Human challenge studies in the study of infectious diseases
What can deliberately infecting healthy people tell us about infectious diseases? How is this useful for developing treatments, and how do we manage the risks?

On 20th March, the Scientific Advisory Group for Emergencies (SAGE) released the evidence behind the government response to Coronavirus disease (COVID-19). This series of short articles summarises these 32 documents. You can view all our reporting on this topic under COVID-19. This article goes over insights from behavioural science such as the risk of public disorder and adherence to household isolation.
DOI: https://doi.org/10.58248/RR20
The Scientific Pandemic Influenza group on Behaviour (SPI-B) is a group of experts that advise SAGE. This advice is limited to anticipating and helping people adhere to the interventions proposed. Group members vary by the topic that is being considered. They have included health psychologists, social psychologists, anthropologists and historians. Experts from Government departments also input to discuss the issues they are facing.
SPI-B provided advice on the use of behavioural and social interventions (COVID-19: Behavioural and social interventions). They have also reported on risk of public disorder and guidance for self-isolation.
The evidence base available to make behavioural recommendations is limited. Studies have shown that the psychological and public responses to the 2009 influenza pandemic varied between countries. For self-isolation and quarantine, a rapid review of the evidence was conducted. This looked at both the psychological impact of quarantine, and ways to improve adherence. For school closures a further rapid evidence review was used.
SPI-B, the behavioural subgroup of SAGE, was asked to consider the risk of public disorder. This was defined as opportunistic crime, community tension and rioting.
Their conclusions were:
Specific issues facing the police may be:
The recommendations of SPI-B to further reduce the risk of public disorder were:
In particular the public needs to understand why the UK response may be different to other countries. SPI-B recommended focusing early messaging on why actions are being taken. Clear expectations of how the response will develop also need to be laid out. This messaging should be coupled with reinforcing a sense of community. This will avoid creating tensions between groups and promote social norms around behaviours.
SPI-B was asked to advise Public Health England on guidance for self-isolation of people with COVID-19 symptoms. In particular they considered:
SPI-B provided Public Health England with advice on its draft guidance for home isolation. In particular they recommended considering more the specific needs of different audiences. They also recommended providing guidance on mental and physical well-being.
An area of difficulty with adherence is where people with symptoms are worried about staying at home. In particular they may worry that they will infected other members of the household. There is a need to understand the increased risk to other household members compared with isolating elsewhere.
Ways to increase adherence and reduce presenteeism (i.e. going to workplaces) could include:
You can find more content from POST on COVID-19 here.
You can find more content on COVID-19 from the Commons Library here.
What can deliberately infecting healthy people tell us about infectious diseases? How is this useful for developing treatments, and how do we manage the risks?
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