Two noteworthy media mentions of variolation: 1. The New Yorker features Douglas Perednia talking about controlled infection and variolation, as its Exhibit A on on why conservative media shouldn’t presume to write on health/medicine, as they will only say stupid obviously terrible things:
> If you had read Hanson's posts, you would know that he has a proposed protocol for quantitatively determining the optimal variolation dose.
I know he has this notion of masks soaking in the water and results getting frozen. All the enzymes and everything, mouth bacteria for a good measure... well at least he added my concern about what freezing does to solutions and suspensions.
Here's the thing, if you run it like this you get no good data nor a safe way to apply it, and if you do everything properly it's just another immunization approach. Apart from extra risks (and after the recipient has recovered from the illness) it's much like a vaccine but slower to test (simply because you have 5+ days added to everything for the incubation period). The immune system still works in very complicated ways if it's the whole virus. I'm smelling a naturalistic fallacy.
edit: I also really dislike the GI infection idea... here's the thing, it's hard to take this as anything other than Hanson acting in some variation of not so good faith. He literally cited a paper where a SARS-CoV-1 patient with GI symptoms had infected a large number of people in his high rise apartment building (20+ stories), and a high rise apartment buildings next door. Obvious implications on how this can actually be quite hazardous to bystanders and would require very serious biosafety measures (or require nonsense that ain't going to happen like remote islands).
Hanson is trying to find experts to collaborate with and get critiques from
If you had read Hanson's posts, you would know that he has a proposed protocol for quantitatively determining the optimal variolation dose. Variolation has a long history - it is not a wild new idea. A vaccine would be better but at present there is no vaccine, and it may be a long way way, and may never arrive.
This is a case where the experts and politicians have visibly not done a good job. If you compare most countries to Taiwan, where authorities have managed the situation well, infection rates and fatality rates are 10-200 times higher. And Taiwan has kept its economy open. When experts and those in charge have so visibly failed, I think it is legitimate for others to have an opinion.
Yeah as opposed to highly quantitative "small doses", "large doses", and proposed precision methods like soaking coronavirus contaminated facemasks in water.
It is a trolley problem where people new to the train yard are proposing to lay a new track and asking people to please stand on it for the greater good.
Yeah I get your point.
What I mean is that even simply the risk of extra direct deaths is large enough to give you negative utility for things that deviate too far from GMP. edit: and GLP when it comes to testing.
Hanson looks at it and sees it is 10x deadlier than flu, so he imagines 1/10th the rigorousness of a flu vaccine would be appropriate, hence masks soaking in water.
But that's not how it scales at all. At best you can cut a few corners here and there with regards to participant exposure to risks, but you still have to prove that it works because say 1/5 probability of increasing death rate by 5x (due to ADE) already beats the hell out of any probability of curing the disease completely with zero side effects.
And you still need all the equipment.
Bottom line is, all the experts had been saying there simply isn't many corners that you can rationally cut for this, and I believe them. Certainly masks soaking in water kind of corner cutting is an extreme overreaction.
My premise was that there exists a somewhat risky vaccine that could actually save some lives during the pandemic. My claim was that deaths caused by the vaccine could cause harm later on. Vaccines only work if a lot of people trust them. If we erode the trust of people in vaccines, that could cause big problems further down the line. This pandemic isn't a walk in the park, but we could pretty easily get some worse ones as the technology to create them becomes ever more accessible.
It's not even that.
Any immunization for COVID-19 , to be effective for herd immunity, would have be applied to a very large number of people whose baseline odds of dying from COVID-19 really are quite low (0.2% or less, even without any healthcare at all).
Any expected utility calculation here is dominated entirely by the risk of making things worse.
Buckets of corona water from masks, that's completely insane. It's panicked thrashing around at best.
"We tried it on 1000 healthy volunteers, nobody died of coronavirus, but 2 people got flesh eating disease". Now what? Mix in antibiotics?
Before you know it, you've rediscovered the need for "good practices" and this is just another live virus vaccine trial, except starting late and the vaccine got the worst side effects of all 100 candidates out by then.
I asked Peter Doherty in the interview, and he said COVID19 has far less chance to have seasonal variants than the flu - it does have small mutations though, but unlikely resulting in new symptoms.I think all viruses mutate .. and this is how they trace infection routes globally (with COVID19 at least).
I am not arguing here for variolation (which has a number of potential downsides, that am still investigating), I am just pointing out a potential benefit.
To be more specific
1. Variolation produces less intense infections thus fewer viruses than allowing the virus to spread randomly. More so if it is applied to young people who will be able to stop their infections even sooner and thus have fewer viruses.
2. Deliberately infecting young volunteers earlier, in general results in fewer viruses produced due to stronger immune response, assuming that the alternative would be uncontrolled saturation.
3. Variolation with quarantine limits the spread from these people. So, you only produce one (human) generation of viruses. If the variolation source is a given generation then the scope for evolution is extremely limited.
If you wanted to lower the risk of extremely devastating developments in future coronavirus history, would you
(a) assume there are real smart people out there who can come up with a strategy that applies to all of us, try to find those people, and then give them the violent power of the state to enforce their rules (say, mandatory masks for all, strict quarantine of everyone of a certain age or race or blood type, forbidding people from venturing outside), and thus risk ushering in a jiu jitsu armageddon (I leave the trivial details of the potential backfires to the reader);
would you (b) try and get to herd immunity by finding as many volunteers as quickly as you could, while the rest of the world goes about its business, with each person in the rest of the world doing approximately what they believe their grandparents would have done, and risk infecting millions of people among your volunteers with a zoonotic disease that might impair their health for life, as zoonotic diseases that are never completely flushed out of the human system have a tendency to do
would you (c) encourage everyone to keep on doing just what we are doing now, including any marginal, non-universal improvements?
Everyone commenting here is intelligent enough to come up with a (d) or an (e).
Hmm. Does that necessarily follow? I am not virologist, but it seems like whichever path results in less overall viral replication would result in less chance of new strains; It does not seem to be a trivial question which option(s) would have this outcome in expectation. Or, to be more precise, which minimises this tail risk.
Clarification: audio of the interview with Prof. Peter Doherty mentioned in this article.
Those interested in audio only, it can be found here: https://archive.org/details...
That's a big problem with letting someone else limit your actions. They may care more about their reputation than your welfare.
Yes. We had an exchange in the comments of my last post.
This quicker we can get herd immunity (e.g. via variolation) the lower the chance that the virus will mutate into a more virulent/deadly form like Spanish Flu.