I wrote up a very basic "business plan" for a "Hero Hotel". Anyone could take it and run with it. Anyone could probably do it following something like the Dan Pena QLA process. Do some due diligence and it might turn out to be profitable and could probably save a lot of lives.

Variolation and plasma antibody transfusion clinic business plan. It's a crazy idea, but maybe it needs to be done.

Vision:A world where people don't have to worry about COVID anymore. ASAP.

Mission:Variolation and plasma antibody transfusion. Premium luxury health services. Immune boosting therapy online and on site. Outpatient services.

Values:Health safety for our clients is our highest value.Legal operation and liability protection for clients and company.

CEO:Visionary, entrepreneur. Asks "How can we do this?"

CHO:Chief Health Officer. Concerned with health risks for clients. Leads health team. Says "We can't do that!" CEO asks CHO "How can we do this?" And they work together to find solutions.

Legal team:Jurisdiction selection. Liability protection. Insurance. Look world wide for jurisdictions in any country.

Financing:Business credit? Private equity? Must be arranged with legal entity setup for protection of investors and company in all jurisdictions.

Take pre-order payments? For initial funding of the business? Non-refundable, or partially refundable if the business doesn't work out. Allow scalable pre-order/investments for people with more demand to fund the business and get preferential treatment. Maybe investments for equity and then they can pay for treatment with equity. If the business fails then their investments go to zero and they don't get treatment, if the business is wildly successful then they might end up getting a treatment and making money from it.

Business Process:Test on animal models first. Then start human volunteer trials.

Physical location for isolation of clients. An existing resort, hotel, cruise ship, clinic, hospital, etc. Lease or buy depending on financing and liability.

Variolation should cause asymptomatic infection while antibodies are built up. Treatments to reduce the viral replication and treat symptoms can be used to ensure safety. Zinc, zinc ionophore like hydroxychloroquine, quercetin, green tea extract, etc. and proven herbal anti-virals like elderberry, echinacea, etc.

People that have cleared the COVID infection can donate plasma for antibody transfusions. Donors could be paid for transfusions. Clients could bid for the price of transfers from different donors to incentivize and compensate and for price discovery.

Test donors for all possible blood diseases. Multiple tests to be sure? Limit number of donors per receiver to limit possible disease risk.

Sell online immune boosting courses and counseling, Wim Hof Method, Cognitive Behavior Therapy, meditation, etc.

Online store for immune boosting supplements and treatments.

Potential outpatient services for patients isolating in a different location. Must be within legally cleared jurisdictions. This may be offered as a premium service.

Basic Client Process:Qualify clients with questionnaires.Pre-pay for the service.Informed on how to be prepared for the travel and treatment.Send appropriate immune boosting supplements to start taking.Send online immune boosting courses to start learning and practicing.Travel to the location. Check in to isolation lodgings.Health check up and measurements. Sleep and immune tracking.Administer dose of variolation.Provide water, food, high speed internet.Provide appropriate immune boosting supplements and anti-viral treatments.Measure health. Monitor for abnormalities.Provide care for complications.Isolate until COVID is cleared and antibodies are established.Decide on donating antibody plasma.Leave location and don't worry about getting infected with COVID anymore.Monitor COVID strains for mutations.Notify pasts clients in case of a mutated strain that the antibodies will not protect against.Clients can get another treatment for the new strain.

Antibody transfusion process:Come to treatment location. Alternately, staff go to client location in cleared jurisdiction.Measure client health. Sleep and immune tracking.Supplements and courses for immune boosting as necessary.Donor travels to treatment location.Staff perform antibody transfusion.Measure client antibodies to ensure immunity.

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What if exposure to the virus does not lead to effective immunity? Maybe it could even make the situation worse through antibody-dependent enhancement, seen in hemorrhagic fevers such as dengue.

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I noted today an article by Bill Gates describing “researchers are confident they’ll have at least one (vaccine) ready within 18 months”.In the same newspaper I read of rioting in Nairobi, TODAY, consequent to hunger associated with their COVID-19 lockdown.Africa can not afford to wait 18 months for a vaccine. Africa can afford neither the time nor the eventual money. Africa could be facing an Armageddon.Doubtless someone will correct me if wrong, but I’ll suggest *no* vaccine can as reliably induce immunity as the actual infection. So, in this sense, SARS-CoV-2 can be its own best “immuniser”.A rapid variolation program in Africa could soon render immune enough young people to keep some semblance of economic activity proceeding. The variolated could be certified as such (after two weeks, or however long it ends up taking) and thereafter work in any capacity for which they are trained.Variolation, once a safe-enough dose is found, would be perfectly cheap. Training in giving intradermal blebs is easy. If someone has a better, faster, cheaper way of protecting Africa from utter calamity I am yet to hear of it.

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Dr Rish, being in Sydney, can you think of any suitable animal model on which some proof-of-concept work could be done?The problem is driving me batty.Ideally, you’d have a park nearby with thousands of a particular species known already to potentially host SARS-CoV-2, ripe for experimentation.A Sentinal Park, or something like that.(btw, no relation to Adam West, I suppose?)

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Wow, that’s a coincidence. I was thinking the same thing.

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Hi RobinI am very happy to have found your blog as I had arrived at a similar idea of variolation only last week. I have a background as a primary care physician in Australia with a special interest in immunisation. I think a key factor in variolation which I think we should call coronaisation is that it was intradermal. Intradermal injection causes a much higher immune response so a lower dose may be used on a less at risk to that sensitive organ the lung. Another point is that sample should come from a person who retrospectively recovered very quickly as potentially less infective strain. I know this method would require a lab assist so more complex than just deliberate exposure but it is still much faster than what may well be a vaccine that never arrives. Naturally this process is voluntary but it would be good to link it to a formal licence to not isolate once recovered plus also some sort of compensation for death or permanent Coranisation injury.

Adam Rish, Sydney Australia

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So, to be clear, variolation isn’t just about low-dose.It’s *also* about infection *site*, and about using our tough-as-nails dermis to lead the fight, and thus protecting our lungs from being the first line of defence

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I don’t think you’re really Carl Sagan

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Not sure whether this is addressed elsewhere in this excellent discussion, but an advantage of variolation is that it introduces the virus at an anatomical site far less vulnerable than the lung. The reticular dermis is loaded with immune defence competence including B lymphocytes to then generate IgG etc. and should a severe local reaction eventuate at least it won’t put you on a ventilator. The virus is adapted to accessing us, its host, via the respiratory tract. Our lungs are our Achilles heel, as it were. Our impervious epidermis protects us, but in this instance also means the virus avoids a fight with our very-immunocompetent dermis.If fight this virus we must, let’s engage with our dermal infantrymen.

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I'm not interested in talking to people who can't track a simple conversation, or who think academic philosophy as being irrelevent because they think ethics have nothing to do with reality... whilst they preach ethics to people at the same exact time.

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There you go, with the "ethics" arguments that have no basis in reality.

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The "may be more likely".The whole problem with ANY model is you're always weighing up risks, as it's always easy to just assume your favourite model is the right one by just assuming everything will turn out just how you want it to.

Vaccine production can be slow, it can be fast, depending on how much funding gets put into it.

It also doesn't require you to deliberately kill 4% of your volunteers on the hope that it's quicker than just finding a more pragmatic method such as increasing PPE protocols and developing better vaccine research.

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1: It only saves lives on net if the assumptions are true and there are no other factors the model doesn't account for.

Which has yet to be proven. A blog doesn't equal peer reviewed medical science

2: Saving lives on net is just the same as John Stuart Mill's utilitarian argument of cutting out living people's organs in order to treat sick people.

eg: 1 person's kidneys can save 2 sick people. 1 life sacrificed to save 2.

Saying the ethics don't matter is side-stepping the entire root issue with the process.

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No, because this obviously saves lives on net and no one is being forced to sign up.

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If you have a problem with caring about the ethics, then you can hardly appeal to the 'ick factor' as you're essentially just saying "I don't care if this kills 100 other people, so long as I'M ok".

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