recognise that it puts those who are already disadvantaged at  even greater risk.

[alancalverd]

"Reasonable expenses" are payable in the UK - but also taxable and can affect eligibility for benefits.

[alancalverd]

These people will eventually be exposed to the virus (sometime) - they just have the option of doing it under controlled conditions and close medical supervision.

Yes, but. Everybody is at some risk of being hit by a bus, but I doubt that it is ethical to "do it under controlled conditions and close medical supervision".

The problem is that we don't have a cure, or any reliable means of predicting the outcome of an individual  COVID infection, but we do have plenty of real subjects at various stages of disease, and perfectly simple means of preventing infection and eliminating the virus. The only worthwhile and ethically defensible research is on treatment of existing patients, and development of a preventive vaccine in case governments continue to mismanage the pandemic.

[set fair]

Perhaps giving a drug which is "said" to give prophilactic protection eg hydroxy chloroquine + zinc and then infecting the subjects with one of the four corona viruses which cause a cold would be an idea worth trying.

[Bored chemist]

Perhaps giving a drug which is "said" to give proohilactic protection eg hydroxy chloroquine + zinc and then infecting the subjects with one of the four corona viruses which cause a cold would be an idea worth trying.

Or not bothering...