Thousands of people want to be exposed to Covid-19 for science

Abie Rohrig had just turned 18 when he told his mom he would be donating a kidney to save a stranger’s life.

“Her answer: No you’re not. He did it anyway — the organ went to a man about his age — and his mom was so inspired she went and donated a kidney herself.”

So Rohrig expected her to understand when he told her that, for the benefit of humanity, he may volunteer to become infected with Covid-19.
It turns out “she’s more worried than she was about the kidney thing,” said Rohrig, now a 20-year-old college student who lives with his parents in a New York City apartment.
“She was like, ‘What? What? I don’t know,'” he said. “She’s skeptical.”

Rohrig is one of more than 16,000 people — most of them young adults — who have signaled their support for a controversial method of speeding up the development of a vaccine by intentionally infecting dozens of volunteers.

The signees of the online registry — a new website called 1 Day Sooner — have all checked a box next to the statement: “I am interested in being exposed to the coronavirus to speed up vaccine development.”

“The practice is called a human-challenge study — or controlled human infection study”, — and it can truncate a conventional vaccine study by several months.

The reason:

Rather than waiting for months to assess what percentage thousands of vaccine-trial volunteers get infected with the disease in question while leading their day-to-day lives, a challenge trial is much simpler, in that it exposes about 100 volunteers directly to the pathogen — via syringe, cocktail, mosquito bite or nasal spray after an experimental vaccine or placebo is administered. (If the Covid-19 study comes to fruition, experts say it would likely be administered by nose drop.)

But if it’s high reward, it’s also high risk: Although Covid-19 is a much more deadly disease for the elderly and the compromised than healthy young adults, it is an unpredictable pathogen that has put star athletes in the hospital. What’s more, should something go wrong, treatment options are limited.

However, with the disease still raging after having killed more than 82,000 Americans and 291,000 people worldwide since it first appeared in China late last year, some say a riskier-than-normal study is justified.

Challenge studies offer high reward, but also high risks
The notion of a human-challenge trial for Covid-19 was jump-started by a March 31 article in the Journal of Infectious Diseases, which made the case that the nature of the global emergency warrants consideration of unconventional approaches.
Co-authored by Nir Eyal of Rutgers, Marc Lipsitch of Harvard, and Peter Smith of the London School of Hygiene & Tropical Medicine, the piece concluded that while a human challenge study would not be without risks, “every week that vaccine rollout is delayed will be accompanied by many thousands of deaths globally.”

“It’s an idea that is controversial when people hear about it for the first time,” Eyal, a bioethicist, told CNN. “However, we show that if you select people in the right way and conduct the trial in the right way, it’s surprisingly low risk and certainly within the bounds of what we already approve.”
Such a study would ultimately need the blessing of the US Food and Drug Administration.
But the researchers’ call for a challenge study has since been propelled by the popular support of those who have indicated on 1 Day Sooner — which is incorporating as a nonprofit organization — that they’d be willing guinea pigs. (This is just an informal expression of interest, not a binding contract.)

The site, which was inspired by the scholarly article, launched in mid-April and is premised on the claim that shaving even one day from the long-distance race for a Covid-19 vaccine could save up to 7,120 lives.
What a human challenge study for coronavirus could look like
At some point, should a group of researchers decide to seriously explore the matter, the site would ask prospective volunteers to fill out pre-qualification questionnaires that would divulge more of their medical history, region of residence and other information that would help determine eligibility, said 1 Day Sooner’s co-founder Josh Morrison.
The researchers would then screen those forms for the most eligible applicants and would eventually seek approval from a research or medical center to host the study, he said.

Morrison is a former corporate lawyer who gave up life in the fast lane to start a nonprofit organization called Waitlist Zero, which matches prospective kidney donors with recipients. Because business is at a near-standstill in the kidney-transplant world, Morrison found himself with a lot of spare time.
“I was like sitting at home in my apartment in New York City, just kind of depressed,” he said.
Morrison came across the Journal article while noodling around on the internet.

“And I thought, ‘Well, would I want to do this?'” he said. “I’m pretty young, 34, and in good health. And so I thought, ‘Yeah, I think I would.'”
The notion seems to be gaining traction in expert circles. On May 6, the World Health Organization released a report outlining “key criteria for the ethical acceptability of Covid-19 human challenge studies.”