All of Dorikka's Comments + Replies

Thank you for this post! One feedback - I found this post much harder to navigate than your other posts (and eventually resorted to summary+bookmark); it is much easier for me to parse/navigate when post sections follow your own line of thinking than when they are structured as replies to sections of other peoples' posts.

i have worn this on an airplane with a surgical mask over the exhale valve

 

https://www.amazon.com/GVS-SPR457-Elipse-Respirator-Medium/dp/B013SIIBFQ/ref=sxts_rp_s1_0?cv_ct_cx=gvs+elipse+p100&gclid=CjwKCAiAzrWOBhBjEiwAq85QZyLzBYwxwOZcFGAMZbn4S6OVwxcQXnl1L6L9xWu1dQgzAFdKK8oxOhoCqo0QAvD_BwE&hvadid=409918312011&hvdev=c&hvlocphy=9014238&hvnetw=g&hvqmt=e&hvrand=6118992613772945421&hvtargid=kwd-267611734495&hydadcr=20509_11115072&keywords=gvs+elipse+p100&pd_rd_i=B013SIIBFQ&pd_rd_r=03b1c070-7191-4557-b0bb-79b3930... (read more)

2Unnamed1y
Me too, except my P100 was wearing a cloth mask rather than a surgical mask.

Without knowledge of potential interactions, melatonin might be another option - I don't take bupropion, but suspect that one would take daily dose in morning to minimize chance of this side effect as well

Depending on when you got your second mRNA dose, the Israeli data suggests there is significant vaccine decline in vaccine efficacy after 3 months (see  https://www.gov.il/BlobFolder/reports/vaccine-efficacy-safety-follow-up-committee/he/files_publications_corona_two-dose-vaccination-data.pdf ) This does not of course indicate whether a third dose would restore efficacy (presumably by reigniting the immune response in some way) - I suspect it would, however. No need for prize money if relevant - just resharing a link that was already in Forbes https:/... (read more)

1Connor_Flexman2y
(Heads up that this is where the Delta variant is widespread though, so this is probably exacerbating the natural effect of waning immunity. Not sure of the exact timescales though)
2Ethan Perez2y
That data is very helpful and clear, thanks for sharing! Pfizer has some initial findings that suggest to me that a third dose would fix the declining efficacy issue: https://cdn.pfizer.com/pfizercom/2021-07/Delta_Variant_Study_Press_Statement_Final_7.8.21.pdf?IPpR1xZjlwvaUMQ9sRn2FkePcBiRPGqw [https://cdn.pfizer.com/pfizercom/2021-07/Delta_Variant_Study_Press_Statement_Final_7.8.21.pdf?IPpR1xZjlwvaUMQ9sRn2FkePcBiRPGqw] "Pfizer and BioNTech have seen encouraging data in the ongoing booster trial of a third dose of the current BNT162b2 vaccine. Initial data from the study demonstrate that a booster dose given 6 months after the second dose has a consistent tolerability profile while eliciting high neutralization titers against the wild type and the Beta variant, which are 5 to 10 times higher than after two primary doses." This seems to make third dosing sound like a pretty good idea, definitely 6 months after the second dose, and probably as early as 3-4 months after the second dose (when the Israel data shows efficacy starting to decline). Curious if others disagree!

Thanks for this as always! Any thoughts on the variant effectiveness estimates in this paper?

https://www.medrxiv.org/content/10.1101/2021.05.22.21257658v1.full-text

2Zvi2y
Will look at this for next week.

The initial pfizer efficacy study and followups in Israel specifically come to mind.

Potential metrics which may be helpful to consider (from a previous location search for me to live): Minimum sunlight per month, months under 200 hrs of sunlight, days above 90F, days below 32F, snow/rain days per year, violent crime level, property crime level, number of internet providers, average speed test result of internet providers, top advertised speed of internet providers, quality of healthcare, attends religious services at least once per week, rate of cigarette use, rate of alcohol use, rate of binge drinking.

Some of these are direct metrics on... (read more)

Would love any context here - not sure if I should parse the linkpost as random person on internet saying things or if any background that would give me a higher prior that their models are accurate and/or useful.

5digital_carver2y
As far as I know, it's just a random person on the Internet saying things that seem well thought-out and with enough research to at least serve as a good starting point. There's also a Hacker News [https://news.ycombinator.com/item?id=26964722] page with critical discussion and other semi-related information, for those interested.

Fluvoxamine is a prescription drug in the FDA, so your doctor can prescribe it; https://www.pushhealth.com/ might work as well. Antiviral procurement is similar if the antiviral you're seeking is a US prescription drug (in any case I'd consider Googling the antiviral name.)

Apologies in advance for not engaging in detail with the analysis itself - my overall synthesis here is that residual risk does exist post-vaccination and is potentially non-negligible. Personally I'll be using my Oura ring to detect nighttime temperature spikes and use a high-accuracy at-home test (https://checkit.lucirahealth.com//) if I detect a spike, followed by aggressive treatment with fluvoxamine (+potential antiviral) if the test comes back positive - these safeguards feel sufficient to travel (airplane) to see family, etc without incurring signif... (read more)

1JesperO2y
Where can one get fluvoxamine and antivirals?

I'm curious if anyone knows of research comparing effectiveness of this to povidone iodine nasal spray? I make a 0.8% solution of that and use it in nose and gargle before going out (in addition to mask)

Thank you both! Zvi - makes sense re short duration of increased interest and effective to capitalize on it while that lasts. Rob - the part I'm not seeing is the causal link between these posts and influencing/improving decisions made by the FDA and CDC.

I note that posts like marginal revolution and others on first doses first likely had a serious effect on causing that to happen. So I think it's fair to think that the discussion around here is having real effects, even if it's indirect and hard to pin down very explicitly.

Out of curiosity, how come the strong speed premium on these posts? AFAICT there's nothing here that informs short-term decisions for readers; I've been skimming and mostly tossing into my to-read pile for that reason. Know I'm not exactly an important stakeholder here, but personally I'd sorta prefer to read the synthesis from a chat between yourself and Scott rather than the blow-by-blow.

2Dorikka2y
Thank you both! Zvi - makes sense re short duration of increased interest and effective to capitalize on it while that lasts. Rob - the part I'm not seeing is the causal link between these posts and influencing/improving decisions made by the FDA and CDC.
4Zvi2y
Interest in things internet has a half-life between 0.5 and 2 days, and I get an order of magnitude or more additional attention after an interest spike like this one. (Also Rob's answer that the underlying problem has a giant speed premium of its own, which is why the weekly posts and such.)
2Rob Bensinger2y
The FDA and CDC's decisions over the coming weeks and months will have a large effect on how much death, suffering, and waste COVID-19 causes. If the FDA and CDC's decisions aren't "efficient", then it makes more sense to try to influence and improve those decisions. We're also early into a presidential administration, when fewer policy and staffing decisions have been locked in (compared to a few months from now).

Thanks - this is super helpful! Wanted to quickly mention in case helpful for calibration - higher quality protection equipment has been available for quite some time given sufficiently dedicated searching; full face respirators were available on Amazon near the beginning of the pandemic; N95 masks and P100 filter cartridges have been reliably available via eBay.

This post is awesome info as arrival time and price are both superior to pre-existing options, but just wanted to mention the above as an update-point: if folks truly believed that this PPE was not purchasable (albeit at a higher price point previously), might be worth updating in the direction of "most things can be purchased on the internet."

As always, a huge thanks to Zvi for the synthesis. I'm posting a comment similar to last week's meeting to consolidate information regarding treatment, as it's a topic that will remain very relevant to many of us for a while.

I continue to follow the guidance provided in the link Zvi previously posted (https://www.quora.com/What-is-the-current-treatment-for-Covid-19) - I would love if anyone has better next actions specifically re treatment than those listed in the Quora response.

My current main selfish takeaway from this is that given the new strain and likely properties of it, I and my loved ones will likely get infected (whereas in the previous world I estimated our precautions as sufficient to prevent infection.)

Hence my main thoughts turn to treatment. I am currently acting on the recommendations provided in the link Zvi previously posted (https://www.quora.com/What-is-the-current-treatment-for-Covid-19) - I would love if anyone has better next actions specifically re treatment than those listed in the Quora response.

2romeostevensit2y
to add to the advice on metformin: berberine has a similar mechanism of action (relevant for COVID: AMPK) and is available OTC.

Thanks for the info! Two questions:

  1. The linked article indicated that 10% solutions were widely available on Amazon, and links this one, but doesn't seem to give any indication why he picked that one in particular - just wanted to check if you might have seen this reasoning somewhere/if it exists.

  2. I'm not familiar with Chris Masterjohn - his web page looks like he's a content creator trying to leverage his Nutritional Science PhD into being seen as knowledgeable about a wide variety of things - is this human known to say true and useful things?

Thanks Zvi, these are super informative!

Use of povidone-iodine as mouthwash and nasal spray looks promising as prophylaxis (and potentially treatment, but lower confidence on that.) The study Zvi linked (https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2770785#ooi200049r25) appears to be the latest in discussions occurring in otolaryngology since April (https://www.google.com/search?q=povidone+iodine+nasal+spray&oq=pobidone&aqs=chrome.1.69i57j35i39l2j0l2.2542j0j4&client=ms-android-att-us&sourceid=chrome-mobile&ie=UTF-8). ... (read more)

4PeterMcCluskey2y
I've got this Povidone Iodine Prep Solution USP [https://smile.amazon.com/gp/product/B07NWZ8L68/ref=ppx_yo_dt_b_asin_title_o04_s00?ie=UTF8&psc=1] , from a Chris Masterjohn recommendation. He suggested [https://chrismasterjohnphd.com/covid-19/povidone-iodine-kills-the-coronavirus-in-60-seconds] (back in May) diluting it 20x.

Would also love your thoughts on this one I posted a while back if convenient - not sure if I'm thinking about this one correctly or not: https://www.lesswrong.com/posts/GoBBmmKzvT8XFwE8g/do-nasal-decongestants-increase-risk-associated-with

2CellBioGuy3y
Unfortunately this is not a direction I have done a lot of looking, sorry.

Thanks for this, super helpful! Is NAC something to start taking when feeling symptomatic or something to start taking way ahead of time (like vitamin D)? Re indomethacin, it sounds like this is something that it would be worth getting a prescription of when feeling symptomatic (assuming it's not a controlled substance or something similarly difficult for a doctor to prescribe) - wanted to feedback this to you to make sure I'm understanding correctly.

2CellBioGuy3y
Apparently I am still consistently a month or two ahead of the curve. https://www.sciencedirect.com/science/article/pii/S0306987720314973 [https://www.sciencedirect.com/science/article/pii/S0306987720314973] https://www.sciencedirect.com/science/article/pii/S1521661620306513 [https://www.sciencedirect.com/science/article/pii/S1521661620306513]
2CellBioGuy3y
You can take NAC every day, it's basically an amino acid and acetate joined together in a peptide bond. Some people do take it every day. I would be hesitant taking it for very long times, since there are a few mouse studies in which mice that got a high dose constantly had higher cancer risks, but mice and cancer are a weird combo already and may not be representative. I would up the dose when actively sick. Indomethacin is a 1960s NSAID that is used less these days because there are slightly safer NSAIDs for most indications - it has several times the rate of causing ulcers compared to advil for example, but I think that's mostly for chronic use rather than short term. They recommend you take it with an antacid, so I would definitely take it with... famotidine, a drug that blocks histamine receptors involved both in stomach acid production AND possibly involved in the inappropriate inflammation that COVID is causing, and which was associated with higher recoveries in some studies. These days I think indomethacin it is mostly used for gout, some types of arthritis, migraines, and some edge cases like helping premature babies rewire their hearts for breathing instead of using a placenta. It's DEFINITELY something you would only take while actively sick, 5-10 days. It's prescription-only in the US, but not exactly 'controlled', it's not like anybody takes it for fun.

Thanks. I haven't used liquid products much before. Anything you've noticed that's significantly different in terms of onset time, effect duration, etc?

0gwern6y
I haven't used them since I haven't tried to go that low dose yet. I assume they would be absorbed faster but otherwise similar.

Anyone know where I can find melatonin tablets <300 mcg? Splitting 300 mcg into 75 mcg quarters still gives me morning sleepiness, thinking smaller dose will reduce remaining melatonin upon wake time. Thanks.

0Douglas_Knight6y
The Netherlands [http://www.hollandandbarrett.nl/shop/product/lucovitaal-melatonine-puur-duo-pack-60001881] . I think that they will ship anywhere in the EU, even places where it requires a prescription. I don't know about the US. But I'm skeptical that dose is your problem.
4gwern6y
You could use liquid melatonin instead, and dilute it to a usably measurably small dose.

Surely, as rationalists, we should

So awkward it hurts that this is even a thing.

Aren't new open threads usually posted on Mondays? Today is the 27th, not 28th.

[anonymous]7y17

It's Monday the 28th in Australia.

Different LessWrongers have different time zones...

Then again, only Clarity would somehow get his open thread downvoted to a negative balance...

404: Generalized model not found

Any particular evidence in favor of this approach, anecdotal or otherwise?

2raydora7y
Late reply, I know! Standardizing decisions through checklists and decision trees has, in general, shown to be useful if the principles behind those algorithms are based on a reliable map. In medical practice, that's probably the evidence-based medicine [https://en.wikipedia.org/wiki/Evidence-based_medicine] approach to screening, diagnosis, and treatment. In addition, all this assumes that patient management skills are not a concern, since it's not something I personally consider important (from the point of view of a patient) when considering a provider of any medical or technical service. If you typically require more from your physician (and many people do see physicians as societal pillars and someone to talk to their non-medical problems about) than medical evaluation and treatment, then it is something to keep in mind. Anecdotally, every medical provider I've encountered who was a vocal opponent of clinical decision support systems had a tendency to jump to dramatic conclusions that were later proven wrong. This [http://www.ncbi.nlm.nih.gov/pubmed/24871243] is one of the few studies on the subject that isn't behind a paywall.

Seem to be implying that you are more likely to be in a simulation if historixcally impt. Interesting

No other source, but keep in mind that helmets are tuned for a certain force level. Too durable and helmet does not reduce peak force as it does not crush. Too weak and it crushes quickly, again with little reduction in peak force. This should just empasize to use the 25% number here though since the forces are more representative.

Redacting "won't do much of anything" except as implied by 25%, but keep in mind that if peak accelerations are much higher than the given case, the helmet will be less effective due to the above. This may or may not be the case in car crashes depending on speed.

Interesting - thanks for checking this. If the Severity Index is claiming no significant damage below 1200, I think it may be incorrect or may have a different criterion for severe damage. Some helmet standards seem to be fairly insensitive, only accounting for moderate or severe brain injury whereas MTBI can have long lasting effects. Yes, I discount Severity claims as the metric does not appear to give reasonable results. 188g is a crapload of linear acceleration, but metric puts it under threshold...I dont buy it, so am left to judge on peak linear accel instead (shame that rotational accel was not measured...)

The data is posted above, unlikely to get around to Dropboxing it so I can link (as it was from an email). I agree with you re body movement in a vehicle collision. However, at some point your body would stop. If your head hit something while your body was in motion, thr impacted object would likely have enough strength to bring the head to an abrupt halt. (Contrast with a knife being punched through paper mache - I would expect the force on the lnofe to be much lower than if hitting concrete, as it would go through the paper mache without much velocity change.)

I am curious about your terminal goal here.

0[anonymous]7y
accidental post

shrug The pdf for sincerity looks bimodal to me.

This is the most tantalizing thread on the page.

-1faul_sname7y
It was a memetic hazard. (not really)

What is this, and why is it here?

(Original response was remarkably vehement, rather like I found a pile of cow dung sitting on my keyboard. Interesting.)

Thanks. How does one go about learning more about this, preferably while encountering minimal bullshit on the way?

2Lumifer7y
Well, there are basically two ways about it. Way one is deciding that you will trust somebody, so you listen to what he/she/it says and you're done. Advantages: easy. Disadvantages: obvious. Way two is reading through a lot of conflicting materials (mostly papers), filtering out people who are stupid, who have an axe to grind, who have been regurgitating cached thoughts for the last couple of decades, etc. and then trying to construct a mostly coherent picture out of what remains. Advantages: you will understand the field. Disadvantage: hard, expensive in time and effort, involves wading through rivers of bullshit. I am not the trusting kind, so I read the papers :-)

Thanks for posting this. Just a quick note, many of the things listed above I would consider may be "common" terminal values, not goals. Might just be a wording thing, but I think of goals as instrumental, with values propagating to actions via the hierarchy values->strategies->campaigns->goals->actions.

Convergent instrumental goals might be an interesting collection as well.

0Elo7y
I have a lot to consider in the way of "values" that are not really covered in this document. Thanks!

A few nutrition-related questions:

  • Why does Soylent 2.0 have so much fat? They appear to be going for 45% of calories from fat, whereas the typical recommendation is 10%-35%.

  • Why does the Bulletproof stuff include so much saturated fat? It appears that the consensus is that saturated fat significantly increases blood cholesterol and arterial plaque formation - curious why such a deviation here.

5Lumifer7y
Nope -- that's a hotly debated topic. There used to be a consensus that saturated fat is bad, but AFAIK it doesn't exist any more. In particular, the low-carb and paleo approaches to nutrition strongly assert that saturated fat is NOT bad -- that's why "Bulletproof stuff" involves a lot of it.

Personal experience that it is useful or just from the indirectly linked papers?

Also, note that it may potentiallly insta-fuck your liver.

A few nutrition-related questions:

  • Why does Soylent 2.0 have so much fat? They appear to be going for 45% of calories from fat, whereas they typical recommendation is 10%-35%.

  • Why does the Bulletproof stuff include so much saturated fat? It appears that the consensus is that saturated fat significantly increases blood cholesterol and arterial plaque formation - curious why such a deviation here.

Thanks for writing this. A few notes:

  • I find Evernote to be an exceptionally great notetaking app.

  • If you end up using Google Calendar, I like Smooth Calendar as a widget that shows a few appts and lets you click through to the full calendar.

  • I previously had an S4, now an S5. I use the InvisibleShield Glass screen cover - people seem to keep finding ways to damage the glass on their phone screen, so the durable cover might pay dividends. (And already did on my S4, when I dropped it about a meter onto slate. I currently have a BodyGlove phone case.

  • I a

... (read more)
0Elo7y
I was new to a smart phone; and was using a soft-plastic case with flip cover; I hold my phone with my fingers around the flip screen (left handed). The first one I went through - the little arms that hold the case on wore down. The second and third ones the fabric between the case and the flip part tore because of how I hold it. now I am using a hard plastic case and the flip part fabric is stronger, so it hasn't broken yet. I think I am also getting used to a smart phone so I don't seem to be dropping it as often as I did in the first month.

I haven't heard of psuedoephedrine having nootropic effects before - what have you heard? (On a related note, it mostly makes me unable to sleep. :( )

0AspiringRationalist7y
Only personal experience. I noticed that I was more focused and could get by on a lot less caffeine when I was taking it for a cold recently.

Lower threshold on safe doses of lead and other contaminants for frequent and infrequent consumption. Mostly just wanted to check if you knew of any such guidelines that you considered sane. :P

0Lumifer7y
No, not really -- in the sense that I consider most such government standards in the first world to be "good enough" provided they cluster around some average. If I were to deep-dive into some particular contaminant, I would probably start with medical literature to check at which level noticeably bad things start to happen...
-1Lumifer7y
You'll have to be more specific: what kind of guidelines do you want and what's "sane" to you? :-)

Citations not really necessary, but would like to know why you have that opinion. I don't know much about contaminant quantities.

8Lumifer7y
Because they don't mean anything and they only serve to desensitise people to warning labels. When I get a power strip at a corner store and it has a big label which says "WARNING: This product contains chemicals known to the State of California to cause cancer and birth defects or other reproductive harm." I can only roll my eyes and marvel at the stupidity. I hope these people won't hear about the dangerous chemical called dihydrogen monoxide...
4Lumifer7y
The California guidelines are stupid.

What topics might you be able to teach others about?

2snarles7y
Undergraduate mathematics, Statistics, Machine Learning, Intro to Apache Spark, Intro to Cloud Computing with Amazon
2leplen7y
Physics, quantum mechanics, related math concepts like linear algebra, abstract vector spaces, differential equations, calculus. Much of the material in the LW sequences. Optimization and machine learning. Also, shell scripting, python, perl, matlab, computability, numerical methods, basic data structures and algorithms. More randomly: electrochemical energy storage, Li-ion batteries, distance running, dog training, Christian theology, Latin, English/American literature, poetry.
2[anonymous]7y
Perhaps more people would sign up if 'teaching' was relaxed into 'guided discussion'? In that case, for example, the vegetarians could hang out together in Skype or just download instructions/videoes, each teaching the others some new dish to make their cooking more robust? I would then brew some vegetarian borsch (although it isn't supposed to be so). Also, there is a difference between teaching a skill and teaching information. I could, for example, help people study Russian and Ukrainian, though I have never taught language before.
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