On January 10th, Chinese scientists published the genetic sequence for the novel coronavirus. Moderna’s mRNA vaccine was designed by January 13th. This means, to first order, the 2 million people who have died from COVID-19 died after we invented a vaccine. If worldwide COVID deaths were a city, it would be the 5th largest in the US.
I’m going to let that sink in for a moment…
So what’s taken so long? Yes, manufacturing had to be scaled up, and apparently distribution is hard, but it’s the clinical trials that took so long. So how could we speed things up?
There’s a thought provoking article by Matthew Yglesias at Slow Boring on the case for vaccine challenge trials. The thinking is…
If you give a bunch of people a vaccine candidate and a bunch of other people a placebo and then expose them all to the virus, you will quickly get statistically powerful information about whether infection is rarer in the treatment group than in the control group.
Makes sense: short-circuit the process of waiting for some fraction of the experiment’s population to be exposed incidentally to provide more definitive results, more quickly, with a smaller sample size.
The objection is obvious: you’re asking half the trial to knowingly expose themselves to a virus that might kill them and will definitely kill some of them. It would also inarguably—on net—save lives. History is of course full of people giving the last full measure of devotion to save others; luckily, it seems like there’s a better way: give everyone in the trial the vaccine and the exposure. No placebo control group. As Yglesias points out:
Doing it [this] way is considered bad science. Once you accept the need to test the candidate against a placebo, there’s no way to avoid the fact that your trial isn’t done until a bunch of people vaccinated with a placebo get sick.
Well I don’t accept the need to test against a placebo, not in this case. This is process getting in the way of progress. Yes, the placebo effect is real, but are we really concerned that humanity is going to beat back COVID-19 with the power of positive thinking?
Let’s do challenge trials, but vaccinate the whole trial and use an alternative control group: the remaining 7.7 billion people. I haven’t worked through all the statistics, but if we give 41k people the vaccine, and then expose them to the virus, and 95 percent don’t get sick, then meanwhile do nothing for everyone else on the planet and the pandemic rages unchecked and kills thousands per day…we have our answer.