A Coronavirus Challenge Trial Is an Ethical Imperative

Before those conversations, I tentatively thought that allowing human challenge trials could be ethically justified in the present pandemic. Now I think that allowing that approach is an ethical imperative.

Josh Morrison lives in Brooklyn, New York, where he leads Waitlist Zero, a nonprofit that tries to make donating a kidney easier. He was feeling depressed and scared as COVID-19 spread to the United States, slowing the normal work of his organization and hitting his city especially hard. Then a friend sent him the proposal that would appear in The Journal of Infectious Diseases.

“It seemed like something I would want to do, were I eligible,” he told me. In 2011, when he was a corporate lawyer, he donated a kidney, accepting a small risk of death to save a life. An early vaccine for COVID-19 could save tens of thousands of lives.

Morrison launched the COVID Challenge, “a hub for people to volunteer and to advocate for safe and rapid vaccine development.” Anyone willing to volunteer for a human challenge trial can add their name to a list that can be winnowed as appropriate and handed over to interested vaccine researchers.

Roughly 1,550 people have already signed up. And Morrison hopes that their eagerness will be taken seriously by government officials, ethicists, and scientists.

“It is not a riskless thing,” Morrison said, “but neither is kidney donation. And each year, thousands in the U.S. and tens of thousands in the world do that … If you think this will move a vaccine forward by even a day and save thousands of lives, the ratio of volunteer lives lost to lives saved would be thousands to one. Any life lost is tragic, but that’s worth doing as a society if you have volunteers who know the risk.”

Gavriel Kleinwaks is 23 and pursuing a graduate degree in mechanical engineering at the University of Colorado at Boulder. As an undergraduate at a small liberal-arts college, she had friends in the effective-altruism movement, and she still reads articles written by its public intellectuals. That’s how she found out about the COVID Challenge. And while researching human challenge trials, she discovered that Jonas Salk, her scientific hero for his work on the polio vaccine and his refusal to patent it, gave the vaccine to himself and his family before asking the public to take it.

Participating in the development of a vaccine, even in a small way, struck her as cool. And she explained to me that the religious tradition in which she was raised, Judaism, ingrained in her the notion that “for anyone who saves one life, it is as if they had saved a whole world.” Many try to save lives by donating time or money, neither of which she has done. “I am lucky in a lot of other ways, including good health,” she said. “I’m young. I don’t get sick a lot. This seems like a way that I can share some of that luck. I empathize with other people. The pain of losing someone you care about is the same no matter who you are. Anything to reduce that amount of pain is something I should try to do.”

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