{"id":8753,"date":"2020-04-07T12:22:49","date_gmt":"2020-04-07T11:22:49","guid":{"rendered":"https:\/\/open-organization.com\/?p=8753"},"modified":"2020-04-07T12:22:49","modified_gmt":"2020-04-07T11:22:49","slug":"cochran-vs-hanson-should-we-expose-ourselves-voluntarily-to-covid-19","status":"publish","type":"post","link":"https:\/\/open-organization.com\/en\/2020\/04\/07\/cochran-vs-hanson-should-we-expose-ourselves-voluntarily-to-covid-19\/","title":{"rendered":"Cochran vs. Hanson: Should we expose ourselves voluntarily to COVID-19?"},"content":{"rendered":"<p>[et_pb_section bb_built=&#8221;1&#8243;][et_pb_row][et_pb_column type=&#8221;4_4&#8243;][et_pb_text _builder_version=&#8221;3.14&#8243;]<\/p>\n<h2><span style=\"font-weight: 400;\">The debate<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Presans organized its first online debate this past Thursday, 3rd of April, and I had the pleasure of hosting it. Here\u2019s the video:\u00a0<\/span><\/p>\n<p><iframe title=\"Should we expose ourselves deliberately to COVID-19?\" width=\"1080\" height=\"608\" src=\"https:\/\/www.youtube.com\/embed\/DFnP5TK61aI?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p><span style=\"font-weight: 400;\">I\u2019m going to refer the reader to Aaron Weiss\u2019 recap of the whole thing, reproduced in the appendix to this article.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Main take-aways<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">This was a debate between two very smart persons, whose positions ended up converging quite a lot. Cochran agrees that attempting Hanson\u2019s suggested variolation strategy would make sense on a small scale at first. He doubts that it would work\u2014his position is that because we currently have little knowledge of what would work, we need to launch a variety of different, small scale approaches, and learn from them in order to scale up what does work best. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Another important point of agreement between the debaters is the importance of viral load. Limited exposure would be a good way to ensure people get infected with low viral load, vs. getting hit with lethal levels of exposure.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hanson makes the case that containment measures<\/span><span style=\"font-weight: 400;\"> were implemented too late in many places, and that existing containment strategies are therefore likely to be insufficient. To complement this point, <\/span><b>my main take-away from this debate is that because many Western countries have let their guard down, the situation may have gotten so out of hand that even adopting the <\/b><a href=\"https:\/\/open-organization.com\/en\/2020\/03\/20\/francais-covid-19-adoptez-le-gangnam-style\/\"><b>Korean approach<\/b><\/a><b> may prove insufficient. And we now know that <\/b><b><i>even in South Korea<\/i><\/b><b>, the situation is not fully under control.<\/b><\/p>\n<h2><b><br \/>\n<\/b><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Q&amp;A<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">We got a lot of questions from a great set of participants during this webinar. Here are two of those that I didn\u2019t have time to bring up: <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">\u201cI certainly agree on the concept of self-exposure, but the tricky part is managing the healthcare of those people that do get sick. Please address that as well. Beyond that, as a nutritionist, what nutritional strategies can I take to mediate the impact of such an infection? This is not getting much attention yet\u2026.\u201d Theo van Kempen, Manager, Nutreco<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cSouth Korea is evidently making a good job of managing COVID 19 in the early stages. The most obvious is that they all wear face masks. Could it be that, contrary to the medical advice that we are being given, there is an airborne mechanism for the contagion? And if deliberate exposure were actually to be a good strategy, then South Korea is in for a worse future than the West.\u201c, Graham Wallis, Fellow<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">And here\u2019s an excerpt from the chat log: <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Cody Moser:<\/span> <span style=\"font-weight: 400;\">Hanson says we should infect people on purpose by placing them in &#8220;hero hotels&#8221; where we can isolate people willing to catch COVID. If medical outcomes are dose-dependent from this thing, aren&#8217;t we basically nuking peoples&#8217; immune systems by putting them in here?<\/span><\/p>\n<p><span style=\"font-weight: 400;\">00:30:40<\/span> <span style=\"font-weight: 400;\">John Alcorn:<\/span> <span style=\"font-weight: 400;\">Dr. Hansen, If perchance variolation experiments reveal that this virus does not have a dose effect, then isn\u2019t there a risk of heightening the curve, instead of flattening the curve, if the experiment doesn\u2019t take place well before peak contagion occurs?<\/span><\/p>\n<p><span style=\"font-weight: 400;\">00:37:00<\/span> <span style=\"font-weight: 400;\">Martial Maben:<\/span> <span style=\"font-weight: 400;\"> Professor Didier SICARD who has been working in the field for years recently expressed the lack of focus on identifying the origin of the pandemic. Should we not focus more on identifying the origin and therefore workout a vaccine through that path rather than focus only on research at the end of the chain ?<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">00:38:57<\/span> <span style=\"font-weight: 400;\">Lisa Wise:<\/span> <span style=\"font-weight: 400;\">Could GWAS studies also identify those who have a low risk to die or develop severe complications as potential good volunteers for variolation? <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">00:42:04<\/span> <span style=\"font-weight: 400;\">Tony Candido:<\/span> <span style=\"font-weight: 400;\">Don&#8217;t need sharp borders if your techniques locally still can keep R0 below 1, no?<\/span><\/p>\n<p><span style=\"font-weight: 400;\">00:45:15<\/span> <span style=\"font-weight: 400;\">John Alcorn:<\/span> <span style=\"font-weight: 400;\">Does the \u201cpsychology of repugnance\u201d create a Catch-22?: People won\u2019t allow (even voluntary) variolation until the pandemic becomes a desperate situation, but then variolation wouldn\u2019t help much anymore because contagion would be galloping towards herd immunity?<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">00:47:08<\/span> <span style=\"font-weight: 400;\">Cody Moser:<\/span> <span style=\"font-weight: 400;\">Hanson says we should purposefully infect people by placing them in &#8220;hero hotels&#8221; where we can isolate people willing to catch COVID. If medical outcomes are dose-dependent from this thing, aren&#8217;t we basically nuking peoples&#8217; immune systems by putting them in here?<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">00:51:44<\/span> <span style=\"font-weight: 400;\">Shlomo Sand:<\/span> <span style=\"font-weight: 400;\">Why would we discuss ancient plagues when people in the distant past were in routinely poor physical condition? <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">00:55:01<\/span> <span style=\"font-weight: 400;\">Shlomo Sand:<\/span> <span style=\"font-weight: 400;\">At least one variolation party has ended in death already:\u00a0<\/span><\/p>\n<blockquote class=\"twitter-tweet\" data-width=\"550\" data-dnt=\"true\">\n<p lang=\"en\" dir=\"ltr\">RT <a href=\"https:\/\/twitter.com\/leucinedreams?ref_src=twsrc%5Etfw\">@leucinedreams<\/a> Spouse of friend went to a coronavirus party where young people try to infect each other to get through it and get back to normal life. Of 22 in attendance, 2 are dead and 6 are in the hospital. Friend\u2019s spouse is sick at home. All of them were under 35.<\/p>\n<p>&mdash; Sam Girgis (@DrSamGirgis) <a href=\"https:\/\/twitter.com\/DrSamGirgis\/status\/1244263288818589696?ref_src=twsrc%5Etfw\">March 29, 2020<\/a><\/p><\/blockquote>\n<p><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n<p><span style=\"font-weight: 400;\">00:56:11<\/span> <span style=\"font-weight: 400;\">Zvi Mowshowitz: I also know of another example\u2026<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">01:03:03<\/span> <span style=\"font-weight: 400;\">Shlomo Sand:<\/span> <span style=\"font-weight: 400;\">For Hanson: Do you believe pandemic events such as this justify some degree of protectionism for relevant industries?<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Can you spot the former pro-level MTG player?<\/span><\/i><\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Conclusion<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">This debate is already having practical consequences: it reinforced my desire to learn more about biology, for one. I don\u2019t know about you, but these days I feel the acute need to update the basic biological knowledge I acquired here and there in the past. <\/span><i><span style=\"font-weight: 400;\">The 10,000 Year explosion<\/span><\/i><span style=\"font-weight: 400;\">, co-authored by Greg Cochran, is proving a great place to start (I\u2019m 20% in). And as I was recently talking about this with Presans Fellow Ben Schwegler, he suggested reading two other books: <\/span><i><span style=\"font-weight: 400;\">Plague Time<\/span><\/i><span style=\"font-weight: 400;\">, by Paul Ewald (who Greg Cochran has worked with), and <\/span><i><span style=\"font-weight: 400;\">The Mind in the Cave<\/span><\/i><span style=\"font-weight: 400;\">, by David Lewis-Williams. Is this the beginning of a new book club?<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Appendix<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Debate notes with timestamps:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201c3:30 Hanson initial statement start<\/span><\/p>\n<p><span style=\"font-weight: 400;\">4:35 initial dosage importance, and lockdown&#8217;s effects on it<\/span><\/p>\n<p><span style=\"font-weight: 400;\">5:38 Plan B justification based on intial dose, and that initial dose matters.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">9:05 Cochrane begins<\/span><\/p>\n<p><span style=\"font-weight: 400;\">11:00 we should be considering and developing plans for every letter of the alphabet, simultaneously\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">(13:50 spending more money for faster progress is a good idea right now)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">16:10 would study variolation (henceforth i will write coronation) but wouldn&#8217;t do a mass version until more knowledge is aquired<\/span><\/p>\n<p><span style=\"font-weight: 400;\">(16:30 short term massive social distancing to get numbers under control)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">17:00 Hanson on likeliness and importance of coronation, along with a further explanation of how to do it<\/span><\/p>\n<p><span style=\"font-weight: 400;\">19:30 Cochrane not against trials but cautions about chances of success (vaguely and unrelatedly to the points at hand in my opinion)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">20:50 Hanson: there seems to be a\u00a0 consensus that the infection load matters, this is given as a reason for medical personnel mask recommendations\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">21:30 Cochrane agrees that if you must be exposed it is better to get a lower load because it may help and in fact likely does, this doesn&#8217;t mean it does help.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">21:50 Even things that seem plausible in medicine are often wrong,\u00a0 so testing is needed<\/span><\/p>\n<p><span style=\"font-weight: 400;\">22:40 Speed is important, so taking some risks may be justified, and Cochrane isn&#8217;t against trying this (testing it)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">23:10 Hanson asks about risks taken with purposely infecting people to test vaccines<\/span><\/p>\n<p><span style=\"font-weight: 400;\">23:30 Cochrane answers<\/span><\/p>\n<p><span style=\"font-weight: 400;\">25:00 Q&amp;A from the crowd<\/span><\/p>\n<p><span style=\"font-weight: 400;\">25:40 Hanson on immunity to the virus<\/span><\/p>\n<p><span style=\"font-weight: 400;\">26:10 Cochrane adds<\/span><\/p>\n<p><span style=\"font-weight: 400;\">27:50 how to get coronation patients<\/span><\/p>\n<p><span style=\"font-weight: 400;\">29:20 Vaccines vs natural herd immunity, urgency of quickly developing tools to improve outcomes<\/span><\/p>\n<p><span style=\"font-weight: 400;\">33:00 Cochrane comments on the situation in the US<\/span><\/p>\n<p><span style=\"font-weight: 400;\">34:00 Hanson comments on the situation in the US, necessity of lowering variance of spread rate or isolating different areas from each other<\/span><\/p>\n<p><span style=\"font-weight: 400;\">34:50 Cochrane pushes back on this point, saying short term\/ lighter travel restrictions can stop R0 variance from ruining measures taken, long term measures are difficult.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">36:20 Wrap-up<\/span><\/p>\n<p><span style=\"font-weight: 400;\">37:40 continuation of Q&amp;A<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Cochrane finding the correct dose for coronation (variolation for the coronavirus) requires testing.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">39:10 Germany, Test and Trace<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hanson this approach is easier the smaller the outbreak is, we have record size outbreaks for this method. Hopefully this method will work but we should be ready for it to fail, and soon.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">39:55 Cochrane differences in Germany numbers, casualties lag<\/span><\/p>\n<p><span style=\"font-weight: 400;\">41:40 Hanson repression tactics don&#8217;t seem to be good enough to put R0 below 1 in Europe<\/span><\/p>\n<p><span style=\"font-weight: 400;\">41:50 Cochrane foolishness of English policy\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">43:00 Cochrane on virus origins\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">46:00 who can try coronation and how? (FDA in the pandemic)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">49:45 Hanson mutation of the virus, advantages of coronation over natural infection.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">50:20 Cochrane on mutation, dangers of large amounts of infection and specifically in medical systems (hospitals). Not much we can do besides stopping the virus.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">(52:30 Herd immunity depends on circumstances)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">53:20 Hanson masks are only one part of a big package,\u00a0 any big part done wrong can mess it all up. The right people should wear masks at the right time.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">53:50 Cochrane on masks usefulness,\u00a0 CDC is stupid.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">55:00 Hanson on chances that global suppression (pretty much hopeless) and local measures (your locale less than 50-50, probably less than 10%) succeed until vaccines or other treatments are developed<\/span><\/p>\n<p><span style=\"font-weight: 400;\">56:05 Cochrane agrees on global suppression,\u00a0 but slightly dissents on regional suppression<\/span><\/p>\n<p><span style=\"font-weight: 400;\">57:20 Cochrane different interventions have different costs<\/span><\/p>\n<p><span style=\"font-weight: 400;\">58:30 Last question. Hanson medical personnel, deliberate infection<\/span><\/p>\n<p><span style=\"font-weight: 400;\">59:30 Cochrane on utilizing people who already have been infected (and recovered) in medical care.\u201d (<\/span><a href=\"https:\/\/www.youtube.com\/watch?v=DFnP5TK61aI&amp;lc=UgwBGGi5YsSrgBAO_b54AaABAg\"><span style=\"font-weight: 400;\">source<\/span><\/a><span style=\"font-weight: 400;\">)<\/span><\/p>\n<p>[\/et_pb_text][et_pb_post_nav _builder_version=&#8221;3.14&#8243; prev_text=&#8221;Previous article&#8221; next_text=&#8221;Next article&#8221; in_same_term=&#8221;on&#8221; background_color=&#8221;#3d59a1&#8243; title_font=&#8221;|800|||||||&#8221; title_text_color=&#8221;#ffffff&#8221; title_font_size=&#8221;15px&#8221; custom_padding=&#8221;10px|10px|10px|10px&#8221; border_radii=&#8221;on|5px|5px|5px|5px&#8221; border_width_all=&#8221;1px&#8221; border_color_all=&#8221;#3d59a1&#8243; saved_tabs=&#8221;all&#8221; custom_margin=&#8221;30px|||&#8221; global_module=&#8221;8506&#8243; \/][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>","protected":false},"excerpt":{"rendered":"<p>Read our recap of the first online debate hosted by Presans, featuring Greg Cochran and Robin Hanson. Should we expose ourselves voluntarily to COVID-19?<\/p>\n","protected":false},"author":8,"featured_media":8761,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[5],"tags":[351,362,426,759,918,1454,1705,1743],"_links":{"self":[{"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/posts\/8753"}],"collection":[{"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/comments?post=8753"}],"version-history":[{"count":0,"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/posts\/8753\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/media\/8761"}],"wp:attachment":[{"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/media?parent=8753"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/categories?post=8753"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/open-organization.com\/en\/wp-json\/wp\/v2\/tags?post=8753"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}