Volunteers inject nCoV into their bodies
While billions of people are trying to find ways to prevent nCoV, there are those who take the risk and actively get infected with the virus to test the vaccine.
This is called human challenge (HTC), and has been used in the past for seasonal flu, malaria, dengue, cholera, and typhoid. After the vaccine is administered, participants are injected with a small amount of the virus, which is considered not dangerous enough. Scientists then evaluate the effectiveness of the product.
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| Estefania Hidalgo, 32, a photography student in the UK, volunteered to be infected with nCoV to test the vaccine. Photo: CNN |
Volunteers sign up for the program through a program called 1 Day Sooner. So far, the campaign has received applications from tens of thousands of people in the UK and the US. One of them is Estefania Hidalgo, 32, a photography student in the UK. She works at a gas station every day to pay for her tuition.
“It was a late shift, and it was lonely,” Hidalgo recalls of her first encounter with the proactive testing program. While walking home after a long shift, she stumbled upon the 1 Day Sooner podcast. She calls it her “lightening moment.”
"I was shaking. No one should be left behind in this fight. The elderly, the poor, people of color, they all deserve to be healthy," she said. "This was my way of taking control, feeling like I was in a less desperate place. I decided to do this, to choose not to be afraid."
Experts say volunteers infected with the coronavirus receive compensation, but organizations must be extremely careful not to turn this into a money-making motive or force others to participate for personal gain. Medical ethics experts also say that the young, healthy volunteers participating in the project do not represent the majority of the world's population. But last month, the British government actively initiated dialogue, promoting cooperation to conduct proactive trials. Discussions were so heated that the UK Health Research Authority (HRA) set up a panel to review ethics of all proposals related to this method.
Terence Stephenson, head of the HRA, said: "There are very few studies that are zero risk. Every day, in this country and many other countries, health professionals put themselves at risk to care for others. Those who would do that (get infected with coronavirus) for the benefit of the wider community, I personally find that not surprising."
Alastair Fraser-Urquhart, 18, a member of the 1 Day Sooner project, agrees. He believes his contribution is insignificant. "It's just a spur-of-the-moment idea. The risk to me is very small. But by taking that small risk, I can protect thousands of other people from the disease."
Urquhart is now leading a British government campaign to support the first active trial. He has postponed his university studies for a year to work on the project. If all goes according to plan, he will be injected with the vaccine and the coronavirus, quarantined in a high-security bio-facility for weeks.
In a typical phase 3 trial, there is always a control group of volunteers, who receive a placebo instead of the vaccine. Scientists will compare the number of vaccinated people who still get infected with nCoV with this group to evaluate the effectiveness of the product. But there is a big difference between natural infection in the living environment and actively introducing the virus into the body.
"The question that arises is if you vaccinate a group of volunteers and expose them to the coronavirus, but no one gets sick, is that because the vaccine actually works or because something went wrong with the injection? You can't really explain that without a placebo group," explains Peter Smith of the London School of Hygiene & Tropical Medicine. But the use of placebos in active infection trials is controversial in medical ethics.
Unsurprisingly, Alastair Fraser-Urquhart's enthusiasm gave his father pause. "Obviously this isn't something you want your son to get involved in. The first thing I thought was, 'Oh, I finally know what he's been doing in his room, sitting on his computer for the last three weeks,'" says Andrew Fraser-Urquhart.
The two talked about Urquhart's decision. Despite "a lump in my throat," Andrew realized that nothing would stop his son.
"This is a pioneering method in the field of science and technology. It is beneficial to the community, extremely daring but also a bit different. That is also what describes my son. If I look at it this way, I am not surprised that he decided to participate," he shared proudly.
For young people like Urquhart, the risk is small but not zero. Less than 1% of Covid-19 deaths in the US have been among people 34 or younger. The long-term health consequences of infection are still unclear.
For the 18-year-old, this is also a reason to participate in the trial, helping to speed up the process of ending the pandemic, avoiding the community having to face those long-term consequences.
“If there comes a time when we have to push the boundaries of how much risk we can take and how quickly we can do this, this is that time,” he said.
