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Since hospitals are practically empty right now, have we thought of allowing people to voluntarily get infected/quarantined (using a tiny viral load)? Obviously

by umvi 7y ago

Since hospitals are practically empty right now, have we thought of allowing people to voluntarily get infected/quarantined (using a tiny viral load)? Obviously no old, immuno-compromised, or other vulnerable people. But for healthy "essential" workers it would mean not living in fear that they might get it... because they already got over it.

quickthrowman 7y ago
I doubt the legal department of the hospital would allow such a thing
chdaniel 7y ago
Genuine question: why are hospitals empty? Aren't people affected by covid taken there?
- SpicyLemonZest 7y ago
  Severe covid cases are, but in most areas that's not enough to fill the hospitals.
- djrogers 7y ago
  The vast majority of places in the US have almost no covid cases. Many emergency hospitals and rent hospitals have been taken down or decommissioned, and in some cases nurses and hospital staff are even being furloughed because demand for elective and non-emergency care have dropped off a cliff.
- sethammons 7y ago
  Hospitals in my area have laid off and/or furloughed nurses. Also in my state, less than 500 people have tested positive (lack of testing for sure) and less than 20 people have died. There are not enough sick people from COVID or anything else to fill our hospitals. However, people are unable to do normal treatments and elective procedures due to lockdowns or are unwilling to go due to fear of COVID. Thus no money coming in to the hospitals thus layoffs and furloughs.
- deleted 7y ago
  [deleted]
- codingdave 7y ago
  They aren't empty. They are less crowded than usual because elective procedures have been cancelled in many cases, but people are still there for non-elective procedures, emergencies, births, etc. And yes, covid cases requiring a hospital are lower than predicted... but they do exist.
OscarCunningham 7y ago
Robin Hanson has been advocating for this. http://www.overcomingbias.com/2020/03/variolation-may-cut-covid19-deaths-3-30x.html http://www.overcomingbias.com/2020/03/variolation-may-cut-co...
pkage 7y ago
It's still risky for healthy young individuals, while most barely present symptoms some people have a very real risk of dying. "Voluntarily allowing people to get infected" creates a perverse incentive for poor essential workers to put their lives on the line in order to put food on the table.
- deleted 7y ago
  [deleted]
- SpicyLemonZest 7y ago
  What's the perverse incentive? I don't think the proposal is that essential workers should have to get infected before they work.
  - dragonwriter 7y ago
    It's not so much a “perverse incentive” for essential workers as a direct attack, as every essential worker who would choose this route to get infected increases the risk profile for everyone they work with (not all of whom are young and otherwise healthy.) But it stops being a problem there if, as most proposals for reopening suggest, general shelter in place is replaced with targeted quarantines of the infected and exposed (and especially if, for this specific option, any resulting lack of employment from choosing voluntary infection by this route is treated as voluntary separation from work and thus not subject to public benefits.) The perverse incentive would be for non-essential workers, but only if this is coupled with one of the existing proposals for “certificates of immunity” (which there is little scientific basis for, but that's another issue) being a factor in allowing them to return to non-remote work.
  - eyelidlessness 7y ago
    It's not an incentive if it's mandatory. It's an incentive if there's some perceived benefit to do it. It's perverse if that perceived benefit is avoiding unnecessary consequences of economic distress. If voluntary infection is allowed, employers may favor employees who test positive for antibodies—for example, by offering a pay increase, or some additional amount of paid sick leave prior to recovery—because they would be less likely to fall ill en masse at some unpredictable later date. States with continued (or resumed in a second wave) shutdown restrictions may exempt businesses whose employees are deemed immune. The people most likely to be incentivized to take this risk are the people who are most economically vulnerable already. I would never consider that risk, but I'm a well paid software engineer working from home.
dragonwriter 7y ago
> But for healthy "essential" workers it would mean not living in fear that they might get it... because they already got over it. Coronaviruses don't tend to produce strong, long-lasting immunity, and we have no evidence that SARS-CoV-2 does, and, also, young otherwise healthy people are dying from strokes that seem to be due to the virus: https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients/ https://www.washingtonpost.com/health/2020/04/24/strokes-cor... So, this would be both high-risk and of dubious utility even in the case where significant adverse effects didn't occur.
- DataWorker 7y ago
  Young people with thrombosi are very rare, so not high risk from that standpoint. As an individual that might be assessed high risk, but in aggregate it is not.
- nostromo 7y ago
  > Coronaviruses don't tend to produce strong, long-lasting immunity Sure they do. But the immunity lasts a few years instead of a lifetime.
- rootusrootus 7y ago
  > Coronaviruses don't tend to produce strong, long-lasting immunity This is a bit misleading. The common coronaviruses that cause the "common cold" do not seem to confer long lasting immunity. But there are very significant differences between those viruses and SC2. The best estimate we have is that immunity will be similar to SC1 (SARS) and immunity to that lasts several years.
jrockway 7y ago
I am assuming people would want to see benefits in being infected before they're going to volunteer. We don't have conclusive data that you can only get COVID-19 once. We don't have conclusive evidence that viral load / exposure volume is what controls the severity of the disease. Right now, it simply looks too risky to attempt; people will volunteer to die painfully, and the ones that survive might not even be spared a second infection. We just don't know right now. More data is necessary. It seems likely to me that exposure to the disease will confer immunity for some period of time, because so many other diseases work that way. But we just don't have solid data that shows that to be the case. (We also don't have data that says the opposite is true.) I kind of have a gut feeling that the total number of people infected is much higher than we think it is, and thus there is less risk. We can watch the states that have reopened to see if that's true (and ship everyone an antibody test with their Census forms or something). More data is being acquired, and with that data, we should be able to make better guesses as to what the next course of action should be. (Reacting to this article specifically, I'd love for the author to get an antibody test. It seems so unlikely to me for people in these very high risk environments to have managed to not get the disease. People travel sick. People wear masks wrong. The disease is incredibly contagious. How could you not get sick? It is all kind of amazing to me.)
- Marsymars 7y ago
  > I am assuming people would want to see benefits in being infected before they're going to volunteer. Counterpoint: I would volunteer for this today if it was an option.
  - newsbinator 7y ago
    I'm curious about your reasoning for that
    - Marsymars 7y ago
      As is, the prime of my life is effectively being wasted; none of my regular pursuits are possible and I can't visit any of my family or friends. For healthy people in my age group there's roughly a 0.1% IFR and with about six decades of life remaining, that works out to about a three week expected loss of my lifespan if I'm infected. If I were able to visit my parents I could do most of their regular shopping/errands for them, decreasing their risk profile. I feel that I'm well informed on the potential risks to myself. Put in reverse - what duration and severity of restrictions to your life would you be willing to endure in exchange for a three-week boost to your life expectancy? I'd even sign up for periodic attempts at re-infection to ensure that I'm (still) immune.
rb808 7y ago
I always thought cruise ships would be great for this.
OJFord 7y ago
> But for healthy "essential" workers it would mean not living in fear that they might get it... because they already got over it. That does seem to be the prevailing public understanding, but it's not actually yet known to be the case. Of course it's possible, but it would be gambling not just on successful recovery (as it always would) but also that it would end up being effective anyway.

by umvi 7y ago

quickthrowman 7y ago

I doubt the legal department of the hospital would allow such a thing

chdaniel 7y ago

Genuine question: why are hospitals empty? Aren't people affected by covid taken there?

SpicyLemonZest 7y ago
Severe covid cases are, but in most areas that's not enough to fill the hospitals.
djrogers 7y ago
The vast majority of places in the US have almost no covid cases. Many emergency hospitals and rent hospitals have been taken down or decommissioned, and in some cases nurses and hospital staff are even being furloughed because demand for elective and non-emergency care have dropped off a cliff.
sethammons 7y ago
Hospitals in my area have laid off and/or furloughed nurses. Also in my state, less than 500 people have tested positive (lack of testing for sure) and less than 20 people have died. There are not enough sick people from COVID or anything else to fill our hospitals. However, people are unable to do normal treatments and elective procedures due to lockdowns or are unwilling to go due to fear of COVID. Thus no money coming in to the hospitals thus layoffs and furloughs.
deleted 7y ago
[deleted]
codingdave 7y ago
They aren't empty. They are less crowded than usual because elective procedures have been cancelled in many cases, but people are still there for non-elective procedures, emergencies, births, etc. And yes, covid cases requiring a hospital are lower than predicted... but they do exist.

OscarCunningham 7y ago

Robin Hanson has been advocating for this. http://www.overcomingbias.com/2020/03/variolation-may-cut-covid19-deaths-3-30x.html http://www.overcomingbias.com/2020/03/variolation-may-cut-co...

pkage 7y ago

It's still risky for healthy young individuals, while most barely present symptoms some people have a very real risk of dying. "Voluntarily allowing people to get infected" creates a perverse incentive for poor essential workers to put their lives on the line in order to put food on the table.

deleted 7y ago
[deleted]
SpicyLemonZest 7y ago
What's the perverse incentive? I don't think the proposal is that essential workers should have to get infected before they work.
- dragonwriter 7y ago
  It's not so much a “perverse incentive” for essential workers as a direct attack, as every essential worker who would choose this route to get infected increases the risk profile for everyone they work with (not all of whom are young and otherwise healthy.) But it stops being a problem there if, as most proposals for reopening suggest, general shelter in place is replaced with targeted quarantines of the infected and exposed (and especially if, for this specific option, any resulting lack of employment from choosing voluntary infection by this route is treated as voluntary separation from work and thus not subject to public benefits.) The perverse incentive would be for non-essential workers, but only if this is coupled with one of the existing proposals for “certificates of immunity” (which there is little scientific basis for, but that's another issue) being a factor in allowing them to return to non-remote work.
- eyelidlessness 7y ago
  It's not an incentive if it's mandatory. It's an incentive if there's some perceived benefit to do it. It's perverse if that perceived benefit is avoiding unnecessary consequences of economic distress. If voluntary infection is allowed, employers may favor employees who test positive for antibodies—for example, by offering a pay increase, or some additional amount of paid sick leave prior to recovery—because they would be less likely to fall ill en masse at some unpredictable later date. States with continued (or resumed in a second wave) shutdown restrictions may exempt businesses whose employees are deemed immune. The people most likely to be incentivized to take this risk are the people who are most economically vulnerable already. I would never consider that risk, but I'm a well paid software engineer working from home.

dragonwriter 7y ago

> But for healthy "essential" workers it would mean not living in fear that they might get it... because they already got over it. Coronaviruses don't tend to produce strong, long-lasting immunity, and we have no evidence that SARS-CoV-2 does, and, also, young otherwise healthy people are dying from strokes that seem to be due to the virus: https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients/ https://www.washingtonpost.com/health/2020/04/24/strokes-cor... So, this would be both high-risk and of dubious utility even in the case where significant adverse effects didn't occur.

DataWorker 7y ago
Young people with thrombosi are very rare, so not high risk from that standpoint. As an individual that might be assessed high risk, but in aggregate it is not.
nostromo 7y ago
> Coronaviruses don't tend to produce strong, long-lasting immunity Sure they do. But the immunity lasts a few years instead of a lifetime.
rootusrootus 7y ago
> Coronaviruses don't tend to produce strong, long-lasting immunity This is a bit misleading. The common coronaviruses that cause the "common cold" do not seem to confer long lasting immunity. But there are very significant differences between those viruses and SC2. The best estimate we have is that immunity will be similar to SC1 (SARS) and immunity to that lasts several years.

jrockway 7y ago

I am assuming people would want to see benefits in being infected before they're going to volunteer. We don't have conclusive data that you can only get COVID-19 once. We don't have conclusive evidence that viral load / exposure volume is what controls the severity of the disease. Right now, it simply looks too risky to attempt; people will volunteer to die painfully, and the ones that survive might not even be spared a second infection. We just don't know right now. More data is necessary. It seems likely to me that exposure to the disease will confer immunity for some period of time, because so many other diseases work that way. But we just don't have solid data that shows that to be the case. (We also don't have data that says the opposite is true.) I kind of have a gut feeling that the total number of people infected is much higher than we think it is, and thus there is less risk. We can watch the states that have reopened to see if that's true (and ship everyone an antibody test with their Census forms or something). More data is being acquired, and with that data, we should be able to make better guesses as to what the next course of action should be. (Reacting to this article specifically, I'd love for the author to get an antibody test. It seems so unlikely to me for people in these very high risk environments to have managed to not get the disease. People travel sick. People wear masks wrong. The disease is incredibly contagious. How could you not get sick? It is all kind of amazing to me.)

Marsymars 7y ago
> I am assuming people would want to see benefits in being infected before they're going to volunteer. Counterpoint: I would volunteer for this today if it was an option.
- newsbinator 7y ago
  I'm curious about your reasoning for that
  - Marsymars 7y ago
    As is, the prime of my life is effectively being wasted; none of my regular pursuits are possible and I can't visit any of my family or friends. For healthy people in my age group there's roughly a 0.1% IFR and with about six decades of life remaining, that works out to about a three week expected loss of my lifespan if I'm infected. If I were able to visit my parents I could do most of their regular shopping/errands for them, decreasing their risk profile. I feel that I'm well informed on the potential risks to myself. Put in reverse - what duration and severity of restrictions to your life would you be willing to endure in exchange for a three-week boost to your life expectancy? I'd even sign up for periodic attempts at re-infection to ensure that I'm (still) immune.

rb808 7y ago

I always thought cruise ships would be great for this.

OJFord 7y ago

> But for healthy "essential" workers it would mean not living in fear that they might get it... because they already got over it. That does seem to be the prevailing public understanding, but it's not actually yet known to be the case. Of course it's possible, but it would be gambling not just on successful recovery (as it always would) but also that it would end up being effective anyway.