Faster use of human guinea pigs to test vaccine would have cut deaths

Hindsight is a wonderful thing, though. Covid-19 was halfway round the world before even China gripped it. Widespread testing would have severely dented transmission, yes, but given people without symptoms spread it too, PCR testing was no fail-safe once Covid-19 was deep in the community. The summer 2020 lull presented opportunities to improve contact tracing, sure, though that was ultimately quelled by politicians egging us on to normalise life.

“Lessons,” though, are surely more valuable if they have structural implications, rather than just retrospectively highlighting when decisions turned out to be misguided.

One unspoken lesson we might learn is the value of “human challenge trials” for vaccines, where volunteers are paid to be exposed to viruses in controlled conditions. Moderna’s vaccine took just two days to produce in January 2020. Months after that were spent navigating trial protocols in various countries, despite the organization 1 Day Sooner having signed up thousands of would-be volunteers for challenge trials worldwide, with little advertising.

Challenge trials could have accelerated vaccine efficacy assessments, speeding up approval, production, and the end of the pandemic. By giving us data more swiftly, this would have saved thousands of lives and around £3.6bn per week in revived UK economic activity once the pandemic was over. As Jessica Flannigan writes in a cover essay for the Cato Institute, “every day of bureaucratic delay is a day that public officials contribute to the invisible graveyard of people whose deaths could have been prevented by faster access to vaccines.”

Recently, UK officials have partnered with researchers to begin challenge trials for other Covid-19 vaccines and aim to use them to answer other questions about doses or combinations. But in the high-stakes months last year, supposedly ethical concerns won out. It was seen as inherently wrong to use health resources to deliberately infect someone, because you might make them sick and die without a corrective treatment. Of course, the “cost” of such paternalistic precaution was accepting thousands of additional deaths as the virus spread in a largely unprotected community.