Among them is Estefania Hidalgo, 32, a photography student in Bristol, England who works at a gas station to pay the bills.
“I work night shifts there and it can be very lonely,” she recalled on a sunny day near her house. She spends those long curfew only podcasting to keep in company, and describes discovering the challenge process movement – and hearing the motivations of volunteers – as an insightful moment.
“I was shocked,” she said. “Nobody should be left behind. Old people, poor people, colored people. Everyone just deserves to be healthy.”
“This was a way for me to regain control of the situation, to feel in a less hopeless place and in a less hopeless world, and to say, OK, I can do this. To do better, I made up my mind have no fear. “
So-called human challenge attempts are sometimes controversial, but nothing new. They have been used against cholera, typhus, malaria and even colds. However, unlike these diseases, we do not yet have a fully effective treatment for Covid-1
Volunteers in challenge attempts are usually compensated for their time and participation, experts say, but organizers must be careful not to pay any amount that could detract from the coercion.
Critics also say that challenge studies have limited utility as the young, healthy people participating do not represent the broader population.
However, as of last month, the UK government announced that it was in active talks to participate in such an attempt, which would be the first in the world for coronavirus.
Several large vaccine developers – including AstraZeneca, Sanofi, and BioNTech – have already stated that they are not interested in participating. Eleven vaccine candidates are in Phase 3 trials, where tens of thousands of people are given a vaccine candidate, released to live their daily lives, and then monitored to see if they contract Covid-19.
“It is not clear that the first vaccines to be evaluated will necessarily be the best,” said Peter Smith of the London School of Hygiene & Tropical Medicine. “I think there is a very strong case for examining challenge studies evaluating vaccines for a large number of potential Covid vaccines in development.”
The challenge attempts discussions are so advanced that the UK Health Research Authority (HRA), which must approve any research on human subjects, has a standby body to evaluate the medical ethics behind possible proposals.
“There is very little research that poses no risk,” said Terence Stephenson, who heads the HRA. “Every day in this country, in every country, health professionals voluntarily put themselves at risk of caring for other people.
“People who, in their opinion, could be ready to do this for the good of society – I personally don’t find that surprising.”
Alastair Fraser-Urquhart, only 18 years old, would readily agree that his decision to volunteer was unremarkable.
“It was such an instant common sense idea,” he said. “The risk to me is small. But if I take this small risk, I can potentially protect thousands of other people from becoming infected without consenting to it.”
Fraser-Urquhart was so drawn to the idea back in June that he joined 1 day early and is now leading a campaign for the UK government to enable the first coronavirus challenge process. He postponed the start of studies for a year to work on the project.
If everything goes according to plan and he passes screening, he hopes to check into a bio-containment facility, take a vaccine candidate, and stay in a room for many weeks.
In normal phase 3 studies, there is always a placebo group – some people who are not receiving a vaccine – to have an infection base. However, there is a big difference between potential infection in everyday life and intentional exposure, albeit in a medical setting.
There is some disagreement about whether a coronavirus study would require a placebo group. Stephenson suggested they not do this, but Smith isn’t so sure.
“The problem,” said Smith, “is essentially that if you give a group of volunteers a vaccine and then challenge them and none of them develop a disease, it’s because the vaccine was protective or something wasn’t true. ” the way you challenged them so they didn’t get infected? And you can only definitely answer this question if you have a control group. “
It is no surprise that Fraser-Urquhart’s enthusiastic participation gave his father a brief break.
“Obviously not at the top of the list of things to expect from your son,” said Andrew Fraser-Urquhart, 52. “The first thing I thought was, at least now, what was the last time he was in his room has done three weeks on his computer, “he said with a chuckle.
They talked about what it would mean and despite a “lump in the throat” he realized there was no stopping Alastair, who talks about the intricacies of the science of challenge trials in ways that contradict his teenage years.
“It’s at the forefront of science and technology,” said Andrew. “It’s something that benefits others. It’s something pretty brave. It’s something else. And that’s how he gets to the point. If you put it that way, no, it’s a surprise at all.”
To put it simply, he is undoubtedly proud of his son.
The risk is of course small, but not zero. Less than 1% of deaths from Covid-19 in the US were among the 34 or younger. However, the long-term health consequences of a viral infection are still largely unknown.
For Alastair, this is all the more reason to undertake a challenge attempt to hasten the end of the pandemic and help more people in the public not avoid these long-term consequences.
“If the time is ever to push the envelope and find out how fast we can do things and how well we can do things and take risks for other people, now is the time.”