I’ve so far tried to avoid writing posts on highly technical subjects–epidemiological, pathophysiological, statistical, methodological, or otherwise–partly because I lack the expertise for it, partly because we lack the data for it, and partly because I don’t see a good practical rationale for it.
Pueyo’s hammer/dance strategy implies that we have to buy time to keep our health care system in tact, giving scientists the time to produce a viable solution, then relax our “lockdown” as a viable solution comes more imminently in sight.
I’ve focused my efforts here on simple, practical solutions that will yield clear benefits, and are within the ken of the average person: abide by “lockdown” orders, unless they’re patently unreasonable*; practice social distancing; give blood and blood plasma; donate to PPE efforts; donate to charitable endeavors with demonstrably deserving beneficiaries, or at least beneficiaries who aren’t demonstrably undeserving; support efforts that promote mutual aid and social solidarity; challenge defeatism and dishonesty; oppose ageism; defend civil liberties.
Finally, don’t expect or demand a response to the pandemic–governmental, corporate, or otherwise–conceived under conditions appropriate to ordinary, and above all, ordinary academic circumstances. We’re not in those circumstances. Donald Trump got at least one thing right: this really is a “national emergency.” For once, that last term, “emergency,” isn’t being misused.
Action in an emergency has to be appropriate to the gravity and urgency of the situation. It can’t proceed by conjuring up idealized circumstances that don’t exist, blaming someone for the fact that they don’t exist, and then offering up world-weary observations on how the people actually solving the problem are doing it all wrong. The implication would appear to be: if only those people did some modal metaphysics, they’d realize there was a possible world in which some other course of action would work. I’ve read a lot of advice of this form lately. The only problem with it is that we don’t inhabit the possible world imagined by the people producing the advice, and imagining it doesn’t get us of the situation we’re actually in.
With that (admittedly long) preface, you might want to consider the possible solution to COVID-19 offered by Daniel Tillett, a molecular biologist and former academic now working in the biotech sector (in Australia, I believe). I can’t claim to have any real knowledge of molecular biology, and my biology itself is rusty, but having read through Tillett’s suggestion, it strikes me as among the better proposals I’ve encountered. It may have some holes in it, and may or may not be practically feasible, or feasible within the time frame he envisions. But I’ve run it by a few physicians and a few biologists, and though they differ in their enthusiasm for the proposal, so far, no one has shot it down as ridiculous.** I offer it here in case readers have thoughts on what to do with it.
The proposal is outlined in two posts. I would ask anyone who wants to comment to read and digest both posts thoroughly before you do. Given that, I’m interested in what readers have to say, and I’m sure Tillett is, as well.
The first of his posts, dated April 5, is called “A (possible) solution to COVID-19.” The second one, dated April 12, is called “How would a search for a natural attenuated SARS-CoV-2 strain work in practice?” Whether he’s ultimately right or wrong, what he’s done strikes me as hitting just the right note: the writing is crystal clear, the arguments are well-structured, and the overall idea is conceptually sound. Take a look, and see what you think.
*Lockdown orders differ by jurisdiction. I live in New Jersey, where the relevant ones are Executive Orders 107 and 108, which I regard as basically reasonable, both in form and in content, that is, both as enforceable orders and in terms of the content of the actual rules laid out.
**I asked three working physicians, and three academics in the biomedical sciences. So far, three have responded (one of the physicians, two of the academics).
The one physician and one of the two academics who responded both suggested that they found the attenuated strain approach promising. The other academic was more pessimistic: without shooting down the proposal, she argued that things were more complicated than Tillet’s posts suggested. But she didn’t precisely shoot the proposal down, either–and may or may not have read the second of Tillet’s posts. (I only sent the first one around). As I hear back from the others (if I do), I’ll describe the responses by anonymous paraphrase, as I’ve described these.
Ht to Anurag Wadehra for pointing me to Tillett’s blog.
Thanks for posting this. The approach seems promising to my lay ears. The main advantage over sped-up vaccine trials (e.g. via human challenge trials) seems to be that nature does the safety-testing for us. I can see how this would buy us a couple of months at least. However, I would like to see defenders of sped-up human-challenge-trial vaccine development make their best case. (After all, we have several vaccine candidates that produce the right antibodies and that are in animal and human trial. If there is a smooth curve balancing safety and efficacy, we could have a first-shot vaccine as soon as production can be ramped-up, at some, perhaps or perhaps not unacceptable, cost to safety.) I think both approaches should be taken up.
I do worry about this style of “vaccine” being perceived (however erroneously) as particularly unacceptable. I could see widespread reluctance or dissent and — unfortunately, of course — the anti-vax and various other conspiracy theorists would probably have a field day. Even more so than with ordinary vaccines. It’s a live vaccine and people will worry — too much but not entirely without reason — that it will kill grandpa and grandma. And it will, sometimes.
Again, we need to do all of the promising things (and this would seem to be one of them). The more we do, the more likely one will end up being a home run (and in any case we’ll get a bunch of singles and doubles).
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I haven’t had a chance to read this yet, but having spotted it, I figured I’d stick it here, if only because of the similarity in subject matter. An interesting site and author that I’ll have to return to when I get time:
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