4 ms·

> If "break" means "make overall better", why not? Well that depends heavily on how well we can predict the outcomes and account for downsides and externalized

> If "break" means "make overall better", why not? Well that depends heavily on how well we can predict the outcomes and account for downsides and externalized costs. That doesn't mean never change anything, I'd never argue for that, but I am generally more hesitant to than most to change things that are working well enough. > My understanding is that you believe there should be some point at which we just stop even if there are still more beneficial changes to be made I think your description here assumes too much clarity in what is possible or what will happen if you continue on. Sometimes the system is well understood and the potential gains are pretty clear, that isn't always the case though. > There are already a couple of diseases (including smallpox) that we've completely eradicated, and more (like polio) that we've made very good progress on I wish virology was that cut and dry. There are diseases that present nearly identically to smallpox and polio but were given different names based on hypothesized causes. Monkeypox and acute flaccid myelitis come to mind, respectively. If I remember right, polio is actually one where the clinical diagnosis steps rules it out simply because polio has been deemed irradiated, meaning anyone with polio-like symptoms must have something else because we got rid of polio. There's a whole rabbit hole around how virology tests and isolates viruses, that's probably not helpful to ho down here. My point stands though, maybe we can eradicate a particular virus but we can't really eradicate a disease when that's largely just a named collection of symptoms.

Ukv 2y ago
> I think your description here assumes too much clarity in what is possible or what will happen if you continue on. Sometimes the system is well understood and the potential gains are pretty clear, that isn't always the case though. Does halting not also come with lack of clarity? For instance, say we're choosing between two options: 1. Continue with disease/vaccine/antibiotic/etc. research 2. Halt said research To me it seems as though both options come with uncertainties, which could resolve positively as well as negatively. That there is uncertainty or a lack of clarity does not bias me towards option 2. My choice would still be based on analysis of which option has the better expected outcome (which is, to my current knowledge, the former) - even if the best analysis available is a guesstimate with very low correlation (so long as it's a positive correlation). > There are diseases that present nearly identically to smallpox and polio but were given different names based on hypothesized causes. Monkeypox and acute flaccid myelitis come to mind Mpox is considerably milder - having killed hundreds of people compared to smallpox's hundreds of millions. > If I remember right, polio is actually one where the clinical diagnosis steps rules it out simply because polio has been deemed irradiated Polio isn't eradicated like smallpox is, though for most people it may as well be. Given ongoing eradication efforts my understanding is that there is fairly extensive testing compared to other diseases of its rarity (e.g: https://polioeradication.org/what-we-do/ https://polioeradication.org/what-we-do/), so it's not just a case of "it's gone because we're ignoring it" if that's what's being implied.
- _heimdall 2y ago
  > Does halting not also come with lack of clarity? That depends on how you choose to view it. Choosing to halt, or to be happy with where you are, is a certainty in that you have what you have but it is uncertain in that you don't know what you could have had if you kept going. > Mpox is considerably milder - having killed hundreds of people compared to smallpox's hundreds of millions. The severity is milder for sure, but the list of symptoms is nearly identical. Severity is a tricky one for most pathogens, its very common for severity to decrease over time as a novel pathogen becomes endemic. > so it's not just a case of "it's gone because we're ignoring it" if that's what's being implied My implication was "we won't diagnose it because we know it was eradicated," but that may come down to semantics. I'm happy to be wrong there too, I can't find the source I remember seeing for clinical diagnosis so maybe I'm thinking of a different condition.
  - Ukv 2y ago
    > is a certainty in that you have what you have If you halt disease research, there's a greater chance of a pandemic - or losing the battle to drug-resistant diseases. If you halt meteor deflection programs, there's a greater chance of a significant portion of life being wiped out by a meteor. That doesn't seem like certainty in any sense to me. > The severity is milder for sure, but the list of symptoms is nearly identical. You could say that we haven't eliminated all diseases with similar clinical presentations, but we have eliminated smallpox - the disease that was killing hundreds of millions. > Severity is a tricky one for most pathogens, its very common for severity to decrease over time as a novel pathogen becomes endemic. Mpox is not just a strain of smallpox that became less virulent over time - they diverged long before smallpox jumped to humans. Smallpox stayed deadly for thousands of years.
    - _heimdall 2y ago
      > If you halt disease research, there's a greater chance of a pandemic To clarify, there is greater chance of natural pandemic. The chance of man made pandemic goes down or disappears entirely though. I don't know how to properly weigh the pros and cons there, especially without know likely top secret details of what biological weapons research is ongoing. > but we have eliminated smallpox We have a definitional disagreement here. My understanding is that diseases are classified and diagnosed by symptom, not by severity of the symptoms. That would be especially tricky as everyone will have a different reaction to the pathogen or condition and the same underlying cause could present with more or less severity. If you consider smallpox eliminated because disease with a similar severity is no longer present then we likely have to consider Covid eliminated as well, I don't think many would agree that it is though. People still test positive for CoV-2 and are diagnosed with Covid based on symptoms, it just isn't nearly as deadly or severe for most of the population now. > Mpox is not just a strain of smallpox that became less virulent over time Maybe I'm being pedantic here, apologies if that it. My understanding, though, is that monkeypox and smallpox are/were diagnosed by symptom and rarely or never diagnosed by isolating and identifying the virus in patients. Monkeypox and smallpox have very similar symptoms, meaning they could very well be considered the same disease even if they are believed to be caused by two different viruses.

Ukv 2y ago

> I think your description here assumes too much clarity in what is possible or what will happen if you continue on. Sometimes the system is well understood and the potential gains are pretty clear, that isn't always the case though. Does halting not also come with lack of clarity? For instance, say we're choosing between two options: 1. Continue with disease/vaccine/antibiotic/etc. research 2. Halt said research To me it seems as though both options come with uncertainties, which could resolve positively as well as negatively. That there is uncertainty or a lack of clarity does not bias me towards option 2. My choice would still be based on analysis of which option has the better expected outcome (which is, to my current knowledge, the former) - even if the best analysis available is a guesstimate with very low correlation (so long as it's a positive correlation). > There are diseases that present nearly identically to smallpox and polio but were given different names based on hypothesized causes. Monkeypox and acute flaccid myelitis come to mind Mpox is considerably milder - having killed hundreds of people compared to smallpox's hundreds of millions. > If I remember right, polio is actually one where the clinical diagnosis steps rules it out simply because polio has been deemed irradiated Polio isn't eradicated like smallpox is, though for most people it may as well be. Given ongoing eradication efforts my understanding is that there is fairly extensive testing compared to other diseases of its rarity (e.g: https://polioeradication.org/what-we-do/ https://polioeradication.org/what-we-do/), so it's not just a case of "it's gone because we're ignoring it" if that's what's being implied.

_heimdall 2y ago
> Does halting not also come with lack of clarity? That depends on how you choose to view it. Choosing to halt, or to be happy with where you are, is a certainty in that you have what you have but it is uncertain in that you don't know what you could have had if you kept going. > Mpox is considerably milder - having killed hundreds of people compared to smallpox's hundreds of millions. The severity is milder for sure, but the list of symptoms is nearly identical. Severity is a tricky one for most pathogens, its very common for severity to decrease over time as a novel pathogen becomes endemic. > so it's not just a case of "it's gone because we're ignoring it" if that's what's being implied My implication was "we won't diagnose it because we know it was eradicated," but that may come down to semantics. I'm happy to be wrong there too, I can't find the source I remember seeing for clinical diagnosis so maybe I'm thinking of a different condition.
- Ukv 2y ago
  > is a certainty in that you have what you have If you halt disease research, there's a greater chance of a pandemic - or losing the battle to drug-resistant diseases. If you halt meteor deflection programs, there's a greater chance of a significant portion of life being wiped out by a meteor. That doesn't seem like certainty in any sense to me. > The severity is milder for sure, but the list of symptoms is nearly identical. You could say that we haven't eliminated all diseases with similar clinical presentations, but we have eliminated smallpox - the disease that was killing hundreds of millions. > Severity is a tricky one for most pathogens, its very common for severity to decrease over time as a novel pathogen becomes endemic. Mpox is not just a strain of smallpox that became less virulent over time - they diverged long before smallpox jumped to humans. Smallpox stayed deadly for thousands of years.
  - _heimdall 2y ago
    > If you halt disease research, there's a greater chance of a pandemic To clarify, there is greater chance of natural pandemic. The chance of man made pandemic goes down or disappears entirely though. I don't know how to properly weigh the pros and cons there, especially without know likely top secret details of what biological weapons research is ongoing. > but we have eliminated smallpox We have a definitional disagreement here. My understanding is that diseases are classified and diagnosed by symptom, not by severity of the symptoms. That would be especially tricky as everyone will have a different reaction to the pathogen or condition and the same underlying cause could present with more or less severity. If you consider smallpox eliminated because disease with a similar severity is no longer present then we likely have to consider Covid eliminated as well, I don't think many would agree that it is though. People still test positive for CoV-2 and are diagnosed with Covid based on symptoms, it just isn't nearly as deadly or severe for most of the population now. > Mpox is not just a strain of smallpox that became less virulent over time Maybe I'm being pedantic here, apologies if that it. My understanding, though, is that monkeypox and smallpox are/were diagnosed by symptom and rarely or never diagnosed by isolating and identifying the virus in patients. Monkeypox and smallpox have very similar symptoms, meaning they could very well be considered the same disease even if they are believed to be caused by two different viruses.