COVID-19: List of ideas to reduce the direct harm from the virus, with an emphasis on unusual ideas

post by JustinShovelain · 2020-04-09T11:33:28.904Z · LW · GW · 13 comments

Contents

  A general list of things for interfering with the causal chain of infection and death
  Policy for accelerating vaccine development (and similar for antivirals and possibly some other potential solutions)
  Unusual ideas
    environmental exposure
    distancing measures and management
    the initial viral load
    means of countering covid 19 infections
    ways of countering covid 19 infections
  Conclusion
      What do you think of these ideas; how probable, costly, and effective would they be?
      Do you have additional ideas you think would be good to investigate and implement?
      I hope that promising ideas from here will inspire additional progress and will be further investigated, forwarded to relevant parties, and acted upon if sufficiently vetted and developed. 
None
12 comments

This is a collection of ideas on what interventions could be investigated, funded, or implemented to potentially reduce the harms from COVID-19 by intervening directly on the causal chain leading to infection and death. In particular, it has a lot of “unusual ideas” that haven’t gotten much attention yet.

Caveats: Most of the “unusual ideas” (see later section) were generated or vetted only quickly. Before implementation, they will definitely need further investigation, and some are only meant to serve as inspiration for better interventions. But capacity to implement them if they do work can generally be built in parallel with investigating whether they work. Further, it’s also possible that some things here could have consequences worse than the disease (stuff like surveillance states, long term harm from bad vaccinations, or dual use dangerous biotechnology). Therefore, the suggestion here is to pour a lot of resources into investigating those particularly risky options, rather than to immediately and unilaterally implement them.

As the surrounding context to keep in mind, we want to:

For some related research topics check out Coronavirus Research Ideas for EAs [EA · GW].


A general list of things for interfering with the causal chain of infection and death

In this section, I’ll list categories of interventions to reduce the harm from COVID-19. These should ideally be investigated and implemented in parallel at speed for something as disruptive as this virus. Some of these are being implemented by varying degrees in nations fighting the pandemic.


Policy for accelerating vaccine development (and similar for antivirals and possibly some other potential solutions)

Note: Some of these ideas will face ethical objections or may be hard politically to implement.


Unusual ideas

Minimizing environmental exposure

Social distancing measures and management

Decrease the initial viral load

Chemical means of countering covid 19 infections

Non-chemical ways of countering covid 19 infections


Conclusion

I again wish to emphasize that the ideas collected here range from strongly implied by science to be helpful (such as copper surfaces) to the very speculative (such as an antiviral “oil” for the lungs), and that some have the potential to cause more harm than the disease itself. Many of these ideas would need to be investigated further before implementation, though capacity to implement could be built up at the same time. And hopefully some of the "unusual ideas" can inspire more such ideas from others. In general, people need to move fast to combat COVID-19, but also need to be thoughtful, and to avoid information hazards [? · GW] and highly risky actions.

What do you think of these ideas; how probable, costly, and effective would they be?

Do you have additional ideas you think would be good to investigate and implement?

I hope that promising ideas from here will inspire additional progress and will be further investigated, forwarded to relevant parties, and acted upon if sufficiently vetted and developed.

Thanks to David Kristoffersson [LW · GW], Michael Aird [LW · GW], and Elizabeth Van Nostrand [LW · GW] for editing help, to Alexey Turchin [LW · GW] for sharing some ideas, and to the many people who have been coming up with great ideas for fighting the pandemic, many of which I've included here or have been inspired by.

13 comments

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comment by CellBioGuy · 2020-04-19T02:51:42.292Z · LW(p) · GW(p)

See my answer of another link below. Short version:

  • Severe disease is associated with hyper-coagulation, and people experiencing breathing difficulties should be treated with anticoagulants.
  • Antivirals and anything believed to decrease viral replication should be given early, to the more moderate cases to decrease the odds of progressing to severe, rather than only to severe cases.
  • A case is likely to be followed by a period of immunosuppression, much like measles, so those who become ill should be prepared to be careful afterwards.

https://www.lesswrong.com/posts/nRX7uwT2wNvvmd2Yd/coronavirus-justified-key-insights-thread [LW · GW]

comment by romeostevensit · 2020-04-09T18:22:39.873Z · LW(p) · GW(p)

A review of studies on copper surfaces found no effect from oxidation on the effectiveness of the anti microbial property. Will look for link when not on phone.

comment by ChristianKl · 2020-04-10T16:24:49.181Z · LW(p) · GW(p)
Leaving soap residues on surfaces to decrease virus lingering time

Given that plenty of people are now were cloth-based masks, could there be a benefit to soak those masks in soap to make them accumulate less virus particles?

comment by CellBioGuy · 2020-04-19T02:45:07.284Z · LW(p) · GW(p)

There have been studies of soaking them in brine, so they have tiny salt crystals in the cloth that dessicate viruses that land on them. Had a positive effect!

comment by waveman · 2020-04-09T23:54:22.380Z · LW(p) · GW(p)

Possible use of ACEi or ARB drugs al long as Blood Pressure is not too low see https://www.tandfonline.com/doi/full/10.1080/22221751.2020.1746200

Nutrient rich diet rich in digestible complete protein, accessible minerals like Zinc and Iron, Vitamins D3 and K2. Hint: meat.

Low carbohydrate healthy fat diet reduces Oxygen requirement by 15% & improves ventilator outcomes. https://www.e-cep.org/journal/view.php?doi=10.3345/kjp.2018.06835

Evidence based approach to reducing incidence of metabolic syndrome, obesity and diabetes in the community. High blood glucose levels impact immune system function adversely and can be rapidly controlled in many people by greatly reducing carbohydrate intake.

Given higher death rates from pneumonia in people with *low* LDL cholesterol, and weak evidence for overall benefits, reconsider widespread use of statin medications.

Use of less accurate tests as pre-screening for tests and for selective isolation e.g. Temperature, as used in the one actual success story Taiwan. You can check far more temperatures than you can do blood tests or swabs. If you have cold/flu symptoms you are not going to stay at school/work/ get on the subway. Selective testing is one way to solve the "needle in a haystack" problem of looking for community transmitted cases https://jamanetwork.com/journals/jama/fullarticle/2762689 See also https://www.worldometers.info/coronavirus/country/taiwan/ for Taiwan's low rate, far lower than much touted alleged success stories.

There is also a whole category of "preparing for the next one" items, which Taiwan did following the SARS episode a while back.

comment by Liron · 2020-04-09T12:31:28.287Z · LW(p) · GW(p)

Related to decreasing initial viral load: Anyone want to guess whether there’s a significant (10%+) chance that getting infected via rectum has a flu-like Infection Fatality Rate at any dose?

comment by ChristianKl · 2020-04-10T16:21:18.703Z · LW(p) · GW(p)

It might both have a higher or lower fatality rate. It's hard to say without clinical trials.

On the plus side, the patients should be less contagious.

comment by spacecadet · 2020-04-10T00:54:35.098Z · LW(p) · GW(p)

Zinc ionophores such as Chloroquin and quercetin transport zinc across cell membranes, increasing zinc density within cells by 100 fold. Zinc interrupts RNA replication within the cell.

https://www.ncbi.nlm.nih.gov/pubmed/25050823

Daily intake of zinc tablets along with quercetin rich foodstuffs washed down with nice glass of red wine is the prophylactic for me.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1760706/

comment by Luke Allen (luke-allen) · 2020-04-20T18:19:28.396Z · LW(p) · GW(p)

By contrast, I take a 50mg zinc pill whenever I wake up with the dry/aching sinus/back of throat I've come to associate with getting a cold half a day later.

Lately, I've done this so early in the infection cycle that I'm often left uncertain as to whether I've even had a cold, at least until the snot starts a couple of days later. I've even combined this with DayQuil/NyQuil for two days as soon as the snot starts, resulting in effectively no downtime.

comment by ChristianKl · 2020-04-10T16:20:17.430Z · LW(p) · GW(p)

Why would you take zinc tablet over lozenges [LW · GW]? How much additional copper are you taking to make up for the additional zinc?