I know several students who joined the military not because it was their first choice, but because they saw it as a way to pay for education or a path “out” for their future that doesn’t otherwise exist. It still happens.
A lot of life is gray - what’s worth the risk and what isn’t. Those with money always have options those without do not.
I’m 100% against using people at random (like a draft) whether that’s civilians or medical folks or military members or whatever group one wants to use to test things on. Volunteers though, that’s different. Be sure they know the risks, and whether it’s altruism or money or a combo of both, their service is appreciated.
I don’t think a challenge trial for Covid is ethical, for these reasons:
There is no clearly established treatment regime or cure.
We already know that Covid manifests and progresses in very different ways among different individuals -- so not only is it hard to predict what will happen to infected participants in the challenge trial, it is also hard to draw any firm conclusions from their experiences -- especially in a small scale trial. (And a large-scale challenge trial only magnifies the ethical concerns).
We still don't know enough about long-term effects of a Covid infection, including things like potential long-term organ damage to individuals even if they are asymptomatic or mildly symptomatic
I don't see the need for a challenge trial in any event. The current worldwide epidemic provides plenty of opportunities for studying the virus "in the wild" -- it seems like the goal of the challenge is to figure out how much of a viral "dose" is needed to infect healthy young people..... but what's the point of that? We already know that this is a highly infectious, likely airborne virus.
@calmom, as I read it, the challenge is given after being dosed with a vaccine to measure the effectiveness of the vaccine in those where exposure is known vs giving a vaccine and waiting to see if they become ill but not knowing even if there was a community exposure.
The first set of challenges will be without vaccine candidates to determine what the infectious dose is that will be used in the challenges with the vaccine candidates.
Knowing the infectious dose could be useful in other ways, such as if the amount of virus in the air in an enclosed space can be measured, the risk level based on the amount of time spent in that enclosed space can be assessed.
But obviously, there are the ethical questions with such a trial.
“For some COVID-19 patients, recovery does not mean the end of their suffering. Effects from the illness could linger in the brain and manifest through symptoms including persistent headaches, brain fog and cognitive difficulties.
To address these long-term neurological effects, doctors at the Yale New Haven Hospital have started a new neuroCOVID clinic — one of the first of its kind in the United States. Led by a team of physicians at YNHH, the clinic started offering telehealth consults on Oct. 12 and will likely transition into a physical setting in the coming months.”
Hopefully start to see more clinics focused on long term effects.
If this proves true in other studies, it’s a bummer to say the least:
"Convalescent plasma does not reduce deaths, halt disease progression in patients with COVID-19, study suggests
Reuters (10/22, Kelland) reports that “using blood of” patients who have recovered from COVID-19 “as a potential treatment is of little benefit in helping hospitalised patients fight off the infection, according to results of a clinical trial in India.” Published in the BMJ British Medical Journal on Friday, “the results show that convalescent plasma, which delivers antibodies from COVID-19 survivors to infected people, failed to reduce death rates or halt progression to severe disease.”
One will have to google the link, I copied the text from a daily medical update email from the AMA my med school lad gets.
My heart goes out to all of them. Yes, it’s rare, but that could be one of my kids. I think that as we understand the immune system better, we will discover that many maladies are caused by post-viral immune dysfunction.
I ran across an interesting article that described a possible risk of treatment of COVID-19 with hydroxychloroquine. It is a rare condition called Methemoglobinemia. The acquired (non-congenital) form of Methemoglobinemia can be caused by many different drugs, one of which is hydroxychloroquine. The drugs that can cause this have an oxidizing effect that changes a portion of the iron in the red blood cells’ hemoglobin from the ferrous to the ferric state. This causes oxygen to be held too tightly by the other iron containing heme molecules so that it is not delivered efficiently to the cells in the body tissues. This can cause cyanosis in which some skin turns a bluish color and can cause life-threatening problems. Doctors are warning that this rare condition may be becoming more common with the use of hydroxychloroquine for COVID-19.
Just wanted to add a personal anecdote here. My 89 year old father had Covid back in the spring. Spent nine weeks in the hospital. The last three weeks, without symptoms, but couldn’t get the required negative Covid test to let him back into his assisted living facility (NY state).
A few days ago, this is now months after being out of the hospital, he had low oxygen levels and some difficulty breathing. He was admitted to the hospital where he was given several tests. Guess what, his Covid test was positive again. He most likely has pneumonia, based upon his chest x-ray. However, the new positive test brings up many questions - are the tests reliable, does his body still have the virus (has not gotten rid of it completely), has he been reinfected (probably not likely), etc.
When speaking to the doctor, they didn’t really have an answer as to why his test was positive after so many months.
I wonder if COVID goes dormant but stays in the body, like chickenpox, TB, and Epstein Barr- and then reactivates with some sort of physical or psychological stress.
@HImom , Mcconnell’s hands look like my Dad’s. In Dad’s case it’s because he’s on blood thinners and every little bump results in a pretty large bruise or outright bleeding. The bruises look nearly black sometimes.
Methemoglobinemia can also be inherited through a recessive gene. My book group just finished “The Book Woman of Troublesome Creek” and the condition figures heavily in the novel, so I researched it.
Reading about reinfections is so frightening. How long will a vaccine be effective?
@dragonmom How amazing that you have been studying this rare condition that I just found out about.
A lot of people think McConnell’s condition is bruising. Did your father’s hands become bruised gradually over time, or did they become dark all of a sudden? Do his hands heal up and become normal color again? Sorry he is dealing with this.
Whenever I’ve read of a reinfection they’ve noted that it has been a different strain, so a confirmed reinfection. I have no idea how many cases are out there, if any, where it’s the same strain. There may be a lot and we’re just not hearing of them?
It would definitely be nice to have more information.
@kiddie I hope your dad is ok. If you find out anything about the strain, please post.
Thanks for the concern from people. He sounds fine and says he feels fine. I think it is most likely pneumonia or another kind of lung infection. They are not treating it as Covid.
I worked at a covid surge facility in California from April through September. Our facility took people who were not sick enough to be in the hospital, but couldn’t go home for whatever reason. Our first patients needed two negative tests to be released. Our first patient was a woman in her 80’s with multiple medical problems. She was there for weeks! Later the standard was changed to the school of thought that they were no longer contagious 14 days after initially testing positive.
Thanks, @dragonmom! Even without blood thinners, seniors seem to bruise very easily, especially if they are on inhaled or even worse oral steroids. Now that I think of it, my dad had awful-looking bruises as he aged and he newer knew how he got them.