J

JMonty

201 karmaJoined Oct 2020

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20

Thanks for sharing this! I donated with Be The Match as well, in March of 2020, which was interesting timing. They actually had to send me to a sister organization called Gift of Life, whose staff was amazing as well. I had preciously started the process to donate a kidney and then let the ball drop and forgotten about it. The call from Be The Match was such a specific call to action:
"You’ve been identified as a possible marrow match for a 57-year-old Male in need of a transplant. The patient’s doctor is trying to determine treatment options as quickly as possible." My reaction was basically "oh my god, of course!" versus the kidney donation which was more like "eh this is mildly annoying right now I'll just not" since there was no single individual being called to my attention.

Interestingly enough, my experience donating stem cells was so rewarding that it reminded me of my previous attempt at kidney donation, and I restarted that process and donated my kidney later that year. I bet if you compared kidney donation rates between people in the bone marrow registry and people who have been matched and donated stem cells, you'd find a significant increase in the latter population.

As I was reading, I was nodding along, agreeing with this post. I also was first introduced to EA by that very same Sam Harris podcast. I in fact did join the military in part because of their very good ads (Marines run towards the sound of chaos was the campaign that got me). 99.etc% of the time, I don't feel like much of anything related to my GWWC pledge- it's just the obviously right thing to do, in many ways the bare minimum for me personally. I started right as I got a large pay increase, so I've never even had to adjust to less income. I feel more warm and fuzzies from helping someone reach a high box at the grocery store than I do from my automatic monthly payments.

So, imagine my surprise when I saw this:

> Given this, when I read about other GWWC members’ attitudes towards their giving I sometimes feel a bit sheepish, maybe even like a bit of an imposter.

Wait- that's my article! I wrote that piece on the one year anniversary of my pledge. It was a conscious effort to reflect on the reasons for that decision, and to reflect on the good it did in the world, exactly because I don't feel warm and fuzzies on a day to day basis. I've lately been trying to build my gratitude muscles, with a gratitude journal and a push to express gratitude to a specific real person when I feel it. That piece was in part a gratitude training for me, because I am immensely grateful to be able to donate 10% of my salary to amazingly effective charities- but I am only grateful when I am really thinking about it. So I wrote a post to make me think about it more. 

I agree with everything you wrote, and I also want to really thank you for taking the pledge. You are making the world a better place, and doing so far and above what most people in our culture consider normal. You help me and others to do the same in your work at GWWC. 

One thing I really admire about our community is that we have taken to heart that the correlation between warm and fuzzy feelings and actual good impact in the world is totally broken, and we donate and work where we can do the most good, not feel the most warm and fuzzies. But I also want to spread some warm and fuzzies! Personally, I've found that I can hack my own system a bit by being intentionally grateful for my opportunity to do something like take the GWWC pledge. It makes me want to keep doing it, and it makes me happier. On my one year GWWC anniversary, I told an EA friend and we went out to celebrate; since that celebration, he has taken the pledge, too. 

Thanks for writing this! Thanks for speaking to the reality that doing really good things doesn’t always come with great rewards in emotions. Our experiences are very, very similar. I wholeheartedly endorse your last section.

Thanks for asking this, I'm in basically the same boat and I am learning a lot from the answer you've gotten so far

Procrastination was definitely a motivator for me too. Better than my procrastination strategy yesterday of watching 30 minutes of boating failures!

Great post! This matches closely with the lessons I've learned and advice I've given after working with virologists and biosafety professionals. I'd also give a plug for the book Biosecurity Dilemmas for anyone who wants to do a deeper dive in the trade offs in this space.

Yeah, you bring up a really good point: most of the "bugs" circulating aren't harmful, so if we have a surveillance system that's completely pathogen agnostic we'll be chasing beneficial gut bacteria or harmless phage. In my previous job in a wastewater testing lab, one of the positive controls we used was a virus that infects peppers- we'd find tons of it.

With regards to viruses, the virus needs to be able to enter human cells, take over the cellular machinery to replicate, and evade the human immune response. We know broadly what kinds of virus families can do this and what kinds can't, so if we see a virus in a family that can infect humans that is increasing exponentially in our surveillance system, we know there is an outbreak/epidemic. We can then do some bench science to figure out what human cells it's infecting, how it's evading the immune system, etc. The viruses that we coexist with relatively well, such as human cytomegalovirus, have coevolved with humans over millennia. A novel virus that was increasing rapidly in a human population would be cause for concern even if there is no symptoms yet. Also, many times there are symptoms, but they are not connected to the novel pathogen because they look so much like other diseases- flu and COVID-19, for example. 

With regards to bacteria, I'll admit I'm not as knowledgeable there, but I'm also not as worried in the near term about GCBRs from bacteria. 

You write: 

...spreading but causes no ill effects (like the majority of microbes in our body).

The second part of your statement makes sense to me- the vast majority of microbes in our body cause no ill effects in people with a healthy immune system. However, I'm not so sure about the first statement: if it's spreading, that means it's either taking over human cells and turning them into virus factories, or it's colonizing more and more human tissue. That means the balance between the immune system and this microbe is out of whack. "Harmless" bacteria or viruses that start spreading out of control kill immunocompromised people all the time- a big part of the "no ill effects" is actually that it's not spreading, but that it's in a stable equilibria with your body and immune system.

Glad to find another Plague Inc fan. I think in the vast majority of cases, that winning strategy only works in the game, because symptoms are directly related to viral replication and the immune system's response to viral replication.

You're right that when we're talking about engineered pandemics this is something to keep an eye out for, but luckily our immune systems are very good at keeping their eyes out

Answer by JMontyJan 19, 20231
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  1. The infectious period and the symptomatic period, and how they interact, is generally more important than how long a pathogen can lay "dormant". However, HIV is an example of when a case can be infectious even during the dormant period- that is very concerning, it's like asymptomatic transmission for COVID-19 but on a much larger scale. People are certainly concerned about a pathogen that has an infectious period that starts before the symptomatic period- it's even bolded on the slidedeck from the presentation you linked to: 
    "I have bolded this because in multiple modeling studies, and in experience...if a disease is contagious during the incubation period, when you're not sick, then it's very, very hard to control".
  2. There will certainly be some patients who die in the next few decades from some damage the SARS-CoV-2 infection did to an organ system or from immune system dysregulation from a SARS-CoV-2 infection. Novel pathogens that infect large swathes of the population often have longer term effects. Following the 1889 "Russian flu" pandemic there was even a noticeable increase in suicides among flu victims (https://macsphere.mcmaster.ca/handle/11375/14366; it was likely not a flu but in fact a novel coronavirus!). However, the magnitude is nowhere near the level needed to bring SARS-CoV-2 into GCBR status. While it is true that people can die of measles, EBV, or herpes after recovering from an acute infection, this is by no means likely. HIV is the outlier here, but it has meaningful differences from SARS-CoV-2: it has a much, much higher mutation rate, it uses reverse transcriptase to integrate its genome into the host cell's genome, and it preferentially attacks immune cells (measles also attacks the immune system in a different way, by attacking memory cells). So yes, in my opinion, we are out of the woods with COVID-19 with regards to GCBRs. 
  3.  The main countermeasure to pathogens that take a while to cause symptoms is good epidemiologic surveillance systems. This "starts the clock" faster on countermeasures. Ideally, you would want a pathogen agnostic system, like what is being worked on at the Nucleic Acid Observatory. There's a game called Plague Inc that models this one aspect well- the sooner humanity realizes something is spreading, the sooner they slow the spread and create cures.
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