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 · 12 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
    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
      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:

• Stop this pandemic in its tracks
• Minimize lives lost, economic disruption, psychological harm, and political harm done directly by the disease or our responses to it
• Perhaps, if lucky, find a way to make humanity better off afterwards

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.

• Large scale prevention of exposure: Social distancing and managing packages and surfaces
• Small scale of prevention of exposure: Physically blocking the virus before it gets to the body
• masks
• sanitation
• etc.
• Chemical interventions once it has entered the body: Vaccines, antivirals
• Physiological support once it has entered the body: Stuff like ventilator production and supplemental oxygen
• Meta: Investigate the alternative causal pathways to death and hypotheses about them; answering questions like: how much damage and death is due to lung damage, cytokine storms, damage to the nervous system, or interfering with oxygen transportation in the blood?
• Miscellaneous “unusual ideas” (see later section)

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

• Many candidates can be tested in parallel for speed
• To speed up the testing of a specific vaccine we can skip directly to later stage trials - exposing humans to the virus
• We can accelerate testing for long-term negative effects by having a large and diverse set of volunteers take it at once - effects that are rare or slow to show themselves will be detected much faster this way
• Slow and rare effects can plausibly also be detected more easily by selecting people based on weakness to the plausible rare or slow effect, or alternatively exposing people to conditions that would cause a plausible rare effect or slow effect to show itself
• In parallel with testing, production capability and perhaps even stocks of plausible vaccine candidates can be built up and even distributed so they are ready to use on a moment’s notice if the vaccine works. (Bill Gates is now doing this.)
• See also the this EA forum post [EA · GW]

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

Unusual ideas

Minimizing environmental exposure

• Coppering surfaces to decrease the virus lingering time (this effect may not last much beyond when the copper surface oxidizes)
• Leaving soap residues on surfaces to decrease virus lingering time (plausible because covid-19 is surrounded by a lipid membrane, but this may not work at normal temperature and humidity)
• There may be other alternative better antiviral coatings that can be coated on surfaces
• Having UVc lights of the ideal wavelength in people dense areas [EA · GW]
• Possibly having them on when people are not around
• Maybe you could even build something to shine in the lungs, unlikely though [EA · GW]
• Assuming COVID-19 exhibits seasonality: changing the temperature, humidity, or wind patterns inside people-dense areas to induce artificial summer and “outside”

Social distancing measures and management

• Applying even more sophisticated strategies for contact tracing and immunity
• Remove the small-world network hubs or perhaps just wait for them to become immune (or replace them with with immune folks) to reduce the viral reproduction number [LW · GW]
• Highly privacy preserving contact tracing: https://covid-watch.org and https://www.novid.org
• Take into account variance of R0 when doing contact tracing and lockdowns
• Do pooled and random sample testing to more efficiently use limited testing ability and search for community spread
• As an idea for inspiration (not feasible as is), change the network topology of interactions
• Another idea for inspiration (not feasible as is), move the recovered people around, integrate them into the social web, and have them act as firebreaks. You take recovered or otherwise immune people and move them to places where there is an outbreak in order to drop R0 below 1
• Apply a more synchronous form of lockdown. In theory if everyone was in lockdown for a month at the same time we’d be able to identify essentially everyone who has it and have the mild cases non contagious by the end of that time period (we’d still have to be careful with contaminated surfaces (especially frozen or refrigerated items)). Something like this could very well be cheaper and easier than an extended partial lockdown.
• In order to spread out the timing of when people are sick, a staggered form of quarantine where you expose some people earlier than others could be implemented. This option is not a good option and more of a last resort to spread out when people are at the hospitals and give us more time to come up with something better. It is better than just letting the epidemic spread freely though. Perhaps implement something like this controlled infection
• Special note: This strategy is risky because the more generations it evolves for the more chances it has to evolve into another form [LW · GW], and flattening the curve increases the depth in generations
• Apply complicated forms of the "dance": things like varying the degree and intensity of tracing and lockdown over time and locations dynamically in response to contagion (perhaps using something like a PID controller). For some concreteness check out:
• Coronavirus: The Hammer and the Dance
• Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand
• Health Before Wealth: The Economic Logic
• Simulating Covid-19
• COVID-19 modelling is wrong
• Simulating an Epidemic
• Views of economists’ on relevant questions
• Ubiquitous health monitoring (temperature sensors, cough sound detectors, ...) - this can done using either attached or far away sensors
• Figure out how to make the symptoms more apparent to people (by education, customized biotracking, something that amplifies symptoms (stuff like the opposite of a cough suppressant or fever reducer?), ...)

Decrease the initial viral load

• Expose people to minimal viral loads in the best vector [LW · GW] - say an injection in the muscle, a scratch, or the gastrointestinal system

Chemical means of countering covid 19 infections

• Put the entire population on weak immune boosters (stuff like vitamins D and C, selenium, ...)
• Put the entire population on stronger forms of immune system boosters (I think there are some immune system boosters in certain vaccines). Alternatively maybe just hand them out to be used at the first sign of illness
• Prime the immune system before or during the earlier stages of the disease
• Put the entire population on other immune boosting strategies: intermittent fasting, cold showers, saunas, good sleep, getting to the ideal weight for respiratory disease [LW · GW], oxytocin/social support/hugs, placebo pills, ...
• Avoid immune system suppressants like steroidal chemicals, NSAIDs and Tylenol, and symptom suppressants (symptom suppressant use may also increase contagion by enabling people to go out without visible signs of illness (to themselves or others) and select for more dangerous versions of the virus)
• Lots of speculative chemicals like quercetin, rosemary, ...
• Transfer blood plasma/antibodies from the recovered to the ill (some people are implementing this) - possibly boost this by hooking up circulatory systems or boosting the recovered antibody production (perhaps by transferring some more viral load later)
• Transfer blood from the young to the old - probably need immune suppressors for this because you'd need to transfer immune cells and in any event this shouldn't work because you very likely need to generate new immune cells to handle the disease
• Disperse zinc lozenges to the population to use as soon as they even speculate they are coming down with something in order to kill the virus in their throat and perhaps upper respiratory system to decrease or perhaps eliminate their viral load. High percentage ethanol vapor can also produce this effect.
• Perhaps the high temperature and humidity of saunas can kill the virus in one's upper respiratory system and perhaps help clear the lower lungs
• Disperse a coat of antiviral and non-cytotoxic oil, docosanol, deep into the lungs - Danielle Fong had this idea but she worries about it gumming up the lungs and it hasn't gone anywhere yet
• See if chemicals useful for dealing with high altitude or boosting oxygen levels help
• Aerobic exercise to boost lung capacity and cardiovascular fitness before exposure (but not after)
• Decrease exposure to air pollution and smoke
• Look into what athletes use when doping to boost red blood cell count and hemoglobin levels
• Use chemicals that decrease cytokine storms (like possibly vitamin C, melatonin, tocilizumab, and drugs that help with autoimmune disorders)
• Maybe some of the chemicals used in preventing autophagy, stroke damage, etc, can be used to prevent damage in this case
• Maybe boost antioxidants to inhibit damage to the lungs and inhibit cytokine storms
• Maybe inject lots of ACE2 receptors into the body and lungs to divert the virus away from its target
• Castration imitation chemicals, to regenerate the thyroid and possibly return it to a state similar to that of younger people where the death rate is lower. I recall reading a discussion on this somewhere but cannot find it again.
• Have people take estrogen or phytoestrogens, assuming that is relevant for the difference between the male and female fatality rates: Estrogen receptor impairs interleukin-6 expression by preventing protein binding on the NF-kappaB site.

Non-chemical ways of countering covid 19 infections

• Implement sophisticated forms of liquid breathing
• Maybe there is a way to ultrasonically shake the lungs to clear them, similar to what is used for kidney stones
• Maybe there is truth to the possibility that some forms of near infrared can boost healing. Maybe bathe the patient or their lungs (somehow) in it
• See if increasing partial air pressure can help for blood oxygenation
• Have people implement prone positions in the earlier stages of the disease or for self care if hospitals are overwhelmed

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.

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