If Dominic Cummings is to be believed, Boris Johnson was so sceptical that Covid-19 was a threat early last year that he was willing to inject himself with the virus that causes the disease on television. But there are actual volunteers – young and healthy people – who elected to be infected with the virus, all in the name of science.
These volunteers lined up to participate in “human challenge trials”, which have long been successfully employed to develop vaccines for diseases from typhoid to cholera.
The world’s first such trial for Covid kicked off in the UK this March with scientists attempting to establish the minimum dose of the virus required to cause infection in volunteers aged 18 to 30.
However, Cummings, in his seven-hour appearance before a Commons inquiry hearing last week, suggested that the challenge trials should have been initiated much earlier. Had that been done, he said, the vaccination rollout could have kicked off in September 2020 instead of months later.
Alastair Fraser-Urquhart signed up “instantly” to be part of the challenge trial and serves as UK chapter manager of 1Day Sooner, a non-profit organisation advocating for human challenge study volunteers.
He said: “We got really, really lucky with … mRNA being a viable platform, but there was no guarantee of that whatsoever. And if it was completely useless, with a challenge trial you could have found that out in weeks rather than months.”
Fraser-Urquhart was one of the first few participants of the first phase of the challenge trial, in which pre-screened volunteers went into quarantine at the Royal Free hospital in London.
A few days in, the virus was administered nasally by a scientist wearing full personal protective equipment (PPE) as Fraser-Urquhart lay on the bed in a T-shirt and jeans. There were about six people in full PPE in his designated room: “One of them was like in the corner just counting down the seconds … like a rocket launch or something,” said Fraser-Urquhart.
The experience was in equal parts terrifying and amazing, he said. “Being in the room with a vast amount of extraordinarily pure [medical grade] virus … it just looked like water, but you don’t expect to see coronavirus like that.”
After being dosed, subjects lie there for 10 minutes and then sit up and stay in that position for another 20 minutes, explained Jacob Hopkins, who was the first volunteer to be directly infected with the virus. “We actually ended up like … high fiving each other. It was a really weird moment, where it’s like, yay, Covid?! And then the whole thing just began.”
After exposure, the participants were monitored 24 hours a day for at least 14 days, with blood samples and nose swabs taken every day. Both Fraser-Urquhart and Hopkins felt fine for the first few days after exposure but experienced a “rough” couple of days before bouncing back.
“Honestly, it wasn’t an easy thing to do but it was incredible, it’s one of the best things I’ve done in my life and maybe ever will do,” said Hopkins. “When you’re part of something that can do so much good … it’s really just an amazing feeling really to be involved.”
After being discharged, the participants will be followed up for a year so that researchers can monitor any long-lasting symptoms. Altogether, they will be compensated with roughly £4,500 for their involvement. Fraser-Urquhart has already donated the first tranche of his compensation to Gavi, the Vaccine Alliance, and plans to give away the rest to other charities.
“It’s nice to be able to demonstrate that at least some challenge trial volunteers are motivated purely by altruism,” he said. “This compensation genuinely never came into my decision-making.”
Some scientists have expressed reservations about exposing volunteers to Sars-CoV-2 – the virus behind Covid-19 – for which there is no cure, although there are some treatments that have been shown to help.
Proponents argue that the risks posed by the coronavirus to young and healthy people are low and the benefits to society high. These benefits include potentially hastening the development of second-generation vaccines, as developing countries grapple with demand that far outstrips supply for the frontrunner jabs. They could also be used to compare multiple vaccine candidates, develop treatments and improve the scientific understanding of the virus.