The New Yorker Radio Hour - Larissa MacFarquhar on a Potentially Deadly Experiment, and Jelani Cobb on the Killing of Ahmaud Arbery

Episode Date: May 22, 2020

Abie Roehrig, a twenty-year-old undergraduate, has put his name on a list of volunteers for a human-challenge trial to test the efficacy of a COVID-19 vaccine. A human-challenge trial for a vaccine would be nearly unprecedented: it would entail giving subjects a candidate vaccine against the virus, and then infecting them deliberately to test its efficacy more quickly than a traditional, safer vaccine trial. Larissa MacFarquhar talks about this highly controversial proposal with the epidemiologist Marc Lipsitch, who supports such trials for COVID-19, and the virologist Angela Rasmussen, who feels that the scientific benefits are too limited to justify the enormous risks. Plus, Jelani Cobb speaks with the legal scholar Ira P. Robbins about the shooting death of Ahmaud Arbery, and why prosecutors declined  for months to arrest the white man who killed him. In the Arbery case, Robbins sees a fatal confusion of citizen’s-arrest laws, stand-your-ground doctrine, and racial profiling.  New Yorker Radio Hour listeners, we want to hear from you.  We have a few questions about the show and how you listen to it. The survey takes about twenty minutes, and your feedback will help us make our podcast better.  Take the survey here.

This is The New Yorker Radio Hour, a co-production of WNYC Studios and The New Yorker. I'm David Remnick, and you're listening to The New Yorker Radio Hour. I would like vaccine development to happen as quick as possible, and for that to happen, there have to be people who are willing to be part of these challenged trials, it seems. And if that's the case, then, you know, I don't see any good reason why it shouldn't be me. This is A.B. Rourke. He's 20 years old, an undergraduate, and he's got some news to break to his mother, Elaine. I know I've talked to you a bit about my involvement with human challenge trials, or at least my desired involvement with human challenge trials to help speed up the development

of a vaccine for coronavirus. And that's basically why I want to talk to you is that I would like to volunteer myself to be part of this trial should it happen. I'm pretty floored by that. But I think that it just seems like that's a huge risk to take, especially with just one kidney. Larissa McFarker is a staff writer for the New Yorker. Larissa, you talked recently to A.B. Rourke, what's going on here? A.B. has volunteered to be a subject in a vaccine trial, a particular kind of high-risk experiment called a human challenge trial. And his mother is pretty worried about it. I totally admire and respect your desire to help people.

I just don't know how safe it is. Right. But you just had your kidney out in July. I can't imagine that would be safe. I mean... But basically, I want to put my name down. And if a trial comes about and experts deem that I am fit actually to be part of a human challenge trial, then I want to do it. Whoa.

Wow. I follow you. And I understand that you want to help, and that's the way you've always been. But it's... I think I feel a sort of broader sense of obligation or almost like a principled obligation that I know that there need to be people who are willing to step up, and I just feel this urge to be one of those people. Or framed the other way, I guess, you know, why shouldn't it be me?

I guess having one kidney is a pretty good reason. Yeah, because it's like you're doing this for the universe, but you are my universe. So it's a little bit hard to, I guess I just need to know more, you know, just who's doing the testing, how much COVID are they exposing you to? And are there any other people who volunteered besides you? Yeah, yeah. There are 16,000 people, over 16,000 people now who have volunteered. It's more than there were people in my hometown of Carlisle. That's a good sign. I've got a lot of questions, Larissa, but first explain what a human challenge,

trial is. Yeah, so normally what you do in a vaccine trial is you give the vaccine candidate to several thousand people. You give several thousand others a placebo and then everybody goes home, they go about their regular lives. And after several months, you see who's gotten the disease, who hasn't. And that tells you something about how effective the vaccine is. Well, just that phase alone takes many months because what you're doing is you're just sending people around their about their daily lives. And so they might not get it. And what's worse, people are not going about their regular lives, right? They're staying at home. They're practicing social distancing. They're doing everything they possibly can to avoid getting sick. So if you were

to follow the normal vaccine protocol and send people out to see if they get it or not, it could be much longer than that. They might not get it and it might tell you nothing about the vaccine candidate at all. Right. In a human challenge trial, you give volunteers a vaccine candidate. And then you expose them to the virus on purpose. That way, you can start to get a sense of whether the vaccine candidate works or not within a couple of weeks. So who's signing up for that? I mean, that sounds awfully dangerous to be deliberately exposed to novel coronavirus. It is, of course. You know, to be clear, this is all still hypothetical. There are no human challenge trials happening right now in the U.S. trials, they would need to be approved by the FDA. But yes, AB is volunteering to get

COVID. Well, I can understand wanting to make things faster, but that, you know, it just seems like certain people react to COVID in ways that are very quickly deadly, right? So I just know the Tuskegee syphilis experience. Like, there are bad cases of people being harmed by, in these trials. So I don't know, but this one, it just somehow seems a bit more dangerous than giving your kidney away. No, I understand. And I think you very well might be. right? You know, this is a question for the scientists and the doctors about whether or not having one kidney will seriously compromise me should I be, should I get coronavirus? Should I be part of a trial? So A.B. said to his mom that more than 16,000 people, including himself,

have signed up to volunteer. But that was already several days ago. And I checked the number this morning. This morning, there were more than 23,000 people signed up to volunteer to be exposed to COVID and in 102 countries. So this thing has become huge. Three researchers wrote a paper at the end of March it was published suggesting these human challenge trials. And a group of people were inspired by this idea and thought, well, how are we going to get people to sign up? They started an online sign-up sheet. This is a group called One Day Sooner. They're called One Day Sooner, because they're estimating that each day that you cut off the process of developing a vaccine could save thousands of lives. Wow.

People volunteer to do risky things on behalf of others that are riskier than this, including kidney donations, all the time. Professor Mark Lipsich was one of the co-authors of the journal article in support of using challenge trials. So he's very much behind this idea. The real reason I wanted to get this idea out. there is that we really face a challenge that's very much worse than challenges we've faced before from infectious diseases. And it seems to me that even a very small benefit in terms of speeding up the approval or availability of a vaccine could be enormously valuable to humanity. if we really thought it was not acceptable for people to voluntarily take on risk on behalf of others,

then we would have to shut down our police, fire, EMT, and military operations, because that's how we run them, as we ask people to take on risks, which are not definable fully in advance, and they're doing that as a job, but also on behalf of other people. and research needs special protections because of the history of bad things that have happened under the guise of research. But I think it's important to see this as one of the many areas where people can take on an altruistic risk if that's something they choose to do. I've been talking to a few people about these volunteers who are signing up. And I think most people's first reaction is that's insane. like why would you voluntarily expose yourself to coronavirus?

But it actually doesn't seem that strange to me. I mean, it feels like this is a world historical moment, and this is, in a sense, the moral test that's held up for this generation. Are you going to put yourself on the line to help us out of this crisis? And, you know. Well, let me ask you this question then, Larissa. Let's say you have a 20-year-old son or daughter. I know, I know, I know.

How do you feel about your kid doing this? Yeah, I asked Professor Lipsitch, that same question. If someone you were close to, someone in your family in the right age bracket, wanted to be part of this trial, what would you say? I would probably try to discourage them, to be honest. Wow. There's this old Jewish idea that people who want to become, convert to Judaism should be discouraged three times before they do it by a rabbi.

And I'm not religious, so this is not a literal translation. But I think that this is a decision that should be done really with a lot of reflection and with understanding that there is a risk that something bad will happen. So I would not say, oh yeah, go ahead, this is fine. I would discourage it because I think it is a risk. But I also think that people should have the ability and even my own children if they were old enough. Larissa, you've said this is controversial, and there do seem to be a number of ways for this to go very badly for a volunteer. And we're also unclear about the effect of the coronavirus on the young.

Initially, we were told, well, this just doesn't affect children at all, doesn't affect young people. if you're healthy and under a certain age, you're going to be just fine. You might not even know you had it. And that's largely true. But now we see young people getting extremely sick. Again, not in the same numbers as somebody 65 and older and so on.

We hear about all kinds of unexpected symptoms and difficulties with this. It complicates matters immensely, doesn't it? Of course. And I talk to a scientist who sees the issue very differently, a virologist who's worked on Ebola and other diseases. When a person is infected with the virus, your body responds to that infection. Sometimes that response can be protective and keep you from getting sick, get rid of the virus, and protect you.

Sometimes that response can actually be harmful and make the disease worse. And I study the nature of those responses and how they contribute to one outcome or another. Her name is Angela Rosmussen, and she's now studying the novel coronavirus. We know so little about this virus other than that it can be lethal, that it's very difficult for a subject in one of these trials to give informed consent. Tell me about Angela Rasmussen. What is her view here? So she has a very different view from Professor Lipsich. She does not believe that these human challenges trials are the way to go. Ethically, she feels that you can't really consent to be a volunteer in a trial where the risks are unknown. So if you sign up to join the military during wartime, you do sign up with the understanding that perhaps you may be going into combat, you could potentially even get killed.

But you also do have a very good understanding of what the risks are. And in terms of doing any kind of human trial, whether it's a drug trial or a vaccine trial, people need to give informed consent. And what informed consent means is that they really have to be informed. of the risks. Many of the people that I have seen, you know, very enthusiastically volunteer to be a subject in a human challenge trial seem to think that they are low risk. And while they acknowledge the possibility that there may be severe risks, they tend to focus on the fact that they don't have any preexisting risk factors and they're relatively young and healthy. And I wonder how the people who have volunteered for these trials, how many of them

truly think that they are going to actually potentially die from participating in it. So Dr. Rasbison disagrees with these human challenge trials on ethical grounds. But she also feels that these trials are not the way to go scientifically because, as we discussed before, you're going to want to have volunteers who are the absolute lowest risk population, very young, very healthy. But the people who need the vaccine the most are not like that at all. They're older people, people with diabetes or hypertension or people who suffer from obesity. They're a very, very different set of people.

Why does that matter for a vaccine? We're worried about side effects? You're worried about side effects, but also, like, suppose a vaccine appears to work in this young healthy population. It may not work remotely the same in this very different population. One of the main reasons why you need to do much larger phase three clinical trials is to account for all of the diversity between different communities and groups of people. If we are looking at a small, relatively homogenous group of human challenge trial volunteers, it potentially might blind us to how other people outside of that homogenous group might be responding to the vaccine and it might change their susceptibility.

I put the same question to Mark Lipsitch, who is advocating for human challenge trials. It's important to realize that if we had a vaccine for, young healthy people, that vaccine would have enormous social value in terms of not only allowing some of those people to, or many of those people, to go back to work because of their direct protection, but also in indirectly protecting those to whom they're exposed, who might not have gotten the vaccine yet. So building herd immunity in the young healthy population would be no small victory. It would be quite a large victory. This is a really unusual situation, and most of the time people aren't like, let's shave off a couple months by doing human challenge

trials for a vaccine. So that's unprecedented, but this is a great conversation to have. I mean, I think that this needs to be discussed by more scientists than just my colleagues that you mentioned before. There are thousands and thousands of mostly young people who've signed up to volunteer to be in these human trials. If they're listening, I think they'll get a sense from you that you don't think it's a good idea. So what should they do? Is there anything they can do to help? Absolutely. And that is they can enroll as subjects in a standard vaccine trial. We need large groups of people to volunteer to be in a phase three vaccine trial. So if people are signing up to get infected with the virus, I suggest they sign up to just get the vaccine. It would certainly be safe.

safer to them, but they would still be making a tremendously important contribution to vaccine development. Larissa, you wrote a book about altruism, and you've also written in the magazine, about people who really put themselves and their health at risk, and they somehow diminish their own lives in order to help others in very serious ways, too. Here's a 20-year-old who says this, all these unknown risks to me are worth it for the greater good. Now, is that youth talking, or is there more to it than that? Are people like Aby somehow wired differently from the rest of us? I definitely don't think it's just youth talking. When I was researching my book, I talked with people of all ages who were just as willing to risk themselves for their principles as ABI is.

And they weren't weeping martyrs either. They wanted to live that way. They didn't want to just be comfortable. What I think does tend to happen as people get older is that others become dependent on you, kids, older parents. And that, that's a lot of people. And that, you know, that's That can be a reason not to take risks yourself. The tricky thing is that this can be both a very good reason and a kind of moral alibi. Protecting your family is, of course, a very deep and essential human instinct, but it can also be an excuse not to care about anyone else. If I had a 20-year-old kid who wanted to volunteer to do this, I would be so proud of them.

I would be terrified. And I don't know that I would have the strength not to try to talk them out of it, But sitting here knowing I don't have a 20-year-old, which is a much easier situation, I like to think that I would support them. I think it's an amazing thing to do. Larissa McFarker is a staff writer, and she spoke with Mark Lipsich, Angela Rasmussen, and A.B. Rourke, a volunteer. This is the New Yorker Radio Hour. More to come.

This is the New Yorker Radio Hour. I'm David Remnick. There are things we don't know yet about the killing of Amad Arbery in Georgia. And as in any trial, the suspects are entitled to the presumption of innocence, but this much seems beyond question. Two white men, one armed with a shotgun, went in pursuit of a black man who was jogging. They later told police that they suspected him of some break-ins in the neighborhood. There was some type of interaction, and Travis McMichael shot and killed Ahmaud Arbery. But local prosecutors didn't see the shooting as a crime. They didn't arrest McMichael and his father Greg for more than two months. To understand the laws and the mindset that makes such a thing

possible, the New Yorker's Jolani Cobb turned last week to Ira P. Robbins. Robbins is a professor at the Law School of American University, and he's co-director of the Criminal Justice Practice and Policy Institute. Here's Jolani Cobb with Ira P. Robbins. You know, Mr. Barnhill, the second prosecutor who later recused himself, wrote a letter to the the police department, the local police department saying it appears that there, here he's referencing the McMicha's, their intent was to stop and hold this criminal suspect until law enforcement arrived. Under Georgia law, this is perfectly legal. Does the statute explicitly allow for pursuit and under what circumstances? Well, I'll answer that, but add another layer. So when the McMichaels

were pursuing Mr. Arbery, thinking they had the right to make a citizen's arrest because they think that Mr. Arbery was committing a crime in that dwelling under construction, I guarantee you the McMichaels had no idea whether the crime being committed was a felony or a misdemeanor. In fact, in the police report, it says two crimes. It mentions two crimes. One is homicide and the other is criminal trespass. Well, if it's criminal trespass, that's a misdemeanor. And in citizens' arrest law, the arrestors would have fewer rights. If it was a burglary that Mr. Arbery was committing, that would be a felony.

And the citizen's arrest law would allow greater leeway to the citizens. So with that in mind, was it surprising to you that the prosecutor, actually two prosecutors, looked at the situation and concluded that, it was a valid citizen's arrest? That conclusion indicates to me either that they don't know anything about the law of citizens' arrest or they are confusing citizens' arrest

with self-defense and stand-your-ground laws. Could you sort those things out for us? Sure. So under the citizens' arrest law, basically a person can hold an offender or suspected offender until the police arrive. Basically, it's their job to operate as witnesses, not to be a substitute for the police, not to take the law into their own hands. You add to that, though, that not all suspected offenders are willing to be arrested.

And if an altercation ensues, then it may be that the arrestor and the suspect get into some situation involving use of force, and then we get into self-defense, which is a complicated area of the law even without issues of stand-your-ground. Ordinary self-defense law has a duty to retreat, with certain exceptions. The stand-your-ground law in Georgia eliminates the duty to retreat. So this case, in my opinion, stands or falls on whether the initial citizen's arrest confrontation was proper in the first place. So we've seen, you know, the stand-your-ground laws that really entered our consciousness around the case of Trayvon Martin, who was a teenager, 17 years old, who was shot by a neighborhood watchman by the name of,

George Zimmerman in Florida. And, you know, this kind of thing, I think this is, I think this alerted the public to the fact that there were so many jurisdictions that had these laws. And now we're seeing a similar conversation beginning to take place around citizens' arrests and the Ahmad Arbery case. Is there any connection in your mind behind Bobby sees such inflammatory situations, specifically around the lines of race with these doctrines? Wonderful question.

It seems to me what we're seeing here is a deadly combination of the law of citizens' arrest, flawed self-defense laws, particularly when we have a stand-your-ground doctrine as we do in Georgia, and arguably racial profiling as well. It may be that when the McMichaels raised this idea, of stand-your-ground and self-defense built on citizens' arrest,

the whole thing is a pretext for what starts out as racial profiling. And I would argue that they should have stayed in the truck. We've seen the video. Greg McMichael was on the phone with the police, who arrived certainly within a minute or so, perhaps less than a minute of the shooting. The role of a citizen in a citizen's arrest is to operate as a witness. It's not as if they had information that Mr. Arbery was escaping from a major felony, a bank robbery, a homicide, or even a burglary.

There was no burglary here. If this was a burglary, perhaps there would have been a right to a citizen's arrest, but since this was only a criminal trespass, no such right. and if there is no such right to do a citizen's arrest here, then when Travis McMichael confronted Mr. Arbery and started the altercation, it seems to me that Travis McMichael was the initial aggressor and as such loses the right to self-defense. Another thing that made this case stand out to me

was that the offense that started the, entire pursuit, at least according to the McMichaels, was his presence on the property or on the grounds of a house that was under construction. And just a few months ago, before the COVID lockdowns began, I was visiting friends in Atlanta, and I went for a walk. There's lots of new construction in the neighborhood, and I saw a house that was under construction, and I thought, hmm, I wonder what the floor plan is for this place. And I didn't go inside. but I walked kind of up onto where the lawn would be and was looking around.

I was like, oh, they're putting a staircase over here and a deck over there. And it was just a kind of interesting observation I made while walking through the neighborhood and continued walking. And the idea that that could be provocation for an armed pursuit was unnerving and shocking to me at the least. I agree with you.

And it seems to me that people don't know what the law is, especially a law that doesn't get a lot of attention like citizens' arrest law. So when somebody does something that even reasonable people might do, even if it might be a very minor crime like criminal trespass going on to someone's property when you don't have a right to be there, that doesn't justify detaining someone using force, unreasonable force, and causing a death. If that part of this whole situation falls, as I think it should,

then any defense the McMichaels are raising, I think would fall like a house of cards. The foundation, the citizen's arrest, is not a good foundation. You've looked at lots of cases of citizens' arrests and attempted citizens' arrests. these laws have created lots of problems and lots of situations that seem to be on the face very difficult and troubling. Why do they stay on the books? A lot of laws whose time has passed stay on the books only because the legislature has not gotten around to repealing them.

Or they think, well, maybe these laws have some purpose that we don't present. presently see, so let's just leave them on the books and hope for the best. But when you see abuses like this, when you see unreasonable use of deadly force, officials have to stand up and pay attention because if we don't do something about it after such an obvious abuse in this case, then we're going to see many more abuses in the future. We don't want citizens' arrest to become a pretext for an unfortunate end to situations that start with racial profiling.

We want organized police forces where the members of the police force have been trained to deal with offenders. We don't want ordinary people to take the law into their own hands. Ira P. Robbins is a law professor and co-director of the Criminal Justice Practice and Policy Institute at American University of Washington College of Law. He spoke with Jelani Cobb, a staff writer at The New Yorker.

This is the New Yorker Radio Hour. Stick around. I'm David Remnick. Recently, staff writer Peter Hessler went to a dance club in China. as that country continues to reopen, and we'll find out what that was like next week. It's the New Yorker Radio Hour. See you next time. The New Yorker Radio Hour is a co-production

of WNYC Studios and The New Yorker. Our theme music was composed and performed by Merrill Garbus of Tune Yards, with additional music by Alexis Quadrado. This episode was produced by Alex Barron, Emily Boutin, Avey Corrieu, Rianan and Corby, Calalia, David Krasnow,

Gauphin and Putubuele, Louis Mitchell, Michelle Moses and Stephen Valentino, with help from Alison McAdam, Mengfei Chen, and Emily Mann. The New Yorker Radio Hour is supported in part by the Cherina Endowment Fund.