"However, extreme “lockdowns”, which isolate most everyone at home, not only limit freedoms and strangle the economy, they also greatly increase death rates. This is because infections at home via close contacts tend to come with higher initial virus doses, in contrast to the smaller doses you might get from, say, a public door handle. As soon as your body notices an infection, it immediately tries to grow a response, while the virus tries to grow itself. From then on, it is a race to see which can grow biggest fastest. And the virus gets a big advantage in this race if its initial dose of infecting virus is larger.
This isn’t just a theory. The medical literature consistently finds strong relations, in both animals and humans, between initial virus dose and symptom severity, including death. The most directly relevant data is on SARS and measles, where natural differences in doses were associated with factors of 3 and 14 in death rates, and in smallpox, where in the 1700s low “variolation” doses given on purpose cut death rates by a factor of 10 to 30. For example, variolation saved George Washington’s troops at Valley Forge.
Early on, it can be worth paying such high costs to end a pandemic. But once a pandemic seems likely to eventually infect most everyone, it becomes less clear whether lockdowns are a net win. However, the dose effect that lockdowns exacerbate, by increasing dose size, also offers a huge opportunity to slash deaths, via voluntary infection with very low doses.
Just as replacing accidental smallpox infections with deliberate low dose infections cut smallpox deaths by a factor of 10 to 30, a factor of 3-30 is plausible for Covid19 death rate cuts due to replacing accidental Covid19 infections with deliberate small dose infections. Observed mortality differences due to natural dose variations give only a lower bound on what is feasible via controlled doses. Of course we can’t be sure until we get more direct evidence. But systematic variolation experiments involving at most a few thousand volunteers seem sufficient to get evidence not only on death rates, but also on ideal infection doses and methods, and on the value of complementary drugs that slow viral replication (e.g., remdesivir)."
This isn’t just a theory. The medical literature consistently finds strong relations, in both animals and humans, between initial virus dose and symptom severity, including death. The most directly relevant data is on SARS and measles, where natural differences in doses were associated with factors of 3 and 14 in death rates, and in smallpox, where in the 1700s low “variolation” doses given on purpose cut death rates by a factor of 10 to 30. For example, variolation saved George Washington’s troops at Valley Forge.
Early on, it can be worth paying such high costs to end a pandemic. But once a pandemic seems likely to eventually infect most everyone, it becomes less clear whether lockdowns are a net win. However, the dose effect that lockdowns exacerbate, by increasing dose size, also offers a huge opportunity to slash deaths, via voluntary infection with very low doses.
Just as replacing accidental smallpox infections with deliberate low dose infections cut smallpox deaths by a factor of 10 to 30, a factor of 3-30 is plausible for Covid19 death rate cuts due to replacing accidental Covid19 infections with deliberate small dose infections. Observed mortality differences due to natural dose variations give only a lower bound on what is feasible via controlled doses. Of course we can’t be sure until we get more direct evidence. But systematic variolation experiments involving at most a few thousand volunteers seem sufficient to get evidence not only on death rates, but also on ideal infection doses and methods, and on the value of complementary drugs that slow viral replication (e.g., remdesivir)."