The first question to ask Alastair Fraser-Urquhart perhaps is what makes a healthy 18-year-old volunteer to be deliberately infected with a virus that has killed millions, left countless more with life-altering conditions and for which, ultimately, there is no known cure.
He does not miss a beat with his reply.
“I’ve been asked this before and I don’t have a good answer,” he says. “I think the benefits will be so extreme that, even though the risks are high, they’re outweighed by those benefits. We need the information this will give us to deal with this pandemic.”
He thinks for a moment more when asked how his family feel. “My parents aren’t overjoyed,” he concedes.
The gap year student is set to be one of up to 90 young adults who, next month, will become the first people anywhere on the planet deliberately infected with coronavirus.
This “human challenge trial” – run by the government’s Vaccines Taskforce alongside Imperial College London and the clinical company hVIVO – will see the bug effectively sprayed into the noses of volunteers so scientists can monitor how their bodies react.
From this, it is hoped, new treatments, cures and vaccines – including those capable of dispatching virus mutations – will eventually be developed.
But, if the scientific rewards are sky-scrapingly high, so ultimately are those risks.
While young adults without underlying health conditions have a vanishingly small chance of dying from Covid-19, the possibility of suffering long-term issues – long-Covid, to use the catch-all term – remains very real.
One estimate suggests that roughly one in 100 people in the 18-30 age bracket will suffer ongoing issues, ranging from loss of smell and taste to continued loss of breath and extreme fatigue. In a trial where 90 participants are potentially exposed to the bug, that figure suggests one of these human guinea pigs could end up in such a situation.
“Right,” says Fraser-Urquhart, who finished his A-levels last summer and plans to study cancer biomedicine at University College London from September. “And there is no cure for that. But, for me, if that happens – I know it’s easy to say now but I mean it – if that happens, I still think this is worth it. Without these trials, this pandemic will only drag on longer.”
He himself read about the possibility of such a trial last summer at his home in Stoke. “My first reaction was: wait, they’re not doing this already?” he says. “My second was to volunteer.”
He has since undergone extensive screening , cleared his diaries of all commitments and is now waiting for the call after the trials were approved by regulators on Wednesday.
When it comes, he will be taken into London’s Royal Free Hospital, where the trials are to be run, and have the bug squirted into his nose. He will then spend 16 days in isolation while undergoing extensive tests and analysis by medical experts.
Among those will be Dr Andrew Catchpole, chief scientific officer with London-based vaccine tester hVIVO.
The first question for him, perhaps, is should we, as a society, be putting young lives at risk like this?
He, too, does not miss a beat.
“So, taken at face value, has there ever been someone aged 18-30 who has died from coronavirus?” he asks. “Absolutely there has. Is it extremely rare? Yes, it is. Extremely. And we believe it’s not in the same situation we are conducting this trial. These volunteers are rigorously screened and are given a very small amount of controlled virus. This is not like catching it naturally when you have no control of the amount of virus you get or even what else is going on with your body at the time.”
All the same, will he be sweating when this starts?
“Not at all,” he replies. “We’re exited to be doing this. We feel it’s the right thing.”
Among key information scientists hope to find is how the virus replicates once in the nose and how it interacts with the body before symptoms show. They will especially focus on those volunteers who remain asymptomatic when infected.
“The information will be a critical tool in the toolbox for being able to answer the questions raised by the pandemic,” says Catchpole. “What we can already see is that, while these first wave of vaccines are excellent, they are not going to be the sole answer to eradicate the virus out the human population. We still need more information on how the virus works and this will give us that.”
The UK is the first country to do this, he adds, because of unmatched historic experience in similar challenge trials.
Volunteers here have, down the years, been given malaria, typhoid and all number of seasonal coronaviruses. In 1796, Edward Jenner famously tested his smallpox vaccine by giving it to an eight-year-old boy – and then exposing him to the deadly disease. He lived.
“We have an absolutely unprecedented pedigree in doing these studies,” says Catchpole. “It is completely unrivalled anywhere across the globe [with regards coronaviruses], going back to the Common Cold Unit where they were conducting this sort of research for decades [from the Forties] right up until the Eighties.”
His company, hVIVO, meanwhile, has spent the last 20 years pioneering viral human challenge models. Nothing they have done before, he admits, will have been watched quite so closely as what they do over the next three or four months at the Royal Free.
Which, perhaps, brings us back to Fraser-Urquhart.
Volunteers will get paid £4,500 for their time. Not bad for an 18-year-old. What will he spend it on?
He won’t, it turns out. He plans to give it away to a research charity. “This isn’t about the money,” he says. “It’s so much more important than that.”