[ Question ]

Should I self-variolate to COVID-19

by elityre 2 min read25th May 202019 comments

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[This is currently in the speculative phase. I am not planning to do anything rash without very careful consideration.

Please do not read this question as an endorsement of the plan described herein.

Please use common sense and don't take dangerous actions without doing due diligence and carefully weighing the costs, benefits, and risks.]

As the coronavirus situation develops, it is becoming more plausible that the pandemic won't meaningfully end for months.

There travel that I would like to do (in the continental US), this year. But, even if I carefully self-isolate, I think it would be socially irresponsible for me to travel from place to place in the country, potentially being a vector for intercity transmission. (Not to mention that I would be visiting committed EAs, who I especially don't want to infect.)

I think the only way that it would be socially responsible for me to travel, is if I knew with very high confidence that I wasn't carrying the virus*. And the only way that I can have that confidence is if I have already caught it, recovered, and now have antibodies against the virus.

I am young (26), healthy, and currently in self isolation. My personal risk of death or disfigurement from catching the virus seems low. (One crux for that is that the risk of developing permanent chronic fatigue is low.)

I'm tempted to intentionally expose myself to (ideally, a controlled dose of) the virus, strictly self-isolate for the contagious period (with careful regular testing of my symptoms), confirm my resistance to the virus with an antibody test, and then travel freely, knowing that I am not a vector for the virus.

I'm wondering if this plane is actually practical.

* - I suppose that another possibility is that, in every city that I visit I could rent an AirBnB and strictly self isolate for 14 days. That seems both expensive and onerous.

The most important question:

Is this a stupid idea?

More specifically,

  • What is the best up to date information on the fatality risk to different age groups?
    • I'm still using the 0.2% fatality rate for 20 to 29 year olds, from China, early in the pandemic. Do we have better numbers now? How much does that figure overestimate, because of asymptomatic cases that are not counted among the "number of infected" denominator?
  • Do we have good information about how much a low initial viral load reduces the probability of developing symptoms or the probability of hospitalization?
    • Do we have anything like the response curve to different initial exposure levels?
  • What is the state of the evidence for long term chronic fatigue resulting from COVID? Did that question get settled?
  • Are there risks that I'm failing to account for?

Logistical questions:

  • Are there any existing variolation projects that I can join?

If not,

  • What is the best way to intentionally catch COVID?
    • Is there a way that a private citizen can get their hands on a sample of the virus?
    • If not, what strategy would result in my catching the virus with high reliability, but low initial viral load? (I would rigorously self-isolate as soon as I was exposed, so it would be really annoying if the virus didn't take hold, but I went into strict isolation needlessly, and then needed to expose myself and isolate again.)
  • What is the ideal dose for a mild case?
  • For how long, counting from the moment I'm exposed to the virus, am I at risk of being contagious? What is the maximum length of time that I could reasonably still be contagious? I would use an antibody test to confirm, but I would probably only have limited tests, and would want to time when to use them.
  • Is there anything else that I'm neglecting here?

I haven't been following this situation closely since entering self isolation, so I would be happy to read answers that merely link to existing articles or LessWrong answers that address my questions.

Again, please don't do anything stupid because I asked this question!

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4 Answers

I think the only way that it would be socially responsible for me to travel, is if I knew with very high confidence that I wasn't carrying the virus*. And the only way that I can have that confidence is if I have already caught it, recovered, and now have antibodies against the virus.

I didn't read all of your post, but I want to mention that people do buy tests (I think like a couple hundred dollars per test but maybe less), and I expect if you looked into it you could find some. I think I know someone who bought some, I know the Joe Rogan podcast gives its guests a test before they come on the show, and also I think that if you know the right people you can just make tests. I mean, it's probably illegal because everything is illegal, but the government primarily finds out when labs try to do mass testing and publish results, so you can probably get a bunch for personal use and nobody will notice.

Then you can take a flight, go to a hotel for one night, use a test, and probably find out pretty quickly (I'd guess either within an hour or within a day but I don't know) whether you're infected. 

I expect this to cost more time and money, but if you're able to take careful precautions in travel (such as those I listed here) I expect there's a large probability that this would be better than getting the disease, especially with the unknown long-term effects and plausibility of a vaccine within 12 months.

At 26, you can expect to life around 55 more years. Let's trade off against waiting for a vaccine, assuming the vaccine is 100% safe and effective, and also assume your quarantining strategy is 100% effective.

By giving yourself COVID-19, you're losing about 55 years * 52 weeks per year * .002 chance of death = 6 weeks of life in expectation. That's not counting the risk of chronic fatigue, or the time you might spend being sick.

Your motivations seem basically selfish, moderated by a desire to be socially responsible. If so, then consider that we'll also probably have faster and more widespread testing in the coming months. More efficacious treatments may emerge. These may permit socially responsible travel prior to the arrival of a vaccine. Then consider that some people may not want you around even if you tell them you're immune. And of course, the world's going to continue being shut down even if you have antibodies in your system.

Does social distancing suck so bad for you that this trade off feels like it makes sense? What is the concrete activity you'd like to be able to do, that you can't do without antibodies in your system?

If deliberately infecting yourself, consider taking measures to check and to optimize your immune response.

Nutritionally rich diet, protein, vitamin D3/sunshine, etc.

Are there any existing variolation projects that I can join?

FWIW, there is this I know of: https://1daysooner.org/

That said, last time I've got an update from them (~1 month ago), any execution of these trials was still at least a few months away. (You could reach out to them via the website for more up to date information.) Also, there is a limited number of places where the trials can actually take place, so you'd have to check whether there is anything close to where you are.

(Meta: This isn't necessarily an endoresement of your main qusetion.)