Concepts: H

Ideas, aesthetics, movements, and abstractions named in the archive. This section collects the H slice of the category index.

Reference Index

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High Modernism

High Modernism is a recurring concept in the Astral Codex Ten archive, appearing 6 times across 6 issues between March 23, 2021 and May 19, 2023. The archive places it in contexts such as "Scott's complaints about High Modernism"; "one of the most egregious failures of High Modernism"; "This was the age of High Modernism, with all of its planned cities and collective farms and so on". It most often appears alongside Britain, Jane Jacobs, Trump.

Article page
High Modernism
Mention count
6
Issue count
6
First seen
March 23, 2021
Last seen
May 19, 2023
March 23, 2021 · Original source
Some sections seemed straight out of Scott. There's the mandatory section on Le Corbusier, Robert Moses, and Jane Jacobs. Taleb's picture of the fragilista prediction-loving intellectual-yet-idiot with his formal system and no willingness to think outside of it matches Scott's complaints about High Modernism. Taleb's ode to tinkering and skin-in-the-game matches Scott's conception of metis. Taleb is much more ambitious (some would say less careful and scholarly) than Scott, so instead of focusing on a few studies of historical farmers, he relates this to almost every part of today's society. But it's the same argument.
April 30, 2021 · Original source
This is a shame, since the mass destruction of books and newspapers by libraries in the post-war era deserves to be better known as one of the most egregious failures of High Modernism, comparable with the wackiest plans of Le Corbusier. The story combines an excessive reliance on simplistic mathematical models, wilful ignorance to the desires of actual library-users and scholars, embracement of miniaturization and modernization as terminal values, and an almost complete disregard of 19th century books as historical artefacts. Unlike industrial farms, which can be broken up, and Brasília-style skyscrapers, which can be torn down and replaced with something else, the losses caused by the mass deaccessioning of books and newspapers from libraries were often irreplaceable.
September 17, 2021 · Original source
Our story begins (says Gurri) in the early 20th century, when governments, drunk on the power of industrialization, sought to remake Society in their own image. This was the age of High Modernism, with all of its planned cities and collective farms and so on. Philosopher-bureaucrat-scientist-dictator-manager-kings would lead the way to a new era of gleaming steel towers, where society was managed with the same ease as a gardener pruning a hedgerow.
In Gurri's telling, High Modernism had always been a failure, but the government-media-academia elite axis had been strong enough to conceal it from the public. Starting in the early 2000s, that axis broke down. People could have lowered their expectations, but in the real world that wasn't how things went. Instead of losing faith in the power of government to work miracles, people believed that government could and should be working miracles, but that the specific people in power at the time were too corrupt and stupid to press the "CAUSE MIRACLE" button which they definitely had and which definitely would have worked. And so the outrage, the protests - kick these losers out of power, and replace them with anybody who had the common decency to press the miracle button!
First, cultivate your garden. We got into this mess by believing the government could solve every problem. We're learning it can''t. We're not going to get legitimate institutions again until we unwind the overly high expectations produced by High Modernism, and the best way to do that is to stop expecting government to solve all your problems. So cultivate your garden. If you're concerned about obesity, go on a diet, or volunteer at a local urban vegetable garden, or organize a Fun Run in your community, do anything other than start a protest telling the government to end obesity. This is an interesting contrast to eg Just Giving, which I interpret as having the opposite model - if you want to fight obesity, you should work through the democratic system by petitioning the government to do something; trying to figure out a way to fight it on your own would be an undemocratic exercise of raw power. Gurri is recommending that we tear that way of thinking up at the root.
December 01, 2022 · Original source
Seeing Like A State and high modernism. Brooks namedrops Seeing Like A State as the quintessential meritocrat book and high modernism as the quintessential meritocrat bogeyman. High Modernism was something like the legitimizing ideology of the WASP aristocracy: we are great because we have raised shining skyscrapers, blasted railways through mountains, and built giant eternally-churning factories. As part of their cultural revolt, the meritocrats had to ritually humiliate all of this, which made them adopt as their legitimizing ideology a James Scott / Jane Jacobs - esque perspective of “skyscrapers disrupt the social fabric and blasting tunnels sounds environmentally unfriendly, how about some nice locally-sourced organic food?” He who has ears to hear, let him hear.
December 09, 2022 · Original source
* Postmodernism is closer to the correct timeframe, but it started in Europe. Furthermore, the concept of a meritocracy determined by standardized testing is *much* closer to High Modernism than premodern elites, and some serious explanation would be needed for this meritocratic elite to be the ones that turned against meritocracy.
May 19, 2023 · Original source
This book is Jacobs’s least read. It was published in 1980, right after the first referendum where Quebecers voted to remain a part of Canada. It is based on lectures that Jacobs (who was an American but had moved to Canada in 1968) gave in Toronto right before the referendum. It’s not hard to guess why the book didn’t have a huge (read: any) impact. First, most people outside Quebec or Canada don’t have any reason to care. Second, the essay — which was written in English — argues in favor of the secession of Quebec, which virtually no one among the English-speaking population of Canada agreed with. The natural reaction from Canada’s intelligentsia was to ignore the book altogether. Meanwhile, few people in Quebec itself read it, since the referendum was over; it wasn’t even translated into French until decades later. As a result, The Question of Separatism sits awkwardly in Jane Jacobs’s bibliography, as if it were “a mistake in an otherwise brilliant career,” like I read somewhere. In a 2005 interview, one year before her death, Jacobs said that no journalist ever asked her about it. But the book was not a mistake. I don’t claim any special insight here: Jane Jacobs herself said so in that same interview. She said that she would have written the same book in 2005, “because that’s the way it is in the world, and it still holds.” Besides, The Question of Separatism is in fact not that much about the specifics of Quebec’s political situation, but rather about interesting generalities: what size means for countries and organizations, and why the fate of nations depends primarily on what happens in their cities. Taken together with Cities and the Wealth of Nations, which Jacobs wrote a few years later to expand on those ideas, we get a coherent and deeply interesting philosophy of economics: one that favors the local scale, cities and small countries, antifragility long before Nassim Taleb coined the term, and avoiding grandstanding theories that always fail to take into account the real complexity of the world. I. A Fake Mystery Cities and the Wealth of Nations opens on an economic mystery. “For a little while in the middle of this century,” writes Jacobs, “it seemed that the wild, intractable, dismal science of economics had yielded up something we all want: instructions for getting or keeping prosperity.” This was the 1940s to 1960s, and economists thought they had it all figured out. It was the golden age of high modernism and scientific technocracy. Everywhere from China to the Soviet Union to the United States and Britain and the nascent European Economic Community, leaders were coming up with elaborate plans, rooted in macroeconomic theories, that were supposed to guarantee future wealth and avoid economic crises. The theories had been developed by many thinkers over the previous two hundred years: Richard Cantillon, Adam Smith, John Stuart Mill, Karl Marx, John Maynard Keynes. Jacobs explains how they each had their own ideas of how the economy worked, disagreeing over things like whether supply or demand was the main driving mechanism, but they all agreed on a fundamental fact: inflation and unemployment have an inverse relationship to each other, like a seesaw. High inflation comes with low unemployment; high unemployment comes with low inflation, or even deflation when prices drop. The Great Depression, a time of deflation, had provided proof of the seesaw. Big government projects, as prescribed by Keynesians, were a way for states to reduce unemployment and bring the seesaw back in a balanced state. Economists developed fancy models, based on historical data, to predict the behavior of the economy. The Phillips curve in particular became popular. It was the golden age of technocracy; it was the triumph of high modernism. From now on wealth was assured, because we weren’t blind anymore: we had the curves. And yet — by the 1970s and 1980s, when Jane Jacobs was writing, the theories all stopped working. There was high inflation and high unemployment. People called it stagflation. Keynesian advisers in various governments were devastated: either their ideas were wrong, or they were applying them wrong. Economists such as Milton Friedman, from a rival school of economists called the monetarists or the Chicago school, came to the rescue — but their remedy, Jacobs believes, only made things worse. Whatever governments did to increase employment made inflation worse; whatever they did to attenuate inflation killed employment. The seesaw from the theories was working in application, even though it didn’t explain reality anymore. Stagflation was not supposed to exist, so stagflation could not be fought. At this point we’re near the end of Chapter 1, the densest part of the book. Jacobs has artfully guided us along economic history and laid out the mystery for us. What’s going on? we wonder. How are we supposed to deal with the two-headed monster of stagflation, if all economists are stumped? Then Jacobs, in a masterstroke, flips the whole thing over. I was impressed enough that I would have inserted a spoiler alert here, if it didn’t feel so silly putting a spoiler alert in an essay on economics. Stagflation is not a strange monster from legend. It is, Jacobs says, just the normal state of everything. Backward economies are in fact constantly in a state of stagflation. The prices in a poor country like Portugal or India (her two examples) feel low for an American or Canadian, but they’re high for most Portuguese or Indian people. At the same time, Portugal and India provide too few jobs to their residents. Inflation and unemployment are both perennially high, and none of that feels surprising whatsoever. Stagflation, in short, is just good ol’ poverty. All these fancy economists, from Cantillon in 1700s France to Keynes and Friedman in the 20th century Anglosphere, were thinking and writing about unusual places: rich countries that were undergoing fast economic development. They were making the classic mistake of treating poverty as a mystery and wealth as a given, when in fact poverty is the normal order of things and wealth, when it does occur, is what warrants an explanation. The result is that we don’t really know how to fix the economy of poor countries, nor do we know how to deal with decline in rich countries, whether we call it stagflation or something else. Jacobs derives from this a pretty damning view of macroeconomics. It is to her a science that has failed again and again, each time engulfing the equivalent of billions of dollars in wasted wealth. “We must,” she writes at the close of Chapter 1, “find more realistic and fruitful lines of observation and thought than we have tried to use so far. It is bootless to choose among existing schools of thought. We are on our own.” Fortunately, she has some ideas. II. Nations and the Wealth of Cities The original sin of macroeconomics, Jacobs believe, is to treat sovereign countries, or nations, as the main unit of economic analysis. This error, she claims, goes back to mercantilism, one of the first formal economic policies. Oversimplified, mercantilism states that wealth is synonymous with the amount of gold and silver in a nation’s treasury. This makes nations the main unit of economic analysis by definition. It’s a tautology — and one that was somehow embedded so deep in economic thinking that even the non-mercantilist Adam Smith would eventually choose, for his masterpiece of economic theory, the title An Inquiry into the Nature and Causes of the Wealth of Nations. Today, even though mercantilism has long been obsolete, we perpetuate the same tautology whenever we talk of the Gross Domestic Product or look at the very nice charts from Our World in Data, which for the most part allow only one level of resolution: sovereign countries. Of course, nations are an economically important concept because of that one property: they are sovereign, and therefore they write laws and implement policies that affect the economy. These policies can be productively compared. But that’s about it — for everything else, nations aren’t the right way to think about wealth. One reason is simply that they’re very different from one another: “it affronts common sense,” Jacobs writes, “to think of units as disparate as, say, Singapore and the United States, or Ecuador and the Soviet Union, or the Netherlands and Canada, as economic common denominators.” I would add that countries are arbitrary and changing: when the Soviet Union was replaced by 15 sovereign countries, the economic reality didn’t suddenly reshape itself to match the new borders. Lastly, nations contain, under the hood, many sub-economies that are also highly different from one another. None of that is secret or forbidden knowledge. Everyone has always been aware that New York City, or Milan, are economically very different from rural Mississippi or Sicily. But I find that it’s far easier to think in terms of “the United States” or “Italy,” especially when you’re not from there. Nations are an abstraction of real-life complexity, and are accordingly very tempting to use. Also, they’re often the entities that collect statistics, which is another difficult-to-resist temptation for anyone who likes quantitative data. Cities as Radiators of Economic Forces If nations aren’t the best unit to analyze the economy, what is? This is a Jane Jacobs book, so the answer is obviously going to be cities. Jacobs doesn’t actually give a clear argument why. Maybe that was in her previous book, The Economy of Cities. So far as I can see, her reasoning is, ironically, a bit tautological: “all developing economic life depends on city economies; it depends on them by definition because, wherever economic life is developing, the very process itself creates cities and has probably always done so.” But so far as I can see, this reasoning is correct. Cities concentrate people, and therefore economic life, and therefore economic power. The driving force for all this is a phenomenon that, from what I gather, was discovered by Jacobs when she wrote The Economy of Cities: import replacement. Consider, say, Boston back when it was a tiny settlement, not yet a city, in colonial times. At first, Boston didn’t produce much, especially not much that would be of interest to its main trading partner, London. It exported some natural resources: timber, fish. Whatever else the Bostonians needed, they needed to import it from other cities, again mostly London. (Remember to think of imports and exports in terms of cities, not nations.) For instance, at first, all metal tools in Boston came from European cities, and were paid for by the revenue from selling the timber and fish. Then, one day, some Bostonians decided to build an ironworks and make metal tools themselves. (Pictured: a reconstruction of the Saugus Iron Works, established 1646.) This wasn’t of any interest to London or other European cities. The Bostonians weren’t nearly as good or efficient at making metal tools as Londonians were. So Boston couldn’t export the metal tools back to Europe — but it could use them internally, and also export them to other American cities that were about as poor as Boston was, or poorer. Internally, this meant the spark of a manufacturing economy in Boston, as easily obtained metal parts made it easier for other Bostonians to replace other imports from European cities, and eventually develop a symbiotic network of industries. It also meant that the revenue from fish and timber could be used to import new things, including new innovations from European cities (which would later become opportunities for more import replacement). And because there were customers for Boston-made metal goods in New York and Philadelphia, and eventually Cincinnati and Chicago and Pittsburgh as these cities came into existence, it meant additional revenue for Boston that it could reinvest into developing its production further. For Jacobs, virtually all city development can be seen through the lens of import replacement (which, to be clear, has approximately nothing to do with policies of import substitution industrialization; import replacement is not a policy, but a naturally arising free market phenomenon). Her book contains many other examples than Boston, such as Venice, which started off in the early Middle Ages as a small town that sold salt to Constantinople, but then diversified its production to become one of the wealthiest cities of its time; or Taipei and Kaohsiung, two cities in Taiwan that kickstarted their development not long before the 1980s, by forcing expropriated landlords to invest into local import-replacing businesses. One is reminded of Scott’s review of How Asia Works. Import replacement, then, is what makes cities economically powerful. And this power is so great that it causes ripples in distant places. In fact it is the main reason that anything happens at all in non-city areas. Jacobs gives the example of Bardou, a small village in southern France. Bardou looks like this: To the extent that Bardou ever had an economic life, that life was almost entirely driven by distant cities. In ancient times, the area was populated because of iron mines nearby. The mines were exploited to serve the needs of people in the distant cities of Lugdunum (Lyon), Nemausus (Nîmes), or even Rome. As Jacobs notes, we could say that the mines served “the Roman Empire,” but that would be another example of using the abstraction of sovereign countries when we should instead be specific. It was Lugdunum, Nemausus and Rome that wanted the iron — not some random rural area of the empire, and certainly not the part of the empire in which Bardou was located. Eventually the mines and the region were abandoned. More than 1,000 years later, peasants moved into the area and built the modern village. For centuries they lived a wretchedly poor life of subsistence farming. No cities exerted any influence on it, and indeed nothing happened. Then, in the 19th century, the people of Bardou learned that they could improve their situation by moving to distant cities such as Paris, and most of them did. Again, the force wasn’t being exerted by “France”; Bardou was already part of France. The force was specifically being exerted by Paris and other cities with jobs for poor peasants. By the 1960s, only one old man was left. That’s when two foreign visitors, a German and an American, happened upon the village, decided to buy most of it, revitalized it, and turned it into a tourist spot (and even, for a brief time, into a set for a movie company). Today Bardou is a popular place for travelers — who are mostly city people, and spend money that was mostly earned in cities. The Bardou story contains examples of several of the forces that import-replacing cities radiate, according to Jacobs. These forces are central to her thinking. There are five of them: Markets. Cities house a lot of people who need a lot of goods and services, and are therefore strong markets to sell goods and services to. This was the force that acted on the Bardou area when it was a Roman mining region, and again today when it functions as a tourist spot for city vacationers.
It was the golden age of technocracy; it was the triumph of high modernism. From now on wealth was assured, because we weren’t blind anymore: we had the curves. And yet — by the 1970s and 1980s, when Jane Jacobs was writing, the theories all stopped working. There was high inflation and high unemployment. People called it stagflation. Keynesian advisers in various governments were devastated: either their ideas were wrong, or they were applying them wrong. Economists such as Milton Friedman, from a rival school of economists called the monetarists or the Chicago school, came to the rescue — but their remedy, Jacobs believes, only made things worse. Whatever governments did to increase employment made inflation worse; whatever they did to attenuate inflation killed employment. The seesaw from the theories was working in application, even though it didn’t explain reality anymore. Stagflation was not supposed to exist, so stagflation could not be fought. At this point we’re near the end of Chapter 1, the densest part of the book. Jacobs has artfully guided us along economic history and laid out the mystery for us. What’s going on? we wonder. How are we supposed to deal with the two-headed monster of stagflation, if all economists are stumped? Then Jacobs, in a masterstroke, flips the whole thing over. I was impressed enough that I would have inserted a spoiler alert here, if it didn’t feel so silly putting a spoiler alert in an essay on economics. Stagflation is not a strange monster from legend. It is, Jacobs says, just the normal state of everything. Backward economies are in fact constantly in a state of stagflation. The prices in a poor country like Portugal or India (her two examples) feel low for an American or Canadian, but they’re high for most Portuguese or Indian people. At the same time, Portugal and India provide too few jobs to their residents. Inflation and unemployment are both perennially high, and none of that feels surprising whatsoever. Stagflation, in short, is just good ol’ poverty. All these fancy economists, from Cantillon in 1700s France to Keynes and Friedman in the 20th century Anglosphere, were thinking and writing about unusual places: rich countries that were undergoing fast economic development. They were making the classic mistake of treating poverty as a mystery and wealth as a given, when in fact poverty is the normal order of things and wealth, when it does occur, is what warrants an explanation. The result is that we don’t really know how to fix the economy of poor countries, nor do we know how to deal with decline in rich countries, whether we call it stagflation or something else. Jacobs derives from this a pretty damning view of macroeconomics. It is to her a science that has failed again and again, each time engulfing the equivalent of billions of dollars in wasted wealth. “We must,” she writes at the close of Chapter 1, “find more realistic and fruitful lines of observation and thought than we have tried to use so far. It is bootless to choose among existing schools of thought. We are on our own.” Fortunately, she has some ideas. II. Nations and the Wealth of Cities The original sin of macroeconomics, Jacobs believe, is to treat sovereign countries, or nations, as the main unit of economic analysis. This error, she claims, goes back to mercantilism, one of the first formal economic policies. Oversimplified, mercantilism states that wealth is synonymous with the amount of gold and silver in a nation’s treasury. This makes nations the main unit of economic analysis by definition. It’s a tautology — and one that was somehow embedded so deep in economic thinking that even the non-mercantilist Adam Smith would eventually choose, for his masterpiece of economic theory, the title An Inquiry into the Nature and Causes of the Wealth of Nations. Today, even though mercantilism has long been obsolete, we perpetuate the same tautology whenever we talk of the Gross Domestic Product or look at the very nice charts from Our World in Data, which for the most part allow only one level of resolution: sovereign countries. Of course, nations are an economically important concept because of that one property: they are sovereign, and therefore they write laws and implement policies that affect the economy. These policies can be productively compared. But that’s about it — for everything else, nations aren’t the right way to think about wealth. One reason is simply that they’re very different from one another: “it affronts common sense,” Jacobs writes, “to think of units as disparate as, say, Singapore and the United States, or Ecuador and the Soviet Union, or the Netherlands and Canada, as economic common denominators.” I would add that countries are arbitrary and changing: when the Soviet Union was replaced by 15 sovereign countries, the economic reality didn’t suddenly reshape itself to match the new borders. Lastly, nations contain, under the hood, many sub-economies that are also highly different from one another. None of that is secret or forbidden knowledge. Everyone has always been aware that New York City, or Milan, are economically very different from rural Mississippi or Sicily. But I find that it’s far easier to think in terms of “the United States” or “Italy,” especially when you’re not from there. Nations are an abstraction of real-life complexity, and are accordingly very tempting to use. Also, they’re often the entities that collect statistics, which is another difficult-to-resist temptation for anyone who likes quantitative data. Cities as Radiators of Economic Forces If nations aren’t the best unit to analyze the economy, what is? This is a Jane Jacobs book, so the answer is obviously going to be cities. Jacobs doesn’t actually give a clear argument why. Maybe that was in her previous book, The Economy of Cities. So far as I can see, her reasoning is, ironically, a bit tautological: “all developing economic life depends on city economies; it depends on them by definition because, wherever economic life is developing, the very process itself creates cities and has probably always done so.” But so far as I can see, this reasoning is correct. Cities concentrate people, and therefore economic life, and therefore economic power. The driving force for all this is a phenomenon that, from what I gather, was discovered by Jacobs when she wrote The Economy of Cities: import replacement. Consider, say, Boston back when it was a tiny settlement, not yet a city, in colonial times. At first, Boston didn’t produce much, especially not much that would be of interest to its main trading partner, London. It exported some natural resources: timber, fish. Whatever else the Bostonians needed, they needed to import it from other cities, again mostly London. (Remember to think of imports and exports in terms of cities, not nations.) For instance, at first, all metal tools in Boston came from European cities, and were paid for by the revenue from selling the timber and fish. Then, one day, some Bostonians decided to build an ironworks and make metal tools themselves. (Pictured: a reconstruction of the Saugus Iron Works, established 1646.) This wasn’t of any interest to London or other European cities. The Bostonians weren’t nearly as good or efficient at making metal tools as Londonians were. So Boston couldn’t export the metal tools back to Europe — but it could use them internally, and also export them to other American cities that were about as poor as Boston was, or poorer. Internally, this meant the spark of a manufacturing economy in Boston, as easily obtained metal parts made it easier for other Bostonians to replace other imports from European cities, and eventually develop a symbiotic network of industries. It also meant that the revenue from fish and timber could be used to import new things, including new innovations from European cities (which would later become opportunities for more import replacement). And because there were customers for Boston-made metal goods in New York and Philadelphia, and eventually Cincinnati and Chicago and Pittsburgh as these cities came into existence, it meant additional revenue for Boston that it could reinvest into developing its production further. For Jacobs, virtually all city development can be seen through the lens of import replacement (which, to be clear, has approximately nothing to do with policies of import substitution industrialization; import replacement is not a policy, but a naturally arising free market phenomenon). Her book contains many other examples than Boston, such as Venice, which started off in the early Middle Ages as a small town that sold salt to Constantinople, but then diversified its production to become one of the wealthiest cities of its time; or Taipei and Kaohsiung, two cities in Taiwan that kickstarted their development not long before the 1980s, by forcing expropriated landlords to invest into local import-replacing businesses. One is reminded of Scott’s review of How Asia Works. Import replacement, then, is what makes cities economically powerful. And this power is so great that it causes ripples in distant places. In fact it is the main reason that anything happens at all in non-city areas. Jacobs gives the example of Bardou, a small village in southern France. Bardou looks like this: To the extent that Bardou ever had an economic life, that life was almost entirely driven by distant cities. In ancient times, the area was populated because of iron mines nearby. The mines were exploited to serve the needs of people in the distant cities of Lugdunum (Lyon), Nemausus (Nîmes), or even Rome. As Jacobs notes, we could say that the mines served “the Roman Empire,” but that would be another example of using the abstraction of sovereign countries when we should instead be specific. It was Lugdunum, Nemausus and Rome that wanted the iron — not some random rural area of the empire, and certainly not the part of the empire in which Bardou was located. Eventually the mines and the region were abandoned. More than 1,000 years later, peasants moved into the area and built the modern village. For centuries they lived a wretchedly poor life of subsistence farming. No cities exerted any influence on it, and indeed nothing happened. Then, in the 19th century, the people of Bardou learned that they could improve their situation by moving to distant cities such as Paris, and most of them did. Again, the force wasn’t being exerted by “France”; Bardou was already part of France. The force was specifically being exerted by Paris and other cities with jobs for poor peasants. By the 1960s, only one old man was left. That’s when two foreign visitors, a German and an American, happened upon the village, decided to buy most of it, revitalized it, and turned it into a tourist spot (and even, for a brief time, into a set for a movie company). Today Bardou is a popular place for travelers — who are mostly city people, and spend money that was mostly earned in cities. The Bardou story contains examples of several of the forces that import-replacing cities radiate, according to Jacobs. These forces are central to her thinking. There are five of them: Markets. Cities house a lot of people who need a lot of goods and services, and are therefore strong markets to sell goods and services to. This was the force that acted on the Bardou area when it was a Roman mining region, and again today when it functions as a tourist spot for city vacationers.
Holocaust

Holocaust is a recurring concept in the Astral Codex Ten archive, appearing 6 times across 6 issues between July 21, 2021 and August 01, 2025. The archive places it in contexts such as "Holocaust survivors"; "Everything about the Holocaust is so tragic"; "as increased awareness of the Holocaust made anti-Semitism déclassé". It most often appears alongside New York, United States, America.

Article page
Holocaust
Mention count
6
Issue count
6
First seen
July 21, 2021
Last seen
August 01, 2025
July 21, 2021 · Original source
Perhaps some are outright malingerers, but clearly for a large number (including a friend of mine) this is real. They really are suffering from a set of symptoms consistent with PTSD. And yet, the vast majority of WWI veterans, Holocaust survivors, everyone who lived through WWII in Western Russia etc., a large fraction of people in the Middle Ages etc. experienced as bad or worse stuff and the vast majority could function as adults. It's hard to escape the conclusion that we've created an expectation of disabling trauma and people fulfill it. Crazy Like Us quotes an American soldier who said that he felt like an actor given a script. Here's PTSD, this is what you do next.
July 13, 2022 · Original source
In my post, I was able to track down a few clues to the mystery. All of the Martians were Jewish, which linked the puzzle to the general puzzle of Jewish overachievement (for example, 36% of US Nobel Prize winners are Jews, compared to only 2% of the US population). Greg Cochran and others suggest a genetic explanation, with Daron Acemoglu and others suggesting a cultural/historical one; unsurprisingly, I side with Cochran. Granting that this is a Jewish phenomenon, it’s not too hard to explain why it happened at the turn of the century in particular - too long before then, and anti-Semitism prevented European Jews from getting a good education; too long after then, and they all died in the Holocaust.
I think this clears up my remaining confusion around the Martians. For whatever reason, Eastern European Jews of the 19th century were unusually bright. The very brightest of this unusual group moved to Budapest, interbred with each other, and had one generation of totally unprecedentedly brilliant children before being wiped out. Everything about the Holocaust is so tragic that it’s hard to make it any worse, but credit to MacRae for his attempt.
December 01, 2022 · Original source
Around 1955 (Brooks writes, building on an earlier book by Nicholas Lemann) Harvard changed their admission policy. Why? Partly a personal decision by Harvard presidents James Conant, and Nathan Pusey, who sincerely believed in meritocracy. And partly because Harvard’s Jewish quota was becoming unpopular, as increased awareness of the Holocaust made anti-Semitism déclassé. Conant and Pusey decided to admit based on academic merit (measured mostly by SAT scores). The thing where Harvard would always admit WASP aristocrats because that was the whole point of Harvard was relegated to occasional “legacy admissions”, a new term for something which was now the exception and not the rule. Other Ivies quickly followed.
May 15, 2023 · Original source
Adraste: A brief aside: eugenics, as implemented in the early part of the 20th century, was extraordinarily evil. We might loosely consider the entire Holocaust eugenics, based on Nazi theory of racial purity1, but even if we restrict the label to the Nazis’ specific campaign against the disabled and mentally ill, it caused about 300,000 deaths. And although “Nazis are bad” is already priced in to our moral system, here in the United States we sterilized between 60,000 and 150,000 people. Also - it wouldn’t have been any better if it was scientifically competent, but it really wasn’t2. They sterilized 2,000 people for a form of blindness that wasn’t even genetic.
September 03, 2024 · Original source
“Hmmm…racism good…oh! I believe the Holocaust had to happen for anthropic reasons.”
“Maybe not directly, but think about it. People always say that it could happen here. That early 20th century Europeans thought they were so great and civilized, but the Holocaust proves that even the seemingly-most-sophisticated countries can descend into barbarism and genocide at any time. But they can’t! Or there’s only a one in a billion chance that they do, the same as everyone thought in 1900. It’s just that everyone who’s still alive comes from world-branches where the one-in-a-billion thing happened. I even think World War I was a fluke - that was the only way the outcome pump could set up Hitler.”
August 01, 2025 · Original source
Basilica: You mean, instead of intervening here, God could intervene when the weak are oppressed by the strong - as in the Holocaust, or Tokugawa's persecutions of the Japanese martyrs, or if He is specifically trying to spread the Christian religion He could make the Crusades a success. If God doesn't discriminate by Christian sect, He could preserve the Byzantine empire, and if He's specifically Catholic, He could have the Thirty Years’ War last just five years and end with a permanent Catholic Holy Roman Empire.
homo sapiens

homo sapiens is a recurring concept in the Astral Codex Ten archive, appearing 5 times across 5 issues between May 28, 2021 and December 01, 2025. The archive places it in contexts such as "Bregman claims we should view all homo subspecies as human but he's using human for homo sapiens"; "appearance of our own species, Homo Sapiens, about 100 or 150,000 thousand years ago in Africa"; "Homo sapiens (broadly: people who wouldn’t look out of place on the subway)". It most often appears alongside Steven Pinker, Brazil, Europe.

Article page
homo sapiens
Mention count
5
Issue count
5
First seen
May 28, 2021
Last seen
December 01, 2025
May 28, 2021 · Original source
Humans are sheep, but in a good way. In the next blow to our intellectual pride Bregman presents exhibit B: Neandertals. Their jutting jaws allow for larger brains than humans (Bregman claims we should view all homo subspecies as human, but within two pages he's using human for homo sapiens in contrast to other hominins), and as we all know larger brain = more intelligent (wait, didn't you just argue the exact opposite of this?!)
You can find out more about potential mechanisms for this, but for our purposes the important point is that homo sapiens looks a lot like a domesticated neandertal - homo puppy Bregman christens us.
June 10, 2022 · Original source
puzzling aspect, which I call the Sapient Paradox. . . we can see in the archeological record. . . the appearance of our own species, Homo Sapiens, about 100 or 150,000 thousand years ago in Africa, and we can follow the out-of-Africa migrations of our species, Homo sapiens, 60-70,000 years ago. . . Apart from the episode of cave art, which was very much limited to Europe and a bit further on to Asia, not a great deal happened until about 10,000 years ago. . . modern genetics has made clear that our genetic composition, speaking in general. . . is very similar to the genetic composition to our ancestors in Africa of about 70,000 years ago.
So, Homo sapiens (broadly: people who wouldn’t look out of place on the subway), go back 200,000 years, possibly having language all that time. And who knows, human-level cognitive abilities might even go back further than that—our cousins (and ancestors) the Neanderthals wouldn’t look very out of place on the subway either, perhaps prehistorical minds were similarly similar.
Some might try to dismiss the Sapient Paradox by pointing to evidence of ongoing human evolution. And while there is some evidence of recent human evolutionary changes, it often seems clustered around things like dietary changes—at least, there’s no well-accepted evidence that human cognitive abilities emerged at 10,000 BC, and almost everyone who tackles these issues, from the Davids to Yuval to Pinker to Diamond, agrees that Homo sapiens was pretty much genetically-intact, at least in the ways we think should matter, somewhere between 100,000 to 200,000 years ago. Indeed, early Homo sapiens 300,000 years ago had brains as large as our own!
July 14, 2023 · Original source
The answer turns out to be quite a lot! She can play the games other kids play, she can figure out her group’s social organization, act out her social role, and learn toolmaking. How can she do this, without language, Egan asks? Mimesis. We are the apes who imitate. “Monkey see, monkey do” is more true of us than actual monkeys; we’re parrots who intuit the meaning of the things we’re repeating. Though Homo sapiens has used language for around 50,000 years, we’ve been around for at least four times that long — and we survived by copying each other. Mimesis, more than words, is the anchor of our uniquely human way of being in the world.
From dry to daring What could a high school curriculum look like, if it were rebuilt on these tools? Once again, Egan has a trick. This time, it’s to ask what fights have driven the development of each of these fields forward — and how we can help students enter them. First, a mini-segment! Intellectuals invented the academic disciplines to better pursue the life of the mind, but the disciplines can get in the way. Some of the most important intellectual discoveries that could help students are too big to fit into any of the disciplines. We need a place to introduce them plainly. Egan proposes another mini-segment — again, just 15 minutes a day, a few times a week — called “Metaknowledge”. Q: Isn’t that already in the International Baccalaureate program? Yes, he acknowledges that he’s borrowing from that! This segment would introduce ideas that would enrich student thinking across the disciplines: game theory, cognitive biases, systems thinking, Bayesian reasoning, epistemology, ethics, logic, cultural evolution, and so on. High school literature How can we help students enter the big fights of literature? Intellectuals of a literary bent — professors, critics, poets, novelists — delight in arguing over literature like rabbis arguing over the Talmud. Take, just for one example, the debates over Shakespeare’s character of Ophelia. Does she love Hamlet, or is she a victim of his emotional abuse? Is she truly insane, or is she acting? Is she passive, or is she pulling the strings? Oceans of ink have been spilled arguing over questions like these; our students can, perhaps, spill a few ounces more. The usefulness of arguing literature, for Egan, isn’t that it’s oh-so important for educated adults to know a lot about Ophelia. (This, again, was where the academicists went wrong — in thinking that being educated was about getting the best knowledge in your head.) Rather, arguing over literature is a training arena for the all-important intellectual move of this kind of understanding: building general schemes out of evidence, and struggling with anomalies. One person, for example, might hold that Ophelia is insane, and cite all sorts of obvious evidence — her father just was murdered by her lover, she rants nonsense while (bizarrely) handing out flowers to friends… But then he’s challenged when he reads a scholar pointing out that, to people in Elizabethan England, types of flowers have symbolic meanings. How does he deal with that? He could ignore it, claiming it an over-reading of Shakespeare. (Sometimes a flower is just a flower!) Or he could address it, complicating his own scheme. This intellectual work is best done with other people, who are incentivized to challenge your understanding of something, and go back and forth, building competing models and calling attention to anomalies. This process — the “dialectic” — pops up again and again in the academic disciplines. It’s the center of how understanding works, at this stage. And the nice thing about practicing it on literature is that, more so than in history or science, the evidence is shared knowledge — it’s right in front of everyone, written out. But there are other ways literature class can be helpful to the general life of the mind. Egan also suggests that we’ll want to specially include literature that helps students understand complex ideas. Camus, Orwell, Borges, Calvino might be particularly helpful here… and I imagine that genres like science fiction and magical realism might be particularly useful, too. (Note, though, that once again none of this requires a radical remaking of the curriculum, or of the canon of texts that we traditionally assign to high schoolers.) Q: Oh yes, the canon — what does Egan have to say about the canon wars? When he wrote Educated Mind in the nineties, the long-brewing canon war was approaching its inevitable apocalyptic climax. On one side of this Plain of Megiddo were the pro-canon traditionalists, arguing that we should keep assigning the texts that had been argued over for centuries. Facing them were the anti-canon reformers, arguing the standard texts over-represented the perspective of dead white men. Onto the middle of the plain rides Egan on a white horse, who bellows above the din: “I’VE GOT A BUSLOAD OF HIGH SCHOOLERS WHO WANTS TO JOIN IN, EVERYONE OKAY WITH THAT?” To do so, he says, we need to give students the arguments from both sides. So, for example, bell hooks, Edward Said, and China Achebe should be on the syllabus, as should Allan Bloom, Mortimer Adler, and Diane Ravitch. And of course they should actually read the texts cherished by both sides, too, so they can argue better. High school history How could entering the big fights help us reinvent high school history? First, we might look for dueling histories. It’s time for students to get into historiography and understand that history isn’t just what happened, it’s something we make. We might help kids read chapters from Howard Zinn’s socialist history of America alongside the corresponding chapters from Paul Johnson’s conservative history of America. How could big questions help? We want to help students see how various people have disagreed over some of the big questions of what human history is, at its most basic. We can have them compare Steven Pinker’s theory of civilization’s progress (Better Angels of our Nature) with Yuvah Noah Harari’s theory of civilization’s woes (Sapiens). We could have them compare so-and-so’s account of human history as an ever-expanding unlatching of energy sources with Robert Wright’s account of human history as unlatching more and more positive-sum games (Nonzero). What role could the lure of certainty play? To help them grow their skills at finding anomalies, we might help them work through pseudo-histories and conspiracy theories. Q: Conspiracy theories! Oh, come now, you’re playing with fire. Well, the world is on fire. Our students will spend the rest of their lives encountering terrible-but-beguiling arguments about how the world works; if we don’t prepare them for those, what have we been doing? So we should introduce arguments that the Moon landing was a hoax, that the Illuminati founded America, that aliens built the pyramids, and so on. At no point can we demean students for falling for any of these theories — the job of a teacher at this stage, Egan writes, is to support students in their reasoning even when their beliefs are offensive and stupid, gradually offering anomalies. There’s no way out of bad theories except through them. By the time students graduate, we want them to have wrestled with terrible ideas and — for a while — lost. They need to experience what it’s like to change their minds about something they felt strongly about. They need to viscerally realize, in Feynman’s famous phrase, “The first principle is that you must not fool yourself and you are the easiest person to fool.” High school natural science How could entering the big fights reinvent high school science? At present, so much of the high school science curriculum — especially “honors” classes — is oriented toward helping amass details. (The same is true of 100-level university classes, which famously “survey” the field to prepare for more advanced studies. I always thought this was stupid — of the huge lecture hall of students in my Geology 100 class, how many went on to take even a second course?) The meaty debates that propel science forward are held back. Egan complains: “The more general and speculative theories in any discipline are treated like an unconventional and disreputable relation who, even though the children find her exciting and entertaining, must be kept hidden from view, her very existence denied as long as possible”. This is a stupid approach — students with an adventurous bent are convinced that science isn’t for them. Egan proposes, simply, that we flip this, and organize high school science classes around the big debates. We shouldn’t be ashamed at how, well, adolescent this might look: “the dramatic, speculative, and contentious theories will be up-front in the early years of the [high school] curriculum”. What might those be? Egan doesn’t give a list, but we can spitball some: instead of explaining what “matter” is from the top down, a physics class could problematize “matter” by following the debates over the nature of dark matter and dark energy, and by becoming familiarized with the various interpretations of quantum mechanics
July 19, 2024 · Original source
This differs from Chomsky’s proposal by around an order of magnitude, time-wise, and portrays language as something not necessarily unique to modern humans. In Everett’s view, Homo sapiens probably improved on the language technology bestowed upon them by their erectus ancestors, but did not invent it.
The feats Everett talks about are things like traveling long distances across continents, possibly even in a directed rather than random fashion; manufacturing nontrivial hand tools (e.g., Oldowan and Mousterian); building complex settlements (e.g., the one found at Gesher Benot Ya'aqov); controlling fire; and using boats to successfully navigate treacherous waters. Long before sapiens arose, paleoanthropological evidence suggests that our predecessors Homo erectus did all of these things. Everett argues that they might have had language over one million years ago6.
Erectus speech perhaps sounded more garbled relative to that of sapiens, making it harder to hear the differences between words. … Part of the reason for erectus’s probably mushy speech is that they lacked a modern hyoid (Greek for ‘U-shaped’) bone, the small bone in the pharynx that anchors the larynx. The muscles that connect the hyoid to the larynx use their hyoid anchor to raise and lower the larynx and produce a wider variety of speech sounds. The hyoid bone of erectus was shaped more like the hyoid bones of the other great apes and had not yet taken on the shape of sapiens’ and neanderthalensis’ hyoids (these two being virtually identical).
December 01, 2025 · Original source
2: If your response is noooo, charity money should be spent on humans, then good news: pro-human Substackers are holding a human welfare fundraiser, also with 50% matching, until the end of the month. All donations go to homo sapiens, guaranteed!
Hebrew

Hebrew is a recurring concept in the Astral Codex Ten archive, appearing 4 times across 4 issues between November 04, 2022 and August 12, 2025. The archive places it in contexts such as "pronounces her Hebrew surprisingly well"; "“lightning” in Hebrew is barak"; "they spoke Greek and not Hebrew". It most often appears alongside America, Athens, Christian morality.

Article page
Hebrew
Mention count
4
Issue count
4
First seen
November 04, 2022
Last seen
August 12, 2025
November 04, 2022 · Original source
Malia Cohen is a black person with the last name Cohen. How did this happen? Apparently not by marriage - her husband has a different name. I eventually found this article on black Cohens, which says that about 4,000 of the 87,000 Cohens in America are black. Some of them are descended from a Cohen in South Carolina who married a black woman in the 1800s, and others are descended from a Cohen who was a pirate in the Caribbean (really!) Most are not Jewish. I can’t tell if Malia is Jewish - I listened to the first few minutes of this talk she gave at a synagogue, and although she sounds extremely at home there and pronounces her Hebrew surprisingly well, she also mentions she’s the daughter of a pastor, so I’m guessing no. She was formerly a San Francisco Supervisor, but I will try not to hold that against her. Her opponent accuses her of literally going to Venezuela to study socialism, but I already assume every San Francisco Supervisor did that.
November 17, 2023 · Original source
The phrase “I see Satan fall like lightning” comes from Luke 10:18. I’d previously encountered it on insane right-wing conspiracy theory websites. You can rephrase it as “I see Satan descend to earth in the form of lightning.” But “lightning” in Hebrew is barak. So the Bible says Satan will descend to Earth in the form of Barak. Seems like a relevant Bible verse for insane right-wing conspiracy theorists!
Girard is against this process. Not just because it involves violent mobs lynching innocent people (although it does), but because that step perpetuates the whole cycle: people greedily desiring whatever their neighbors have, people hating their neighbors, internecine war of all against all. He dubs the process Satan, based partly on the original Hebrew meaning of Satan as “prosecutor”. Satan is the force that tells people that the victim is guilty and deserves to be lynched.
So how does the Hebrew Bible escape this failure mode? Girard says divine intervention. God (here meaning literal God, exactly as the average churchgoer understands Him) tried to break the reign of Satan (here meaning metaphorical Satan, the single-victim process) over the Jewish people, by constantly providing them with examples of the single-victim process being bad and ensuring those examples were written up accurately. He got the Israelites to obsess over these examples and worship them as a holy text, trying to hammer the whole thing into their heads. Finally, He sent His only begotten Son as the perfect victim, who would undergo the process in its entirety and have it be written up with unprecedented attention to detail. This extra-compelling example finally penetrated the Israelites’ thick skulls. Although Peter and the other disciples sort of joined the mob in denying Jesus at the beginning, after the Resurrection they started thinking previously barely-thinkable thoughts, like “what if our mob was in the wrong?” and “what if mob violence is bad?”
November 12, 2024 · Original source
Instead of being forced to attribute the Christians’ growth to miracles, we can pin down a specific growth rate and find that it falls within the range of the most successful modern cults. Indeed, if we think of this as each existing Christian having to convert 0.4 new people, on average, per decade, it starts to sound downright do-able. Still, how did the early Christians maintain this conversion rate over so many generations? Through The Social Graph This is another of Stark’s findings from his work with the Moonies. The first Moonie in America was a Korean missionary named Young Oon Kim, who arrived in 1959. Her first convert was her landlady. The next two were the landlady’s friends. Then came the landlady’s friends’ husbands and the landlady’s friends’ husbands’ co-workers. That was when Stark showed up. “At the time . . . I arrived to study them, the group had never succeeded in attracting a stranger.” Stark theorized that “the only [people] who joined were those whose interpersonal attachments to members overbalanced their attachments to nonmembers.” I don’t think this can be literally correct - taken seriously, it implies that the second convert could have no other friends except the first, which would prevent her from spreading the religion further. But something like “your odds of converting are your number of Moonie friends, divided by your number of non-Moonie friends” seems to fit his evidence. History confirms this story. Mohammed’s first convert was his wife, followed by his cousin, servant, and friend. Joseph Smith’s first converts were his brothers, friends, and lodgers. Indeed, in spite of the Mormons’ celebrated door-knocking campaign, their internal data shows that only one in a thousand door-knocks results in a conversion, but “when missionaries make their first contact with a person in the home of a Mormon friend or relative of that person, this results in conversion 50% of the time”. 1 This theory of social-graph-based-conversation was controversial when Stark proposed it, because if you ask cultists retrospectively, they’ll usually say they were awed by the beauty of the sacred teachings. But Stark says: I knew better, because we had met them well before they had learned to appreciate the doctrines, before they had learned how to testify to their faith, back when they were not seeking faith at all. Indeed, we could remember when most of them regarded the religious beliefs of their new set of friends as quite odd. I recall one who told me that he was puzzled that such nice people could get so worked up about “some guy in Korea” . . . Then, one day, he got worked up about this guy too. Through Jews And Weajoos Jews were scattered across the Mediterranean even before the fall of the Temple. I don’t know why. We Jews tell ourselves that we left Israel only after the Romans kicked us out. But Stark cites plenty of historians who argue that no, it was well before that. Around the time of Christ, there were a million Jews in Israel and five million in the Diaspora, especially Alexandria, Antioch, Anatolia, and Rome. What were these Jews’ spiritual lives like? Without hard evidence, Stark supposes they were marginal. Throughout history, Jews have succeeded at keeping the Law only within tight-knit communities. If you want to keep kosher, it helps to have everyone around you keeping kosher and a local kosher butcher. If you want to keep the Sabbath, it helps to have an eruv and a synagogue within walking distance. But even more than that, the Law is strange and complicated, and unless everyone around you follows it too, you are likely to slip. Thus, when Jews were first emancipated and allowed to live among Gentiles in the 18th-19th centuries, a split emerged in the Jewish community. Those Jews who stayed in the ghettos and shtetls - or who founded new self-imposed-quasi-ghettos like Crown Heights - remained Orthodox. Those Jews who mingled with the Gentiles cast off the more difficult rules and became Reform. Only a sliver of Modern Orthodox remained in the middle, often with abysmal attrition rates. Stark asks whether the first great intermingling of Jews and Gentiles had the same effect. While the Jews in Palestine stayed religious and laid the foundations for the Rabbinic Judaism of future centuries, the Jews in the Diaspora - did what? Presumably Hellenized into some sort of semi-assimilated proto-Reform movement. Although we have limited historical evidence about these Jews’ religious behavior, we know they spoke Greek and not Hebrew (otherwise why would they need the Septuagint?) and that many of them took Greek names. Of inscriptions on the Jewish catacombs in Rome, 76% are in Greek, 22% in Latin, and only 2% in Hebrew or Aramaic. Reform Judaism is unstable. The Law of Moses is central to the Jewish faith; relax it too much, and believers can justly wonder what’s left. In America, Reform Jews are over-represented not only among atheists and agnostics, but among every cult under the sun. 33% of American Buddhists come from a Jewish background, and even the Moonies were 30% Jewish at one point! (they’re now down to 6%) As the Jews were assimilating into Greeks, some Greeks were assimilating into Judaism. They were impressed enough with monotheism and the Jews’ upright behavior to adopt some of the rituals, but they couldn’t take the final step and circumcise themselves. Instead, they hung around the fringes of Jewish society, admiring it from without. The Bible and the historical record call them “God-fearers”, but by analogy I can’t help but think of them as “weajoos”. These weajoos would have been easy prey for the first semi-Jewish sect to shed the circumcision requirement and explicitly pivot away from being an ethnic religion. The Apostles and other early Christians, leaving Palestine to minister to the wider world, would have made use of existing Jewish networks and connections. They would have found themselves in the middle of the spiritually-disaffected, half-assimilated pseudo-Reform Jewish communities of the Roman world, plus their half-assimilated-the-other direction Greek hangers-on. They would have preached that Judaism was basically true, but that you can drop the restrictive Law of Moses and avoid getting circumcised. They would have sliced through the cultural angst of these in-between communities, saying that Jews could join together with Gentiles in a big friendly tent under the leadership of the God of Abraham, Isaac, and Jacob. Here, says Stark, were the early Christians’ first few million converts. Because, I Regret To Inform You, The Pronatalists Are Right About Everything We found above that the Christian population needed to grow at 40% per decade, and assumed this meant conversion. But you could also do this through a fertility advantage. If a generation lasts thirty years, and Christians have 3x more children than pagans per generation, they can get 40%/decade growth without converting anyone at all. In reality, it was probably a mix: some conversion plus some fertility advantage. Here I start to worry that some right-wing pronatalist organization bribed Rodney Stark to abandon his usual scholarly attitude and write some kind of over-the-top pronatalist fanfic. I was waiting for the part where the eagle named MORE BIRTHS perches on the blackboard and the childfree professor was tossed into the lake of fire for all eternity. Still, let’s take it at face value and see what the fanfic has to say. By the Imperial era, Roman fertility was plummeting. Partly this was because the Romans practiced sex-selective infanticide, there were 130 men for every 100 women, and so many men would never be able to find a wife. But partly this was because the men who could find wives dragged their feet. (Male) Roman culture took it as a given that women were terrible, that you couldn’t possibly enjoy interacting with them, and that there was no reason besides duty that you would ever marry one. In 131 BC, the Roman censor Quintus Caecilius Metellus Macedonicus2 proposed that that the senate make marriage compulsory because so many men, especially in the upper classes, preferred to stay single. Acknowledging that “we cannot have a really harmonious life with our wives”, the censor pointed out that "since “we cannot have any sort of life without them,” the long term welfare of the state must be served”… As Beryl Rawsom has reported, “one theme that recurs in Latin literature is that wives are difficult and therefore men do not care much for marriage.” The Romans understood that this was long-term fatal for their empire, and tried all sorts of schemes to increase family formation. In the mid-first-century BC, Cicero re-proposed Metellus’ scheme to make marriage compulsory, but it failed once again. Augustus contented himself with punitive taxes and second-class citizenship for unmarried and childless couples, combined with subsidies and affirmative action for men with at least three children. Formal and informal social pressure eventually convinced most Roman men to take wives, but no amount of love or money could make them have children. Dense cities discouraged large families, Roman children were expensive (nobles would have to spend immense effort and political favors grooming them for high positions), and (the scourge of all nobilities) too many children risked splitting the inheritance. Also, if you had a girl you’d probably just kill her (she would consume resources without continuing the family line), and half of children died before adulthood from some disease or another anyway. It was just a really bad value proposition. Nor did the sex drive force the matter. Horny Roman men had their choice of a wide variety of male and female slaves and prostitutes - despite Augustus and his spiritual heirs’ fuming about monogamy, this was never really enforced on the male half of the population. When men did have sex with women, it was usually oral or anal sex, specifically to avoid procreation. When they did have vaginal sex, they had a wide variety of birth control methods available, including the famous silphium but also proto-condoms and spermicidal ointments. If a child was conceived despite these efforts, abortion was common albeit unsanitary (maternal death rates were extremely high, but this was not really a deal-breaker for the Roman men making the decision). If a baby was born in spite of all this, infanticide was legal and extremely common: Far more babies were born than were allowed to live. Seneca regarded the drowning of children at birth as both reasonable and commonplace. Tacitus charged that the Jewish teaching that it is “a deadly sin to kill an unwanted child” was but another of their “sinister and revolting practices” . . . not only was the exposure of infants a common practice, it was justified by law and advocated by philosophers.” Christians followed the opposite of all these practices. They recommended that men love their wives, and held this as a plausible and expected outcome. This was not exactly unprecedented, but it was a dramatic reversal of Roman custom. From Ephesians 5: Husbands, love your wives, just as Christ loved the church and gave himself up for her to make her holy, cleansing her by the washing with water through the word, and to present her to himself as a radiant church, without stain or wrinkle or any other blemish, but holy and blameless. In this same way, husbands ought to love their wives as their own bodies. He who loves his wife loves himself. After all, no one ever hated their own body, but they feed and care for their body, just as Christ does the church — for we are members of his body. “For this reason a man will leave his father and mother and be united to his wife, and the two will become one flesh.” This is a profound mystery — but I am talking about Christ and the church. However, each one of you also must love his wife as he loves himself, and the wife must respect her husband. The Christians banned adultery (and, unlike the Roman bans, gave it teeth), meaning that married men who wanted sex had no choice but to go to their wives. They held that sex had to be procreative, banning anal sex, oral sex, homosexual sex, and birth control. And obviously they banned infanticide (many of these bans weren’t active decisions, but carry-overs from the movement’s Jewish roots). Also, I regret to say I fell for the liberal meme that Republicans tricked Christians into being anti-abortion in 1960, and previous generations of Christian had thought abortion was fine. This is absolutely not true. The Didache, the first Christian text outside the New Testament itself, probably dating from about 90 AD, says that “Thou shalt not murder a child by abortion nor kill them when born”. The second-century church father Athenagoras wrote: We say that women who use drugs to bring on an abortion commit murder, and will have to give an account to God for the abortion . . . for we regard the very foetus in the womb as a created being, and therefore an object of God’s care . . . and [we do not] expose an infant, because those who expose them are chargeable with child-murder. The end result is that while pagans delayed marriage, cheated, had nonprocreative sex, used birth control, performed abortions, and committed infanticide, Christians did none of these things. This section gave me a new appreciation for conservative Christian purity culture: it was obviously suited for the environment in which it evolved, and it’s also obvious why its founders would etch it so deeply into its memetic DNA that it’s still going strong millennia later. But I’ll end this section with a note of caution - I’m not sure how relevant any of this is. Stark refuses to speculate on pagan vs. Christian fertility rates, but when I look up modern scholarship, they reasonably point out that pagan rates must have been around “replacement”, given that the Roman population stayed steady (or slowly increased) for hundreds of years. “Replacement” is in quotes because Romans were constantly dying of plague, warfare, fire, and a million other causes; since only a third to half of people survived to reproduce, “replacement” here is something like 4-6 children per women. This doesn’t sound like the antinatalist disaster Stark describes! I think Stark is mostly talking about Roman elites - the group who Augustus kept pestering to have at least three children - and more broadly about the urban population. These people were constantly dying and being replaced by commoners and villagers. Early Christianity was primarily an urban and upper-class movement (does this surprise you? Stark urges us to think of modern cults and new religions, like American Buddhism, which predominantly recruit disillusioned children of the upper classes). So perhaps it did better than its urban upper-class pagan comparison group. Still, since the urban upper-class pagans were constantly being replaced by village lower-class pagans as soon as they died out, how much, in numerical terms, can this contribute to Christianity’s growth? A possible synthesis: if you imagine a city as having a constant population (because it’s walled, plus its hinterland can only support a certain number of non-food-producing urbanites), and villagers as replacing urbanites on a one-to-one basis as they die, then greater Christian urban fertility rates can at least contribute to the cities and upper classes becoming Christian. And once the cities and upper classes are Christian, you get Constantine, and the lower classes can be forced to comply. Remember, “pagan” originally meant “rural”! Because Where Women Go, Men Will Follow One thing Stark did not mention discovering in his study of cults, but which I have heard anecdotally - a lot of male cult members join because the cult has hot girls. This seems to have been a big factor in the spread of early Christianity as well. Stark collects various forms of evidence that early Christians were predominantly women. Paul’s Epistle to the Romans greets thirty-three prominent Christians by name, of whom 15 were men and 18 women; if (as seems likely) men were more likely to become prominent than women, this near-equality at the upper ranks suggests a female predominance at the lower. A third-century inventory of property at a Christian church includes “sixteen men’s tunics and eighty-two women’s tunics”. The book quotes historian Adolf von Harnack, who says: [Ancient sources] simply swarm with tales of how women of all ranks were converted in Rome and in the provinces; although the details of these stories are untrustworthy, they express correctly enough the general truth that Christianity was laid hold of by women in particular, and also that the percentage of Christian women, especially among the upper classes, was larger than that of men. Why were women converted in such disproportionate numbers? Again, Stark’s sociological background serves him well: he is able to find reports of the same phenomenon in modern religions: By examining manuscript census returns for the latter half of the nineteenth century, Bainbridge (1983) found that approximately two-third of the Shakers were female. Data on religious movements included in the 1926 census of religious bodies show that 75% of Christian Scientists were women, as were more than 60% of Theosophists, Swedenborgians, and Spiritualists. The same is true of the immense wave of Protestant conversions taking place in Latin America. But along with a general tendency for women to convert, Stark notes that Christianity was especially attractive to women. The pagan world treated women as their husbands’ property, and not particularly well-liked property at that. The book cites the Athenian laws as typical: The status of Athenian women was very low. Girls received little or no education. Typically, Athenian females were married at puberty and often before. Under Athenian law, a woman was classified as a child, regardless of age, and therefore was the legal property of some man at all stages of her life. Males could divorce by simply ordering a wife out of the household. Moreover, if a woman was seduced or raped, her husband was legally compelled to divorce her. If a woman wanted a divorce, she had to have her father or some other man bring her case before a judge. Finally, Athenian women could own property, but control of the property was always vested in the male to whom she “belonged”. Meanwhile, Christian woman had relatively high status, sometimes rising to the position of deacon within a church. Christian men were ordered to treat their wives kindly, were prohibited from cheating on them, and mostly could not divorce. Christianity, unlike paganism, did not especially pressure widows to remarry (important since a remarrying widow lost all her property to her new husband). Christian women were only a third as likely as Roman women to be married off before age 13. Women noticed all these benefits and flocked to Christianity. Aside from all of this, the Romans were practicing sex-selective infanticide, reducing their female numbers still further, and making the Christians even more proportionally female-heavy. If the Christians, like many modern cults, were 65% female, and the Romans (as some sources attest) were about 40 - 45% female, this is a pretty profound difference. The Romans grumbled about marriage, but in the end most Roman men did want wives (if only to avoid government penalties). But 1.4 men per women - maybe even less among the upper classes - puts young men seeking wives in a difficult situation (for comparison, modern San Francisco is only 1.05 men per women, and dating is already hell). To any remotely heterosexual Roman men, the 65% female Christian community must have started looking pretty good. Meanwhile, the Christians had the opposite problem: too many women, not enough men. There’s an obvious solution, and it sounds like the pagans and Christians had also figured it out: From 1 Peter 3: Wives ... submit yourselves to your own husbands so that, if any of them do not believe the Word, they may be won over without words by the behavior of their wives, when they see the purity and reverence of your lives. History records many such intermarriages, almost always ending with the conversion of the pagan husband. If you are a Christian of English descent, you may owe your religion to Queen Bertha of Kent, who convinced her husband, one of the early Anglo-Saxon kings, to take her faith. But Ruxandro Teslo has a great post reviewing the work of historian Michele Salzman, who disagrees with all of this. Salzman has a database of 400 aristocratic Romans during the 4th century period of Christianity’s fastest growth. She finds few intermarriages, few examples of women converting their husbands, and equal (or slightly male-biased) conversion ratios. Granted, this is only a small sample from one period. But it makes us question how good our evidence really is. Doesn’t all this hinge on one passage from Paul which, technically, named more men than women, plus one inventory of tunics which was so female-biased that it couldn’t possibly have been representative of even a very woman-heavy church? Are we sure that we can make the leap from “Christianity promised women more rights” to “Therefore, women flocked to Christianity?” Wasn’t that the same argument that pundits used last week to predict a blue wave for Kamala? Didn’t white women actually go for Trump, 53-46? Salzman has one more concern, which is that women had so few rights in ancient Roman society that it’s hard to see how they could have converted at all. When unmarried, they were under the care of their father, who would hardly have let them go out visiting churches full of strange men. When married, they were under the care of their husband, who likewise. A typical Roman man wouldn’t have cared about his wife’s religious opinions, which is maybe why so many of our stories about intermarriages and conversions come from later periods like the Anglo-Saxons. I don’t know enough about history to referee this dispute, except that say that I think the answer could easily have been different for each of early Romans, late Romans, Hellenized-Jewish-Romans, pagan Romans, upper-class Romans, and lower-class Romans, plus all combinations thereof. Because Of The Testimony Of The Martyrs The martyrs are one of the most dramatic parts of the early Christian story. Men and women would endure seemingly-unbearable tortures, continuing to praise God the whole time, sometimes in spite of Roman officials who promised to let them go free if they would just make the tiniest concession to praising Jupiter. These martyrdoms impressed their contemporaries as much as they impress us, and were a major factor driving pagans to Christianity. The Christian Martyrs’ Last Prayer, by Jean-Leon Gerome (maybe slight nominative determinism?) Stark is writing in the 1990s, and martyrology c. 1995 does not exactly cover itself in glory. At the time of writing, the most popular theory among scholars (claims Stark) was that the martyrs were masochists. He considers this dumb and offensive theory a natural consequence of historians being reluctant to accept anything that sounds too miraculous or amazing, and there being few other hard-headed rational explanations of the martyrs’ behavior (for some reason, the obvious one - that they believed in God and Heaven - impresses neither Stark’s foils nor himself). He sets out to build an alternative theory: the martyrs were rationally seeking the approval of their community. Martyrdom not only occurred in public, often before a large audience, but it was often the culmination of a long period of preparation during which those faced with martyrdom were the object of intense, face-to-face adulation. Consider the case of Ignatius of Antioch … Ignatius was condemned to death as a Christian. But instead of being executed in Antioch, he was sent off to Rome in the custody of ten Roman soldiers. Thus began a long, leisurely journey during which local Christians came out to meet him all along the route, which passed through many of the more important sites of early Christianity in Asia Minor on its way to the West. At each stop Ignatius was allowed to preach to and meet with those who gathered, none of whom was in any apparent danger although their Christian identity was obvious. Moreover, his guards allowed Ignatius to write letters to many Christian congregations in cities bypassed along the way, such as Ephesus and Philadelphia … As William Schoedel remarked, “It is no doubt as a conquering hero that Ignatius thinks of himself as he looks back on part of his journey and says that the churches who received him dealt with him not as a ‘transient traveller,’ noting that ‘even churches that do not lie on my way according to the flesh went before me city by city.’” What Ignatius feared was not death in the arena, but that well-meaning Christians might gain him a pardon…He expected to be remembered through the ages, and compares himself to martyrs gone before him, including Paul, “in whose footsteps I wish to be found when I come to meet God.” It soon was clear to all Christians that extraordinary fame and honor attached to martyrdom. Nothing illustrates this better than the description of the martyrdom of Polycarp, contained in a letter sent by the church in Smyrna to the church in Philomelium. Polycarp was the bishop of Smyrna who was burned alive in about 156. After the execution his bones were retrieved by some of his followers - an act witnessed by Roman officials, who took no action against them. The letter spoke of “his sacred flesh” and described his bones as “being of more value than precious stones and more esteemed than gold.” The letter-writer reported that the Christians in Smyrna would gather at the burial place of Polycarp’s bones every year “to celebrate with great gladness and joy the birthday of his martyrdom.” The letter concluded, “The blessed Polycarp ... to whom be glory, honour, majesty, and a throne eternal, from generation to generation. Amen.” It also included the instruction: “On receiving this, send on the letter to the more distant brethren that they may glorify the Lord who makes choice of his own servants.” In fact, today we actually know the names of nearly all of the Christian martyrs because their contemporaries took pains that they should be remembered for their very great holiness. I don’t know, I’m not putting too much effort into writing up this section, because it doesn’t feel like as much of a mystery as some of the others. Maybe all of this was weird in 1996. But since then, we’ve seen plenty of suicide bombers willing to die for their faith. I accept that the Christian martyrs were more impressive - a slow death in the Colosseum takes more grit than the quick detonation of an explosive vest, and dying for peace is more impressive than dying in war - but it hardly seems like as much of a leap. Honestly, Stark’s “social approval” theory seems only slightly less objectifying than the masochism theory. Some people just have a tendency towards self-sacrifice. I know many effective altruists who, for example, deliberately let themselves be infected with malaria to help speed vaccine research. If someone told them a way that they could help the neediest people in the world by feeding themselves to lions, the lions would no doubt eat well. Because They Survived The Plagues However bad you imagine daily life in ancient Rome, it was worse. Historians estimate that ancient Rome had a population density of 300 people per acre. That’s almost ten times denser than modern New York City, two thousand years before anyone invented the skyscraper3. How did they do it? By cramming people together in unbearable filth and misery: Most people lived in tiny cubicles in multistoried tenements…”there was only one private house for every 26 blocks of apartments”. Within these tenements, the crowding was extreme - the tenants rarely had more than one room in which “entire families were herded together”. Thus, as Stambaugh tells us, privacy was “a hard thing to find”. Not only were people terribly crowded within these buildings, the streets were so narrow that if people leaned out their window they could chat with someone living across the street without having to raise their voices… To make matters worse, Greco-Roman tenements lacked both furnaces and fireplaces. Cooking was done over wood or charcoal braziers, which were also the only source of heat; since tenements lacked chimneys, the rooms were always smoky in winter. Because windows could be “closed” only by “hanging cloths or skins blown by rain”, the tenements were sufficiently drafty to prevent frequent asphyxiation. But the drafts increased the danger of rapidly spreading fires, and “dread of fire was an obsession among rich and poor alike.” Packer4 (1967) doubted that people could actually spend much time in quarters so cramped and squalid. Thus he concluded that the typical residents of Greco-Roman cities spent their lives mainly in public places and that the average “domicile must have served only as a place to sleep and store possessions.” These tenements had no plumbing. Waste was eliminated by pouring it onto the street, often to the detriment of people walking underneath. Water was brought home from public wells; if you were out, you either walked back to the well or made do. The total public baths capacity of Rome was about 30,000; the total population of Rome was about a million; in practice, the upper classes used the “public” baths and the average citizen had never bathed in their life. Soap had been invented a century or two earlier but was limited to a small pool of early adopters. The cities buzzed with flies, mosquitos, and other insects. It would be eighteen hundred years before anyone invented germ theory. Tenements were six stories high and frequently collapsed, killing everyone inside. Fires consumed the city on a regular basis, giving rise to colorful legends like Nero fiddling while Rome burnt. Police were limited, and it was understood that you would be robbed immediately if you set foot outside at nighttime. This kind of smart, walkable, mixed-use urbanism is illegal to build in most American cities. How did people survive? Mostly they didn’t. Cities were destroyed regularly - multiple times within a single human lifetime! - then rebuilt and replenished with rural population. Stark focuses on Antioch, a Syrian city which was a center of early Christianity. During “six hundred years of intermittent Roman rule”, he finds: It was conquered 11 times
Of inscriptions on the Jewish catacombs in Rome, 76% are in Greek, 22% in Latin, and only 2% in Hebrew or Aramaic. Reform Judaism is unstable. The Law of Moses is central to the Jewish faith; relax it too much, and believers can justly wonder what’s left. In America, Reform Jews are over-represented not only among atheists and agnostics, but among every cult under the sun. 33% of American Buddhists come from a Jewish background, and even the Moonies were 30% Jewish at one point! (they’re now down to 6%) As the Jews were assimilating into Greeks, some Greeks were assimilating into Judaism. They were impressed enough with monotheism and the Jews’ upright behavior to adopt some of the rituals, but they couldn’t take the final step and circumcise themselves. Instead, they hung around the fringes of Jewish society, admiring it from without. The Bible and the historical record call them “God-fearers”, but by analogy I can’t help but think of them as “weajoos”. These weajoos would have been easy prey for the first semi-Jewish sect to shed the circumcision requirement and explicitly pivot away from being an ethnic religion. The Apostles and other early Christians, leaving Palestine to minister to the wider world, would have made use of existing Jewish networks and connections. They would have found themselves in the middle of the spiritually-disaffected, half-assimilated pseudo-Reform Jewish communities of the Roman world, plus their half-assimilated-the-other direction Greek hangers-on. They would have preached that Judaism was basically true, but that you can drop the restrictive Law of Moses and avoid getting circumcised. They would have sliced through the cultural angst of these in-between communities, saying that Jews could join together with Gentiles in a big friendly tent under the leadership of the God of Abraham, Isaac, and Jacob. Here, says Stark, were the early Christians’ first few million converts. Because, I Regret To Inform You, The Pronatalists Are Right About Everything We found above that the Christian population needed to grow at 40% per decade, and assumed this meant conversion. But you could also do this through a fertility advantage. If a generation lasts thirty years, and Christians have 3x more children than pagans per generation, they can get 40%/decade growth without converting anyone at all. In reality, it was probably a mix: some conversion plus some fertility advantage. Here I start to worry that some right-wing pronatalist organization bribed Rodney Stark to abandon his usual scholarly attitude and write some kind of over-the-top pronatalist fanfic. I was waiting for the part where the eagle named MORE BIRTHS perches on the blackboard and the childfree professor was tossed into the lake of fire for all eternity. Still, let’s take it at face value and see what the fanfic has to say. By the Imperial era, Roman fertility was plummeting. Partly this was because the Romans practiced sex-selective infanticide, there were 130 men for every 100 women, and so many men would never be able to find a wife. But partly this was because the men who could find wives dragged their feet. (Male) Roman culture took it as a given that women were terrible, that you couldn’t possibly enjoy interacting with them, and that there was no reason besides duty that you would ever marry one. In 131 BC, the Roman censor Quintus Caecilius Metellus Macedonicus2 proposed that that the senate make marriage compulsory because so many men, especially in the upper classes, preferred to stay single. Acknowledging that “we cannot have a really harmonious life with our wives”, the censor pointed out that "since “we cannot have any sort of life without them,” the long term welfare of the state must be served”… As Beryl Rawsom has reported, “one theme that recurs in Latin literature is that wives are difficult and therefore men do not care much for marriage.” The Romans understood that this was long-term fatal for their empire, and tried all sorts of schemes to increase family formation. In the mid-first-century BC, Cicero re-proposed Metellus’ scheme to make marriage compulsory, but it failed once again. Augustus contented himself with punitive taxes and second-class citizenship for unmarried and childless couples, combined with subsidies and affirmative action for men with at least three children. Formal and informal social pressure eventually convinced most Roman men to take wives, but no amount of love or money could make them have children. Dense cities discouraged large families, Roman children were expensive (nobles would have to spend immense effort and political favors grooming them for high positions), and (the scourge of all nobilities) too many children risked splitting the inheritance. Also, if you had a girl you’d probably just kill her (she would consume resources without continuing the family line), and half of children died before adulthood from some disease or another anyway. It was just a really bad value proposition. Nor did the sex drive force the matter. Horny Roman men had their choice of a wide variety of male and female slaves and prostitutes - despite Augustus and his spiritual heirs’ fuming about monogamy, this was never really enforced on the male half of the population. When men did have sex with women, it was usually oral or anal sex, specifically to avoid procreation. When they did have vaginal sex, they had a wide variety of birth control methods available, including the famous silphium but also proto-condoms and spermicidal ointments. If a child was conceived despite these efforts, abortion was common albeit unsanitary (maternal death rates were extremely high, but this was not really a deal-breaker for the Roman men making the decision). If a baby was born in spite of all this, infanticide was legal and extremely common: Far more babies were born than were allowed to live. Seneca regarded the drowning of children at birth as both reasonable and commonplace. Tacitus charged that the Jewish teaching that it is “a deadly sin to kill an unwanted child” was but another of their “sinister and revolting practices” . . . not only was the exposure of infants a common practice, it was justified by law and advocated by philosophers.” Christians followed the opposite of all these practices. They recommended that men love their wives, and held this as a plausible and expected outcome. This was not exactly unprecedented, but it was a dramatic reversal of Roman custom. From Ephesians 5: Husbands, love your wives, just as Christ loved the church and gave himself up for her to make her holy, cleansing her by the washing with water through the word, and to present her to himself as a radiant church, without stain or wrinkle or any other blemish, but holy and blameless. In this same way, husbands ought to love their wives as their own bodies. He who loves his wife loves himself. After all, no one ever hated their own body, but they feed and care for their body, just as Christ does the church — for we are members of his body. “For this reason a man will leave his father and mother and be united to his wife, and the two will become one flesh.” This is a profound mystery — but I am talking about Christ and the church. However, each one of you also must love his wife as he loves himself, and the wife must respect her husband. The Christians banned adultery (and, unlike the Roman bans, gave it teeth), meaning that married men who wanted sex had no choice but to go to their wives. They held that sex had to be procreative, banning anal sex, oral sex, homosexual sex, and birth control. And obviously they banned infanticide (many of these bans weren’t active decisions, but carry-overs from the movement’s Jewish roots). Also, I regret to say I fell for the liberal meme that Republicans tricked Christians into being anti-abortion in 1960, and previous generations of Christian had thought abortion was fine. This is absolutely not true. The Didache, the first Christian text outside the New Testament itself, probably dating from about 90 AD, says that “Thou shalt not murder a child by abortion nor kill them when born”. The second-century church father Athenagoras wrote: We say that women who use drugs to bring on an abortion commit murder, and will have to give an account to God for the abortion . . . for we regard the very foetus in the womb as a created being, and therefore an object of God’s care . . . and [we do not] expose an infant, because those who expose them are chargeable with child-murder. The end result is that while pagans delayed marriage, cheated, had nonprocreative sex, used birth control, performed abortions, and committed infanticide, Christians did none of these things. This section gave me a new appreciation for conservative Christian purity culture: it was obviously suited for the environment in which it evolved, and it’s also obvious why its founders would etch it so deeply into its memetic DNA that it’s still going strong millennia later. But I’ll end this section with a note of caution - I’m not sure how relevant any of this is. Stark refuses to speculate on pagan vs. Christian fertility rates, but when I look up modern scholarship, they reasonably point out that pagan rates must have been around “replacement”, given that the Roman population stayed steady (or slowly increased) for hundreds of years. “Replacement” is in quotes because Romans were constantly dying of plague, warfare, fire, and a million other causes; since only a third to half of people survived to reproduce, “replacement” here is something like 4-6 children per women. This doesn’t sound like the antinatalist disaster Stark describes! I think Stark is mostly talking about Roman elites - the group who Augustus kept pestering to have at least three children - and more broadly about the urban population. These people were constantly dying and being replaced by commoners and villagers. Early Christianity was primarily an urban and upper-class movement (does this surprise you? Stark urges us to think of modern cults and new religions, like American Buddhism, which predominantly recruit disillusioned children of the upper classes). So perhaps it did better than its urban upper-class pagan comparison group. Still, since the urban upper-class pagans were constantly being replaced by village lower-class pagans as soon as they died out, how much, in numerical terms, can this contribute to Christianity’s growth? A possible synthesis: if you imagine a city as having a constant population (because it’s walled, plus its hinterland can only support a certain number of non-food-producing urbanites), and villagers as replacing urbanites on a one-to-one basis as they die, then greater Christian urban fertility rates can at least contribute to the cities and upper classes becoming Christian. And once the cities and upper classes are Christian, you get Constantine, and the lower classes can be forced to comply. Remember, “pagan” originally meant “rural”! Because Where Women Go, Men Will Follow One thing Stark did not mention discovering in his study of cults, but which I have heard anecdotally - a lot of male cult members join because the cult has hot girls. This seems to have been a big factor in the spread of early Christianity as well. Stark collects various forms of evidence that early Christians were predominantly women. Paul’s Epistle to the Romans greets thirty-three prominent Christians by name, of whom 15 were men and 18 women; if (as seems likely) men were more likely to become prominent than women, this near-equality at the upper ranks suggests a female predominance at the lower. A third-century inventory of property at a Christian church includes “sixteen men’s tunics and eighty-two women’s tunics”. The book quotes historian Adolf von Harnack, who says: [Ancient sources] simply swarm with tales of how women of all ranks were converted in Rome and in the provinces; although the details of these stories are untrustworthy, they express correctly enough the general truth that Christianity was laid hold of by women in particular, and also that the percentage of Christian women, especially among the upper classes, was larger than that of men. Why were women converted in such disproportionate numbers? Again, Stark’s sociological background serves him well: he is able to find reports of the same phenomenon in modern religions: By examining manuscript census returns for the latter half of the nineteenth century, Bainbridge (1983) found that approximately two-third of the Shakers were female. Data on religious movements included in the 1926 census of religious bodies show that 75% of Christian Scientists were women, as were more than 60% of Theosophists, Swedenborgians, and Spiritualists. The same is true of the immense wave of Protestant conversions taking place in Latin America. But along with a general tendency for women to convert, Stark notes that Christianity was especially attractive to women. The pagan world treated women as their husbands’ property, and not particularly well-liked property at that. The book cites the Athenian laws as typical: The status of Athenian women was very low. Girls received little or no education. Typically, Athenian females were married at puberty and often before. Under Athenian law, a woman was classified as a child, regardless of age, and therefore was the legal property of some man at all stages of her life. Males could divorce by simply ordering a wife out of the household. Moreover, if a woman was seduced or raped, her husband was legally compelled to divorce her. If a woman wanted a divorce, she had to have her father or some other man bring her case before a judge. Finally, Athenian women could own property, but control of the property was always vested in the male to whom she “belonged”. Meanwhile, Christian woman had relatively high status, sometimes rising to the position of deacon within a church. Christian men were ordered to treat their wives kindly, were prohibited from cheating on them, and mostly could not divorce. Christianity, unlike paganism, did not especially pressure widows to remarry (important since a remarrying widow lost all her property to her new husband). Christian women were only a third as likely as Roman women to be married off before age 13. Women noticed all these benefits and flocked to Christianity. Aside from all of this, the Romans were practicing sex-selective infanticide, reducing their female numbers still further, and making the Christians even more proportionally female-heavy. If the Christians, like many modern cults, were 65% female, and the Romans (as some sources attest) were about 40 - 45% female, this is a pretty profound difference. The Romans grumbled about marriage, but in the end most Roman men did want wives (if only to avoid government penalties). But 1.4 men per women - maybe even less among the upper classes - puts young men seeking wives in a difficult situation (for comparison, modern San Francisco is only 1.05 men per women, and dating is already hell). To any remotely heterosexual Roman men, the 65% female Christian community must have started looking pretty good. Meanwhile, the Christians had the opposite problem: too many women, not enough men. There’s an obvious solution, and it sounds like the pagans and Christians had also figured it out: From 1 Peter 3: Wives ... submit yourselves to your own husbands so that, if any of them do not believe the Word, they may be won over without words by the behavior of their wives, when they see the purity and reverence of your lives. History records many such intermarriages, almost always ending with the conversion of the pagan husband. If you are a Christian of English descent, you may owe your religion to Queen Bertha of Kent, who convinced her husband, one of the early Anglo-Saxon kings, to take her faith. But Ruxandro Teslo has a great post reviewing the work of historian Michele Salzman, who disagrees with all of this. Salzman has a database of 400 aristocratic Romans during the 4th century period of Christianity’s fastest growth. She finds few intermarriages, few examples of women converting their husbands, and equal (or slightly male-biased) conversion ratios. Granted, this is only a small sample from one period. But it makes us question how good our evidence really is. Doesn’t all this hinge on one passage from Paul which, technically, named more men than women, plus one inventory of tunics which was so female-biased that it couldn’t possibly have been representative of even a very woman-heavy church? Are we sure that we can make the leap from “Christianity promised women more rights” to “Therefore, women flocked to Christianity?” Wasn’t that the same argument that pundits used last week to predict a blue wave for Kamala? Didn’t white women actually go for Trump, 53-46? Salzman has one more concern, which is that women had so few rights in ancient Roman society that it’s hard to see how they could have converted at all. When unmarried, they were under the care of their father, who would hardly have let them go out visiting churches full of strange men. When married, they were under the care of their husband, who likewise. A typical Roman man wouldn’t have cared about his wife’s religious opinions, which is maybe why so many of our stories about intermarriages and conversions come from later periods like the Anglo-Saxons. I don’t know enough about history to referee this dispute, except that say that I think the answer could easily have been different for each of early Romans, late Romans, Hellenized-Jewish-Romans, pagan Romans, upper-class Romans, and lower-class Romans, plus all combinations thereof. Because Of The Testimony Of The Martyrs The martyrs are one of the most dramatic parts of the early Christian story. Men and women would endure seemingly-unbearable tortures, continuing to praise God the whole time, sometimes in spite of Roman officials who promised to let them go free if they would just make the tiniest concession to praising Jupiter. These martyrdoms impressed their contemporaries as much as they impress us, and were a major factor driving pagans to Christianity. The Christian Martyrs’ Last Prayer, by Jean-Leon Gerome (maybe slight nominative determinism?) Stark is writing in the 1990s, and martyrology c. 1995 does not exactly cover itself in glory. At the time of writing, the most popular theory among scholars (claims Stark) was that the martyrs were masochists. He considers this dumb and offensive theory a natural consequence of historians being reluctant to accept anything that sounds too miraculous or amazing, and there being few other hard-headed rational explanations of the martyrs’ behavior (for some reason, the obvious one - that they believed in God and Heaven - impresses neither Stark’s foils nor himself). He sets out to build an alternative theory: the martyrs were rationally seeking the approval of their community. Martyrdom not only occurred in public, often before a large audience, but it was often the culmination of a long period of preparation during which those faced with martyrdom were the object of intense, face-to-face adulation. Consider the case of Ignatius of Antioch … Ignatius was condemned to death as a Christian. But instead of being executed in Antioch, he was sent off to Rome in the custody of ten Roman soldiers. Thus began a long, leisurely journey during which local Christians came out to meet him all along the route, which passed through many of the more important sites of early Christianity in Asia Minor on its way to the West. At each stop Ignatius was allowed to preach to and meet with those who gathered, none of whom was in any apparent danger although their Christian identity was obvious. Moreover, his guards allowed Ignatius to write letters to many Christian congregations in cities bypassed along the way, such as Ephesus and Philadelphia … As William Schoedel remarked, “It is no doubt as a conquering hero that Ignatius thinks of himself as he looks back on part of his journey and says that the churches who received him dealt with him not as a ‘transient traveller,’ noting that ‘even churches that do not lie on my way according to the flesh went before me city by city.’” What Ignatius feared was not death in the arena, but that well-meaning Christians might gain him a pardon…He expected to be remembered through the ages, and compares himself to martyrs gone before him, including Paul, “in whose footsteps I wish to be found when I come to meet God.” It soon was clear to all Christians that extraordinary fame and honor attached to martyrdom. Nothing illustrates this better than the description of the martyrdom of Polycarp, contained in a letter sent by the church in Smyrna to the church in Philomelium. Polycarp was the bishop of Smyrna who was burned alive in about 156. After the execution his bones were retrieved by some of his followers - an act witnessed by Roman officials, who took no action against them. The letter spoke of “his sacred flesh” and described his bones as “being of more value than precious stones and more esteemed than gold.” The letter-writer reported that the Christians in Smyrna would gather at the burial place of Polycarp’s bones every year “to celebrate with great gladness and joy the birthday of his martyrdom.” The letter concluded, “The blessed Polycarp ... to whom be glory, honour, majesty, and a throne eternal, from generation to generation. Amen.” It also included the instruction: “On receiving this, send on the letter to the more distant brethren that they may glorify the Lord who makes choice of his own servants.” In fact, today we actually know the names of nearly all of the Christian martyrs because their contemporaries took pains that they should be remembered for their very great holiness. I don’t know, I’m not putting too much effort into writing up this section, because it doesn’t feel like as much of a mystery as some of the others. Maybe all of this was weird in 1996. But since then, we’ve seen plenty of suicide bombers willing to die for their faith. I accept that the Christian martyrs were more impressive - a slow death in the Colosseum takes more grit than the quick detonation of an explosive vest, and dying for peace is more impressive than dying in war - but it hardly seems like as much of a leap. Honestly, Stark’s “social approval” theory seems only slightly less objectifying than the masochism theory. Some people just have a tendency towards self-sacrifice. I know many effective altruists who, for example, deliberately let themselves be infected with malaria to help speed vaccine research. If someone told them a way that they could help the neediest people in the world by feeding themselves to lions, the lions would no doubt eat well. Because They Survived The Plagues However bad you imagine daily life in ancient Rome, it was worse. Historians estimate that ancient Rome had a population density of 300 people per acre. That’s almost ten times denser than modern New York City, two thousand years before anyone invented the skyscraper3. How did they do it? By cramming people together in unbearable filth and misery: Most people lived in tiny cubicles in multistoried tenements…”there was only one private house for every 26 blocks of apartments”. Within these tenements, the crowding was extreme - the tenants rarely had more than one room in which “entire families were herded together”. Thus, as Stambaugh tells us, privacy was “a hard thing to find”. Not only were people terribly crowded within these buildings, the streets were so narrow that if people leaned out their window they could chat with someone living across the street without having to raise their voices… To make matters worse, Greco-Roman tenements lacked both furnaces and fireplaces. Cooking was done over wood or charcoal braziers, which were also the only source of heat; since tenements lacked chimneys, the rooms were always smoky in winter. Because windows could be “closed” only by “hanging cloths or skins blown by rain”, the tenements were sufficiently drafty to prevent frequent asphyxiation. But the drafts increased the danger of rapidly spreading fires, and “dread of fire was an obsession among rich and poor alike.” Packer4 (1967) doubted that people could actually spend much time in quarters so cramped and squalid. Thus he concluded that the typical residents of Greco-Roman cities spent their lives mainly in public places and that the average “domicile must have served only as a place to sleep and store possessions.” These tenements had no plumbing. Waste was eliminated by pouring it onto the street, often to the detriment of people walking underneath. Water was brought home from public wells; if you were out, you either walked back to the well or made do. The total public baths capacity of Rome was about 30,000; the total population of Rome was about a million; in practice, the upper classes used the “public” baths and the average citizen had never bathed in their life. Soap had been invented a century or two earlier but was limited to a small pool of early adopters. The cities buzzed with flies, mosquitos, and other insects. It would be eighteen hundred years before anyone invented germ theory. Tenements were six stories high and frequently collapsed, killing everyone inside. Fires consumed the city on a regular basis, giving rise to colorful legends like Nero fiddling while Rome burnt. Police were limited, and it was understood that you would be robbed immediately if you set foot outside at nighttime. This kind of smart, walkable, mixed-use urbanism is illegal to build in most American cities. How did people survive? Mostly they didn’t. Cities were destroyed regularly - multiple times within a single human lifetime! - then rebuilt and replenished with rural population. Stark focuses on Antioch, a Syrian city which was a center of early Christianity. During “six hundred years of intermittent Roman rule”, he finds: It was conquered 11 times
August 12, 2025 · Original source
If I wanted to be in a very strong community, I don’t think there’s any way to just “expend effort” and make it happen. Maybe I could learn Hebrew and convert to Orthodox Judaism, but there are lots of reasons not to do that besides just laziness (plus one extra reason for people who aren’t already circumcised!) If I wanted a community of the “ten normal-ish families on a suburban block raising children together” variety, this seems about as tough as founding a new company, in the sense that you need to be creative, agentic, and willing to risk everything falling apart.
Henry George Theorem

Henry George Theorem is a recurring concept in the Astral Codex Ten archive, appearing 4 times across 4 issues between April 16, 2021 and December 11, 2021. The archive places it in contexts such as "He called this the Henry George Theorem"; "ATCOR and the Henry George Theorem"; "The HG Theorem doesn't claim to apply to other forms of public spending". It most often appears alongside Georgism, Henry George, Progress and Poverty.

Mention count
4
Issue count
4
First seen
April 16, 2021
Last seen
December 11, 2021
April 16, 2021 · Original source
(source, CC BY-SA 3.0, author: Explodicle) A vertical supply curve means no matter what the price of land is, the same amount will always be supplied. This is because you can't make land – the supply is effectively fixed. Remember, the Netherlands doesn't count because the sea bed is land, and filling it in is just an improvement to land that already existed. And even if we granted "The Netherlands occasionally makes land" for the sake of argument, the amount of land "created" in this way is pretty darn negligible in the grand scheme of the economy, and almost exclusively the domain of governments or state-owned actors. The supply of land being fixed has some really interesting properties. By contrast, consider oil, the supply of which is not fixed. If we tax oil, some of the more marginal wells will be too expensive to operate and make a profit, so producers shut those down and the supply of oil decreases. Deadweight loss comes from a producer's ability to change the amount of product they supply in response to price signals. You'll notice the above graph of land tax has no deadweight loss at all! Since nobody produces land, it's the one thing you can tax without getting less of it. This drives out speculators entirely. Speculators can no longer distort rents by bidding up the price of land and holding it out of use, and can no longer compete with those who actually intend to use the land. This restores the proper balance of land, labor, and capital. Now if you work harder, or invest more capital, you can actually expect to see an increasing return without it all being gobbled up by ever-increasing rent. If you think about it this way, land value tax has negative deadweight loss, because it eliminates the speculative distortion that is the unearned privilege of landownership. Okay, but won't the landlords just pass the land tax on to their tenants? By George, no. Rent is a price, and price is governed by supply and demand. Supply of land is fixed, so land value tax has no effect on supply. What about demand? Except in cases where it causes the economy to boom (a good thing), land value tax won't increase land value – what it always does, however, is reduce the demand for land by speculators. If it costs nothing to hold on to land, of course I'm going to want to grab some and HODL. If the rent I could hope to gain is taxed away, I won't bother. Consider the case of oil again, where a tax reduces the supply. Reduced supply, given unchanged demand, causes a rise in price. And you'll find the increase in price tracks very closely with the amount of tax. Land value tax is just about the only kind of tax that can't be passed off to someone else. For more on deadweight loss and the land value tax, see Welfare Economics of the Land Value Tax by BlueRepublik. So does this mean there can never be profitable landlords ever again? Of course not – they just have to earn their living honestly like everyone else. Remember, we don't tax the improvements, just the "ground rent." So Ms. Nguyen still gets paid for all her honest work and judicious investments, but Mr. Slumlord doesn't make a dime until he gets off his lazy butt and does something productive. This is really important, because aside from speculation, the principal cause of land value increase is the productivity of your neighbors. An empty lot in the middle of nowhere is worthless, but an otherwise identical empty lot in the middle of New York city is priceless. As they say in real estate - "location, location, location." The reason location is valuable is because of the activity and contributions of the community, and yet the landlord claims the right to seize it all as rent. Modern economists have some interesting things to say about George's ideas, too. In 1977 Joseph Stiglitz demonstrated that land rents have a tendency to almost perfectly equal the value of investment in public goods. He called this the Henry George Theorem. Milton Friedman famously called land value tax the "Least Worst" tax. But one of my all-time favorite endorsements will always be that one time the economist Ramin Shokrizade unwittingly re-derived land value tax from first principles to (successfully!) fix recessions in EVE Online. Okay, so we tax all the ground rent. It will remove the speculative component of the rent (because there will no longer be any incentive to jack the prices up artificially), but it won't drive the price down to zero. That's because 100% LVT is only achievable on a frictionless plane populated by spherical cows; here in the real world you'll be left with a small sliver of land value. And of course regardless of the LVT rate, houses and buildings will still have a price. And that's fine. Land in Times Square will still be a lot more valuable than land in Podunk, Saskatchewan, but both will approach the same price as the LVT rate gets closer to 100%. This encourages people to actually make use of valuable land rather than holding it out of use, blighting the urban core and forcing development to sprawl out for miles in every direction, leading to worse transportation and more pollution. But... doesn't this mean that if people aren't putting land to productive use, they'll eventually be pressured to sell it off to someone who will? George sees this as a good thing. Without land value tax you get situations where somebody can anticipate that an empty lot will become valuable in the future, buy it, HODL forever, lobby against future development that would depress their property values, and now you have the Bay Area's housing crisis. Or buy an apartment block, do the absolute minimum the tenants will tolerate without killing you, constantly jack up the rent as the city grows, and you get slums. As BlueRepublik observes in No, Georgism is Still Sane: If you look at the commercial blight in New York City (http://www.vacantnewyork.com/) 90%+ is from landlords refusing to lease out to small businesses, waiting for a larger bank or big business to pay a higher rent bill. This causes property values of nearby businesses to drop, equity value to drop, and businesses to move out from the city center, increasing urban sprawl and urban blight. It’s a massive drain on personal wealth, and is very highly linked with poverty and higher crime rates. It’s also not a great model for having a stable social fabric. In a fit of performance art, a Georgist by the name of Fay Lewis once famously bought an empty lot and stuck a big sign on it to demonstrate the principle in action: Okay, but isn't building too much stuff bad for the environment? Won't this encourage over-development? By George, no. What's bad for the environment is sprawl, which the current system encourages and which the land tax would directly attack. If you want dense, walkable cities that don't depend on cars to get around, you should eliminate land speculation. A stronger objection to land value tax is when it's not some shifty speculator or a genocidal English landlord who suffers the brunt of it, but, say, this guy: The premise of Pixar's movie Up is that Carl Fredricksen, a lovably grumpy pensioner, is the last holdout standing in the way of developers bulldozing the rest of his neighborhood in the name of Progress™. He refuses to sell because he can't bear to part with the house which for him is tied up with all the cherished memories of his departed wife. This isn't just sentimental fiction, this is something that really does happen. Isn't Georgism just going to price the poor Carl Fredricksens out of their homes so that someone with a more """productive""" use can have it instead? There's several good response to this. For starters, if you're worried about kindly old people losing their homes, that's a thing that's happening already, and most of the time it's because The Rent Is Too Damn High, and our existing system is net worse on this score. We are currently facing an unprecedented crisis of evictions in tandem with the COVID pandemic, and it's not like things were peachy before. And even though homelessness seems to be declining in the US overall, it's getting worse in the most prosperous cities, exactly as George predicted. Okay, maybe it's better for renters, but what about people who own their homes, like Carl? Isn't it unfair to stick them with land taxes that might kick them out? What if they're retired? Remember, let's not confuse land tax with land confiscation, Here's George (emphases mine): I do not propose either to purchase or to confiscate private property in land. The first would be unjust; the second, needless. Let the individuals who now hold it still retain, if they want to, possession of what they are pleased to call their land. Let them continue to call it their land. let them buy and sell, and bequeath and devise it. We may safely leave them the shell, if we take the kernel. It is not necessary to confiscate land; it is only necessary to confiscate rent. Okay, but you have to admit that even if the state isn't confiscating everybody's land, if you can't pay your land taxes you have no choice but to sell your land, right? Isn't this morally unjust to the Carl Fredricksens of the world? First, it's not a given that Mr. Fredricksen will be worse off on net: he already pays income and sales taxes, capital gains on any investments, as well as property tax which taxes both land value and the value of his house. As speculators leave the real estate market the land tax that replaces his property tax drop will drop, and his house is an improvement that goes entirely untaxed. Also, if the speculators holding onto all the most valuable real estate in the downtown districts are forced to give it up, there won't be as much competition for land and so there's a good chance developers won't be interested in trying to buy up land in a bedroom community in the first place. BlueRepublik further points out that LVT can be used to fund a Universal Basic Income, which should soften the blow considerably: Keep in mind also that the Georgist Land Value Tax is pair with a "Citizen's Dividend" or what we see as UBI, so that it's not the government claiming land rent, rather the land rent is taxed and split up equally for all men. But as a matter of political practicality, in the rare event that after all that Mr. Fredricksen still somehow finds himself in the hole after LVT is applied, Nate Blair suggests a deferment option to grandfather the Carls of the world through the transition: The LVT gets assessed annually for everyone, but owner occupiers (businesses and homeowners) can apply to defer the sum of those payments until they sell or transfer the land. Government can charge a nominal interest. A final point of modern application of land value taxes is to level the playing field between different areas by eliminating "cost of living" discrepancies that arise entirely from speculative rent. This is pretty relevant given the "location pay" debate going on in Silicon Valley right now in response to increased remote work as a direct consequence of the COVID pandemic. Back to George. Great, we've taxed ground rent at 100% and eliminated speculation and all other manner of social ills. Now what do we do with the money? Lots of things! For one, you can get rid of some other taxes. Back in George's day it was even argued that a 100% land value tax on ground rents should be the only tax – the "Single Tax," replacing all other tariffs, duties, and other taxes (keep in mind this was in the late 1800's and Federal income tax wasn't introduced until the 16th amendment in 1913). Remember, all these other taxes have deadweight loss. Income tax is a tax on labor, and so taxing it means we really do get less productive labor. The portion of property tax that targets improvements punishes you for investing in improvements, and sales tax is just straight up regressive, hitting the poor harder than the rich. There's some argument today about whether the "Single Tax" would be enough to fund the modern US budget, with some Georgists saying it would be sufficient and others saying we would still need some other taxes but could at least significantly offset what we already have. But by George, another thing we could do is just give all the money back to the people, as BlueRepublik mentioned above. This could be used as a straightforward Universal Basic Income – what George calls a Citizen's Dividend, or what Andrew Yang calls the Freedom Dividend. It could also be used for the funding of public goods. George doesn't see this as an act of charity on the state's behalf – the value of the land has its origin in the productive labors of the entire community, so it's a simple act of justice to give the returns to those who actually produced the value, which is society at large. Another effect George asserts is that once land is no longer monopolized, labor is no longer forced into one-sided competition, so wages start to go up. Even better, laborers now have far more opportunity to go into business for themselves, which spurs innovation and investment. So to sum up, if we tax the ever loving hell out of ground rent, George says we'll see the following benefits: Make housing much more affordable
December 09, 2021 · Original source
ATCOR and the Henry George Theorem
Then there's the Henry George Theorem. Nobel laureate Joseph Stiglitz published it in 1979, and it says that under certain conditions, expenditures on public goods will be soaked up by land rents to such a degree that a 100% LVT is necessarily sufficient to finance all public goods spending in perpetuity. A pure "public good" is something that is "non-rival" and "non-excludable." Non-rival means that you using it doesn't mean I can use it any less, and non-excludable means that there's no way anyone can keep me from benefiting from it once it's out there. Common examples include a fireworks display, national defense, and clean air. The HG Theorem doesn't claim to apply to other forms of public spending, such as mass transit, which are both excludable and rival to some degree. (Transit has a capacity limit, and even if we've abolished racially discriminatory Jim Crow laws, the fact that they were even possible proves excludability.)
If you put ATCOR, the Henry George Theorem, and observations about non-pure-public-goods-spending together, one could postulate a virtuous cycle where government investment is always able to pay for itself without creating a drag on the economy and without any deficit spending or debt.
December 10, 2021 · Original source
...which seems like a straight-up affirmation that a weak form of the Henry George theorem is true.
December 11, 2021 · Original source
Aggregate Land Rents, Expenditure on Public Goods, and Optimal City Size by Arnott and Stiglitz (the origin paper of the Henry George Theorem)
hydroxychloroquine

hydroxychloroquine is a recurring concept in the Astral Codex Ten archive, appearing 4 times across 4 issues between November 17, 2021 and May 21, 2025. The archive places it in contexts such as "patients who happened to be given ivermectin (along with hydroxychloroquine and azithromycin)"; "lots of other different compounds: zinc, hydroxychloroquine, quercetin, nigella sativa, melatonin"; "given ivermectin (along with hydroxychloroquine and azithromycin)". It most often appears alongside COVID, ivermectin, Alexandros Marinos.

Article page
hydroxychloroquine
Mention count
4
Issue count
4
First seen
November 17, 2021
Last seen
May 21, 2025
November 17, 2021 · Original source
Click to expand. # is how many people were in the smallest relevant group (eg if there were 20 people in placebo and 10 in ivermectin, it was 10). Dose is ivermectin dose x number of days. Tested w/ is what drugs were given alongside ivermectin; compare is what drugs were in the “placebo” group (I excluded some very common things like paracetamol). %-PCR7 is what percent of patients had a negative PCR test (indicating recovery) after 7 days (though if 7 wasn’t available, I accepted anything from 6-12); the (I) and (P) are ivermectin and placebo groups. R is the ratio - green if statistically significant, red otherwise. DaysPCR is how many days it took to get a negative PCR test. Days to -sym are how many days it took symptoms to resolve. -outc is some serious negative outcome in the study, either clinical worsening, hospitalization, or death. I was inconsistent which one I chose, trying to pick whichever I thought struck a balance between high sample size and severity. Since this was almost never significant, I made it blue if it favored ivermectin and orange if it favored placebo (which it never did; there is no orange). Lowest p is the lowest p-value in the study for one of the headline results. 1o+ is whether the primary outcome was positive or not. I made this very quickly and unprincipledly and I am sure there are a lot of errors; please forgive me. Of studies that included any of the endpoints I recorded, ivermectin had a statistically significant effect on the endpoint 13 times, and failed to reach significance 8 times. Of studies that named a specific primary endpoint, 9 found ivermectin affected it significantly, and 12 found it didn’t. But that’s still pretty good. And “doesn’t affect to a statistically significant degree” doesn’t mean it doesn’t work. It might just mean your study is too small for a real and important effect to achieve statistical significance. That’s why people do meta-analyses to combine studies. And the ivmmeta people say they did that and it was really impressive. All of this is still basically what things would look like if ivermectin worked. But of course we can’t give every study one vote. We’ve got to actually look at these and see which ones are good and which ones are bad. So, God help us, let’s go over all thirty of the ivermectin studies in this top panel of ivmmeta.com. (if you get bored of this, scroll down to the section called “The Analysis”) The Studies Elgazzar et al: This one isn’t on the table above, but we can’t start talking about the others until we get it out of the way. 600 Egyptian patients were randomized into six groups, including three that got ivermectin. The ivermectin groups did substantially better: for example, 2 vs. 20 deaths in ivermectin group 3 vs. non-ivermectin group 4. There were various other equally impressive outcomes. Unfortunately, it’s all false. Some epidemiologists and reporters were able to obtain the raw data (it was password-protected, but the password was “1234”), and it was pretty bizarre. Some patients appeared to have died before the trial started; others were arranged in groups of four such that it seemed like the authors had just copy-pasted the same four patients again and again. Probably either the study never happened, or at least the data were heavily edited afterwards. You can read more here. A lot of the apparent benefit of ivermectin in meta-analyses disappeared after taking out this paper (though remember, this isn’t even on the table at the top of the post, so it doesn’t directly affect that). Since the Elgazzar debacle, a group of researchers including Gideon Meyerowitz-Katz, Kyle Sheldrake, James Heathers, Nick Brown, Jack Lawrence, etc, have been trying to double-check as many other ivermectin studies as possible. At least three others - Samaha, Carvallo, and Niaee - have similar problems and have been retracted. Those studies were all removed before I screenshotted the table above, and they’re not on there. But everybody is pretty paranoid right now and looking for fraud a lot harder than they might be in normal situations. Moving on: Chowdury et al: Bangladeshi RCT. 60 patients in Group A got low-dose ivermectin plus the antibiotic doxycycline, 56 in Group B got hydroxychloroquine (another weird COVID treatment which most scientists think doesn’t work) plus the antibiotic azithromycin. No declared primary outcome. Ivermectin group got to negative PCR a little faster than the other (5.9 vs. 7 days) but it wasn’t statistically significant (p = 0.2). A couple of other non-statistically-significant things happened too. 2 controls were hospitalized, 0 ivermectin patients were. This is a boring study that got boring results, so nobody has felt the need to assassinate it, but if they did, it would probably focus on both groups getting various medications besides ivermectin. None of these other medications are believed to work, so I don’t really care about this, but you could tell a story where actually doxycycline works great at addressing associated bacterial pneumonias, or where HCQ causes lots of side effects and that makes the ivermectin group look good in comparison, or whatever. Espitia-Hernandez et al: Mexican trial which is probably not an RCT - all it says is that “patients were voluntarily allocated”. 28 ended up taking a cocktail of low-dose ivermectin, vitamin D, and azithromycin; 7 were controls. On day ten, everyone (!) in the experimental group was PCR negative; everyone (!) in the control group was still positive. Also, symptoms in the experimental group lasted an average of three days; in the control group, more like 10. These results make ivermectin look amazingly super-good, probably better than any other drug for any other disease, except maybe stuff like vitamins for treatment of vitamin deficiency. Any issues? We don’t know how patients were allocated, but they discuss patient characteristics and they don’t look different enough to produce this big an effect size. The experimental group got a lot of things other than ivermectin, but I would be equally surprised if vitamin D or azithromycin cured COVID this effectively. It deviated from its preregistration in basically every way possible, but you shouldn’t be able to get “every experimental patient tested negative when zero control patients did” by garden-of-forking-paths alone! But this has to be false, right? Even the other pro-ivermectin studies don’t show effects nearly this big. In all other studies combined, ivermectin patients took an average of 8 days to recover; in Espitia-Hernandez, they took 3. Also, it’s pretty weird that the entire control group had positive PCRs on day 10 - in most other studies, a majority of people had negative PCRs by day 7 or so, regardless of whether they were control or placebo. Everything about this is so shoddy that I can easily believe something went wrong here. I don’t have a great understanding of this one but I don’t trust it at all. Luckily it is small and non-randomized so it will be easy to ignore going forward. I’m not saying this is related, but I’m not saying it *isn’t* related either. Carvallo et al: This one has all the disadvantages of Espitia-Hernandez, plus it’s completely unreadable. It’s hard to figure out how many patients there were, whether it was an RCT or not, etc. It looks like maybe there were 42 experimentals and 14 controls, and the controls were about 10x more likely to die than the experimentals. Seems pretty bad. On the other hand, another Carvallo paper was retracted because of fraud: apparently the hospital where the study supposedly took place said it never happened there. I can’t tell if this is a different version of that study, a pilot study for that study, or a different study by the same guy. Anyway, it’s too confusing to interpret, shows implausible results, and is by a known fraudster, so I feel okay about ignoring this one. Mahmud et al: RCT from Bangladesh. 200 patients received ivermectin plus doxycycline, 200 received placebo. Everything was written up very nicely in real English, by people who were clearly not on 34 lbs of meth at the time. They designated a primary outcome, “number of days required for clinical recovery”, and found a statistically significant difference at p < 0.001: Okay, fine, they misspelled “recovery” once. But they spelled it right the other time! That puts it in the top 50% for ivermectin papers! The fraud-hunters have examined this paper closely and are unable to find any signs of fraud. @PubPeer on the Mahmud trial of ivermectin in covid patients.\n\nI have now reviewed the individual patient data master sheet.\n\nI did not find any irregularities and the summary data matches the published data.\n\n","username":"K_Sheldrick","name":"Kyle Sheldrick","profile_image_url":"","date":"Sat Jul 17 11:06:25 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":12,"impression_count":0,"expanded_url":{"url":"https://pubpeer.com/publications/E1D65711EF28D14517731BEACB89C8#2","title":"PubPeer - Ivermectin in combination with doxycycline for treating COVI...","description":"There are comments on PubPeer for publication: Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial (2021)","domain":"pubpeer.com"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> I think this paper is legitimate and that its findings need to be seriously considered. Serious consideration doesn’t always meant they’re true - sometimes if we have strong evidence otherwise we can dismiss things without understanding why. And there’s always the chance it was a fluke, right? Can something have a p-value less than 0.001 and still be a fluke? Szenta Fonseca et al: This is a chart review from Brazil. Researchers looked at various people who had been treated for COVID in an insurance company database, saw whether they got ivermectin or not, and saw whether the people who got it did better or worse. About a hundred people got it, and a few hundred others didn’t. The people who got it did not do any better than anyone else, and you’ll notice this is one of the rare red boxes on the table above. But we shouldn’t take this study seriously. Nobody took any effort to avoid selection bias, so it’s very possible that sicker people were given more medication (including ivermectin), which unfairly handicaps the ivermectin group. Also, it’s hard to tell from the paper who was on how much of what, and the discussion of ivermectin seems like kind of an afterthought after discussing lots of other meds in much more depth. This is another one I feel comfortable ignoring. Cadegiani et al: A crazy person decided to put his patients on every weird medication he could think of, and 585 subjects ended up on a combination of ivermectin, hydroxychloroquine, azithromycin, and nitazoxanide, with dutasteride and spironolactone "optionally offered" and vitamin D, vitamin C, zinc, apixaban, rivaraxoban, enoxaparin, and glucocorticoids "added according to clinical judgment". There was no control group, but the author helpfully designated some random patients in his area as a sort-of-control, and then synthetically generated a second control group based on “a precise estimative based on a thorough and structured review of articles indexed in PubMed and MEDLINE and statements by official government agencies and specific medical societies”. Patients in the experimental group were twice as likely to recover (p < 0.0001), had negative PCR after 14 vs. 21 days, and had 0 vs. 27 hospitalizations. Speaking of low p-values, some people did fraud-detection tests on another of Cadegiani’s COVID-19 studies and got values like p < 8.24E-11 in favor of it being fraudulent. And, uh, he’s also studied whether ultra-high-dose antiandrogens treated COVID, and found that they did, cutting mortality by 92% . But the trial is under suspicion, with a BMJ article calling it “[the worst] violations of medical ethics and human rights in Brazil’s history” and “an ethical cesspit of violations”. [update 2022: this section originally contained more accusations against Cadegiani. Alexandros Marinos does a deeper dive with information not available at the time I wrote this, and finds some of them were overstated or false by implication] Anyway, let’s not base anything important on the results of this study, mmkay? A defiant Flavio Cadegiani. Imagine a guy who looks like this telling you to take ultra-high-dose antiandrogens. Ahmed et al: And we’re back in Bangladesh. 72 hospital patients were randomized to one of three arms: ivermectin only, ivermectin + doxycycline, and placebo. Primary endpoint was time to negative PCR, which was 9.7 days for ivermectin only and 12.7 days for placebo (p = 0.03). Other endpoints including duration of hospitalization (9.6 days ivermectin vs. 9.7 days placebo, not significant). This looks pretty good for ivermectin and does not have any signs of fraud or methodological problems. If I wanted to pick at it anyway, I would point out that the ivermectin + doxycycline group didn’t really differ from placebo, and that if you average out both ivermectin groups (with and without doxycycline) it looks like the difference would not be significant. I had previously committed to considering only ivermectin alone in trials that had multiple ivermectin groups, so I’m not going to do this. I can’t find any evidence this trial was preregistered so I don’t know whether they waited to see what would come out positive and then made that their primary endpoint, but virological clearance is a pretty normal primary endpoint and this isn’t that suspicious. It’s impossible to find any useful commentary on this study because Elgazzar (the guy who ran the most famous fraudulent ivermectin study) had the first name Ahmed, everyone is talking about Elgazzar all the time, and this overwhelms Google whenever I try to search for Ahmed et al. For now I’ll just keep this as a mildly positive and mildly plausible virological clearance result, in the context of no effect on hospitalization length or most symptoms. Chaccour et al: 24 patients in Spain were randomized to receive either medium-dose ivermectin or placebo. The primary outcome was percent of patients with negative PCR at day 7; secondary outcomes were viral load and symptoms. The primary endpoint ended up being kind of a wash - everyone still PCR positive by day 7 so it was impossible to compare groups. Ivermectin trended toward lower viral load but never reached significance. Weirdly, ivermectin did seem to help symptoms, but only anosmia and cough towards the end (p = 0.03), which you would usually think of as lingering post-COVID problems. The paper says: Given these findings, consideration could be given to alternative mechanisms of action different from a direct antiviral effect. One alternative explanation might be a positive allosteric modulation of the nicotinic acetylcholine receptor caused by ivermectin and leading to a downregulation of the ACE-2 receptor and viral entry into the cells of the respiratory epithelium and olfactory bulb. Another mechanism through which ivermectin might influence the reversal of anosmia is by inhibiting the activation of pro-inflammatory pathways in the olfactory epithelium. Inflammation of the olfactory mucosa is thought to play a key role in the development of anosmia in SARS-CoV-2 infection This seems kind of hedge-y. If you’re wondering where things went from there, Dr. Chaccour is now a passionate anti-ivermectin activist: @Finneganporter in @BusinessInsider \n\nThe roots of #ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm\n\n","username":"carlos_chaccour","name":"Dr. Carlos Chaccour ??????","profile_image_url":"","date":"Sun Nov 07 18:40:28 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":9,"impression_count":0,"expanded_url":{"url":"https://www.businessinsider.in/international/news/the-roots-of-ivermectin-mania-how-south-america-incubated-a-fake-medicine-craze-that-took-the-us-by-storm/articleshow/87554081.cms","image":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/88d08e70-c9e2-46d4-a5df-96807b6c3a13_2000x1000.jpeg","title":"The roots of ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm","description":"The popularity of unproven anti-parasitic drug ivermectin as a COVID-19 treatment is surging. Its use has roots in South America, where it was hyped by populist","domain":"businessinsider.in"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> So I guess he must think of this trial as basically negative, although realistically it’s 24 people and we shouldn’t put too much weight on it either way. Ghauri et al: Pakistan, 95 patients. Nonrandom; the study compared patients who happened to be given ivermectin (along with hydroxychloroquine and azithromycin) vs. patients who were just given the latter two drugs. There’s some evidence this produced systematic differences between the two groups - for example, patients in the control group were 3x more likely to have had diarrhea (this makes sense; diarrhea is a potential ivermectin side effect, so you probably wouldn’t give it to people already struggling with this problem). Also, the control group was twice as likely to be getting corticosteroids, maybe a marker for illness severity. Primary outcome was what percent of both groups had a fever: on day 7 it was 21% of ivermectin patients vs. 65% of controls, p < 0.001. No other outcomes were reported. I don’t hate this study, but I think the nonrandom assignment (and observed systematic differences) is a pretty fatal flaw. I can’t find anyone else talking about this one. At least no one seems to be saying anything bad. Babaloba et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakoloko”, because that’s really fun to say. This was a Nigerian RCT comparing 21 patients on low-dose ivermectin, 21 patients on high-dose ivermectin, and 20 patients on a combination of lopinavir and ritonavir, a combination antiviral which later studies found not to work for COVID and which might as well be considered a placebo. Primary outcome, as usual, was days until a negative PCR test. High dose ivermectin was 4.65 days, low dose was 6 days, control was 9.15, p = 0.035. Figure 2 is apparently a photograph of the computer screen where they did this calculation. Gideon Meyerowitz-Katz, part of the team that detects fraud in ivermectin papers, is not a fan of this one: He doesn’t say there what means, but elsewhere he tweets this figure: It’s always a bad sign when your study features in an image with “NUMEROUS IMPOSSIBLE NUMBERS” in red at the top. I think his point is that if you have 21 people, it’s impossible to have 50% of them have headache, because that would be 10.5. If 10 people have a headache, it would be 47.6%; if 11, 52%. So something is clearly wrong here. Seems like a relatively minor mistake, and Meyerowitz-Katz stops short of calling fraud, but it’s not a good look. I’m going to be slightly uncomfortable with this study without rejecting it entirely, and move on. Ravakirti et al: Here we’re in Eastern India - not exactly Bangladesh again, but a stone’s throw away from it. In this RCT patients were randomized into an ivermectin group (57) and a placebo group (58). Primary outcome was negative PCR on day 6, because doing it on day 7 like everyone else would be too easy. As with several other groups, this was a bad move; too few people had it to make a good comparison; it was 13% of intervention vs. 18% of placebo, p = 0.3. Secondary outcomes were also pretty boring, except for the most important: 4 people in the placebo group died, compared to 0 in ivermectin (p = 0.045). On the one hand, this is one outcome of many, reaching the barest significance threshold. Another fluke? Still, there are no real problems with this study, and nobody has anything to say against it. Let’s add this one to the scale as another very small and noisy piece of real evidence in ivermectin’s favor. Bukhari et al: Now we’re in Pakistan. 50 patients were randomized to low-dose ivermectin, another 50 got standard of care including vitamin D. There was no placebo, but primary outcome was number of days to reach negative PCR, which it seems hard for placebo to affect much, so I don’t care. 5 controls and 9 ivermectin patients left the hospital against medical advice and could not be followed up, which is bad but not necessarily study-ruining. They never measured their supposed primary outcome of “days to reach negative PCR” directly, but they did measure how many people had negative PCR on various days, and ivermectin had a clear advantage - for example, on day 7, it was 37/50 for IVR and only 20/50 for control. Even if we assume all the lost-to-followup patients had maximally bad-for-the-hypothesis results, that’s still a positive finding. Nobody else has much to say about this one, certainly no accusations that they’ve found anything suspicious. Keep. Mohan et al: India. RCT. 40 patients got low-dose ivermectin, 40 high-dose ivermectin, and 45 placebo. Primary outcomes were time to negative PCR, and viral load on day 5. In the results, they seem to have reinterpreted “time to negative PCR” as the subtly different “percent with negative PCR on some specific day”. High-dose ivermectin did best (47.5% negative on day 5) and placebo worst (31% negative), but it was insignificant (p = 0.3). There was no difference in viral load. All groups took about the same amount of time for symptoms to resolve. More placebo patients had failed to recover by the end of the study (6) than ivermectin patients (2), but this didn’t reach statistical significance (p = 0.4). Overall a well-done, boring, negative study, although ivermectin proponents will correctly point out that, like basically every other study we have looked at, the trend was in favor of ivermectin and this could potentially end up looking impressive in a meta-analysis. Biber et al: This is an RCT from Israel. 47 patients got ivermectin and 42 placebo. Primary endpoint was viral load on day 6. I am having trouble finding out what happened with this; as far as I can tell it was a negative result and they buried it in favor of more interesting things. In a "multivariable logistic regression model, the adjusted odds ratio of negative SARS-CoV-2 RT-PCR negative test" favored ivermectin over placebo (p = 0.03 for day 6, p = 0.01 for day 8), but this seems like the kind of thing you do when your primary outcome is boring and you’re angry. Gideon Meyerowitz-Katz is not a fan: He notes that the study excluded people with high viral load, but the preregistration didn’t say they would do that. Looking more closely, he finds they did that because, if you included these people, the study got no positive results. So probably they did the study, found no positive results, re-ran it with various subsets of patients until they did get a positive result, and then claimed to have “excluded” patients who weren’t in the subset that worked. I’m going to toss this one. Elalfy et al: What even is this? Where am I? As best I can tell, this is some kind of Egyptian trial. It might or might not be an RCT; it says stuff like “Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment”. Were they self-allocated in the sense that they got to choose? Doesn’t that mean it’s not random? Aren’t there seven days in a week? These are among the many questions that Elalfy et al do not answer for us. The control group (which they seem to think can also be called “the white group”) took zinc, paracetamol, and maybe azithromycin. The intervention group took zinc, nitazoxanide, ribavirin, and ivermectin. There were very large demographic differences between the groups of the sort which make the study unusable, which they mention and then ignore. From there, they follow this normal and totally comprehensible flowchart: There is no primary outcome assigned, but viral clearance rates on day seven were 58% in the yellow group compared to 0% in the white group, which I guess is a strong positive result. This table… …looks very impressive, in terms of the experimental group doing better than the control, except that they don’t specify whether it was before the trial or after it, and at least one online commentator thinks it might have been before, in which case it’s only impressive how thoroughly they failed to randomize their groups. Overall I don’t feel bad throwing this study out. I hope it one day succeeds in returning to its home planet. Lopez-Medina et al: Colombian RCT. 200 patients took ivermectin, another 200 took placebo. They originally worried the placebo might taste different than real ivermectin, then solved this by replacing it with a different placebo, which is a pretty high level of conscientiousness. Primary outcome was originally percent of patients whose symptoms worsened by two points, as rated on a complicated symptom scale when a researcher asked them over the phone. Halfway through the study, they realized nobody was worsening that much, so they changed the primary outcome to time until symptoms got better, as measured by the scale. In the ivermectin group, symptoms improved that much after 10 days; in the placebo group, after 12, p = 0.53. By the end of the study, symptoms had improved in 82% of ivermectin users and 79% of controls, also insignificant. 4 patients in the ivermectin group needed to be hospitalized compared to 6 in the placebo group, again insignificant. This study is bigger than most of the other RCTs, and more polished in terms of how many spelling errors, photographs of computer screens, etc, it contains. It was published in JAMA, one of the most prestigious US medical journals, as opposed to the crappy nth-tier journals most of the others have been in. When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. Ivermectin proponents make some good arguments against it. In order to get as big as it did, Lopez-Medina had to compromise on rigor. Its outcome is how people self-score their symptoms on a hokey scale in a phone interview, instead of viral load or PCR results or anything like that. Still, this is basically what we want, right? In the end, we want people to feel better and less sick, not to get good scores on PCR tests. Also, it changed its primary outcome halfway through; isn’t that bad? I think maybe not; the reason we want a preregistered primary outcome is so that you don’t change halfway through to whatever outcome shows the results you want. The researchers in this study did a good job explaining why they changed their outcome, the change makes sense, and their original outcome would also have shown ivermectin not working (albeit less accurately and effectively). I don’t know of any evidence that they knew (or suspected) final results when switching to this new outcome, and it seems like the most reasonable new outcome to switch to. Finally, their original placebo tasted different from ivermectin (though they switched halfway through). This is one of the few studies where I actually care about placebo, because people are self-rating their symptoms. But realistically most of these people don’t know what ivermectin is supposed to taste like. Also, they did a re-analysis and found there was no difference between the people who got the old placebo and the new one. I’m making a big deal of this because ivmmeta.com - the really impressive meta-analysis site I’ve been going off of - puts a special warning letter underneath their discussion of this study, urging us not to trust it. They don’t do this for any of the other ones we’ve addressed so far - not the one by the guy whose other studies were all frauds, not the one where 50% of 21 people had headaches, not the unrandomized one where the groups were completely different before the experiment started, not even the one by the guy accused of crimes against humanity. Only this one. This makes me a lot less charitable to ivmmeta than I would otherwise be; I think it’s hard to choose this particular warning letter strategy out of well-intentioned commitment to truth. They just really don’t like this big study that shows ivermectin doesn’t work. Also, the warning itself irritates me, and includes paragraphs like: RCTs have a fundamental bias against finding an effect for interventions that are widely available — patients that believe they need treatment are more likely to decline participation and take the intervention [Yeh], i.e., RCTs are more likely to enroll low-risk participants that do not need treatment to recover (this does not apply to the typical pharmaceutical trial of a new drug that is otherwise unavailable). This trial was run in a community where ivermectin was available OTC and very widely known and used. Nobody else worries about this, and there are a million biases that non-randomized studies have that would be super-relevant when discussing those, but somehow when they’re pro-ivermectin the site forgets to be this thorough. I think a better pro-ivermectin response to this study is to point out that all the trends support ivermectin. Symptoms took 10 days to resolve in the ivermectin group vs. 12 in placebo; 4 ivermectin patients were hospitalized vs. 6 placebo patients, etc. Just say that this was an unusually noisy trial because of the self-report methodology, and you’re confident that these small differences will add up to significance when you put them into a meta-analysis. Roy et al: We’re back in East India, and back to non-randomized trials. 56 patients were retrospectively examined; some had been given ivermectin + doxycycline, others hydroxychloroquine, other azithromycin, and others symptomatic treatment only. We don’t get any meaningful information about how this worked, but we are told that they did not differ in “clinical well-being reporting onset timing”. Whatever. Chahla et al: The first of many Argentine trials. 110 patients received medium-dose ivermectin; 144 were kept as a control (no placebo). This was “cluster randomized”, which means they randomize different health centers to either give the experimental drug or not. This is worse than regular randomization, because there could be differences between these health centers (eg one might have better doctors who otherwise give better treatment, one might be in the poor part of town and have sicker patients, etc). They checked to see if there were any differences between the groups, and it sure looks like there were (the experimental group had twice as many obese people as the controls), but as per them, these differences were not statistically significant. Note that if this did make a difference, it would presumably make ivermectin look worse, not better. The primary outcome was given as “increase discharge from outpatient care with COVID-19 mild disease”. This favored the treatment; only 2/110 patients in the ivermectin group failed to be discharged, compared to 20 patients in the control group. But, uh, these were at different medical centers. Can’t different medical centers just have different discharge policies? One discharges you as soon as you seem to be getting better, the other waits to really make sure? This is an utterly crap endpoint to do a cluster randomized controlled trial on. If you’re going to do cRCT, which is never a great idea, you should be using some extremely objective endpoint that doctors and clinic administrators can’t possibly affect, like viral load according to some third-party laboratory, using the same third-party laboratory for both clinics. This is such a bad idea that I can’t help worrying I’m missing or misunderstanding something. If not, this is dumb and bad and should be ignored. Mourya et al: We’re back in India. This is a nonrandomized study comparing 50 patients given ivermectin to 50 patients given hydroxychloroquine. No primary outcome was named, but they focus on PCR negativity. Only 6% of patients in the hydroxychloroquine group were negative, compared to 90% of patients in the ivermectin group! On what day did they do the test? Uh, kind of random, and they admit that “in [the hydroxychloroquine group], mean time difference from the date of initiation of treatment and second test was significantly longer (7.24±2.75 days) as compared to 5.22±1.21 days in [the ivermectin group] (p=0.021).” Since they assessed these groups at different times, we shouldn’t draw any conclusions from them getting different results. Except that as far as I can tell this should handicap ivermectin, making it especially impressive that it did better. But also, the ivermectin group was made mostly of people who had been asymptomatic at the beginning (70%), and the hydroxychloroquine group had almost no asymptomatic cases (8%) . They were giving the ivermectin to healthy people and the hydroxychloroquine to sick people! They admit deep in the discussion that this “may be a confounding factor”. So basically they got totally different groups of people, tested them at totally different times, and the two sets of test results differed. So what? So this is why normal people do RCTs instead of whatever the heck this is, that’s what. Loue et al: …this one isn’t going to be an RCT either. Loue tells a story about a cluster of COVID cases at the French nursing home where he works. He asked people if they wanted to try ivermectin; 10 did and 15 didn’t. 1 ivermectin patient died, compared to 5 non-ivermectin patients. The non-ivermectin group looked a bit sicker than the ivermectin group in the inevitable Table 1, though it’s hard to tell. One interesting possible confounder (not mentioned, but I’m imagining it) is that demented patients probably couldn’t consent to ivermectin and ended up in the control group. This is another case of “I’m not going to trust anything that isn’t an RCT”. Merino et al: Another (sigh) non-RCT. Mexico City tried a public health program where if you called a hotline and said you had COVID, they sent you an emergency kit with various useful supplies. One of those supplies was ivermectin tablets. 18,074 people got the kit (and presumably some appreciable fraction took the ivermectin, though there’s no way to prove that). Their control group is people from before they started giving out the kits, people from after they stopped giving out the kits, and people who didn’t want the kits. There are differences in who got COVID early in the epidemic vs. later, and in people who did opt for medical kits vs. didn’t. To correct these, the researchers tried to adjust for confounders, something which - as I keep trying to hammer home again and again - never works. They found that using the kit led to a 75% or so reduction in hospitalization, though they were unable to separate out the ivermectin from the other things in the kit (paracetamol and aspirin), or from the placebo effect of having a kit and feeling like you had already gotten some treatment (if I understand right, the decision to go to the hospital was left entirely to the patient). I think this study is a moderate point in favor of giving people kits in order to prevent hospital overcrowding, but I’m not willing to accept that it tells us much about ivermectin in particular. Faisal et al: This one was published in The Professional Medical Journal (mispelled as “Profesional Medical Journal” in its URL), so you know it’s going to be good! It describes itself as “a cross-sectional study”, but later says it “randomized patients into two groups”, which would make it an RCT - I think they might just be using the term “cross-sectional” different from the standard American usage. A hospital in Pakistan got 50 patients on ivermectin + azithromycin, and another 50 on azithromycin alone. Primary outcome was not mentioned, and the data were presented confusingly, but a typical result is that only 4% of the ivermectin group had symptoms lasting more than 10 days, whereas 16% of the control group did, p < 0.01. They do a really weird thing where they compare how long it took symptoms to resolve between IVM and control groups within each bin. That is, if I’m understanding correctly, they ask “of the people who took between 3-5 days for symptoms to resolve, did they resolve faster for IVM or control?”. This is an utterly bizarre analysis to perform, although it doesn’t affect the fact that their other results still seem to favor ivermectin. Maybe I’m confused about what’s going on here. I’ve mostly been letting people off easy on no placebo, but I as far as I can tell (not very far) this paper seems to be going off whether patients reported continuing to have symptoms to the hospital doing the study, and I think that is potentially susceptible to placebo effects. Additionally, there’s no preregistration, and even though they talk a lot about doing PCR tests they don’t present the results. This is by no means the worst study here but I still think it’s pretty low quality and I don’t trust it. Aref et al: This one is published in the International Journal Of Nanomedicine, even though I’m pretty sure that isn’t a real thing. In this case the “nanomedicine” is a new nasal spray version of ivermectin which is so confusing I cannot for the life of me figure out what dose they are giving these patients. This Egyptian study gives 57 patients intranasal ivermectin plus hydroxychloroquine, azithromycin, oseltamavir, and some vitamins; another 57 patients get all that stuff except the ivermectin. Primary outcome is not stated, but they look at various symptoms, all of which look better in the ivermectin group: 95% of ivermectin patients got negative PCRs at some time point, compared to 75% of controls, p = 0.004. I am pretty suspicious of this study, not least because it comes from Egypt which has an awful reputation for fake studies, and it returns extreme results that I wouldn’t expect even if ivermectin was actually a wonder drug. But I cannot find any particular thing wrong with it, nor did anyone else I looked at, so I will grudgingly let it stand. Krolewiecki et al: Another Argentine study. This one is a real RCT. 30 patients received ivermectin, 15 were the control group (no placebo, again). Primary outcome was difference in viral load on day 5. The trend favored ivermectin but it was not statistically significant, although they were able to make it statistically significant if they looked at a subset of higher-IVM-plasma-concentration patients. They did not find any difference in clinical outcomes. A pro-ivermectin person could point out that in the subgroup with the highest ivermectin concentrations, the drug seemed to work. A skeptic could point out that this is exactly the kind of subgroup slicing that you are not supposed to do without pre-registering it, which I don’t think this team did. I agree with the skeptic. Vallejos et al: Another Argentine study. It’s big (250 people in each arm). It’s an RCT. It tries to define a primary outcome (“Primary outcome: the trial ended when the last patient who was included achieved the end of study visit”), but that’s not what “primary outcome” means, and they don’t offer an alternative. Other outcomes: no difference in PCR on days 3 or 12. Hospitalization is nonsignificantly better in the ivermectin group (14 vs. 21, p = 0.2), but death is nonsigificantly better in the placebo group (3 vs. 4, p = 0.7). This isn’t even the kind of nonsignificant that might contribute to an exciting meta-analysis later. This is just a pure null result. I cannot find any problem with this study, and neither can anyone else I checked. This is the biggest RCT we’ve seen so far, so we should take it seriously. TOGETHER Trial: Speaking of big RCTs… This one hasn’t been published yet. There’s a video of a talk about it, but I am not going to watch it, because it is a video, so I am getting information secondhand from eg here. Apparently, it compares 677 people (!) randomized to ivermectin to 678 people randomized to placebo. 86 ivermectin patients ended up in the hospital compared to 95 placebo patients, p-value not significant. This was a really big professional trial done by bigshot researchers from a major Canadian university, and the medical establishment is taking it much more seriously than any of these others. When it comes out, it will probably get published in a top journal. When discussing Lopez-Medina, I wrote: When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. This is the other one. Not coincidentally, it’s also the other trial that ivmmeta.com has a warning letter underneath telling you to disregard. Their main concern is that instead of truly randomizing patients to ivermectin vs. placebo, they did a time-dependent randomization that meant during some weeks more patients were getting one or the other. This is a problem because the trial takes place in Brazil, where different variants were more common at different times. Here’s their image: On the one hand, I have immense contempt for ivmmeta for letting all those other awful studies pass and then pulling out all the stops to try to nitpick this one. I have no idea if their proposed randomization failure really happened. And no doubt the reason they’re even able to investigate this is that this study is really careful and transparent - most of them don’t tell you anything about their randomization method. I would be shocked if other studies don’t have all these problems and worse. On the other hand, the point isn’t to be fair, it’s to be right. And this is a potential confounder. Not a huge one. But a potential one. I guess all we can do is try to bound the damage. Even if the confounding is 100% real and bad, there’s no way to make this study consistent with the crazy super-pro-ivermectin results of studies like Espitia-Hernandez and Aref. And even if we deny any confounding, we see the same slight pro-ivermectin trend - 86 hospitalizations vs. 95 - that we’ve seen in so many other studies. Nothing is going to make me believe that this isn’t in the top 33% of studies we’ve been looking at, so let’s add it as grist for the meta-analysis (though maybe not quite as much grist as its vast size indicates) and move on, angrily. Buonfrate et al: An Italian RCT. Patients were randomized into low-dose ivermectin (32), placebo (29), or high-dose ivermectin (32). Primary outcome was viral load on day 7. There was no significant difference (average of 2 in ivermectin groups, 2.2 in placebo group). They admit that they failed to reach the planned sample size, but did a calculation to show that even if they had, the trial could not have returned a positive result. Clinically, an average of 2 patients were hospitalized in each of the ivermectin arms, compared to 0 in the placebo arm - which bucks our previously-very-constant pro-ivermectin trend. Mayer et al: Not an RCT. Patients in an Argentine province were offered the opportunity to try ivermectin; 3266 said yes and become the experimental group, 17966 said no and became the control group. There were many obvious differences between the groups, but they all seemed to handicap ivermectin. There was a nonsignificant trend toward less hospitalization and significantly less mortality (1.5% vs. 2.1%, p = 0.03). While looking into this study, I learned the term “immortal time bias”. This means a period in between selection for the study and the beginning of study recording where patient outcomes are not counted. I think the problem here is that if you signed up for the system on Day X, and if you got sick before they could give you ivermectin, you were in the control group. See this Twitter thread, I have not confirmed everything he says. This only hardens my resolve to stay away from non-RCTs. Borody et al: Our last paper! …is it a paper? I can’t find it published anywhere. It mostly seems to be on news sites. Doesn’t look peer-reviewed. And it starts with “Note that views expressed in this opinion article are the writer’s personal views”. Whatever. 600 Australians were treated with ivermectin, doxycycline, and zinc. The article compares this to an “equivalent control group” made of “contemporary infected subjects in Australia obtained from published Covid Tracking Data”; this is not how you control group, @#!% you. Then it gets excited about the fact that most patients had better symptoms at the end of the ten-day study period than the beginning (untreated COVID resolves in about ten days). Why are these people wasting my time with this? Let’s move on. The Analysis If we remove all fraudulent and methodologically unsound studies from the table above, we end up with this: Gideon Meyerowitz-Katz, who investigated many of the studies above for fraud, tried a similar exercise. I learned about his halfway through, couldn’t help seeing it briefly, but tried to avoid remembering it or using it when generating mine (also, I did take the result of his fraud investigations into account), so they should be considered not quite independent efforts. His looks like this: He nixed Chowdhury, Babaloba, Ghauri, Faisal, and Aref, but kept Szenta Fonseca, Biber (?), and Mayer. There was correlation of 0.45, which I guess is okay. I asked him about his decision-making, and he listed a combination of serious statistical errors and small red flags adding up. I was pretty uncomfortable with most of these studies myself, so I will err on the side of severity, and remove all studies that either I or Meyerowitz-Katz disliked. We end up with the following short list: We’ve gone from 29 studies to 11, getting rid of 18 along the way. For the record, we eliminated 2/19 for fraud, 1/19 for severe preregistration violations, 10 for methodological problems, and 6 because Meyerowitz-Katz was suspicious of them. …but honestly this table still looks pretty good for ivermectin, doesn’t it? Still lots of big green boxes. Meyerowitz-Katz accuses ivmmeta of cherry-picking what statistic to use for their forest plot. That is, if a study measures ten outcomes, they sometimes take the most pro-ivermectin outcome. Ivmmeta.com counters that they used a consistent and reasonable (if complicated) process for choosing their outcome of focus, that being: If studies report multiple kinds of effects then the most serious outcome is used in calculations for that study. For example, if effects for mortality and cases are both reported, the effect for mortality is used, this may be different to the effect that a study focused on. If symptomatic results are reported at multiple times, we used the latest time, for example if mortality results are provided at 14 days and 28 days, the results at 28 days are used. Mortality alone is preferred over combined outcomes. Outcomes with zero events in both arms were not used (the next most serious outcome is used — no studies were excluded). For example, in low-risk populations with no mortality, a reduction in mortality with treatment is not possible, however a reduction in hospitalization, for example, is still valuable. Clinical outcome is considered more important than PCR testing status. When basically all patients recover in both treatment and control groups, preference for viral clearance and recovery is given to results mid-recovery where available (after most or all patients have recovered there is no room for an effective treatment to do better). If only individual symptom data is available, the most serious symptom has priority, for example difficulty breathing or low SpO2 is more important than cough. I’m having trouble judging this, partly because Meyerowitz-Katz says ivmmeta has corrected some earlier mistakes, and partly because there really is some reasonable debate over how to judge studies with lots of complicated endpoints. By this point I had completely forgotten what ivmmeta did, so I independently coded all 11 remaining studies following something in between my best understanding of their procedure and what I considered common sense. The only exception was that when the most severe outcome was measured in something other than patients (ie average number of virus copies per patient), I defaulted to one that was measured in patients instead, to keep everything with the same denominator. My results mostly matched ivmmeta’s, with one or two exceptions that I think are within the scope of argument or related to my minor deviations from their protocol. Placebo vs. ivermectin groups sometimes differed in size, which I’ve adjusted for and rounded off. Probably I’m forgetting some reason I can’t just do simple summary statistics to this, but whatever. It is p = 0.15, not significant. This is maybe unfair, because there aren’t a lot of deaths in the sample, so by focusing on death rather than more common outcomes we’re pointlessly throwing away sample size. What happens if I unprincipledly pick whatever I think the most reasonable outcome to use from each study is? I’ve chosen “most reasonable” as a balance between “is the most severe” and “has a lot of data points”: Now it’s p = 0.04, seemingly significant, but I had to make some unprincipled decisions to get there. I don’t think I specifically replaced negative findings with positive ones, but I can’t prove that even to myself, let alone to you. [UPDATE 5/31/22: A reader writes in to tell me that the t-test I used above is overly simplistic. A Dersimonian-Laird test is more appropriate for meta-analysis, and would have given 0.03 and 0.005 on the first and second analysis, where I got 0.15 and 0.04. This significantly strengthens the apparent benefit of ivermectin from ‘debatable’ to ‘clear’. I discuss some reasons below why I am not convinced by this apparent benefit.] (how come I’m finding a bunch of things on the edge of significance, but the original ivmmeta site found a lot of extremely significant things? Because they combined ratios, such that “one death in placebo, zero in ivermectin” looked like a nigh-infinite benefit for ivermectin, whereas I’m combining raw numbers. Possibly my way is statistically illegitimate for some reason, but I’m just trying to get a rough estimate of how convinced to be) So we are stuck somewhere between “nonsignificant trend in favor” and “maybe-significant trend in favor, after throwing out some best practices”. This is normally where I would compare my results to those of other meta-analyses made by real professionals. But when I look at them, they all include studies later found to be fake, like Elgazzar, and unsurprisingly come up with wildly positive conclusions. There are about six in this category. One of them later revised their results to exclude Elgazzar and still found strong efficacy for ivermectin, but they still included Niaee and some other dubious studies. The only meta-analysis that doesn’t make these mistakes is Popp (a Cochrane review), which is from before Elgazzar was found to be fraudulent, but coincidentally excludes it for other reasons. It also excludes a lot of good studies like Mahmud and Ravakirti because they give patients other things like HCQ and azithromycin - I chose to include them, because I don’t think they either work or have especially bad side effects, so they’re basically placebo - but Cochrane is always harsh like this. They end up with a point estimate where ivermectin cuts mortality by 40% - but say the confidence intervals are too wide to draw any conclusion. I think this basically agrees with my analyses above - the trends really are in ivermectin’s favor, but once you eliminate all the questionable studies there are too few studies left to have enough statistical power to reach significance. Except that everyone is still focusing on deaths and hospitalizations just because they’re flashy. Mahmud et al, which everyone agrees is a great study, found that ivermectin decreased days until clinical recovery, p = 0.003? So what do you do? This is one of the toughest questions in medicine. It comes up again and again. You have some drug. You read some studies. Again and again, more people are surviving (or avoiding complications) when they get the drug. It’s a pattern strong enough to common-sensically notice. But there isn’t an undeniable, unbreachable fortress of evidence. The drug is really safe and doesn’t have a lot of side effects. So do you give it to your patients? Do you take it yourself? Here this question is especially tough, because, uh, if you say anything in favor of ivermectin you will be cast out of civilization and thrown into the circle of social hell reserved for Klan members and 1/6 insurrectionists. All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele. But good doctors aren’t supposed to care about such things. Your only goal is to save your patient. Nothing else matters. I am telling you that Mahmud et al is a good study and it got p = 0.003 in favor of ivermectin. You can take the blue pill, and stay a decent respectable member of society. Or you can take the horse dewormer pill, and see where you end up. In a second, I’ll tell you my answer. But you won’t always have me to answer questions like this, and it might be morally edifying to observe your thought process in situations like this. So take a second, and meet me on the other side of the next section heading. … … … … … The Synthesis Hopefully you learned something interesting about yourself there. But my answer is: worms! As several doctors and researchers have pointed out (h/t especially Avi Bitterman and David Boulware), the most impressive studies come from places that are teeming with worms. Mahmud from Bangladesh, Ravakirti from East India, Lopez-Medina from Colombia, etc. Here’s the prevalence of roundworm infections by country (source). But alongside roundworms, there are threadworms, hookworms, blood flukes, liver flukes, nematodes, trematodes, all sorts of worms. Add them all up and somewhere between half and a quarter of people in the developing world have at least one parasitic worm in their body. Being full of worms may impact your ability to fight coronavirus. Gluchowska et al write: Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases. Treatment of worm infections might reduce the negative effect of COVID-19! And ivermectin is a deworming drug! You can see where this is going… The most relevant species of worm here is the roundworm Strongyloides stercoralis. Among the commonest treatments for COVID-19 is corticosteroids, a type of immunosuppresant drug. The types of immune responses it suppresses do more harm than good in coronavirus, so turning them off limits collateral damage and makes patients better on net. But these are also the types of immune responses that control Strongyloides. If you turn them off even very briefly, the worms multiply out of control, you get what’s called “Strongyloides hyperinfection”, and pretty often you die. According to the WHO: The current COVID-19 pandemic serves to highlight the risk of using systemic corticosteroids and, to a lesser extent, other immunosuppressive therapy, in populations with significant risk of underlying strongyloidiasis. Cases of strongyloidiasis hyperinfection in the setting of corticosteroid use as COVID-19 therapy have been described and draw attention to the necessity of addressing the risk of iatrogenic strongyloidiasis hyperinfection syndrome in infected individuals prior to corticosteroid administration. Although this has gained importance in the midst of a pandemic where corticosteroids are one of few therapies shown to improve mortality, its relevance is much broader given that corticosteroids and other immunosuppressive therapies have become increasingly common in treatment of chronic diseases (e.g. asthma or certain rheumatologic conditions). So you need to “address the risk” of strongyloides infection during COVID treatment in roundworm-endemic areas. And how might you address this, WHO? Treatment of chronic strongyloidiasis with ivermectin 200 µg/kg per day orally x 1-2 days is considered safe with potential contraindications including possible Loa loa infection (endemic in West and Central Africa), pregnancy, and weight <15kg. Given ivermectin’s safety profile, the United States has utilized presumptive treatment with ivermectin for strongyloidiasis in refugees resettling from endemic areas, and both Canada and the European Centre for Disease Prevention and Control have issued guidance on presumptive treatment to avoid hyperinfection in at risk populations. Screening and treatment, or where not available, addition of ivermectin to mass drug administration programs should be studied and considered. This is serious and common enough that, if you’re not going to screen for it, it might be worth “add[ing] ivermectin to mass drug administration programs” in affected areas! Dr. Avi Bitterman carries the hypothesis to the finish line: First two images are with all relevant studies; second two are a sensitivity analysis that removes some of the most dubious. The good ivermectin trials in areas with low Strongyloides prevalence, like Vallejos in Argentina, are mostly negative. The good ivermectin trials in areas with high Strongyloides prevalence, like Mahmud in Bangladesh, are mostly positive. Worms can’t explain the viral positivity outcomes (ie PCR), but Dr. Bitterman suggests that once you remove low quality trials and worm-related results, the rest looks like simple publication bias: This is still just a possibility. Maybe I’m over-focusing too hard on a couple positive results and this will all turn out to be nothing. Or who knows, maybe ivermectin does work against COVID a little - although it would have to be very little, fading to not at all in temperate worm-free countries. But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong! The people who called it a miracle drug against COVID were wrong. The people who dismissed all the studies because they F@#king Love Science were wrong. Ivmmeta.com was wrong. Gideon Meyerowitz-Katz was…well, he was right, actually, I got the worm-related meta-analysis graphic above from his Twitter timeline. Still, an excellent troll. Also, the best part is that I ignorantly asked, in my description of Mahmud et al above: And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true! The Scientific Takeaway About ten years ago, when the replication crisis started, we learned a certain set of tools for examining studies. Check for selection bias. Distrust “adjusting for confounders”. Check for p-hacking and forking paths. Make teams preregister their analyses. Do forest plots to find publication bias. Stop accepting p-values of 0.049. Wait for replications. Trust reviews and meta-analyses, instead of individual small studies. These were good tools. Having them was infinitely better than not having them. But even in 2014, I was writing about how many bad studies seemed to slip through the cracks even when we pushed this toolbox to its limits. We needed new tools. I think the methods that Meyerowitz-Katz, Sheldrake, Heathers, Brown, Lawrence and others brought to the limelight this year are some of the new tools we were waiting for. Part of this new toolset is to check for fraud. About 10 - 15% of the seemingly-good studies on ivermectin ended up extremely suspicious for fraud. Elgazzar, Carvallo, Niaee, Cadegiani, Samaha. There are ways to check for this even when you don’t have the raw data. Like: The Carlisle-Stouffer-Fisher method: Check some large group of comparisons, usually the Table 1 of an RCT where they compare the demographic characteristics of the control and experimental groups, for reasonable p-values. Real data will have p-values all over the map; one in every ten comparisons will have a p-value of 0.1 or less. Fakers seem bad at this and usually give everything a nice safe p-value like 0.8 or 0.9.
Okay, fine, they misspelled “recovery” once. But they spelled it right the other time! That puts it in the top 50% for ivermectin papers! The fraud-hunters have examined this paper closely and are unable to find any signs of fraud. @PubPeer on the Mahmud trial of ivermectin in covid patients.\n\nI have now reviewed the individual patient data master sheet.\n\nI did not find any irregularities and the summary data matches the published data.\n\n","username":"K_Sheldrick","name":"Kyle Sheldrick","profile_image_url":"","date":"Sat Jul 17 11:06:25 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":12,"impression_count":0,"expanded_url":{"url":"https://pubpeer.com/publications/E1D65711EF28D14517731BEACB89C8#2","title":"PubPeer - Ivermectin in combination with doxycycline for treating COVI...","description":"There are comments on PubPeer for publication: Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial (2021)","domain":"pubpeer.com"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> I think this paper is legitimate and that its findings need to be seriously considered. Serious consideration doesn’t always meant they’re true - sometimes if we have strong evidence otherwise we can dismiss things without understanding why. And there’s always the chance it was a fluke, right? Can something have a p-value less than 0.001 and still be a fluke? Szenta Fonseca et al: This is a chart review from Brazil. Researchers looked at various people who had been treated for COVID in an insurance company database, saw whether they got ivermectin or not, and saw whether the people who got it did better or worse. About a hundred people got it, and a few hundred others didn’t. The people who got it did not do any better than anyone else, and you’ll notice this is one of the rare red boxes on the table above. But we shouldn’t take this study seriously. Nobody took any effort to avoid selection bias, so it’s very possible that sicker people were given more medication (including ivermectin), which unfairly handicaps the ivermectin group. Also, it’s hard to tell from the paper who was on how much of what, and the discussion of ivermectin seems like kind of an afterthought after discussing lots of other meds in much more depth. This is another one I feel comfortable ignoring. Cadegiani et al: A crazy person decided to put his patients on every weird medication he could think of, and 585 subjects ended up on a combination of ivermectin, hydroxychloroquine, azithromycin, and nitazoxanide, with dutasteride and spironolactone "optionally offered" and vitamin D, vitamin C, zinc, apixaban, rivaraxoban, enoxaparin, and glucocorticoids "added according to clinical judgment". There was no control group, but the author helpfully designated some random patients in his area as a sort-of-control, and then synthetically generated a second control group based on “a precise estimative based on a thorough and structured review of articles indexed in PubMed and MEDLINE and statements by official government agencies and specific medical societies”. Patients in the experimental group were twice as likely to recover (p < 0.0001), had negative PCR after 14 vs. 21 days, and had 0 vs. 27 hospitalizations. Speaking of low p-values, some people did fraud-detection tests on another of Cadegiani’s COVID-19 studies and got values like p < 8.24E-11 in favor of it being fraudulent. And, uh, he’s also studied whether ultra-high-dose antiandrogens treated COVID, and found that they did, cutting mortality by 92% . But the trial is under suspicion, with a BMJ article calling it “[the worst] violations of medical ethics and human rights in Brazil’s history” and “an ethical cesspit of violations”. [update 2022: this section originally contained more accusations against Cadegiani. Alexandros Marinos does a deeper dive with information not available at the time I wrote this, and finds some of them were overstated or false by implication] Anyway, let’s not base anything important on the results of this study, mmkay? A defiant Flavio Cadegiani. Imagine a guy who looks like this telling you to take ultra-high-dose antiandrogens. Ahmed et al: And we’re back in Bangladesh. 72 hospital patients were randomized to one of three arms: ivermectin only, ivermectin + doxycycline, and placebo. Primary endpoint was time to negative PCR, which was 9.7 days for ivermectin only and 12.7 days for placebo (p = 0.03). Other endpoints including duration of hospitalization (9.6 days ivermectin vs. 9.7 days placebo, not significant). This looks pretty good for ivermectin and does not have any signs of fraud or methodological problems. If I wanted to pick at it anyway, I would point out that the ivermectin + doxycycline group didn’t really differ from placebo, and that if you average out both ivermectin groups (with and without doxycycline) it looks like the difference would not be significant. I had previously committed to considering only ivermectin alone in trials that had multiple ivermectin groups, so I’m not going to do this. I can’t find any evidence this trial was preregistered so I don’t know whether they waited to see what would come out positive and then made that their primary endpoint, but virological clearance is a pretty normal primary endpoint and this isn’t that suspicious. It’s impossible to find any useful commentary on this study because Elgazzar (the guy who ran the most famous fraudulent ivermectin study) had the first name Ahmed, everyone is talking about Elgazzar all the time, and this overwhelms Google whenever I try to search for Ahmed et al. For now I’ll just keep this as a mildly positive and mildly plausible virological clearance result, in the context of no effect on hospitalization length or most symptoms. Chaccour et al: 24 patients in Spain were randomized to receive either medium-dose ivermectin or placebo. The primary outcome was percent of patients with negative PCR at day 7; secondary outcomes were viral load and symptoms. The primary endpoint ended up being kind of a wash - everyone still PCR positive by day 7 so it was impossible to compare groups. Ivermectin trended toward lower viral load but never reached significance. Weirdly, ivermectin did seem to help symptoms, but only anosmia and cough towards the end (p = 0.03), which you would usually think of as lingering post-COVID problems. The paper says: Given these findings, consideration could be given to alternative mechanisms of action different from a direct antiviral effect. One alternative explanation might be a positive allosteric modulation of the nicotinic acetylcholine receptor caused by ivermectin and leading to a downregulation of the ACE-2 receptor and viral entry into the cells of the respiratory epithelium and olfactory bulb. Another mechanism through which ivermectin might influence the reversal of anosmia is by inhibiting the activation of pro-inflammatory pathways in the olfactory epithelium. Inflammation of the olfactory mucosa is thought to play a key role in the development of anosmia in SARS-CoV-2 infection This seems kind of hedge-y. If you’re wondering where things went from there, Dr. Chaccour is now a passionate anti-ivermectin activist: @Finneganporter in @BusinessInsider \n\nThe roots of #ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm\n\n","username":"carlos_chaccour","name":"Dr. Carlos Chaccour ??????","profile_image_url":"","date":"Sun Nov 07 18:40:28 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":9,"impression_count":0,"expanded_url":{"url":"https://www.businessinsider.in/international/news/the-roots-of-ivermectin-mania-how-south-america-incubated-a-fake-medicine-craze-that-took-the-us-by-storm/articleshow/87554081.cms","image":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/88d08e70-c9e2-46d4-a5df-96807b6c3a13_2000x1000.jpeg","title":"The roots of ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm","description":"The popularity of unproven anti-parasitic drug ivermectin as a COVID-19 treatment is surging. Its use has roots in South America, where it was hyped by populist","domain":"businessinsider.in"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> So I guess he must think of this trial as basically negative, although realistically it’s 24 people and we shouldn’t put too much weight on it either way. Ghauri et al: Pakistan, 95 patients. Nonrandom; the study compared patients who happened to be given ivermectin (along with hydroxychloroquine and azithromycin) vs. patients who were just given the latter two drugs. There’s some evidence this produced systematic differences between the two groups - for example, patients in the control group were 3x more likely to have had diarrhea (this makes sense; diarrhea is a potential ivermectin side effect, so you probably wouldn’t give it to people already struggling with this problem). Also, the control group was twice as likely to be getting corticosteroids, maybe a marker for illness severity. Primary outcome was what percent of both groups had a fever: on day 7 it was 21% of ivermectin patients vs. 65% of controls, p < 0.001. No other outcomes were reported. I don’t hate this study, but I think the nonrandom assignment (and observed systematic differences) is a pretty fatal flaw. I can’t find anyone else talking about this one. At least no one seems to be saying anything bad. Babaloba et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakoloko”, because that’s really fun to say. This was a Nigerian RCT comparing 21 patients on low-dose ivermectin, 21 patients on high-dose ivermectin, and 20 patients on a combination of lopinavir and ritonavir, a combination antiviral which later studies found not to work for COVID and which might as well be considered a placebo. Primary outcome, as usual, was days until a negative PCR test. High dose ivermectin was 4.65 days, low dose was 6 days, control was 9.15, p = 0.035. Figure 2 is apparently a photograph of the computer screen where they did this calculation. Gideon Meyerowitz-Katz, part of the team that detects fraud in ivermectin papers, is not a fan of this one: He doesn’t say there what means, but elsewhere he tweets this figure: It’s always a bad sign when your study features in an image with “NUMEROUS IMPOSSIBLE NUMBERS” in red at the top. I think his point is that if you have 21 people, it’s impossible to have 50% of them have headache, because that would be 10.5. If 10 people have a headache, it would be 47.6%; if 11, 52%. So something is clearly wrong here. Seems like a relatively minor mistake, and Meyerowitz-Katz stops short of calling fraud, but it’s not a good look. I’m going to be slightly uncomfortable with this study without rejecting it entirely, and move on. Ravakirti et al: Here we’re in Eastern India - not exactly Bangladesh again, but a stone’s throw away from it. In this RCT patients were randomized into an ivermectin group (57) and a placebo group (58). Primary outcome was negative PCR on day 6, because doing it on day 7 like everyone else would be too easy. As with several other groups, this was a bad move; too few people had it to make a good comparison; it was 13% of intervention vs. 18% of placebo, p = 0.3. Secondary outcomes were also pretty boring, except for the most important: 4 people in the placebo group died, compared to 0 in ivermectin (p = 0.045). On the one hand, this is one outcome of many, reaching the barest significance threshold. Another fluke? Still, there are no real problems with this study, and nobody has anything to say against it. Let’s add this one to the scale as another very small and noisy piece of real evidence in ivermectin’s favor. Bukhari et al: Now we’re in Pakistan. 50 patients were randomized to low-dose ivermectin, another 50 got standard of care including vitamin D. There was no placebo, but primary outcome was number of days to reach negative PCR, which it seems hard for placebo to affect much, so I don’t care. 5 controls and 9 ivermectin patients left the hospital against medical advice and could not be followed up, which is bad but not necessarily study-ruining. They never measured their supposed primary outcome of “days to reach negative PCR” directly, but they did measure how many people had negative PCR on various days, and ivermectin had a clear advantage - for example, on day 7, it was 37/50 for IVR and only 20/50 for control. Even if we assume all the lost-to-followup patients had maximally bad-for-the-hypothesis results, that’s still a positive finding. Nobody else has much to say about this one, certainly no accusations that they’ve found anything suspicious. Keep. Mohan et al: India. RCT. 40 patients got low-dose ivermectin, 40 high-dose ivermectin, and 45 placebo. Primary outcomes were time to negative PCR, and viral load on day 5. In the results, they seem to have reinterpreted “time to negative PCR” as the subtly different “percent with negative PCR on some specific day”. High-dose ivermectin did best (47.5% negative on day 5) and placebo worst (31% negative), but it was insignificant (p = 0.3). There was no difference in viral load. All groups took about the same amount of time for symptoms to resolve. More placebo patients had failed to recover by the end of the study (6) than ivermectin patients (2), but this didn’t reach statistical significance (p = 0.4). Overall a well-done, boring, negative study, although ivermectin proponents will correctly point out that, like basically every other study we have looked at, the trend was in favor of ivermectin and this could potentially end up looking impressive in a meta-analysis. Biber et al: This is an RCT from Israel. 47 patients got ivermectin and 42 placebo. Primary endpoint was viral load on day 6. I am having trouble finding out what happened with this; as far as I can tell it was a negative result and they buried it in favor of more interesting things. In a "multivariable logistic regression model, the adjusted odds ratio of negative SARS-CoV-2 RT-PCR negative test" favored ivermectin over placebo (p = 0.03 for day 6, p = 0.01 for day 8), but this seems like the kind of thing you do when your primary outcome is boring and you’re angry. Gideon Meyerowitz-Katz is not a fan: He notes that the study excluded people with high viral load, but the preregistration didn’t say they would do that. Looking more closely, he finds they did that because, if you included these people, the study got no positive results. So probably they did the study, found no positive results, re-ran it with various subsets of patients until they did get a positive result, and then claimed to have “excluded” patients who weren’t in the subset that worked. I’m going to toss this one. Elalfy et al: What even is this? Where am I? As best I can tell, this is some kind of Egyptian trial. It might or might not be an RCT; it says stuff like “Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment”. Were they self-allocated in the sense that they got to choose? Doesn’t that mean it’s not random? Aren’t there seven days in a week? These are among the many questions that Elalfy et al do not answer for us. The control group (which they seem to think can also be called “the white group”) took zinc, paracetamol, and maybe azithromycin. The intervention group took zinc, nitazoxanide, ribavirin, and ivermectin. There were very large demographic differences between the groups of the sort which make the study unusable, which they mention and then ignore. From there, they follow this normal and totally comprehensible flowchart: There is no primary outcome assigned, but viral clearance rates on day seven were 58% in the yellow group compared to 0% in the white group, which I guess is a strong positive result. This table… …looks very impressive, in terms of the experimental group doing better than the control, except that they don’t specify whether it was before the trial or after it, and at least one online commentator thinks it might have been before, in which case it’s only impressive how thoroughly they failed to randomize their groups. Overall I don’t feel bad throwing this study out. I hope it one day succeeds in returning to its home planet. Lopez-Medina et al: Colombian RCT. 200 patients took ivermectin, another 200 took placebo. They originally worried the placebo might taste different than real ivermectin, then solved this by replacing it with a different placebo, which is a pretty high level of conscientiousness. Primary outcome was originally percent of patients whose symptoms worsened by two points, as rated on a complicated symptom scale when a researcher asked them over the phone. Halfway through the study, they realized nobody was worsening that much, so they changed the primary outcome to time until symptoms got better, as measured by the scale. In the ivermectin group, symptoms improved that much after 10 days; in the placebo group, after 12, p = 0.53. By the end of the study, symptoms had improved in 82% of ivermectin users and 79% of controls, also insignificant. 4 patients in the ivermectin group needed to be hospitalized compared to 6 in the placebo group, again insignificant. This study is bigger than most of the other RCTs, and more polished in terms of how many spelling errors, photographs of computer screens, etc, it contains. It was published in JAMA, one of the most prestigious US medical journals, as opposed to the crappy nth-tier journals most of the others have been in. When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. Ivermectin proponents make some good arguments against it. In order to get as big as it did, Lopez-Medina had to compromise on rigor. Its outcome is how people self-score their symptoms on a hokey scale in a phone interview, instead of viral load or PCR results or anything like that. Still, this is basically what we want, right? In the end, we want people to feel better and less sick, not to get good scores on PCR tests. Also, it changed its primary outcome halfway through; isn’t that bad? I think maybe not; the reason we want a preregistered primary outcome is so that you don’t change halfway through to whatever outcome shows the results you want. The researchers in this study did a good job explaining why they changed their outcome, the change makes sense, and their original outcome would also have shown ivermectin not working (albeit less accurately and effectively). I don’t know of any evidence that they knew (or suspected) final results when switching to this new outcome, and it seems like the most reasonable new outcome to switch to. Finally, their original placebo tasted different from ivermectin (though they switched halfway through). This is one of the few studies where I actually care about placebo, because people are self-rating their symptoms. But realistically most of these people don’t know what ivermectin is supposed to taste like. Also, they did a re-analysis and found there was no difference between the people who got the old placebo and the new one. I’m making a big deal of this because ivmmeta.com - the really impressive meta-analysis site I’ve been going off of - puts a special warning letter underneath their discussion of this study, urging us not to trust it. They don’t do this for any of the other ones we’ve addressed so far - not the one by the guy whose other studies were all frauds, not the one where 50% of 21 people had headaches, not the unrandomized one where the groups were completely different before the experiment started, not even the one by the guy accused of crimes against humanity. Only this one. This makes me a lot less charitable to ivmmeta than I would otherwise be; I think it’s hard to choose this particular warning letter strategy out of well-intentioned commitment to truth. They just really don’t like this big study that shows ivermectin doesn’t work. Also, the warning itself irritates me, and includes paragraphs like: RCTs have a fundamental bias against finding an effect for interventions that are widely available — patients that believe they need treatment are more likely to decline participation and take the intervention [Yeh], i.e., RCTs are more likely to enroll low-risk participants that do not need treatment to recover (this does not apply to the typical pharmaceutical trial of a new drug that is otherwise unavailable). This trial was run in a community where ivermectin was available OTC and very widely known and used. Nobody else worries about this, and there are a million biases that non-randomized studies have that would be super-relevant when discussing those, but somehow when they’re pro-ivermectin the site forgets to be this thorough. I think a better pro-ivermectin response to this study is to point out that all the trends support ivermectin. Symptoms took 10 days to resolve in the ivermectin group vs. 12 in placebo; 4 ivermectin patients were hospitalized vs. 6 placebo patients, etc. Just say that this was an unusually noisy trial because of the self-report methodology, and you’re confident that these small differences will add up to significance when you put them into a meta-analysis. Roy et al: We’re back in East India, and back to non-randomized trials. 56 patients were retrospectively examined; some had been given ivermectin + doxycycline, others hydroxychloroquine, other azithromycin, and others symptomatic treatment only. We don’t get any meaningful information about how this worked, but we are told that they did not differ in “clinical well-being reporting onset timing”. Whatever. Chahla et al: The first of many Argentine trials. 110 patients received medium-dose ivermectin; 144 were kept as a control (no placebo). This was “cluster randomized”, which means they randomize different health centers to either give the experimental drug or not. This is worse than regular randomization, because there could be differences between these health centers (eg one might have better doctors who otherwise give better treatment, one might be in the poor part of town and have sicker patients, etc). They checked to see if there were any differences between the groups, and it sure looks like there were (the experimental group had twice as many obese people as the controls), but as per them, these differences were not statistically significant. Note that if this did make a difference, it would presumably make ivermectin look worse, not better. The primary outcome was given as “increase discharge from outpatient care with COVID-19 mild disease”. This favored the treatment; only 2/110 patients in the ivermectin group failed to be discharged, compared to 20 patients in the control group. But, uh, these were at different medical centers. Can’t different medical centers just have different discharge policies? One discharges you as soon as you seem to be getting better, the other waits to really make sure? This is an utterly crap endpoint to do a cluster randomized controlled trial on. If you’re going to do cRCT, which is never a great idea, you should be using some extremely objective endpoint that doctors and clinic administrators can’t possibly affect, like viral load according to some third-party laboratory, using the same third-party laboratory for both clinics. This is such a bad idea that I can’t help worrying I’m missing or misunderstanding something. If not, this is dumb and bad and should be ignored. Mourya et al: We’re back in India. This is a nonrandomized study comparing 50 patients given ivermectin to 50 patients given hydroxychloroquine. No primary outcome was named, but they focus on PCR negativity. Only 6% of patients in the hydroxychloroquine group were negative, compared to 90% of patients in the ivermectin group! On what day did they do the test? Uh, kind of random, and they admit that “in [the hydroxychloroquine group], mean time difference from the date of initiation of treatment and second test was significantly longer (7.24±2.75 days) as compared to 5.22±1.21 days in [the ivermectin group] (p=0.021).” Since they assessed these groups at different times, we shouldn’t draw any conclusions from them getting different results. Except that as far as I can tell this should handicap ivermectin, making it especially impressive that it did better. But also, the ivermectin group was made mostly of people who had been asymptomatic at the beginning (70%), and the hydroxychloroquine group had almost no asymptomatic cases (8%) . They were giving the ivermectin to healthy people and the hydroxychloroquine to sick people! They admit deep in the discussion that this “may be a confounding factor”. So basically they got totally different groups of people, tested them at totally different times, and the two sets of test results differed. So what? So this is why normal people do RCTs instead of whatever the heck this is, that’s what. Loue et al: …this one isn’t going to be an RCT either. Loue tells a story about a cluster of COVID cases at the French nursing home where he works. He asked people if they wanted to try ivermectin; 10 did and 15 didn’t. 1 ivermectin patient died, compared to 5 non-ivermectin patients. The non-ivermectin group looked a bit sicker than the ivermectin group in the inevitable Table 1, though it’s hard to tell. One interesting possible confounder (not mentioned, but I’m imagining it) is that demented patients probably couldn’t consent to ivermectin and ended up in the control group. This is another case of “I’m not going to trust anything that isn’t an RCT”. Merino et al: Another (sigh) non-RCT. Mexico City tried a public health program where if you called a hotline and said you had COVID, they sent you an emergency kit with various useful supplies. One of those supplies was ivermectin tablets. 18,074 people got the kit (and presumably some appreciable fraction took the ivermectin, though there’s no way to prove that). Their control group is people from before they started giving out the kits, people from after they stopped giving out the kits, and people who didn’t want the kits. There are differences in who got COVID early in the epidemic vs. later, and in people who did opt for medical kits vs. didn’t. To correct these, the researchers tried to adjust for confounders, something which - as I keep trying to hammer home again and again - never works. They found that using the kit led to a 75% or so reduction in hospitalization, though they were unable to separate out the ivermectin from the other things in the kit (paracetamol and aspirin), or from the placebo effect of having a kit and feeling like you had already gotten some treatment (if I understand right, the decision to go to the hospital was left entirely to the patient). I think this study is a moderate point in favor of giving people kits in order to prevent hospital overcrowding, but I’m not willing to accept that it tells us much about ivermectin in particular. Faisal et al: This one was published in The Professional Medical Journal (mispelled as “Profesional Medical Journal” in its URL), so you know it’s going to be good! It describes itself as “a cross-sectional study”, but later says it “randomized patients into two groups”, which would make it an RCT - I think they might just be using the term “cross-sectional” different from the standard American usage. A hospital in Pakistan got 50 patients on ivermectin + azithromycin, and another 50 on azithromycin alone. Primary outcome was not mentioned, and the data were presented confusingly, but a typical result is that only 4% of the ivermectin group had symptoms lasting more than 10 days, whereas 16% of the control group did, p < 0.01. They do a really weird thing where they compare how long it took symptoms to resolve between IVM and control groups within each bin. That is, if I’m understanding correctly, they ask “of the people who took between 3-5 days for symptoms to resolve, did they resolve faster for IVM or control?”. This is an utterly bizarre analysis to perform, although it doesn’t affect the fact that their other results still seem to favor ivermectin. Maybe I’m confused about what’s going on here. I’ve mostly been letting people off easy on no placebo, but I as far as I can tell (not very far) this paper seems to be going off whether patients reported continuing to have symptoms to the hospital doing the study, and I think that is potentially susceptible to placebo effects. Additionally, there’s no preregistration, and even though they talk a lot about doing PCR tests they don’t present the results. This is by no means the worst study here but I still think it’s pretty low quality and I don’t trust it. Aref et al: This one is published in the International Journal Of Nanomedicine, even though I’m pretty sure that isn’t a real thing. In this case the “nanomedicine” is a new nasal spray version of ivermectin which is so confusing I cannot for the life of me figure out what dose they are giving these patients. This Egyptian study gives 57 patients intranasal ivermectin plus hydroxychloroquine, azithromycin, oseltamavir, and some vitamins; another 57 patients get all that stuff except the ivermectin. Primary outcome is not stated, but they look at various symptoms, all of which look better in the ivermectin group: 95% of ivermectin patients got negative PCRs at some time point, compared to 75% of controls, p = 0.004. I am pretty suspicious of this study, not least because it comes from Egypt which has an awful reputation for fake studies, and it returns extreme results that I wouldn’t expect even if ivermectin was actually a wonder drug. But I cannot find any particular thing wrong with it, nor did anyone else I looked at, so I will grudgingly let it stand. Krolewiecki et al: Another Argentine study. This one is a real RCT. 30 patients received ivermectin, 15 were the control group (no placebo, again). Primary outcome was difference in viral load on day 5. The trend favored ivermectin but it was not statistically significant, although they were able to make it statistically significant if they looked at a subset of higher-IVM-plasma-concentration patients. They did not find any difference in clinical outcomes. A pro-ivermectin person could point out that in the subgroup with the highest ivermectin concentrations, the drug seemed to work. A skeptic could point out that this is exactly the kind of subgroup slicing that you are not supposed to do without pre-registering it, which I don’t think this team did. I agree with the skeptic. Vallejos et al: Another Argentine study. It’s big (250 people in each arm). It’s an RCT. It tries to define a primary outcome (“Primary outcome: the trial ended when the last patient who was included achieved the end of study visit”), but that’s not what “primary outcome” means, and they don’t offer an alternative. Other outcomes: no difference in PCR on days 3 or 12. Hospitalization is nonsignificantly better in the ivermectin group (14 vs. 21, p = 0.2), but death is nonsigificantly better in the placebo group (3 vs. 4, p = 0.7). This isn’t even the kind of nonsignificant that might contribute to an exciting meta-analysis later. This is just a pure null result. I cannot find any problem with this study, and neither can anyone else I checked. This is the biggest RCT we’ve seen so far, so we should take it seriously. TOGETHER Trial: Speaking of big RCTs… This one hasn’t been published yet. There’s a video of a talk about it, but I am not going to watch it, because it is a video, so I am getting information secondhand from eg here. Apparently, it compares 677 people (!) randomized to ivermectin to 678 people randomized to placebo. 86 ivermectin patients ended up in the hospital compared to 95 placebo patients, p-value not significant. This was a really big professional trial done by bigshot researchers from a major Canadian university, and the medical establishment is taking it much more seriously than any of these others. When it comes out, it will probably get published in a top journal. When discussing Lopez-Medina, I wrote: When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. This is the other one. Not coincidentally, it’s also the other trial that ivmmeta.com has a warning letter underneath telling you to disregard. Their main concern is that instead of truly randomizing patients to ivermectin vs. placebo, they did a time-dependent randomization that meant during some weeks more patients were getting one or the other. This is a problem because the trial takes place in Brazil, where different variants were more common at different times. Here’s their image: On the one hand, I have immense contempt for ivmmeta for letting all those other awful studies pass and then pulling out all the stops to try to nitpick this one. I have no idea if their proposed randomization failure really happened. And no doubt the reason they’re even able to investigate this is that this study is really careful and transparent - most of them don’t tell you anything about their randomization method. I would be shocked if other studies don’t have all these problems and worse. On the other hand, the point isn’t to be fair, it’s to be right. And this is a potential confounder. Not a huge one. But a potential one. I guess all we can do is try to bound the damage. Even if the confounding is 100% real and bad, there’s no way to make this study consistent with the crazy super-pro-ivermectin results of studies like Espitia-Hernandez and Aref. And even if we deny any confounding, we see the same slight pro-ivermectin trend - 86 hospitalizations vs. 95 - that we’ve seen in so many other studies. Nothing is going to make me believe that this isn’t in the top 33% of studies we’ve been looking at, so let’s add it as grist for the meta-analysis (though maybe not quite as much grist as its vast size indicates) and move on, angrily. Buonfrate et al: An Italian RCT. Patients were randomized into low-dose ivermectin (32), placebo (29), or high-dose ivermectin (32). Primary outcome was viral load on day 7. There was no significant difference (average of 2 in ivermectin groups, 2.2 in placebo group). They admit that they failed to reach the planned sample size, but did a calculation to show that even if they had, the trial could not have returned a positive result. Clinically, an average of 2 patients were hospitalized in each of the ivermectin arms, compared to 0 in the placebo arm - which bucks our previously-very-constant pro-ivermectin trend. Mayer et al: Not an RCT. Patients in an Argentine province were offered the opportunity to try ivermectin; 3266 said yes and become the experimental group, 17966 said no and became the control group. There were many obvious differences between the groups, but they all seemed to handicap ivermectin. There was a nonsignificant trend toward less hospitalization and significantly less mortality (1.5% vs. 2.1%, p = 0.03). While looking into this study, I learned the term “immortal time bias”. This means a period in between selection for the study and the beginning of study recording where patient outcomes are not counted. I think the problem here is that if you signed up for the system on Day X, and if you got sick before they could give you ivermectin, you were in the control group. See this Twitter thread, I have not confirmed everything he says. This only hardens my resolve to stay away from non-RCTs. Borody et al: Our last paper! …is it a paper? I can’t find it published anywhere. It mostly seems to be on news sites. Doesn’t look peer-reviewed. And it starts with “Note that views expressed in this opinion article are the writer’s personal views”. Whatever. 600 Australians were treated with ivermectin, doxycycline, and zinc. The article compares this to an “equivalent control group” made of “contemporary infected subjects in Australia obtained from published Covid Tracking Data”; this is not how you control group, @#!% you. Then it gets excited about the fact that most patients had better symptoms at the end of the ten-day study period than the beginning (untreated COVID resolves in about ten days). Why are these people wasting my time with this? Let’s move on. The Analysis If we remove all fraudulent and methodologically unsound studies from the table above, we end up with this: Gideon Meyerowitz-Katz, who investigated many of the studies above for fraud, tried a similar exercise. I learned about his halfway through, couldn’t help seeing it briefly, but tried to avoid remembering it or using it when generating mine (also, I did take the result of his fraud investigations into account), so they should be considered not quite independent efforts. His looks like this: He nixed Chowdhury, Babaloba, Ghauri, Faisal, and Aref, but kept Szenta Fonseca, Biber (?), and Mayer. There was correlation of 0.45, which I guess is okay. I asked him about his decision-making, and he listed a combination of serious statistical errors and small red flags adding up. I was pretty uncomfortable with most of these studies myself, so I will err on the side of severity, and remove all studies that either I or Meyerowitz-Katz disliked. We end up with the following short list: We’ve gone from 29 studies to 11, getting rid of 18 along the way. For the record, we eliminated 2/19 for fraud, 1/19 for severe preregistration violations, 10 for methodological problems, and 6 because Meyerowitz-Katz was suspicious of them. …but honestly this table still looks pretty good for ivermectin, doesn’t it? Still lots of big green boxes. Meyerowitz-Katz accuses ivmmeta of cherry-picking what statistic to use for their forest plot. That is, if a study measures ten outcomes, they sometimes take the most pro-ivermectin outcome. Ivmmeta.com counters that they used a consistent and reasonable (if complicated) process for choosing their outcome of focus, that being: If studies report multiple kinds of effects then the most serious outcome is used in calculations for that study. For example, if effects for mortality and cases are both reported, the effect for mortality is used, this may be different to the effect that a study focused on. If symptomatic results are reported at multiple times, we used the latest time, for example if mortality results are provided at 14 days and 28 days, the results at 28 days are used. Mortality alone is preferred over combined outcomes. Outcomes with zero events in both arms were not used (the next most serious outcome is used — no studies were excluded). For example, in low-risk populations with no mortality, a reduction in mortality with treatment is not possible, however a reduction in hospitalization, for example, is still valuable. Clinical outcome is considered more important than PCR testing status. When basically all patients recover in both treatment and control groups, preference for viral clearance and recovery is given to results mid-recovery where available (after most or all patients have recovered there is no room for an effective treatment to do better). If only individual symptom data is available, the most serious symptom has priority, for example difficulty breathing or low SpO2 is more important than cough. I’m having trouble judging this, partly because Meyerowitz-Katz says ivmmeta has corrected some earlier mistakes, and partly because there really is some reasonable debate over how to judge studies with lots of complicated endpoints. By this point I had completely forgotten what ivmmeta did, so I independently coded all 11 remaining studies following something in between my best understanding of their procedure and what I considered common sense. The only exception was that when the most severe outcome was measured in something other than patients (ie average number of virus copies per patient), I defaulted to one that was measured in patients instead, to keep everything with the same denominator. My results mostly matched ivmmeta’s, with one or two exceptions that I think are within the scope of argument or related to my minor deviations from their protocol. Placebo vs. ivermectin groups sometimes differed in size, which I’ve adjusted for and rounded off. Probably I’m forgetting some reason I can’t just do simple summary statistics to this, but whatever. It is p = 0.15, not significant. This is maybe unfair, because there aren’t a lot of deaths in the sample, so by focusing on death rather than more common outcomes we’re pointlessly throwing away sample size. What happens if I unprincipledly pick whatever I think the most reasonable outcome to use from each study is? I’ve chosen “most reasonable” as a balance between “is the most severe” and “has a lot of data points”: Now it’s p = 0.04, seemingly significant, but I had to make some unprincipled decisions to get there. I don’t think I specifically replaced negative findings with positive ones, but I can’t prove that even to myself, let alone to you. [UPDATE 5/31/22: A reader writes in to tell me that the t-test I used above is overly simplistic. A Dersimonian-Laird test is more appropriate for meta-analysis, and would have given 0.03 and 0.005 on the first and second analysis, where I got 0.15 and 0.04. This significantly strengthens the apparent benefit of ivermectin from ‘debatable’ to ‘clear’. I discuss some reasons below why I am not convinced by this apparent benefit.] (how come I’m finding a bunch of things on the edge of significance, but the original ivmmeta site found a lot of extremely significant things? Because they combined ratios, such that “one death in placebo, zero in ivermectin” looked like a nigh-infinite benefit for ivermectin, whereas I’m combining raw numbers. Possibly my way is statistically illegitimate for some reason, but I’m just trying to get a rough estimate of how convinced to be) So we are stuck somewhere between “nonsignificant trend in favor” and “maybe-significant trend in favor, after throwing out some best practices”. This is normally where I would compare my results to those of other meta-analyses made by real professionals. But when I look at them, they all include studies later found to be fake, like Elgazzar, and unsurprisingly come up with wildly positive conclusions. There are about six in this category. One of them later revised their results to exclude Elgazzar and still found strong efficacy for ivermectin, but they still included Niaee and some other dubious studies. The only meta-analysis that doesn’t make these mistakes is Popp (a Cochrane review), which is from before Elgazzar was found to be fraudulent, but coincidentally excludes it for other reasons. It also excludes a lot of good studies like Mahmud and Ravakirti because they give patients other things like HCQ and azithromycin - I chose to include them, because I don’t think they either work or have especially bad side effects, so they’re basically placebo - but Cochrane is always harsh like this. They end up with a point estimate where ivermectin cuts mortality by 40% - but say the confidence intervals are too wide to draw any conclusion. I think this basically agrees with my analyses above - the trends really are in ivermectin’s favor, but once you eliminate all the questionable studies there are too few studies left to have enough statistical power to reach significance. Except that everyone is still focusing on deaths and hospitalizations just because they’re flashy. Mahmud et al, which everyone agrees is a great study, found that ivermectin decreased days until clinical recovery, p = 0.003? So what do you do? This is one of the toughest questions in medicine. It comes up again and again. You have some drug. You read some studies. Again and again, more people are surviving (or avoiding complications) when they get the drug. It’s a pattern strong enough to common-sensically notice. But there isn’t an undeniable, unbreachable fortress of evidence. The drug is really safe and doesn’t have a lot of side effects. So do you give it to your patients? Do you take it yourself? Here this question is especially tough, because, uh, if you say anything in favor of ivermectin you will be cast out of civilization and thrown into the circle of social hell reserved for Klan members and 1/6 insurrectionists. All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele. But good doctors aren’t supposed to care about such things. Your only goal is to save your patient. Nothing else matters. I am telling you that Mahmud et al is a good study and it got p = 0.003 in favor of ivermectin. You can take the blue pill, and stay a decent respectable member of society. Or you can take the horse dewormer pill, and see where you end up. In a second, I’ll tell you my answer. But you won’t always have me to answer questions like this, and it might be morally edifying to observe your thought process in situations like this. So take a second, and meet me on the other side of the next section heading. … … … … … The Synthesis Hopefully you learned something interesting about yourself there. But my answer is: worms! As several doctors and researchers have pointed out (h/t especially Avi Bitterman and David Boulware), the most impressive studies come from places that are teeming with worms. Mahmud from Bangladesh, Ravakirti from East India, Lopez-Medina from Colombia, etc. Here’s the prevalence of roundworm infections by country (source). But alongside roundworms, there are threadworms, hookworms, blood flukes, liver flukes, nematodes, trematodes, all sorts of worms. Add them all up and somewhere between half and a quarter of people in the developing world have at least one parasitic worm in their body. Being full of worms may impact your ability to fight coronavirus. Gluchowska et al write: Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases. Treatment of worm infections might reduce the negative effect of COVID-19! And ivermectin is a deworming drug! You can see where this is going… The most relevant species of worm here is the roundworm Strongyloides stercoralis. Among the commonest treatments for COVID-19 is corticosteroids, a type of immunosuppresant drug. The types of immune responses it suppresses do more harm than good in coronavirus, so turning them off limits collateral damage and makes patients better on net. But these are also the types of immune responses that control Strongyloides. If you turn them off even very briefly, the worms multiply out of control, you get what’s called “Strongyloides hyperinfection”, and pretty often you die. According to the WHO: The current COVID-19 pandemic serves to highlight the risk of using systemic corticosteroids and, to a lesser extent, other immunosuppressive therapy, in populations with significant risk of underlying strongyloidiasis. Cases of strongyloidiasis hyperinfection in the setting of corticosteroid use as COVID-19 therapy have been described and draw attention to the necessity of addressing the risk of iatrogenic strongyloidiasis hyperinfection syndrome in infected individuals prior to corticosteroid administration. Although this has gained importance in the midst of a pandemic where corticosteroids are one of few therapies shown to improve mortality, its relevance is much broader given that corticosteroids and other immunosuppressive therapies have become increasingly common in treatment of chronic diseases (e.g. asthma or certain rheumatologic conditions). So you need to “address the risk” of strongyloides infection during COVID treatment in roundworm-endemic areas. And how might you address this, WHO? Treatment of chronic strongyloidiasis with ivermectin 200 µg/kg per day orally x 1-2 days is considered safe with potential contraindications including possible Loa loa infection (endemic in West and Central Africa), pregnancy, and weight <15kg. Given ivermectin’s safety profile, the United States has utilized presumptive treatment with ivermectin for strongyloidiasis in refugees resettling from endemic areas, and both Canada and the European Centre for Disease Prevention and Control have issued guidance on presumptive treatment to avoid hyperinfection in at risk populations. Screening and treatment, or where not available, addition of ivermectin to mass drug administration programs should be studied and considered. This is serious and common enough that, if you’re not going to screen for it, it might be worth “add[ing] ivermectin to mass drug administration programs” in affected areas! Dr. Avi Bitterman carries the hypothesis to the finish line: First two images are with all relevant studies; second two are a sensitivity analysis that removes some of the most dubious. The good ivermectin trials in areas with low Strongyloides prevalence, like Vallejos in Argentina, are mostly negative. The good ivermectin trials in areas with high Strongyloides prevalence, like Mahmud in Bangladesh, are mostly positive. Worms can’t explain the viral positivity outcomes (ie PCR), but Dr. Bitterman suggests that once you remove low quality trials and worm-related results, the rest looks like simple publication bias: This is still just a possibility. Maybe I’m over-focusing too hard on a couple positive results and this will all turn out to be nothing. Or who knows, maybe ivermectin does work against COVID a little - although it would have to be very little, fading to not at all in temperate worm-free countries. But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong! The people who called it a miracle drug against COVID were wrong. The people who dismissed all the studies because they F@#king Love Science were wrong. Ivmmeta.com was wrong. Gideon Meyerowitz-Katz was…well, he was right, actually, I got the worm-related meta-analysis graphic above from his Twitter timeline. Still, an excellent troll. Also, the best part is that I ignorantly asked, in my description of Mahmud et al above: And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true! The Scientific Takeaway About ten years ago, when the replication crisis started, we learned a certain set of tools for examining studies. Check for selection bias. Distrust “adjusting for confounders”. Check for p-hacking and forking paths. Make teams preregister their analyses. Do forest plots to find publication bias. Stop accepting p-values of 0.049. Wait for replications. Trust reviews and meta-analyses, instead of individual small studies. These were good tools. Having them was infinitely better than not having them. But even in 2014, I was writing about how many bad studies seemed to slip through the cracks even when we pushed this toolbox to its limits. We needed new tools. I think the methods that Meyerowitz-Katz, Sheldrake, Heathers, Brown, Lawrence and others brought to the limelight this year are some of the new tools we were waiting for. Part of this new toolset is to check for fraud. About 10 - 15% of the seemingly-good studies on ivermectin ended up extremely suspicious for fraud. Elgazzar, Carvallo, Niaee, Cadegiani, Samaha. There are ways to check for this even when you don’t have the raw data. Like: The Carlisle-Stouffer-Fisher method: Check some large group of comparisons, usually the Table 1 of an RCT where they compare the demographic characteristics of the control and experimental groups, for reasonable p-values. Real data will have p-values all over the map; one in every ten comparisons will have a p-value of 0.1 or less. Fakers seem bad at this and usually give everything a nice safe p-value like 0.8 or 0.9.
A defiant Flavio Cadegiani. Imagine a guy who looks like this telling you to take ultra-high-dose antiandrogens. Ahmed et al: And we’re back in Bangladesh. 72 hospital patients were randomized to one of three arms: ivermectin only, ivermectin + doxycycline, and placebo. Primary endpoint was time to negative PCR, which was 9.7 days for ivermectin only and 12.7 days for placebo (p = 0.03). Other endpoints including duration of hospitalization (9.6 days ivermectin vs. 9.7 days placebo, not significant). This looks pretty good for ivermectin and does not have any signs of fraud or methodological problems. If I wanted to pick at it anyway, I would point out that the ivermectin + doxycycline group didn’t really differ from placebo, and that if you average out both ivermectin groups (with and without doxycycline) it looks like the difference would not be significant. I had previously committed to considering only ivermectin alone in trials that had multiple ivermectin groups, so I’m not going to do this. I can’t find any evidence this trial was preregistered so I don’t know whether they waited to see what would come out positive and then made that their primary endpoint, but virological clearance is a pretty normal primary endpoint and this isn’t that suspicious. It’s impossible to find any useful commentary on this study because Elgazzar (the guy who ran the most famous fraudulent ivermectin study) had the first name Ahmed, everyone is talking about Elgazzar all the time, and this overwhelms Google whenever I try to search for Ahmed et al. For now I’ll just keep this as a mildly positive and mildly plausible virological clearance result, in the context of no effect on hospitalization length or most symptoms. Chaccour et al: 24 patients in Spain were randomized to receive either medium-dose ivermectin or placebo. The primary outcome was percent of patients with negative PCR at day 7; secondary outcomes were viral load and symptoms. The primary endpoint ended up being kind of a wash - everyone still PCR positive by day 7 so it was impossible to compare groups. Ivermectin trended toward lower viral load but never reached significance. Weirdly, ivermectin did seem to help symptoms, but only anosmia and cough towards the end (p = 0.03), which you would usually think of as lingering post-COVID problems. The paper says: Given these findings, consideration could be given to alternative mechanisms of action different from a direct antiviral effect. One alternative explanation might be a positive allosteric modulation of the nicotinic acetylcholine receptor caused by ivermectin and leading to a downregulation of the ACE-2 receptor and viral entry into the cells of the respiratory epithelium and olfactory bulb. Another mechanism through which ivermectin might influence the reversal of anosmia is by inhibiting the activation of pro-inflammatory pathways in the olfactory epithelium. Inflammation of the olfactory mucosa is thought to play a key role in the development of anosmia in SARS-CoV-2 infection This seems kind of hedge-y. If you’re wondering where things went from there, Dr. Chaccour is now a passionate anti-ivermectin activist: @Finneganporter in @BusinessInsider \n\nThe roots of #ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm\n\n","username":"carlos_chaccour","name":"Dr. Carlos Chaccour ??????","profile_image_url":"","date":"Sun Nov 07 18:40:28 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":9,"impression_count":0,"expanded_url":{"url":"https://www.businessinsider.in/international/news/the-roots-of-ivermectin-mania-how-south-america-incubated-a-fake-medicine-craze-that-took-the-us-by-storm/articleshow/87554081.cms","image":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/88d08e70-c9e2-46d4-a5df-96807b6c3a13_2000x1000.jpeg","title":"The roots of ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm","description":"The popularity of unproven anti-parasitic drug ivermectin as a COVID-19 treatment is surging. Its use has roots in South America, where it was hyped by populist","domain":"businessinsider.in"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> So I guess he must think of this trial as basically negative, although realistically it’s 24 people and we shouldn’t put too much weight on it either way. Ghauri et al: Pakistan, 95 patients. Nonrandom; the study compared patients who happened to be given ivermectin (along with hydroxychloroquine and azithromycin) vs. patients who were just given the latter two drugs. There’s some evidence this produced systematic differences between the two groups - for example, patients in the control group were 3x more likely to have had diarrhea (this makes sense; diarrhea is a potential ivermectin side effect, so you probably wouldn’t give it to people already struggling with this problem). Also, the control group was twice as likely to be getting corticosteroids, maybe a marker for illness severity. Primary outcome was what percent of both groups had a fever: on day 7 it was 21% of ivermectin patients vs. 65% of controls, p < 0.001. No other outcomes were reported. I don’t hate this study, but I think the nonrandom assignment (and observed systematic differences) is a pretty fatal flaw. I can’t find anyone else talking about this one. At least no one seems to be saying anything bad. Babaloba et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakoloko”, because that’s really fun to say. This was a Nigerian RCT comparing 21 patients on low-dose ivermectin, 21 patients on high-dose ivermectin, and 20 patients on a combination of lopinavir and ritonavir, a combination antiviral which later studies found not to work for COVID and which might as well be considered a placebo. Primary outcome, as usual, was days until a negative PCR test. High dose ivermectin was 4.65 days, low dose was 6 days, control was 9.15, p = 0.035. Figure 2 is apparently a photograph of the computer screen where they did this calculation. Gideon Meyerowitz-Katz, part of the team that detects fraud in ivermectin papers, is not a fan of this one: He doesn’t say there what means, but elsewhere he tweets this figure: It’s always a bad sign when your study features in an image with “NUMEROUS IMPOSSIBLE NUMBERS” in red at the top. I think his point is that if you have 21 people, it’s impossible to have 50% of them have headache, because that would be 10.5. If 10 people have a headache, it would be 47.6%; if 11, 52%. So something is clearly wrong here. Seems like a relatively minor mistake, and Meyerowitz-Katz stops short of calling fraud, but it’s not a good look. I’m going to be slightly uncomfortable with this study without rejecting it entirely, and move on. Ravakirti et al: Here we’re in Eastern India - not exactly Bangladesh again, but a stone’s throw away from it. In this RCT patients were randomized into an ivermectin group (57) and a placebo group (58). Primary outcome was negative PCR on day 6, because doing it on day 7 like everyone else would be too easy. As with several other groups, this was a bad move; too few people had it to make a good comparison; it was 13% of intervention vs. 18% of placebo, p = 0.3. Secondary outcomes were also pretty boring, except for the most important: 4 people in the placebo group died, compared to 0 in ivermectin (p = 0.045). On the one hand, this is one outcome of many, reaching the barest significance threshold. Another fluke? Still, there are no real problems with this study, and nobody has anything to say against it. Let’s add this one to the scale as another very small and noisy piece of real evidence in ivermectin’s favor. Bukhari et al: Now we’re in Pakistan. 50 patients were randomized to low-dose ivermectin, another 50 got standard of care including vitamin D. There was no placebo, but primary outcome was number of days to reach negative PCR, which it seems hard for placebo to affect much, so I don’t care. 5 controls and 9 ivermectin patients left the hospital against medical advice and could not be followed up, which is bad but not necessarily study-ruining. They never measured their supposed primary outcome of “days to reach negative PCR” directly, but they did measure how many people had negative PCR on various days, and ivermectin had a clear advantage - for example, on day 7, it was 37/50 for IVR and only 20/50 for control. Even if we assume all the lost-to-followup patients had maximally bad-for-the-hypothesis results, that’s still a positive finding. Nobody else has much to say about this one, certainly no accusations that they’ve found anything suspicious. Keep. Mohan et al: India. RCT. 40 patients got low-dose ivermectin, 40 high-dose ivermectin, and 45 placebo. Primary outcomes were time to negative PCR, and viral load on day 5. In the results, they seem to have reinterpreted “time to negative PCR” as the subtly different “percent with negative PCR on some specific day”. High-dose ivermectin did best (47.5% negative on day 5) and placebo worst (31% negative), but it was insignificant (p = 0.3). There was no difference in viral load. All groups took about the same amount of time for symptoms to resolve. More placebo patients had failed to recover by the end of the study (6) than ivermectin patients (2), but this didn’t reach statistical significance (p = 0.4). Overall a well-done, boring, negative study, although ivermectin proponents will correctly point out that, like basically every other study we have looked at, the trend was in favor of ivermectin and this could potentially end up looking impressive in a meta-analysis. Biber et al: This is an RCT from Israel. 47 patients got ivermectin and 42 placebo. Primary endpoint was viral load on day 6. I am having trouble finding out what happened with this; as far as I can tell it was a negative result and they buried it in favor of more interesting things. In a "multivariable logistic regression model, the adjusted odds ratio of negative SARS-CoV-2 RT-PCR negative test" favored ivermectin over placebo (p = 0.03 for day 6, p = 0.01 for day 8), but this seems like the kind of thing you do when your primary outcome is boring and you’re angry. Gideon Meyerowitz-Katz is not a fan: He notes that the study excluded people with high viral load, but the preregistration didn’t say they would do that. Looking more closely, he finds they did that because, if you included these people, the study got no positive results. So probably they did the study, found no positive results, re-ran it with various subsets of patients until they did get a positive result, and then claimed to have “excluded” patients who weren’t in the subset that worked. I’m going to toss this one. Elalfy et al: What even is this? Where am I? As best I can tell, this is some kind of Egyptian trial. It might or might not be an RCT; it says stuff like “Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment”. Were they self-allocated in the sense that they got to choose? Doesn’t that mean it’s not random? Aren’t there seven days in a week? These are among the many questions that Elalfy et al do not answer for us. The control group (which they seem to think can also be called “the white group”) took zinc, paracetamol, and maybe azithromycin. The intervention group took zinc, nitazoxanide, ribavirin, and ivermectin. There were very large demographic differences between the groups of the sort which make the study unusable, which they mention and then ignore. From there, they follow this normal and totally comprehensible flowchart: There is no primary outcome assigned, but viral clearance rates on day seven were 58% in the yellow group compared to 0% in the white group, which I guess is a strong positive result. This table… …looks very impressive, in terms of the experimental group doing better than the control, except that they don’t specify whether it was before the trial or after it, and at least one online commentator thinks it might have been before, in which case it’s only impressive how thoroughly they failed to randomize their groups. Overall I don’t feel bad throwing this study out. I hope it one day succeeds in returning to its home planet. Lopez-Medina et al: Colombian RCT. 200 patients took ivermectin, another 200 took placebo. They originally worried the placebo might taste different than real ivermectin, then solved this by replacing it with a different placebo, which is a pretty high level of conscientiousness. Primary outcome was originally percent of patients whose symptoms worsened by two points, as rated on a complicated symptom scale when a researcher asked them over the phone. Halfway through the study, they realized nobody was worsening that much, so they changed the primary outcome to time until symptoms got better, as measured by the scale. In the ivermectin group, symptoms improved that much after 10 days; in the placebo group, after 12, p = 0.53. By the end of the study, symptoms had improved in 82% of ivermectin users and 79% of controls, also insignificant. 4 patients in the ivermectin group needed to be hospitalized compared to 6 in the placebo group, again insignificant. This study is bigger than most of the other RCTs, and more polished in terms of how many spelling errors, photographs of computer screens, etc, it contains. It was published in JAMA, one of the most prestigious US medical journals, as opposed to the crappy nth-tier journals most of the others have been in. When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. Ivermectin proponents make some good arguments against it. In order to get as big as it did, Lopez-Medina had to compromise on rigor. Its outcome is how people self-score their symptoms on a hokey scale in a phone interview, instead of viral load or PCR results or anything like that. Still, this is basically what we want, right? In the end, we want people to feel better and less sick, not to get good scores on PCR tests. Also, it changed its primary outcome halfway through; isn’t that bad? I think maybe not; the reason we want a preregistered primary outcome is so that you don’t change halfway through to whatever outcome shows the results you want. The researchers in this study did a good job explaining why they changed their outcome, the change makes sense, and their original outcome would also have shown ivermectin not working (albeit less accurately and effectively). I don’t know of any evidence that they knew (or suspected) final results when switching to this new outcome, and it seems like the most reasonable new outcome to switch to. Finally, their original placebo tasted different from ivermectin (though they switched halfway through). This is one of the few studies where I actually care about placebo, because people are self-rating their symptoms. But realistically most of these people don’t know what ivermectin is supposed to taste like. Also, they did a re-analysis and found there was no difference between the people who got the old placebo and the new one. I’m making a big deal of this because ivmmeta.com - the really impressive meta-analysis site I’ve been going off of - puts a special warning letter underneath their discussion of this study, urging us not to trust it. They don’t do this for any of the other ones we’ve addressed so far - not the one by the guy whose other studies were all frauds, not the one where 50% of 21 people had headaches, not the unrandomized one where the groups were completely different before the experiment started, not even the one by the guy accused of crimes against humanity. Only this one. This makes me a lot less charitable to ivmmeta than I would otherwise be; I think it’s hard to choose this particular warning letter strategy out of well-intentioned commitment to truth. They just really don’t like this big study that shows ivermectin doesn’t work. Also, the warning itself irritates me, and includes paragraphs like: RCTs have a fundamental bias against finding an effect for interventions that are widely available — patients that believe they need treatment are more likely to decline participation and take the intervention [Yeh], i.e., RCTs are more likely to enroll low-risk participants that do not need treatment to recover (this does not apply to the typical pharmaceutical trial of a new drug that is otherwise unavailable). This trial was run in a community where ivermectin was available OTC and very widely known and used. Nobody else worries about this, and there are a million biases that non-randomized studies have that would be super-relevant when discussing those, but somehow when they’re pro-ivermectin the site forgets to be this thorough. I think a better pro-ivermectin response to this study is to point out that all the trends support ivermectin. Symptoms took 10 days to resolve in the ivermectin group vs. 12 in placebo; 4 ivermectin patients were hospitalized vs. 6 placebo patients, etc. Just say that this was an unusually noisy trial because of the self-report methodology, and you’re confident that these small differences will add up to significance when you put them into a meta-analysis. Roy et al: We’re back in East India, and back to non-randomized trials. 56 patients were retrospectively examined; some had been given ivermectin + doxycycline, others hydroxychloroquine, other azithromycin, and others symptomatic treatment only. We don’t get any meaningful information about how this worked, but we are told that they did not differ in “clinical well-being reporting onset timing”. Whatever. Chahla et al: The first of many Argentine trials. 110 patients received medium-dose ivermectin; 144 were kept as a control (no placebo). This was “cluster randomized”, which means they randomize different health centers to either give the experimental drug or not. This is worse than regular randomization, because there could be differences between these health centers (eg one might have better doctors who otherwise give better treatment, one might be in the poor part of town and have sicker patients, etc). They checked to see if there were any differences between the groups, and it sure looks like there were (the experimental group had twice as many obese people as the controls), but as per them, these differences were not statistically significant. Note that if this did make a difference, it would presumably make ivermectin look worse, not better. The primary outcome was given as “increase discharge from outpatient care with COVID-19 mild disease”. This favored the treatment; only 2/110 patients in the ivermectin group failed to be discharged, compared to 20 patients in the control group. But, uh, these were at different medical centers. Can’t different medical centers just have different discharge policies? One discharges you as soon as you seem to be getting better, the other waits to really make sure? This is an utterly crap endpoint to do a cluster randomized controlled trial on. If you’re going to do cRCT, which is never a great idea, you should be using some extremely objective endpoint that doctors and clinic administrators can’t possibly affect, like viral load according to some third-party laboratory, using the same third-party laboratory for both clinics. This is such a bad idea that I can’t help worrying I’m missing or misunderstanding something. If not, this is dumb and bad and should be ignored. Mourya et al: We’re back in India. This is a nonrandomized study comparing 50 patients given ivermectin to 50 patients given hydroxychloroquine. No primary outcome was named, but they focus on PCR negativity. Only 6% of patients in the hydroxychloroquine group were negative, compared to 90% of patients in the ivermectin group! On what day did they do the test? Uh, kind of random, and they admit that “in [the hydroxychloroquine group], mean time difference from the date of initiation of treatment and second test was significantly longer (7.24±2.75 days) as compared to 5.22±1.21 days in [the ivermectin group] (p=0.021).” Since they assessed these groups at different times, we shouldn’t draw any conclusions from them getting different results. Except that as far as I can tell this should handicap ivermectin, making it especially impressive that it did better. But also, the ivermectin group was made mostly of people who had been asymptomatic at the beginning (70%), and the hydroxychloroquine group had almost no asymptomatic cases (8%) . They were giving the ivermectin to healthy people and the hydroxychloroquine to sick people! They admit deep in the discussion that this “may be a confounding factor”. So basically they got totally different groups of people, tested them at totally different times, and the two sets of test results differed. So what? So this is why normal people do RCTs instead of whatever the heck this is, that’s what. Loue et al: …this one isn’t going to be an RCT either. Loue tells a story about a cluster of COVID cases at the French nursing home where he works. He asked people if they wanted to try ivermectin; 10 did and 15 didn’t. 1 ivermectin patient died, compared to 5 non-ivermectin patients. The non-ivermectin group looked a bit sicker than the ivermectin group in the inevitable Table 1, though it’s hard to tell. One interesting possible confounder (not mentioned, but I’m imagining it) is that demented patients probably couldn’t consent to ivermectin and ended up in the control group. This is another case of “I’m not going to trust anything that isn’t an RCT”. Merino et al: Another (sigh) non-RCT. Mexico City tried a public health program where if you called a hotline and said you had COVID, they sent you an emergency kit with various useful supplies. One of those supplies was ivermectin tablets. 18,074 people got the kit (and presumably some appreciable fraction took the ivermectin, though there’s no way to prove that). Their control group is people from before they started giving out the kits, people from after they stopped giving out the kits, and people who didn’t want the kits. There are differences in who got COVID early in the epidemic vs. later, and in people who did opt for medical kits vs. didn’t. To correct these, the researchers tried to adjust for confounders, something which - as I keep trying to hammer home again and again - never works. They found that using the kit led to a 75% or so reduction in hospitalization, though they were unable to separate out the ivermectin from the other things in the kit (paracetamol and aspirin), or from the placebo effect of having a kit and feeling like you had already gotten some treatment (if I understand right, the decision to go to the hospital was left entirely to the patient). I think this study is a moderate point in favor of giving people kits in order to prevent hospital overcrowding, but I’m not willing to accept that it tells us much about ivermectin in particular. Faisal et al: This one was published in The Professional Medical Journal (mispelled as “Profesional Medical Journal” in its URL), so you know it’s going to be good! It describes itself as “a cross-sectional study”, but later says it “randomized patients into two groups”, which would make it an RCT - I think they might just be using the term “cross-sectional” different from the standard American usage. A hospital in Pakistan got 50 patients on ivermectin + azithromycin, and another 50 on azithromycin alone. Primary outcome was not mentioned, and the data were presented confusingly, but a typical result is that only 4% of the ivermectin group had symptoms lasting more than 10 days, whereas 16% of the control group did, p < 0.01. They do a really weird thing where they compare how long it took symptoms to resolve between IVM and control groups within each bin. That is, if I’m understanding correctly, they ask “of the people who took between 3-5 days for symptoms to resolve, did they resolve faster for IVM or control?”. This is an utterly bizarre analysis to perform, although it doesn’t affect the fact that their other results still seem to favor ivermectin. Maybe I’m confused about what’s going on here. I’ve mostly been letting people off easy on no placebo, but I as far as I can tell (not very far) this paper seems to be going off whether patients reported continuing to have symptoms to the hospital doing the study, and I think that is potentially susceptible to placebo effects. Additionally, there’s no preregistration, and even though they talk a lot about doing PCR tests they don’t present the results. This is by no means the worst study here but I still think it’s pretty low quality and I don’t trust it. Aref et al: This one is published in the International Journal Of Nanomedicine, even though I’m pretty sure that isn’t a real thing. In this case the “nanomedicine” is a new nasal spray version of ivermectin which is so confusing I cannot for the life of me figure out what dose they are giving these patients. This Egyptian study gives 57 patients intranasal ivermectin plus hydroxychloroquine, azithromycin, oseltamavir, and some vitamins; another 57 patients get all that stuff except the ivermectin. Primary outcome is not stated, but they look at various symptoms, all of which look better in the ivermectin group: 95% of ivermectin patients got negative PCRs at some time point, compared to 75% of controls, p = 0.004. I am pretty suspicious of this study, not least because it comes from Egypt which has an awful reputation for fake studies, and it returns extreme results that I wouldn’t expect even if ivermectin was actually a wonder drug. But I cannot find any particular thing wrong with it, nor did anyone else I looked at, so I will grudgingly let it stand. Krolewiecki et al: Another Argentine study. This one is a real RCT. 30 patients received ivermectin, 15 were the control group (no placebo, again). Primary outcome was difference in viral load on day 5. The trend favored ivermectin but it was not statistically significant, although they were able to make it statistically significant if they looked at a subset of higher-IVM-plasma-concentration patients. They did not find any difference in clinical outcomes. A pro-ivermectin person could point out that in the subgroup with the highest ivermectin concentrations, the drug seemed to work. A skeptic could point out that this is exactly the kind of subgroup slicing that you are not supposed to do without pre-registering it, which I don’t think this team did. I agree with the skeptic. Vallejos et al: Another Argentine study. It’s big (250 people in each arm). It’s an RCT. It tries to define a primary outcome (“Primary outcome: the trial ended when the last patient who was included achieved the end of study visit”), but that’s not what “primary outcome” means, and they don’t offer an alternative. Other outcomes: no difference in PCR on days 3 or 12. Hospitalization is nonsignificantly better in the ivermectin group (14 vs. 21, p = 0.2), but death is nonsigificantly better in the placebo group (3 vs. 4, p = 0.7). This isn’t even the kind of nonsignificant that might contribute to an exciting meta-analysis later. This is just a pure null result. I cannot find any problem with this study, and neither can anyone else I checked. This is the biggest RCT we’ve seen so far, so we should take it seriously. TOGETHER Trial: Speaking of big RCTs… This one hasn’t been published yet. There’s a video of a talk about it, but I am not going to watch it, because it is a video, so I am getting information secondhand from eg here. Apparently, it compares 677 people (!) randomized to ivermectin to 678 people randomized to placebo. 86 ivermectin patients ended up in the hospital compared to 95 placebo patients, p-value not significant. This was a really big professional trial done by bigshot researchers from a major Canadian university, and the medical establishment is taking it much more seriously than any of these others. When it comes out, it will probably get published in a top journal. When discussing Lopez-Medina, I wrote: When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. This is the other one. Not coincidentally, it’s also the other trial that ivmmeta.com has a warning letter underneath telling you to disregard. Their main concern is that instead of truly randomizing patients to ivermectin vs. placebo, they did a time-dependent randomization that meant during some weeks more patients were getting one or the other. This is a problem because the trial takes place in Brazil, where different variants were more common at different times. Here’s their image: On the one hand, I have immense contempt for ivmmeta for letting all those other awful studies pass and then pulling out all the stops to try to nitpick this one. I have no idea if their proposed randomization failure really happened. And no doubt the reason they’re even able to investigate this is that this study is really careful and transparent - most of them don’t tell you anything about their randomization method. I would be shocked if other studies don’t have all these problems and worse. On the other hand, the point isn’t to be fair, it’s to be right. And this is a potential confounder. Not a huge one. But a potential one. I guess all we can do is try to bound the damage. Even if the confounding is 100% real and bad, there’s no way to make this study consistent with the crazy super-pro-ivermectin results of studies like Espitia-Hernandez and Aref. And even if we deny any confounding, we see the same slight pro-ivermectin trend - 86 hospitalizations vs. 95 - that we’ve seen in so many other studies. Nothing is going to make me believe that this isn’t in the top 33% of studies we’ve been looking at, so let’s add it as grist for the meta-analysis (though maybe not quite as much grist as its vast size indicates) and move on, angrily. Buonfrate et al: An Italian RCT. Patients were randomized into low-dose ivermectin (32), placebo (29), or high-dose ivermectin (32). Primary outcome was viral load on day 7. There was no significant difference (average of 2 in ivermectin groups, 2.2 in placebo group). They admit that they failed to reach the planned sample size, but did a calculation to show that even if they had, the trial could not have returned a positive result. Clinically, an average of 2 patients were hospitalized in each of the ivermectin arms, compared to 0 in the placebo arm - which bucks our previously-very-constant pro-ivermectin trend. Mayer et al: Not an RCT. Patients in an Argentine province were offered the opportunity to try ivermectin; 3266 said yes and become the experimental group, 17966 said no and became the control group. There were many obvious differences between the groups, but they all seemed to handicap ivermectin. There was a nonsignificant trend toward less hospitalization and significantly less mortality (1.5% vs. 2.1%, p = 0.03). While looking into this study, I learned the term “immortal time bias”. This means a period in between selection for the study and the beginning of study recording where patient outcomes are not counted. I think the problem here is that if you signed up for the system on Day X, and if you got sick before they could give you ivermectin, you were in the control group. See this Twitter thread, I have not confirmed everything he says. This only hardens my resolve to stay away from non-RCTs. Borody et al: Our last paper! …is it a paper? I can’t find it published anywhere. It mostly seems to be on news sites. Doesn’t look peer-reviewed. And it starts with “Note that views expressed in this opinion article are the writer’s personal views”. Whatever. 600 Australians were treated with ivermectin, doxycycline, and zinc. The article compares this to an “equivalent control group” made of “contemporary infected subjects in Australia obtained from published Covid Tracking Data”; this is not how you control group, @#!% you. Then it gets excited about the fact that most patients had better symptoms at the end of the ten-day study period than the beginning (untreated COVID resolves in about ten days). Why are these people wasting my time with this? Let’s move on. The Analysis If we remove all fraudulent and methodologically unsound studies from the table above, we end up with this: Gideon Meyerowitz-Katz, who investigated many of the studies above for fraud, tried a similar exercise. I learned about his halfway through, couldn’t help seeing it briefly, but tried to avoid remembering it or using it when generating mine (also, I did take the result of his fraud investigations into account), so they should be considered not quite independent efforts. His looks like this: He nixed Chowdhury, Babaloba, Ghauri, Faisal, and Aref, but kept Szenta Fonseca, Biber (?), and Mayer. There was correlation of 0.45, which I guess is okay. I asked him about his decision-making, and he listed a combination of serious statistical errors and small red flags adding up. I was pretty uncomfortable with most of these studies myself, so I will err on the side of severity, and remove all studies that either I or Meyerowitz-Katz disliked. We end up with the following short list: We’ve gone from 29 studies to 11, getting rid of 18 along the way. For the record, we eliminated 2/19 for fraud, 1/19 for severe preregistration violations, 10 for methodological problems, and 6 because Meyerowitz-Katz was suspicious of them. …but honestly this table still looks pretty good for ivermectin, doesn’t it? Still lots of big green boxes. Meyerowitz-Katz accuses ivmmeta of cherry-picking what statistic to use for their forest plot. That is, if a study measures ten outcomes, they sometimes take the most pro-ivermectin outcome. Ivmmeta.com counters that they used a consistent and reasonable (if complicated) process for choosing their outcome of focus, that being: If studies report multiple kinds of effects then the most serious outcome is used in calculations for that study. For example, if effects for mortality and cases are both reported, the effect for mortality is used, this may be different to the effect that a study focused on. If symptomatic results are reported at multiple times, we used the latest time, for example if mortality results are provided at 14 days and 28 days, the results at 28 days are used. Mortality alone is preferred over combined outcomes. Outcomes with zero events in both arms were not used (the next most serious outcome is used — no studies were excluded). For example, in low-risk populations with no mortality, a reduction in mortality with treatment is not possible, however a reduction in hospitalization, for example, is still valuable. Clinical outcome is considered more important than PCR testing status. When basically all patients recover in both treatment and control groups, preference for viral clearance and recovery is given to results mid-recovery where available (after most or all patients have recovered there is no room for an effective treatment to do better). If only individual symptom data is available, the most serious symptom has priority, for example difficulty breathing or low SpO2 is more important than cough. I’m having trouble judging this, partly because Meyerowitz-Katz says ivmmeta has corrected some earlier mistakes, and partly because there really is some reasonable debate over how to judge studies with lots of complicated endpoints. By this point I had completely forgotten what ivmmeta did, so I independently coded all 11 remaining studies following something in between my best understanding of their procedure and what I considered common sense. The only exception was that when the most severe outcome was measured in something other than patients (ie average number of virus copies per patient), I defaulted to one that was measured in patients instead, to keep everything with the same denominator. My results mostly matched ivmmeta’s, with one or two exceptions that I think are within the scope of argument or related to my minor deviations from their protocol. Placebo vs. ivermectin groups sometimes differed in size, which I’ve adjusted for and rounded off. Probably I’m forgetting some reason I can’t just do simple summary statistics to this, but whatever. It is p = 0.15, not significant. This is maybe unfair, because there aren’t a lot of deaths in the sample, so by focusing on death rather than more common outcomes we’re pointlessly throwing away sample size. What happens if I unprincipledly pick whatever I think the most reasonable outcome to use from each study is? I’ve chosen “most reasonable” as a balance between “is the most severe” and “has a lot of data points”: Now it’s p = 0.04, seemingly significant, but I had to make some unprincipled decisions to get there. I don’t think I specifically replaced negative findings with positive ones, but I can’t prove that even to myself, let alone to you. [UPDATE 5/31/22: A reader writes in to tell me that the t-test I used above is overly simplistic. A Dersimonian-Laird test is more appropriate for meta-analysis, and would have given 0.03 and 0.005 on the first and second analysis, where I got 0.15 and 0.04. This significantly strengthens the apparent benefit of ivermectin from ‘debatable’ to ‘clear’. I discuss some reasons below why I am not convinced by this apparent benefit.] (how come I’m finding a bunch of things on the edge of significance, but the original ivmmeta site found a lot of extremely significant things? Because they combined ratios, such that “one death in placebo, zero in ivermectin” looked like a nigh-infinite benefit for ivermectin, whereas I’m combining raw numbers. Possibly my way is statistically illegitimate for some reason, but I’m just trying to get a rough estimate of how convinced to be) So we are stuck somewhere between “nonsignificant trend in favor” and “maybe-significant trend in favor, after throwing out some best practices”. This is normally where I would compare my results to those of other meta-analyses made by real professionals. But when I look at them, they all include studies later found to be fake, like Elgazzar, and unsurprisingly come up with wildly positive conclusions. There are about six in this category. One of them later revised their results to exclude Elgazzar and still found strong efficacy for ivermectin, but they still included Niaee and some other dubious studies. The only meta-analysis that doesn’t make these mistakes is Popp (a Cochrane review), which is from before Elgazzar was found to be fraudulent, but coincidentally excludes it for other reasons. It also excludes a lot of good studies like Mahmud and Ravakirti because they give patients other things like HCQ and azithromycin - I chose to include them, because I don’t think they either work or have especially bad side effects, so they’re basically placebo - but Cochrane is always harsh like this. They end up with a point estimate where ivermectin cuts mortality by 40% - but say the confidence intervals are too wide to draw any conclusion. I think this basically agrees with my analyses above - the trends really are in ivermectin’s favor, but once you eliminate all the questionable studies there are too few studies left to have enough statistical power to reach significance. Except that everyone is still focusing on deaths and hospitalizations just because they’re flashy. Mahmud et al, which everyone agrees is a great study, found that ivermectin decreased days until clinical recovery, p = 0.003? So what do you do? This is one of the toughest questions in medicine. It comes up again and again. You have some drug. You read some studies. Again and again, more people are surviving (or avoiding complications) when they get the drug. It’s a pattern strong enough to common-sensically notice. But there isn’t an undeniable, unbreachable fortress of evidence. The drug is really safe and doesn’t have a lot of side effects. So do you give it to your patients? Do you take it yourself? Here this question is especially tough, because, uh, if you say anything in favor of ivermectin you will be cast out of civilization and thrown into the circle of social hell reserved for Klan members and 1/6 insurrectionists. All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele. But good doctors aren’t supposed to care about such things. Your only goal is to save your patient. Nothing else matters. I am telling you that Mahmud et al is a good study and it got p = 0.003 in favor of ivermectin. You can take the blue pill, and stay a decent respectable member of society. Or you can take the horse dewormer pill, and see where you end up. In a second, I’ll tell you my answer. But you won’t always have me to answer questions like this, and it might be morally edifying to observe your thought process in situations like this. So take a second, and meet me on the other side of the next section heading. … … … … … The Synthesis Hopefully you learned something interesting about yourself there. But my answer is: worms! As several doctors and researchers have pointed out (h/t especially Avi Bitterman and David Boulware), the most impressive studies come from places that are teeming with worms. Mahmud from Bangladesh, Ravakirti from East India, Lopez-Medina from Colombia, etc. Here’s the prevalence of roundworm infections by country (source). But alongside roundworms, there are threadworms, hookworms, blood flukes, liver flukes, nematodes, trematodes, all sorts of worms. Add them all up and somewhere between half and a quarter of people in the developing world have at least one parasitic worm in their body. Being full of worms may impact your ability to fight coronavirus. Gluchowska et al write: Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases. Treatment of worm infections might reduce the negative effect of COVID-19! And ivermectin is a deworming drug! You can see where this is going… The most relevant species of worm here is the roundworm Strongyloides stercoralis. Among the commonest treatments for COVID-19 is corticosteroids, a type of immunosuppresant drug. The types of immune responses it suppresses do more harm than good in coronavirus, so turning them off limits collateral damage and makes patients better on net. But these are also the types of immune responses that control Strongyloides. If you turn them off even very briefly, the worms multiply out of control, you get what’s called “Strongyloides hyperinfection”, and pretty often you die. According to the WHO: The current COVID-19 pandemic serves to highlight the risk of using systemic corticosteroids and, to a lesser extent, other immunosuppressive therapy, in populations with significant risk of underlying strongyloidiasis. Cases of strongyloidiasis hyperinfection in the setting of corticosteroid use as COVID-19 therapy have been described and draw attention to the necessity of addressing the risk of iatrogenic strongyloidiasis hyperinfection syndrome in infected individuals prior to corticosteroid administration. Although this has gained importance in the midst of a pandemic where corticosteroids are one of few therapies shown to improve mortality, its relevance is much broader given that corticosteroids and other immunosuppressive therapies have become increasingly common in treatment of chronic diseases (e.g. asthma or certain rheumatologic conditions). So you need to “address the risk” of strongyloides infection during COVID treatment in roundworm-endemic areas. And how might you address this, WHO? Treatment of chronic strongyloidiasis with ivermectin 200 µg/kg per day orally x 1-2 days is considered safe with potential contraindications including possible Loa loa infection (endemic in West and Central Africa), pregnancy, and weight <15kg. Given ivermectin’s safety profile, the United States has utilized presumptive treatment with ivermectin for strongyloidiasis in refugees resettling from endemic areas, and both Canada and the European Centre for Disease Prevention and Control have issued guidance on presumptive treatment to avoid hyperinfection in at risk populations. Screening and treatment, or where not available, addition of ivermectin to mass drug administration programs should be studied and considered. This is serious and common enough that, if you’re not going to screen for it, it might be worth “add[ing] ivermectin to mass drug administration programs” in affected areas! Dr. Avi Bitterman carries the hypothesis to the finish line: First two images are with all relevant studies; second two are a sensitivity analysis that removes some of the most dubious. The good ivermectin trials in areas with low Strongyloides prevalence, like Vallejos in Argentina, are mostly negative. The good ivermectin trials in areas with high Strongyloides prevalence, like Mahmud in Bangladesh, are mostly positive. Worms can’t explain the viral positivity outcomes (ie PCR), but Dr. Bitterman suggests that once you remove low quality trials and worm-related results, the rest looks like simple publication bias: This is still just a possibility. Maybe I’m over-focusing too hard on a couple positive results and this will all turn out to be nothing. Or who knows, maybe ivermectin does work against COVID a little - although it would have to be very little, fading to not at all in temperate worm-free countries. But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong! The people who called it a miracle drug against COVID were wrong. The people who dismissed all the studies because they F@#king Love Science were wrong. Ivmmeta.com was wrong. Gideon Meyerowitz-Katz was…well, he was right, actually, I got the worm-related meta-analysis graphic above from his Twitter timeline. Still, an excellent troll. Also, the best part is that I ignorantly asked, in my description of Mahmud et al above: And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true! The Scientific Takeaway About ten years ago, when the replication crisis started, we learned a certain set of tools for examining studies. Check for selection bias. Distrust “adjusting for confounders”. Check for p-hacking and forking paths. Make teams preregister their analyses. Do forest plots to find publication bias. Stop accepting p-values of 0.049. Wait for replications. Trust reviews and meta-analyses, instead of individual small studies. These were good tools. Having them was infinitely better than not having them. But even in 2014, I was writing about how many bad studies seemed to slip through the cracks even when we pushed this toolbox to its limits. We needed new tools. I think the methods that Meyerowitz-Katz, Sheldrake, Heathers, Brown, Lawrence and others brought to the limelight this year are some of the new tools we were waiting for. Part of this new toolset is to check for fraud. About 10 - 15% of the seemingly-good studies on ivermectin ended up extremely suspicious for fraud. Elgazzar, Carvallo, Niaee, Cadegiani, Samaha. There are ways to check for this even when you don’t have the raw data. Like: The Carlisle-Stouffer-Fisher method: Check some large group of comparisons, usually the Table 1 of an RCT where they compare the demographic characteristics of the control and experimental groups, for reasonable p-values. Real data will have p-values all over the map; one in every ten comparisons will have a p-value of 0.1 or less. Fakers seem bad at this and usually give everything a nice safe p-value like 0.8 or 0.9.
November 24, 2021 · Original source
But what’s true of curcumin is equally true of lots of other different compounds: zinc, hydroxychloroquine, quercetin, nigella sativa, melatonin…just going off the ones on the sidebar of ivmmeta.com, there are about thirty different things that have this same level of very early, very dubious super-promising COVID results. Some are expensive and some are dangerous, but I think about twenty of them are cheap and safe.
February 01, 2023 · Original source
Gideon (correctly) phrased this as a non-sinister albeit potentially weird misstep by the study authors, but in trying to summarize Gideon, I (incorrectly) phrased it as a sinister attempt to inflate results. After looking into it, I think Alexandros is completely right and I was completely wrong. Although I sometimes get details wrong, this one was especially disappointing because I incorrectly tarnished the reputation of Biber et al and implicitly accused them of bad scientific practices, which they were not doing. I believed I was relaying an accusation by Gideon (who I trust), but I was wrong and he was not accusing them of that. I apologize to Biber et al, my readers, and everyone else involved in this. My only reservation is that I don’t want to say too strongly that Gideon’s critique is wrong: I haven’t looked through the study documents enough to say with certainty that Alexandros’ reanalysis of the protocol issues is correct (though the superficial check I’ve done looks that way). But my mistakes are completely separate from anything Gideon did and definitely real and egregious. Cadegiani et al (Alexandros 50% right) Flavio Cadegiani did several studies on ivermectin in Brazil; I edited this section in response to criticism by Marinos and others, but the earliest version I can find on archive.is (I can’t guarantee it was the first I wrote) said: A crazy person decided to put his patients on every weird medication he could think of, and 585 subjects ended up on a combination of ivermectin, hydroxychloroquine, azithromycin, and nitazoxanide, with dutasteride and spironolactone "optionally offered" and vitamin D, vitamin C, zinc, apixaban, rivaraxoban, enoxaparin, and glucocorticoids "added according to clinical judgment". There was no control group, but the author helpfully designated some random patients in his area as a sort-of-control, and then synthetically generated a second control group based on “a precise estimative based on a thorough and structured review of articles indexed in PubMed and MEDLINE and statements by official government agencies and specific medical societies”. Patients in the experimental group were twice as likely to recover (p < 0.0001), had negative PCR after 14 vs. 21 days, and had 0 vs. 27 hospitalizations. Speaking of low p-values, some people did fraud-detection tests on another of Cadegiani’s COVID-19 studies and got values like p < 8.24E-11 in favor of it being fraudulent. Also in Cadegiani news: he apparently has the record for completing one of the fastest PhDs in Brazilian history (7 months), he was involved in a weird scandal where the Brazilian government tried to create a COVID recommendation app but it just recommended ivermectin to everybody regardless of what input it got, and he describes himself as: …the only author of the sole book in Overtraining Syndrome, the prevailing sport-related disease among amateur and professional athletes. He is also responsible for approximately 70% of the articles published in the field in the world in the last 05 years, and reviewer for more than 90% of the manuscripts in the field. And, uh, he’s also studied whether ultra-high-dose antiandrogens treated COVID, and found that they did, cutting mortality by 92% . Which sounds great, except that it looks like most of this is that the control group had a shockingly high mortality rate, much higher than makes sense even in the context of severe COVID. I think the charitable explanation here is that he made this data up too. But the Brazilian Parliament seems to be going with an uncharitable explanation, seeing as they have recommended that Cadegiani be charged with crimes against humanity. Anyway, let’s not base anything important on the results of this study. You can find Alexandros’ full critique here, but again I’ll try to summarize it as best I can. Alexandros is unhappy with my portrayal of Cadegiani’s background. I cite details that make him look strange and maybe fake, but there are other details that make him seem more impressive, like that he won gold medals at a Brazilian Scientific Olympiad.
Carvallo said that zero people in the treatment group of his study got COVID, compared to 58% of people in the control group. This is a pretty implausibly big effect, even by the standards of other pro-ivermectin studies, although I don’t know if anyone else tried the exact same preventative protocol as Carvallo. I think this is a more nuanced story than Alexandros’ version where Buzzfeed just doesn’t know that sometimes studies happen at more than one hospital. Is fraud the best explanation? I think Alexandros thinks of Carvallo as just not keeping very good records, so he doesn’t have raw data, and probably mixed up his numbers a few times or gave false numbers, and didn’t have anything to send his collaborators when they asked. I think this is maybe possible, although it seems suspicious that he falsely said Dr. Lombardo was involved, falsely claimed the hospital involved was doing a different trial, and got very implausible results. I can imagine weird chains of events that would cause all of these things through honest misunderstandings. But they don’t seem like the best explanation. After discussing this with Alexandros, he objects to my use of the term “known fraudster”. Perhaps I should have said “highly credibly suspected fraudster” instead, although in a Bayesian sense nothing can ever be 100% and at some point plausibility shades imperceptibly into knowledge. Still, I feel like my description here was more accurate than Alexandros’, which just mentions the hospital approval issue and says nothing about any of the rest of this in a thousand word subsection about this study in particular. I did err in saying the Carvallo paper was retracted. According to the article: After BuzzFeed News raised questions about how the study’s data was collected and analyzed, a representative from the Journal of Biomedical Research and Clinical Investigation, which published the results, said late Monday, “We will remove the paper temporarily.” A link was removed from the table of contents — but was reinstated by Thursday. The journal’s explanation, provided after this story was published, was that the author “informed us that he has already provided the evidence of his study to the media.” I apologize for the error. Elalfy et al (still disagree with Alexandros) I described this as: As best I can tell, this is some kind of Egyptian trial. It might or might not be an RCT; it says stuff like “Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment”. Were they self-allocated in the sense that they got to choose? Doesn’t that mean it’s not random? Aren’t there seven days in a week? These are among the many questions that Elalfy et al do not answer for us. The control group (which they seem to think can also be called “the white group”) took zinc, paracetamol, and maybe azithromycin. The intervention group took zinc, nitazoxanide, ribavirin, and ivermectin. There were very large demographic differences between the groups of the sort which make the study unusable […] There is no primary outcome assigned, but viral clearance rates on day seven were 58% in the yellow group compared to 0% in the white group, which I guess is a strong positive result. This table looks very impressive, in terms of the experimental group doing better than the control, except that they don’t specify whether it was before the trial or after it, and at least one online commentator thinks it might have been before, in which case it’s only impressive how thoroughly they failed to randomize their groups. Overall I don’t feel bad throwing this study out. I hope it one day succeeds in returning to its home planet. In the summary post, Alexandros’ entire criticism of my coverage of this trial, one of the seven trials he focuses on as most unfairly covered and uses as the lynchpin of his argument that I am morally culpable for disastrously bad reporting, is: [Elalfy et al] are accused of incompetence for failing to randomize their groups multiple times in Scott’s piece. The paper writes in six separate places that it is not reporting on a randomized trial, amongst them on a diagram that Scott included in his own essay. Hard to imagine how else they could have made it clear. In his full post on this, he goes line by line to point out all the places they say they are non-randomized, pausing to snark about how dumb I am for not noticing each time4. But he never addresses the actual source of my confusion, which is the part of the paper where it says that: Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment. If this was done as described, it should be an (almost) random trial; patients who come in on Wednesdays shouldn’t systematically differ from patients who come in on Thursdays5. But in fact, it looks (assuming I am understanding a very ambiguous table correctly) like there are very large pre-existing differences between the groups, sufficient to explain the entire result. If they in fact followed their days-of-the-week protocol, and it was random as expected, then I’m misunderstanding the table seeming to show very large differences, and they have indeed found evidence for ivermectin’s efficacy. If they didn’t follow their day-of-the-week protocol and it’s non-random, then maybe I’m understanding the table correctly and their groups had large differences to begin with and the fact that they had large differences at the end of the trial doesn’t demonstrate anything about ivermectin. This is all I was trying to say in the post, and instead of having any opinion on it Alexandros just makes fun of me for saying it. I think our actual crux is that Alexandros thinks a table of big differences between the groups has to be post-treatment (based on how big the differences are), whereas I’m not sure (because it’s unclear in the study, and also because the authors describe what could be a randomization method but also go on and on about how nonrandom they are). This is why I thought it mattered how random it was! Maybe instead of mocking me for this, you can admit it’s an important and relevant question! Ghauri et al (still disagree with Alexandros) I describe this as: Pakistan, 95 patients. Nonrandom; the study compared patients who happened to be given ivermectin (along with hydroxychloroquine and azithromycin) vs. patients who were just given the latter two drugs. There’s some evidence this produced systematic differences between the two groups - for example, patients in the control group were 3x more likely to have had diarrhea (this makes sense; diarrhea is a potential ivermectin side effect, so you probably wouldn’t give it to people already struggling with this problem). Also, the control group was twice as likely to be getting corticosteroids, maybe a marker for illness severity. Primary outcome was what percent of both groups had a fever: on day 7 it was 21% of ivermectin patients vs. 65% of controls, p < 0.001. No other outcomes were reported. I don’t hate this study, but I think the nonrandom assignment (and observed systematic differences) is a pretty fatal flaw. Alexandros notes that these are three differences between experimental/control groups, out of 33 listed characteristics that could have been different. There is approximately a 23% chance (he calculates) that you could get these differences by chance. He accuses me of failing to do a formal Carlisle test - the usual test you would use to determine whether weird differences between randomized groups are because of fraud - instead eyeballing it and getting it wrong. Here I do want to defend myself: I am not accusing Ghauri et al of fraud. In fact, this would be nonsensical: they admit they are assigning patients nonrandomly. Carlisle tests are usually done to show that something about group assignment is impossible (and therefore fraudulent) in a fair random assignment. But these people aren’t claiming to have done a fair random assignment, so I’m not sure what a Carlisle test would prove. My argument is more like: this is nonrandom, therefore we should expect it to be unfair. It is unnecessary, but helpful, to note an actual apparent unfairness - there’s some evidence they gave the ivermectin to less severe patients (as measured by corticosteroid use). Therefore, we can’t necessarily trust this to be a fair trial (which it was never really claiming to be). In the end I kept Ghauri as an okay study, although GMK didn’t so it ended out trashed in the final analysis anyway. I think my thinking was that I never claimed to be only looking at RCTs, so this non-RCT whose between-group-differences confirmed that it was indeed a non-RCT with all the risk of bias that entails, didn’t necessarily need to be ruled out. Still, I don’t think I was wrong to mention this possibility, and I think Alexandros was wrong to suggest that I needed to do extra tests for this to be fair. Borody et al (still disagree with Alexandros) I described this as: Our last paper! …is it a paper? I can’t find it published anywhere. It mostly seems to be on news sites. Doesn’t look peer-reviewed. And it starts with “Note that views expressed in this opinion article are the writer’s personal views”. Whatever. 600 Australians were treated with ivermectin, doxycycline, and zinc. The article compares this to an “equivalent control group” made of “contemporary infected subjects in Australia obtained from published Covid Tracking Data”; this is not how you control group, @#!% you. Then it gets excited about the fact that most patients had better symptoms at the end of the ten-day study period than the beginning (untreated COVID resolves in about ten days). Why are these people wasting my time with this? Let’s move on. Alexandros lists his full concerns here. My summary: Scott is being incredibly disrespectful to the authors, who are in fact a legendary gastroenterologist who invented life-saving h. pylori therapy and a brilliant immunologist who invented a well-regarded bronchitis vaccine (in particular, in describing their control group, I said “this is not how you control group, @#!% you”.
May 21, 2025 · Original source
Five years later, we can’t stop talking about COVID. Remember lockdowns? The conflicting guidelines about masks - don’t wear them! Wear them! Maybe wear them! School closures, remote learning, learning loss, something about teachers’ unions. That one Vox article on how worrying about COVID was anti-Chinese racism. The time Trump sort of half-suggested injecting disinfectants. Hydroxychloroquine, ivermectin, fluvoxamine, Paxlovid. Those jerks who tried to pressure you into getting vaccines, or those other jerks who wouldn’t get vaccines even though it put everyone else at risk. Anthony Fauci, Pierre Kory, Great Barrington, Tomas Pueyo, Alina Chan. Five years later, you can open up any news site and find continuing debate about all of these things.
Harry Potter

Harry Potter is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between January 19, 2022 and March 25, 2025. The archive places it in contexts such as "If we tell it about the Harry Potter universe and ask it how to defeat Voldemort"; "We love that Harry Potter is a powerful wizard who sacrifices his life for the herd"; "This is a Harry Potter themed room on level 1". It most often appears alongside Cambridge, effective altruism, Europe.

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Harry Potter
Mention count
3
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3
First seen
January 19, 2022
Last seen
March 25, 2025
January 19, 2022 · Original source
Second, it…doesn’t realize the universe exists, or something to that effect? It just likes connecting premises to conclusions. If we tell it about the Harry Potter universe and ask it how to defeat Voldemort, it will reason about that and come up with a plan. If we tell it about our universe and ask it how to solve world hunger, it will reason about it and come up with a plan. It doesn’t see much difference between these two tasks. It’s not an agent, just a…thing that is good at thinking like agents, or about agents, or whatever.
August 08, 2024 · Original source
But a fundamental question for that kind of society is "Do the master virtues exist genuinely, or just to lend the slave virtues more meaning?" Because, the herd does love their sacrificial heroes. We love that Harry Potter is a powerful wizard _who sacrifices his life for the herd_. We love that Jesus is infinitely powerful _so he can save us_. The greater the power, the more meaningful the sacrifice - that is one way to valuate power. The other way is to value power for its own sake. In which case you'd use the altruistic virtues as means to more power: build a network of people who owe you a favor; leave a good impression on everybody so they vote for you, etc.
March 25, 2025 · Original source
Contact: Andy B Contact Info: Andy[period]Bachler[a t]gmail[period]com Time: Tuesday, April 8th, 5:30 PM Location: We'll be in the Common Room in the Wollongong Library. This is a Harry Potter themed room on level 1 (excellent vibes)! I will have a sign on the door saying ACX Meetup. Coordinates: https://plus.codes/4RQGHVFX+4G
Hell

Hell is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between September 01, 2023 and May 29, 2025. The archive places it in contexts such as "medieval Europe believed in Hell and heresy"; "even an all-merciful God could not restrain Himself from creating Hell"; "endorsed by leading Hell experts". It most often appears alongside George Mason University, Marginal Revolution, PEPFAR.

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Hell
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3
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September 01, 2023
Last seen
May 29, 2025
September 01, 2023 · Original source
More than three thousand years ago, the Shang dynasty ruled the Chinese heartland. They raised a sprawling capital out of the yellow plains, and cast magnificent ritual vessels from bronze. One of the criteria of civilization is writing, and they had the first Chinese writing, incising questions on turtle shells and ox scapulae, applying a heated rod, and reading the response of the spirits in the pattern of cracks. “This year will Shang receive good harvest?” “Is the sick stomach due to ancestral harm?” “Offer three hundred Qiang prisoners to [the deceased] Father Ding?” The kings of Shang maintained a hegemony over their neighbors through military prowess, and sacrificed war captives from their campaigns totaling in the tens of thousands for the favor of their ancestors.
I’ve seen one reader exclaim that the people of the Spring and Autumn era read like demonic spirits. Figures from even a century or two later argue from nice rational self-interest in ways that are comprehensible to us today, but for the people in the Zuozhuan, especially the early figures, the world spun on different axes. That’s not to say they didn’t understand self-interest, or that their high-flown speeches couldn’t disguise ruthless calculation, but they interfaced with the world through concepts like Heaven’s Mandate and ritual propriety, truly believed in them the way medieval Europe believed in Hell and heresy. Only, while medieval thinkers at least had ideas from the Classical world to draw on, the thinkers of the Spring and Autumn had no predecessors from more advanced societies than theirs. They were from a Bronze Age kin-based society forced to rapidly scale up by its own success, far beyond what their existing customs and worldview had evolved for. Later peripheral conquerors of China could at least copy the homework of the existing empire, but the Zhou conquered the Shang, whose rudimentary state had never managed more than loose hegemony beyond their core lands, a parochial project next to what the Zhou had committed to. In that light, it’s truly impressive that the Zhou were as successful as they were.
May 22, 2025 · Original source
Politics is nasty and sometimes involves lies. But the thousands of doctors, nurses, and charity workers who give up more lucrative careers elsewhere to save lives in the developing world are some of my heroes. I’ve talked to many of these people (see my father’s story of his time in this world here) and I couldn’t do what they do for a month, let alone a whole career. When Trump and Rubio try to tar them as grifters in order to make it slightly easier to redistribute their Congress-earmarked money to kleptocrats and billionaire cronies, this goes beyond normal political lying into the sort of thing that makes you the scum of the earth, the sort of person for whom even an all-merciful God could not restrain Himself from creating Hell.
May 29, 2025 · Original source
Scott writes: “When Trump and Rubio try to tar them [US AID] as grifters in order to make it slightly easier to redistribute their Congress-earmarked money to kleptocrats and billionaire cronies, this goes beyond normal political lying into the sort of thing that makes you the scum of the earth, the sort of person for whom even an all-merciful God could not restrain Himself from creating Hell.” Is that how the rationalist community should be presenting itself? In a time when innocent Americans are gunned down in the streets for their (ostensible) political views, and political assassination attempts seem to be rising, and there even has been a rationalist murder cult running around, does this show a morally responsible and clear thinking approach to the post that was published?
I want to make it clear: I am not recommending that people kill Donald Trump or Marco Rubio. I am recommending that God consider sending them to Hell. I think this is a moderate compromise proposal, endorsed by leading Hell experts2.
As a Jew, I believe that people are only tortured in Hell for twelve months, and get Saturdays off (really!). Like I said, moderate compromise!
Hinduism

Hinduism is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between May 12, 2021 and August 16, 2024. The archive places it in contexts such as ""what if Christianity sucked and the real religion was my headcanon of Hinduism I made up after learning three Sanskrit words?""; "Hinduism has Indic Bricks"; "The origins of Christianity and Judaism (and Buddhism and Hinduism) are very murky". It most often appears alongside Christianity, Ireland, Islam.

Article page
Hinduism
Mention count
3
Issue count
3
First seen
May 12, 2021
Last seen
August 16, 2024
May 12, 2021 · Original source
Massachussetts in 1692 may have been one of the most repressive societies ever to exist. Anyone who spoke out against it was burned as a witch or exiled. Fine, okay, point taken, don't speak out against Puritanism. But by the 1820s, Massachussetts was one of the most open societies in the world. The Puritan Church turned into the Unitarian Church (I swear this is true, the Unitarian Universalists are the direct descendants of the 1600 Puritans). Intellectuals like Ralph Waldo Emerson and Henry David Thoreau explored exciting new ideas like "what if Christianity sucked and the real religion was my headcanon of Hinduism I made up after learning three Sanskrit words?" How did this happen? I would love to read a book or a paper about it but I don't know of any.
February 29, 2024 · Original source
26: Did you know: lots of religions have their own version of LEGO, usually with sets depicting their mythology or temples. Islam has Muslim Blocks, Hinduism has Indic Bricks, and Judaism has Binyan Blocks. But my favorite is Mormonism with - wait for it - Brick’em Young (h/t @seanw_m)
August 16, 2024 · Original source
Given Marvel Comics, why Silver Age (1961-1965)? I.a. Why Superhero Comic Books? The winner of last year’s Astral Codex Ten book review contest was Brandon Hendrickson. Brandon wrote about Kieran Egan’s The Educated Mind. One of the foundations of Egan’s educational philosophy is that people learn through stories. He believes early education should focus on teaching lessons through myths and legends. This matches my experience. My kids’ favorite podcast is Greeking Out – a very well produced, very entertaining, National Geographic podcast about Greek Legends. Aside #1: When my oldest daughter was three years old she would ask everyone she met “Do you know any myths? Can you tell me a myth?” She especially liked asking people from different places to get myths from their local cultures. Once, she asked the question to a friend of mine who grew up in South Africa, “Can you tell me any South African myths?” He struggled for a minute and then said, “Okay! I have one! Bread never falls butter side down!”. That was not the type of myth she was looking for; nor the type of myth we will be discussing in this review. Every culture has foundational myths. These stories are entertaining and engaging, but they also teach valuable lessons about both what is important in that culture, and how people in that culture are expected to behave (or at least the Platonic Ideal of how they should behave). In the modern, Western world, we have assimilated many of these foundational stories, particularly the Greek myths. My kids definitely know the Greek myths, but they also know elements of Norse mythology, Egyptian myths, stories about Anasi from West Africa and more. More fundamentally my wife and I, while not religious ourselves, have made a point of exposing the kids to the stories from the Bible. It is not politically correct to call Biblical stories “myths”, but they serve the same purpose – shared cultural understanding of the way the world works. My wife grew up without any religion, and when she was in high school, she struggled with the metaphors and religious allegories that were omnipresent in most of the Western canon. In our culture, familiarity with the Bible is important for an educated person – whether they are religious or not – because it is the foundation of so much of the rest of our culture. I believe the other set of mythological stories that are foundational to our culture are – and by this point I am sure you see where I am going here – comic book superheroes. If true, then having more than a surface-level understanding of the most important superhero stories is important in a similar way to that knowing the Bible stories is important. “Do unto others as you would have them do unto you” is an important idea to understand. So is, “With great power comes great responsibility”. I.b. Why Marvel? While there are many independent superheroes that are not owned by major conglomerates, the superheroes who have built our modern foundational myths are currently owned by two corporations. Warner Bros. Discover owns the DC library of superheroes including Superman, Batman and Wonder Woman. In 2009 Disney purchased Marvel Comics and took ownership of their characters, including Spiderman, X-men and the Avengers. Aside #2: Marvel has sold temporary film rights to many of their characters over the years. The most relevant sales started in 1994 when Marvel sold the film rights of X-men and mutants to 20th century Fox, then in 1996, when Marvel went bankrupt, Fox picked up the rights to the Fantastic Four (and New Line picked up Blade). In 1999 Marvel sold the film rights (and live action TV, and animated TV longer than 44 minutes) of Spider-man and related characters to Columbia Pictures (part of Sony) for $7MM. Marvel actually attempted to sell ALL of their remaining Marvel IP film rights to Sony for $25MM, but the top management at Sony was not interested. Sony’s management allegedly told their chief negotiator “Nobody gives a shi*t about any of the other Marvel characters. Go back and do a deal for only Spider-Man). Disney acquired Marvel in 2009, and then Fox in 2019, bringing the two separated packages of characters all back together under one roof (Blade reverted back to Marvel in 2012). Sony still owns the rights to Spider-man but has made a deal with Disney to include some of his films within the Marvel-Disney universe. Marvel sold the film rights of The Hulk to Universal in 1990 and the current status of that agreement is complicated (the consensus is that Marvel now controls the film rights to the character, but Universal owns distribution rights to any stand-alone Hulk film, which could be why Disney let's Hulk co-star in Thor movies, but not vice versa). In the early aughts Marvel wanted to build their own film franchise, but were limited to only using their remaining “B-list” characters – Spider-man, X-men, and the Fantastic Four were all off limits. Fortunately, Kevin Feige, president of production for Marvel at the time, saw a way forward. He convinced Ike Perlmutter, Marvel CEO, to allow for the production of a series of films with the remaining characters begining with Iron Man (2008). Jon Favreau directed and cast Robert Downey Jr as Tony Stark. The film blew away expectations. Kevin’s plan of a series of movies where the characters would interconnect was suddenly feasible. Iron Man was followed by The Incredible Hulk, Thor, and Captain America: The First Avenger. None managed the box office magic of Iron Man, but all were successful enough that the plan stayed on track. In 2012 the characters were all brought together in the first Avengers film, which opened to over $200MM domestically and went on to gross more than $1.5B (which made it the 3rd highest grossing film of all time). Marvel became the first studio to take the interconnected world of their comic books and make the model work on the big screen (for a much larger audience). Once the model was proven to work, other studios tried to duplicate it. Aside #3: Warner Bros’ stumbles with the DC shared universe of Batman, Superman and the Justice League are well known, but that was actually their SECOND attempt at a shared universe. Their first attempt tried to copy the Marvel method more closely. They chose their own B-list hero and set up his first film to allow for a wider mythology. Alas Green Lantern (2011) failed at the box office and we never got stand-alone films about Sinestro (Yellow Lantern), Carol Ferris (Star Sapphire, the Violet Lantern), John Stewart (African American Green Lantern), Kyle Rayner (1990s Green Lantern), Alan Scott (original Green Lantern), or the Blue, Red, and Orange Lantern Corps. At least so far, no studio has successfully created anything with close to the traction obtained by the Marvel Cinematic Universe (MCU). Warner’s DC Extended universe (DCEU) had trifling success, but is being shelved and rebooted for a fresh attempt next year. Universal’s attempt at a “Dark Universe” kicked off with Tom Cruise in The Mummy (2017), but was dead on arrival. Paramount’s attempt to link the Transformers Universe to GI Joe at the end of Transformers: Rise of the Beasts has been appropriately mocked. Sony’s Spider-man films linked to the MCU have been very successful, but their attempt at a stand-alone non-MCU Spider-man universe using Spider-man’s villains as anti-heroes has floundered (mostly succeeding only as a source of memes). Next Mattel will be attempting to build a universe off the success of last year’s Barbie and may include Polly Pocket, American Girl, Hot Wheels, and He-Man and the Masters of the Universe (no word yet on Thomas the Tank Engine, View Master and the Magic-8 Ball, but all are apparently in development). To date, only Marvel has successfully built a “Cinematic Universe”. One potential reason for the MCU’s success is that Kevin Feige built his cinematic universe on the back of the existing interconnected universe of the comics. But those comics were not the first interconnected universe of stories. For that we would need to go back to our foundational myths. The Bible stories mostly interconnect. Adam and Eve flows into Cain and Abel. David and Goliath leads to the Wisdom of Solomon. Greek Myths DEFINITELY interconnect. Supporting characters in one Greek myth have starring roles in their own stories. The Greek pantheon of tales even have their own version of the Avengers. In the Quest for the Golden Fleece, Jason brings together the Argonauts, who included in their number Theseus (who defeated the Minotaur), Orpheus (who braved the underworld) and Hercules himself – all A-list stars in their own “franchises”. Stand alone stories that exist within an interconnected universe are rare in modern media but were common in the ancient myths that have stood the test of time. Only Marvel has successfully created a shared universe that follows the pattern of ancient myths. Only Marvel films have stand-alone stories and protagonists who exist together in an interconnected world. Something about that method of storytelling is deeply pleasing for humans across many cultures. Marvel films are the first and most successful modern version of the mythological universe, and that it is worth spending more time exploring Marvel’s underlying mythology and where it came from. I.c. Why 1961? The origins of Christianity and Judaism (and Buddhism and Hinduism) are very murky. Even Islam is far enough in the past that we only have a very rough understanding of how it came to exist. When scholars want to understand in detail how a new religion is born they are far better to look at Mormonism or, if you accept it as a religion, Dianetics. Similarly, we have versions of Greek myths that have been passed down to us, but we can never know how those myths changed from their first telling to their “final” versions. Were the stories once unrelated, and only later became crafted into a single “universe”? Or were the stories built off each other one by one (“Dad that Golden Fleece story was amazing! Do you know any other stories about the Hercules guy?”)? Or was it something in between? Perhaps the stories all existed independently, but were later crafted together (“Remember that 12-labors story I told you? Actually that was the same guy who was on the Argo!”) Unlike Greek legends, we can know the origin of the Marvel Universe. We can see how it was constructed step-by-step. The people who did it (most importantly Stan Lee, Jack Kirby, and Steve Ditko) are dead now, but they have not been dead for long. We can read the original work, see how it changed over the last 60 years, and we can ask the creators “what were you thinking at the time” (or at least read their answers from old interviews). We can’t always trust what Stan Lee says, but at least we can hear his point of view. No one has a transcript of an interview with Homer, or knows exactly what he was thinking when he called it the “wine-dark sea”. Tl;dr: Why read about Marvel Comic superheroes 1961-1965? Because interconnected mythological stories are very important to cultures, Marvel is the leading contender of the most recent modern mythology, and it originated in the first half-decade of the 1960s. II. How did Marvel Superhero Comics happen? Timely Comics published their first comic book in 1939 and called it “Marvel Comics”. Their most popular World War II comics included Captain America, the Human Torch (an android unrelated to the modern Human Torch except in powers, appearance and name), and Namor, the Submariner. In the early 1950s superheroes became less popular, so Timely changed its name to Atlas Comics and focused on humor, western, horror, war and science fiction stories. But in 1956 DC Comics began re-introducing their Golden Age superheroes and, in the second half of the 1950s, the genre took off again – particularly Superman, whose title, Action Comics, became the number one selling comic in America. Stan Lee, editor and chief at Atlas at the time, wanted to get in on the superhero action. Unfortunately in 1957 Atlas lost its distributor and the company had to rely on “Independent News” to get its comics on newsstands. The complication was that Independent News was owned by “National Periodical Publications”, who also owned DC-comics and did not want Atlas to introduce superheroes to compete with Superman, Green Lantern and the Flash. Independent News agreed to distribute Atlas comics but limited the publisher to eight titles per month, and only in non-super hero genres (like horror, romance and science fiction). Blocked from creating and launching new superhero titles, Stan Lee got creative, and in August 1961 Atlas Comics published Fantastic Four #1. Aside #4: Fantastic Four #1 was on newsstands in August 8th, 1961, but the date on the cover was November 1961. The convention at the time was that the cover date was not the “publication date” but rather the “pull date”. The pull date was the time when the retailer could send back unsold copies back to the publisher for a refund. In fact the retailer did not need to send the entire issue back, just the cover, as it was assumed that comic books could not be sold without the cover, and it saved on postage. This was only relevant because it was great for my dad who was a child at the time. My dad was friends with the kid whose father owed the local pharmacy which meant he had access to every comic book published in the late 1950s as long as he was willing to wait a few months and read it without a cover. Going forward in this essay I will always use the pull dates rather than the publication dates for individual comic book issues as they are far easier to source. If you want to convert pull dates back into publication dates you can subtract roughly two months, but it is inconsistent and sometimes longer, as was the case with Fantastic Four #1. Check out the cover of Fantastic Four #1: To the modern eye this certainly looks like a superhero comic. Four heroes with super powers fighting a giant monster. But in the eyes of publishers in 1961 this looked more like a science fiction adventure comic than something that would go head to head with Superman. Here are the covers of Action Comics (the best selling superhero comic at the time) from the three months leading up to Fantastic Four #1: Notice what they have in common? “Super Rivals”, “Super revenge”, “Super Substitutes”. And all include Superman in his blue and red tights. Fantastic Four’s cover featured super powers, but never used the word “super” and no one was wearing superhero costumes. Fantastic Four, as a superhero story, slipped under the radar because it wasn’t really a superhero story at all. It was a story about four close friends who attempted to fly into space, but then something goes wrong and they crash back to Earth. The experience changes them and they decide they now need to use their new abilities to help the rest of humanity – specifically against monsters who are invading from under the Earth. It is a fantastical science fiction story – not a superhero story. Later in his career Jack Kirby, the illustrator of the issue and co-creator of the Fantastic Four, was asked about his inspiration for the Fantastic Four heroes. He did NOT say Superman – or any superhero. He said Challengers of the Unknown. Challengers of the Unknown was an adventure story co-created by Kirby in Showcase #6 in February 1957. Here is how Wikipedia describes the Challengers origin: When acquaintances miraculously survive a plane crash unscathed, they conclude that since they are "living on borrowed time" they should band together for hazardous adventures. The four—pilot Kyle "Ace" Morgan, daredevil Matthew "Red" Ryan, strong and slow-witted Leslie "Rocky" Davis, and scientist Walter Mark "Prof" Haley—became the Challengers of the Unknown. Showcase #6, and the first appearance of the Challengers of the Unknown, by Jack Kirby Visually the Challengers and the Fantastic Four were similar. Both wore skin tight uniforms with belts and minimal decoration. The Fantastic Four’s relatively simple characterizations were practically pulled from Challengers. Reed takes on the traits of both Kyle, the leader, and Walter, the scientist. Johnny, the Human Torch is the daredevil. The Thing is “strong and slow-witted”. Sue, the only woman on the team, seems like a new addition, but is likely based on June Robbins who joined the Challengers team in Showcase #7, as an “honorary” or “girl-Challenger”. After surviving their respective “miraculous” crashes, both the Challengers and the Fantastic Four band together to help the world. They both travel through space and other dimensions, fighting mad scientists and monsters. The Fantastic Four’s early antagonists were not traditional super villains. In the first few issues they fight monsters from under the Earth (Issue #1), shape changing aliens (#2), and a charlatan who uses hypnotism to steal from his audience (#3). In issue #4 Kirby and Lee re-introduce Namor, the Submariner, one of Marvel’s top IP from the 1940s, and have him kidnap Sue. Only in Issue #5 and #6 (June and August 1962) and do we get a more standard-supervillain when Dr Doom attempts to steal the Fantastic Four headquarters and throw it into space. The next superhero Lee created was even less heroic than the Fantastic Four. In April 1962 (pull date), Marvel published The Incredible Hulk. If it was even a superhero story in disguise it was a very good disguise. The story was a scientific-filtered version of Dr Jekyl and Mr Hyde. It was a pure monster-story with nothing very super about it. Nothing on the cover suggests this has anything to do with superheroes: It is not clear if even Lee at the time thought the Hulk would be a superhero. In Fantastic Four #5 Johnny is reading a “great new comic mag” and mocks the Thing by comparing him to the Hulk. It seems pretty clear at this point that in the Fantastic Four’s world, the Hulk is just a fictional comic book, like in ours (more on that later): The other two superheroes the Marvel introduces in this period have even more subtle introductions. At the time Marvel had a number of generic-sounding titles and told science fiction and fantasy stand-alone stories: Tales to Astonish
Hispanics

Hispanics is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between October 10, 2022 and July 21, 2025. The archive places it in contexts such as "celebrating the undeniable fact that Hispanics literally would not exist"; "we respect Hispanics as much as ever"; "No number of polls showing that respect for Hispanics stayed stable between 2002 and 2013 would change his mind". It most often appears alongside America, US, 9-11.

Article page
Hispanics
Mention count
3
Issue count
3
First seen
October 10, 2022
Last seen
July 21, 2025
October 10, 2022 · Original source
Many countries have some kind of holiday on October 12 but the US is the only one to call it "Columbus Day" in most of Latin America it's Dia de la Raza, celebrating the undeniable fact that Hispanics literally would not exist if not for October 12, 1492
Oooh, I like this one. Italians aren’t powerful enough to maintain their own holiday these days, so draw the Hispanics into the coalition. Columbus didn’t destroy indigenous peoples, he initiated their transformation into a more powerful form! We can ditch Cinco de Mayo (boring, unrelated to America, non-inclusive of non-Mexican Hispanics), save Columbus Day, and have an extra excuse to eat tacos. Let’s do it!
June 30, 2023 · Original source
Compared to the past, have things gotten better, worse or stayed the same [regarding] treating Hispanics with respect and courtesy? (2002 vs. 2013)
You describe this state of affairs as “I’m worried about a moral decline”. Then some psychologists pounce on you with one million graphs showing that actually we respect Hispanics as much as ever which means you’re just biased.
The correct interpretation of the Livy quote isn’t “people think morals are declining today, but Livy thought morals were declining in Rome, so clearly everyone’s equally wrong and morals are the same everywhere forever.” If Livy were to see modern America, he would consider us morally insane. No number of polls showing that respect for Hispanics stayed stable between 2002 and 2013 would change his mind. Our only recourse would be to retort back that no, he was morally insane.
July 21, 2025 · Original source
“Four months ago, we started our biggest project yet. We formed a front group, the Patriotic Defense League. Its supposed goal: shoplift from stores owned by illegal immigrants, to ‘destroy their livelihood and force them back where they belong’. None of us had the guts to actually shoplift, but we distributed flyers about it all over town. We said that if you didn’t know who was illegal or not, you could just shoplift from any store owned by Hispanics and it would all be the same in the end. We assumed some of the usual shoplifters would hit Hispanic-owned stores by coincidence and we would get the credit.”
HKU1

HKU1 is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between December 23, 2021 and April 09, 2024. The archive places it in contexts such as "two other coronaviruses called OC43 and HKU1"; "HKU1 is another emergent Chinese coronavirus that caused a small outbreak of pneumonia in 2004"; "HKU1 might also fit these criteria. It’s a coronavirus discovered in 2004". It most often appears alongside Twitter, BANAL-52, China.

Article page
HKU1
Mention count
3
Issue count
3
First seen
December 23, 2021
Last seen
April 09, 2024
December 23, 2021 · Original source
The authors (including Marc Lipsitch who some of you might know from Twitter) are writing in May 2020, trying to predict the future course of COVID. To that end, they investigate the past course of two other coronaviruses called OC43 and HKU1, which cause mild colds. These show a seasonal pattern. Why?
March 28, 2024 · Original source
Lineage A (left) was used by the Minoan Cretans, but has never been deciphered. Lineage B (right) was used by the Mycaeneans for lists of palace goods. This matches Saar’s story above. The lab leaked to somewhere else in Wuhan, not the wet market. The virus spread undetected in the population for a while. During this time, it mutated to Lineage B. Then one of the people with Lineage B went to the wet market and started a superspreader event. The authorities sampled the patients, found Lineage B, then started looking elsewhere. Later they detected some of the earlier Lineage A cases. The market is unlikely to be the origin of the pandemic, because the original Lineage A strain wasn’t found there. Peter: Although Lineage A is evolutionarily older, Lineage B started spreading in humans first. We know this because Lineage B is more common. Throughout the early pandemic, until the D614G variant drove all other strains extinct, a consistent 2/3 of the cases were B, compared to 1/3 A. Both strains spread at the same rate, so the best explanation is that B started earlier than A. Since COVID doubles every 3-4 days, probably Lineage B started 3-4 days earlier than Lineage A, which explains why it’s always been twice as many cases. But also, Lineage B also has more internal genetic diversity than Lineage A. In general, older viruses have more genetic diversity (the “molecular clock”). This is further evidence that B started spreading first. Pekar 2022 and Pipes 2021 do analyses with known parameters for spread rate and diversity, and find 90%+ odds that Lineage B was the first one in humans. Why did the older strain start spreading later? Probably the virus crossed from bats into raccoon-dogs on some raccoon-dog farm out in the country. It spread in the raccoon-dogs for a while, racking up mutations, including the (less mutated) Lineage A strain and the (slightly more mutated) Lineage B strain. Then several raccoon-dogs were taken to Wuhan for sale, including one with Lineage A and another with Lineage B. The one with Lineage B passed its virus to humans earlier. Then 3-4 days later, the Lineage A one passed its virus to humans. Lineage A was first found in a Wuhan neighborhood right next to the wet market (closer to the wet market than 97% of Wuhan’s population). Again, it would be a bizarre coincidence if a lab leak pandemic was first detected at a wet market. But it would be an even more bizarre coincidence if a lab leak pandemic separated into two strains, and both were first detected at a wet market! Although no known wet market cases were Lineage A, a positive Lineage A environmental sample was found at the wet market, and everyone agrees most cases went undetected. So maybe the Lineage B raccoon-dog spread its virus to a vendor, and that sub-strain mostly stayed in the market. But the Lineage A raccoon-dog spread its virus to a customer, who went back to his house nearby, and that strain spread in the neighborhoods next to the market. This is the only story that explains the evolutionary precedence of A, the greater spread and older molecular clock of B, and the fact that both strains were first found very close to the wet market. Yuri/Saar: Lineage B could be more common and diverse because it got the advantage of a super-spreader event in the wet market. There are a few scattered cases of intermediates between A and B, and a few other scattered cases of lineages that seem even more ancestral (ie closer to the bat virus) than either. This doesn’t make sense in a double spillover hypothesis. But it does make sense if the lineages separated in human transmission somewhere between the lab and the first super-spreader event at the wet market. Peter: Again, the wet market wasn’t a super-spreader event. COVID spread in the wet market at exactly its normal spread rate, doubling about once every 3.5 days. Stop calling the wet market a super-spreader event. The scattered cases of “intermediates” are sequencing errors. They were all found by the same computer software, which “autofills” unsequenced bases in a genome to the most plausible guess. Because Lineage B was already in the software, depending on which part of a Lineage A virus you sequenced, you might get one half or the other autofilled as Lineage B, which looked like an “intermediate”. We know this because all the supposed “intermediates” were partial cases sequenced by this particular software. We can confirm this by noting that there are too many intermediates! That is, where Lineage A is (T/C) and Lineage B is (C/T), the software found both (T/T) “intermediates” and (C/C) “intermediates”. But obviously there can only be one real intermediate form, and we have to dismiss one or the other. But in fact we can dismiss both, because they were both caused by the same software bug. The scattered “progenitor” cases - those closer to the ancestral bat virus than either A or B - are reversions, ie cases where a new mutation in the virus happened to hit an already-mutated base and shift it back towards the ancestral virus. We know this because all of these “progenitors” were scattered cases found months after the pandemic started, often in entirely different countries from Wuhan. If these were real progenitor viruses, they would have either fizzled out or exploded into a substantial portion of all cases, not be found one time in one guy in Malaysia. Given the number of mutations the virus developed over the course of the pandemic, it’s inevitable that some of them would be mutations that bring it closer to the original bat virus, and in fact we find the number of “progenitors” found very nicely matches the number of progenitor-appearing viruses we would expect by chance. And in many cases, we know the “progenitors” are newer than the original lineages, because they also have some of the later mutations that Lineage A or B picked up along the way, alongside their apparent ancestral-bat-virus-like mutations. Session 2: Viral Genetics Yuri: Two years before COVID, scientists at the Wuhan Institute of Virology, together with colleagues at the University of North Carolina, sent in a grant proposal for the DEFUSE program. This program, intended to locate and better understand potential future pandemic viruses, involved going into bat caves and collecting new coronaviruses. Once they had them, they would do gain-of-function: specifically, they would add a furin cleavage site to make them more infectious and see what happened. (quick interlude: COVID’s spike protein has two sections: one binds to human cells through the ACE2 receptor, the other helps fuse with the cell after binding. In order to avoid the immune system, it hides both of these into one spike. But when it reaches a cell, it needs to separate them again. It takes advantage of a human respiratory enzyme, furin, to do the separation - this also ensures that it only infects its primary target, human respiratory cells. The part of COVID that lets it get separated by furin is called the “furin cleavage site”. COVID’s bat-virus ancestors were gastrointestinal viruses; the addition of a furin cleavage site was what made them respiratory viruses.) We’ve found two close relatives of COVID: bat viruses called RATG-13 and BANAL-52. In particular, COVID looks more or less like BANAL-52 plus a furin cleavage site. There are 1500 sarbecoviruses, members of the family of viruses that includes SARS and SARS2/COVID. None of them except COVID have furin cleavage sites. BANAL-52, COVID’s closest ancestor, doesn’t even have anything resembling one that could mutate into a functional furin cleavage site like COVID’s. Instead, COVID - which mostly just resembles BANAL-52 with a few scattered single-point mutations - has twelve completely new nucleotides in a row - a fully formed furin cleavage site that came out of nowhere. There is nowhere else in the genome that COVID differs from BANAL-52 in such a profound way. It’s just BANAL-52 plus a little bit of random mutation plus a fully-formed furin cleavage site that came out of nowhere. Further, the furin cleavage site is weird. It uses the protein arginine twice. But instead of the nucleotides coding for arginine in the usual viral way, both times it uses the codons CGG - the way that higher animals code for arginine. This works fine - it’s just not how viruses do it. So the obvious conclusion is that WIV, which said in 2018 that it was going to find viruses and add furin cleavage sites to them, found a close relative of BANAL-52 and added a furin cleavage site. Since they were humans, and most familiar with the human way of encoding arginine, they added it as CGG both times. COVID seemed surprisingly optimized for infecting humans. Of fifty animals it was tested in, including the usual coronavirus intermediate hosts (pangolins, raccoon-dogs, etc), it was best at infecting human cells. Further, a virus that enters a new species will usually show a burst of mutations as it “figures out” the best way to adapt to that species’ unique biology. But COVID has had a pretty constant mutation rate in humans, from the beginning of the pandemic to the end. That suggests it was already adapted to humans. This could be because the lab screened for viruses with existing adaptations, because they passed it through humanized mice in the lab, or because it adapted in the hundreds of undetected cases that happened between the lab and detection in the wet market. Usually, research with potentially dangerous coronaviruses is done in BSL-3 or 4, ie high to very-high security. But WIV was irresponsibly doing it in BSL-2, ie medium security. The researchers weren’t even required to wear masks. In general, about 1/500 labs will leak any given pathogen they’re working on (?!). But because WIV was researching such an infectious virus in such an irresponsible way, the odds of a leak were much higher. The most likely explanation for all these facts is that WIV went ahead and did the gain-of-function research they said they were going to do (the particular DEFUSE grant proposal we know about got rejected, but it proves that Wuhan wanted to do this, and they could easily have gotten funding somewhere else, or done it out of their regular budget). They found a close relative of BANAL-52 and added a furin cleavage site as a simple twelve-nucleotide insertion, using the human method of encoding arginine that their genetic engineers were familiar with. Then it leaked, spread for a while in the general Wuhan population, and eventually made it to the wet market where it got detected. Peter: As mentioned earlier, the DEFUSE grant was rejected. Further, the grant said that the Wuhan Institute of Virology was responsible for finding the viruses, and the University of North Carolina would do all the gain-of-function research. This was a reasonable division of labor, since UNC was actually good at gain-of-function research, and WIV mostly wasn’t. They had done a few very simple gain-of-function projects before, but weren’t really set up for this particular proposal and were happy to leave it for their American colleagues. Even if WIV did try to create COVID, they couldn’t have. As Yuri said, COVID looks like BANAL-52 plus a furin cleavage site. But WIV didn’t have BANAL-52. It wasn’t discovered until after the COVID pandemic started, when scientists scoured the area for potential COVID relatives. WIV had a more distant COVID relative, RATG-13. But you can’t create COVID from RATG-13; they’re too different. You would need BANAL-52, or some as-yet-undiscovered extremely close relative. WIV had neither. Are we sure they had neither? Yes. Remember, WIV’s whole job was looking for new coronaviruses. They published lists of which ones they had found pretty regularly. They published their last list in mid-2019, just a few months before the pandemic. Although lab leak proponents claimed these lists showed weird discrepancies, this was just their inability to keep names consistent, and all the lists showed basically the same viruses (plus a few extra on the later ones, as they kept discovering more). The lists didn’t include BANAL-52 or any other suitable COVID relatives - only RATG-13, which isn’t close enough to work. Could they have been keeping their discovery of BANAL-52 secret? No. Pre-pandemic, there was nothing interesting about it; our understanding of virology wasn’t good enough to point this out as a potential pandemic candidate. WIV did its gain-of-function research openly and proudly (before the pandemic, gain-of-function wasn’t as unpopular as it is now) so it’s not like they wanted to keep it secret because they might gain-of-function it later. Their lists very clearly showed they had no virus they could create COVID from, and they had no reason to hide it if they did. COVID’s furin cleavage site is admittedly unusual. But it’s unusual in a way that looks natural rather than man-made. Labs don’t usually add furin cleavage sites through nucleotide insertions (they usually mutate what’s already there). On the other hand, viruses get weird insertions of 12+ nucleotides in nature. For example, HKU1 is another emergent Chinese coronavirus that caused a small outbreak of pneumonia in 2004. It had a 15 nucleotide insertion right next to its furin cleavage site. Later strains of COVID got further 12 - 15 nucleotide insertions. Plenty of flus have 12 to 15 nucleotide insertions compared to other earlier flu strains. Sometimes insertions happen because of a mistake in viral replication. Other times the virus gets confused between its own RNA and its host’s, and splices a bit of the host RNA into the virus. This would neatly explain why the insertion used the unusual coding CGG for arginine, which is common in animals but rare in viruses. On the other hand, it’s not that rare in viruses - COVID uses CGG for arginine about 3% of the time. And human engineers don’t necessarily use it any more than that - Peter was able to find one example of humans adding arginine to a virus, and 0 out of the 5 arginines added were CGG. COVID’s furin cleavage site is a mess. When humans are inserting furin cleavage sites into viruses for gain-of-function, the standard practice is RRKR, a very nice and simple furin cleavage site which works well. COVID uses PRRAR, a bizarre furin cleavage site which no human has ever used before, and which virologists expected to work poorly. They later found that an adjacent part of COVID’s genome twisted the protein in an unusual way that allowed PRRAR to be a viable furin cleavage site, but this discovery took a lot of computer power, and was only made after COVID became important. The Wuhan virologists supposedly doing gain-of-function research on COVID shouldn’t have known this would work. Why didn’t they just use the standard RRKR site, which would have worked better? Everyone thinks it works better! Even the virus eventually decided it worked better - sometime during the course of the pandemic, it mutated away from its weird PRRAR furin cleavage site towards a more normal form. Further, COVID’s furin cleavage site was inserted via what seems to be a frameshift mutation - it wasn’t a clean insertion of the amino acids that formed the site, it was an insertion of a sequence which changed the context of the surrounding nucleotides into the amino acids that formed the site. This is a pointless too-clever-by-half “flourish” that there would be no reason for a human engineer to do. But it’s exactly the kind of weird thing that happens in the random chance of evolution. COVID is hard to culture. If you culture it in most standard media or animals, it will quickly develop characteristic mutations. But the original Wuhan strains didn’t have these mutations. The only ways to culture it without mutations are in human airway cells, or (apparently) in live raccoon-dogs. Getting human airway cells requires a donor (ie someone who donates their body to science), and Wuhan had never done this before (it was one of the technologies only used at the superior North Carolina site). As for raccoon-dogs, it sure does seems suspicious that the virus is already suited to them. The claim that COVID is uniquely adapted to humans is false. The paper that claimed that defined how well COVID was adapted to different animals by those animals’ difference (on the relevant cell receptors) from humans. So in its methodology, humans came out #1 by default. If you don’t do that, COVID is better-adapted to many other animals. It’s not necessarily true that viruses see a burst of mutations when they enter a new host. COVID spread to deer and mink, and in neither case was there a burst of mutations. COVID has a pretty simple job of infecting respiratory cells and is already very good at it, regardless of species. In Yuri’s model, Wuhan Institute of Virology picked up a discarded grant and decided to do the gain-of-function half allotted to a different university, despite their relative inexperience. They skipped over all the SARS-like viruses they were supposed to work on, and all the standard gain-of-function model backbones, in favor of BANAL-52, a virus which would not be discovered for another two years, but which they somehow had samples of, which they had for some reason decided to keep secret despite its total lack of interestingness. Then they would have had to eschew all usual gain-of-function practices in favor of inserting a weird furin cleavage site that shouldn’t have worked according to the theory they had at the time, via a frameshift mutation. Then they would have had to culture it, a technique beyond their limited capabilities. Then it would have had to leak, and magically show up again in front of the raccoon-dog stall at a wet market. Yuri: WIV wouldn’t have needed to keep BANAL-52 “secret” in some kind of sinister way. Plenty of researchers have backlogs of work they haven’t published yet. Probably they a found BANAL relative in one of their normal sampling trips, did some preliminary studies on it, and planned to publish it later once they cleaned up their data. Everyone works like this. The part of DEFUSE saying that they would only work on viruses that were 95% similar to SARS is unclear and might mean something else. It looks more like they say they’ll start with those viruses, but also do some work on novel viruses. BANAL-52 could have been one of the novel viruses. The furin cleavage site is weird, but the researchers might have done that on purpose, to make the virus easier to keep track of, or to test different furin cleavage sites. Depending on the exact BANAL-52 relative they used, it might not even be a frameshift; there’s a particular way to spell serine that would make the insertion more natural. The claims that COVID can’t be cultured in normal media are based on speculative original research by Peter and might not hold up. Peter: WIV did most of its virus-gathering in a trip to a Yunnan cave between 2010 and 2015. All those viruses have long since been processed and added to the database. There’s no sign that they made more trips to Yunnan caves, and no reason for them to keep that secret. So the idea that they might just have some new viruses they didn’t publish doesn’t hold up. But suppose they did make more trips. Given the amount of time between the DEFUSE proposal and COVID, if they kept to their normal virus-collection rate, they would have gotten about thirty new viruses. What’s the chance that one of those was BANAL-52? There are thousands of bat viruses, and BANAL-52 is so rare that it wasn’t found until well after the pandemic started and people were looking for it very hard. So the chance that one of their 30 would be BANAL-52 is low. Also, they said in DEFUSE that they planned to go back to the same Yunnan cave. But BANAL-52 was found far away from that cave, so unless it ranged over a wide area, they probably couldn’t have found it even if they got very lucky. Session 3: Closing Arguments This third debate was supposed to be about “inference”, ie how much Bayesian evidence was provided by each of the facts given so far, and how to fit them into the Rootclaim probabilistic model. I’m going to relegate my summary of the more probabilistic half to the next section of this post, and just include the closing arguments here. Saar: Peter’s case hinges on the idea that it’s very improbable that a lab leak pandemic would first show up at a wet market. But this isn’t necessarily improbable. The Huanan Seafood Market had several factors that made it a likely location for a superspreader event. It was busy, with over 10,000 visitors a day. Many of the people there (eg the 1,000 vendors) came back daily, letting them reinfect each other. It had poor ventilation, especially in the high-positivity area near the raccoon-dog stall. It had cold wet surfaces on which the virus could survive for long periods. It was indoors, which prevented UV light from killing the virus. Given a small amount of sporadic COVID going around Wuhan, it’s not surprising for the first place it started spreading en masse to be a wet market. In fact, we have several examples of this. When China was COVID Zero, there would occasionally be small outbreaks that the authorities would have to contain. Most of these were at wet markets. For example, the big COVID outbreak in Beijing started at Xinfadi Market, their local seafood market. This couldn’t be an animal spillover, because there were no raccoon-dogs or other weird wildlife there. So it must be that wet markets are natural places for superspreader events. There are several other examples, which make up about half of the total outbreaks in Zero COVID era China, plus others in Singapore and Thailand. Since COVID clusters concentrate in wet markets even when there is no animal spillover, we should accept this as a property of the virus, and not attribute any significance to the fact that this happened in Wuhan too. Peter: About 1/10,000 citizens of Wuhan was a wet market vendor. So there’s a 1/10,000 chance that the first known COVID case should be a wet market vendor by chance alone. Weibo lists the most popular places for people to check in to their network on their phones, and the wet market was the 1600th most popular place in Wuhan, meaning that if you weight locations by busy-ness, there’s a less than 1/1600 chance that the first cases would be in the wet market. Yes, the wet market is indoors, has mediocre ventilation, has repeat visitors, etc. So do thousands of other places in Wuhan, like schools, hospitals, workplaces, places of worship. The wet market isn’t special in any way. And again, it wasn’t a superspreader event! COVID spread at the same rate in the wet market as it does everywhere else: doubling once per 3.5 days. It doesn’t matter what kinds of arguments you can come up with for why the wet market should have been the perfect superspreader event location, we can look at it and see that it wasn’t. It’s an environment that spreads COVID at exactly the normal rate. Zero COVID era Chinese outbreaks were concentrated in wet markets because they received infected animal products. We know why there was an outbreak in the Xinfadi Market in Beijing: it was because the seafood stall got frozen fish from some non-Zero-COVID country, the fish had COVID particles on it, and the vendor got infected and spread it to everyone else. Something like this is true for the other Chinese wet market based outbreaks we know about it. So this makes the opposite point you think it does: wet markets start outbreaks because there are infected goods being sold there. Then the virus spreads through the wet market at a completely normal rate. Saar: The Weibo list of 1600 places bigger than the wet market is likely inaccurate, because it's based on check-in data and people don't check in to seafood markets. Most of those 1600 places aren't amenable to superspread. The 70 markets supposedly bigger than Huanan are irrelevant, because they're supermarkets, open air markets, etc. Huanan is the largest seafood market in central China, and a more likely place for the first cluster of cases to be noticed. Markets weren't a common spillover location in SARS1, so the zoonosis hypothesis hasn't "called" this event in a way that should give them a high Bayes factor. And there’s still plenty of evidence for isolated (though not super-spreading) pre-market cases. A British expatriate in Wuhan, Connor Reed, says he got sick in November, three weeks before the first wet market case. Later the hospital tested his samples and said it was COVID. Another paper reports 90 cases before the first wet market one. Peter: Connor Reed was lying. The case wasn’t reported in any peer-reviewed paper. It was reported in the tabloid The Daily Mail, months after it supposedly happened. He also told the Mail that his cat died of coronavirus too, which is rare-to-impossible. Also, to get a positive hospital test, he would have had to go to the hospital, but he was 25 years old and almost no 25-year-olds go to the hospital for coronavirus. His only evidence that it was COVID was that two months later, the hospital supposedly “notified” him that it was. The hospital never informed anyone else of this extremely surprising fact which would be the biggest scientific story of the year if true. So probably he was lying. Incidentally, he died of a drug overdose shortly after giving the Mail that story; while not all drug addicts are liars, given all the other implausibilities in his story, this certainly doesn’t make him seem more credible. And in any case, he claimed he got his case at a market “like in the media” The other 90 cases are also fake. A lab leak guy found a paper that mentioned 90 more cases than other papers, and made up a conspiracy theory where the author was trying to secretly communicate that there had been 90 secret cases before any of the confirmed cases, even though there was nothing about this in the text of the paper. But actually that paper just counted cases differently than other papers, and they were referring to normal cases after the pandemic officially started. Again, I’ll come back to the discussion about inference later, but for now, here’s a table of both sides’ reasoning. This exact presentation comparing both analyses is mine3, but you can see Saar’s version here, and Peter’s starting at 45:33 of this video. Slightly made up; the two sides didn’t express their probabilities in the same way and I had to make editorial decisions to match them. Note that these aren't entirely comparable because Peter is being laxer about out-of-model probability than Saar. Although Saar's final odds here are 533-to-1, this just the central estimate. Rootclaim’s real final probability is 94% lab leak. You can see their analysis here. And The Winner Is . . . … … … … … Peter and the zoonosis hypothesis. This was a decisive victory. There were two judges, who each gave separate verdicts (or were allowed to declare a draw). Both judges decided in favor of Peter. You can see the judges’ own summary of their reasoning here (Will, Eric) Manifold agreed with the judges. There was a prediction market on who would win. It started out 70-30 in favor of lab leak. As the videos came out, zoonosis started doing better and better. I don’t want to take the exact final numbers too seriously, since I think some of the later price increases involved hints from the participants’ behavior. But it’s clear which way viewers thought the wind was blowing4. Around the same time, the Good Judgment Project - Philip Tetlock’s group studying superforecasters - put out a report on the lab leak hypothesis. After studying it in depth, his forecasters ended up 75-25 in favor of zoonosis. The Rootclaim debate was one of ten sources they said they found especially interesting. And also around the same time, and unrelated to any of this, the Global Catastrophic Risks Institute surveyed experts (“168 virologists, infectious disease epidemiologists, and other scientists from 47 countries”) and found the same thing (though see here for some potential problems with the survey): For what it’s worth, I was close to 50-50 before the debate, and now I’m 90-10 in favor of zoonosis. III. The Math And The Aftermath The third debate session was about “inference”, how to put evidence together. I put this part off until after disclosing the winner, because I wanted to talk about some of these issues at more length. The Math: Judges Both judges included a probabilistic analysis in their written decision. Here’s the same table as above, expanded to add the judges: I shoehorned the judges’ factors into the categories I already had; some of them were actually subtly different from Peter’s, Saar’s, and each other’s. The “priors” category is especially a mess here. We’ll go over these later, but I get the impression that they both thought of probabilistic analyses as an afterthought. For example, Judge Eric wrote 30,000 words about which considerations moved him, and only then includes the analysis, saying: I am not convinced that this Bayesian calculation is even an appropriate way to estimate the relative posterior probability of Z and LL; it just seemed fair that after criticizing Rootclaim’s calculations at length I should make an attempt at it myself. Judge Will’s decision ran to 10,000 words. He said he independently tried both reasoning it out intuitively, and running the Bayesian analysis, and was relieved when these two methods returned the same result. He said: I am skeptical that the Bayesian decision making/evaluation methods are any more "objective" than [intuitive reasoning]. I think they maximize legibility, not objectivity, and tend to hide the intuitive/heuristic portion in the data inclusion step and values, where it’s harder to see . . . I am not skilled in the Bayesian method, and I am sure I made significant mistakes. More time and practice would improve and refine my estimates. At the fundamental rules of the universe level, Bayesian analysis must be the best way to evaluate evidence. However, I am unsure that it’s a good strategy for a human given our cognitive limitations, and doubly unsure it’s truly being used (in the dispassionate sense) where the outcome is social desirability/fame/Twitter likes. I’m focusing on this because Saar’s opinion is that the debate went wrong (for his side) because he didn’t realize the judges were going to use Bayesian math, they did the math wrong (because Saar hadn’t done enough work explaining how to do it right), and so they got the wrong answer. I want to discuss the math errors he thinks the judges made, but this discussion would be incomplete without mentioning that the judges themselves say the numbers were only a supplement for their intuitive reasoning. That having been said, let’s look deeper into some of Saar’s concerns. The Math: Extreme Odds Saar complained that Peter’s odds were too extreme. For example, Peter said there was only a 1/10,000 chance that a lab leak pandemic would first show up at a wet market. Peter’s argument went something like: obviously a zoonotic pandemic would start at a site selling weird animals. But a lab leak pandemic - if it didn’t start at the lab - could show up anywhere. 1/10,000 Wuhan citizens work at the wet market. So if a lab leak was going to show up somewhere random, the wet market was a 1/10,000 chance. Saar had specific arguments against this, but he also had a more general argument: you should rarely see odds like 1/10,000 outside of well-understood domains. In his blog post, he gave this example: A prosecutor shows the court a statistical analysis of which DNA markers matched the defendant and their prevalence, arriving at a 1E-9 probability they would all match a random person, implying a Bayes factor near 1E9 for guilty. But if we try to estimate p(DNA|~guilty) by truly assuming innocence, it is immediately evident how ridiculous it is to claim only 1 out of a billion innocent suspects will have a DNA match to the crime scene. There are obviously far better explanations like a lab mistake, framing, an object of the suspect being brought by someone to the scene, etc. So the real p(wet market|lab leak) isn’t the 1/10,000 chance a pandemic arising in a random place hits the wet market, but the (higher?) probability that there’s something wrong with Peter’s argument. Then Saar tried to show specific things that might be wrong with Peter’s argument. I didn’t find his specific examples convincing. But maybe the question shouldn’t be whether I agreed with him. It should be whether I’m so confident he’s wrong that I would give it 10,000-to-1 odds. This makes total sense, it’s absolutely true, and I want to be really, really careful with it. If you take this kind of reasoning too far, you can convince yourself that the sun won’t rise tomorrow morning. All you have to do is propose 100 different reasons the sunrise might not happen. For example: The sun might go nova.
April 09, 2024 · Original source
HKU1 might also fit these criteria. It’s a coronavirus discovered in 2004 that seems to have spilled over in China and spread globally (it’s fine; it just causes yet another subtype of common cold). The exact animal reservoir has never been identified, although Wikipedia says it “likely originated from rodents”.
This collapses the ‘extreme coincidence’ claim, which as explained above, turns lab-leak into the leading hypothesis. My strongest disagreement is with his Point 3 - the inference from other seafood-market-based COVID spread events. Saar writes: A common objection to this method is that these outbreaks are caused by cold-chain products brought into these markets. However, this still fails to explain why markets form these early clusters and not the many other places where cold chain products are delivered to. Additionally, this only demonstrates the importance of cold wet surfaces in preserving SARS2 infectivity, further strengthening the hypothesis in method 1 that a crowded location with many wet surfaces like HSM is highly conducive for rapid SARS2 spread. Last, it also opens the possibility that the HSM outbreak was also caused by cold-chain products. This would reduce the significance of Wuhan being the outbreak location (as the product could have come from anywhere), but since the other evidence for lab-leak is so strong, Wuhan can be given no weight and still lab-leak would be highly likely – Rootclaim’s conclusion will only drop from 94% to 92%. Most of these outbreaks have been traced back to either a migrant worker (eg a fisherman from a country with COVID sells fish at the market of a country with Zero COVID) or a cold chain product. For example, here’s Dai et al on the Xinfadi outbreak, the most important event of this type: According to a joint publication by the Beijing CDC and 13 research institutions, the outbreak at Xinfadi Market was likely to be initiated by fomite transmission from contaminated foods imported via cold-chain logistics (Pang et al., 2020; Beijing Daily, 2020b). Based on the epidemiological investigations at the Xinfadi Market, the researchers preliminarily concluded that booth #S14 in the aquaculture product selling area on the basement floor of the primary trading hall was the source of the initial transmission. Specifically, five customers were tested positive for IgG/IgM antibodies against SARS-CoV-2 in serological screenings, all of whom visited booth #S14 on May 30 and 31, 2020. On May 30, 2020, the owner of booth #S14 procured imported and fully packaged salmon from a company's cold storage warehouse, then cut and processed the salmon for sale at the Xinfadi Market. Laboratory tests showed that sample swabs from five salmon fish from this supplier were tested positive by examining all salmon in the original sealed packages (n = 3582) in the cold storage facility. Viral genome sequencing showed that the viral strain isolated from one of the positive salmon swabs was homologous to that isolated from the infected persons and environmental samples at the Xinfadi Market (Beijing Daily, 2020b). The joint study reported that an ancestral strain isolated from the Xinfadi Market in Beijing was markedly different from the strains identified in two preceding outbreaks in China and the sequences obtained in March 2020 in Beijing. Phylogenetic analysis assigned the ancestral Xinfadi strain to clade B.1.1. Given the fact that the ancestral sequences were mainly identified in Europe, the strain was more likely to be imported to Beijing rather than derived from strains previously circulating in China (Pang et al., 2020). I know China has a bias towards believing frozen food COVID explanations, but this all sounds pretty convincing to me. Why is it more often markets than other places with cold chain products? Partly it’s the migrant workers - a lot of seafood markets are right next to seaports, and the contact tracing eventually traces back to a fisherman who came in through the seaport - I don’t think this is any more mysterious than epidemics often starting via airport or any other transportation hub. But even just keeping the focus on cold chain products, - there have also been outbreaks in seafood distribution warehouses, on docks, and in a seafood processing work area. Markets have many more people than any of those locations, and maybe (total speculation) cutting on cutting boards could aerosolize bits of fish. The strongest evidence that the Wuhan / Huanan Seafood Market epidemic wasn’t caused by migrant workers or imported seafood products is that there was no previous COVID-infected source of workers or seafood. If there had been, we would have noticed when the outbreak there spread (see Section 1.4 on Brazil). Responses to a few of Saar’s other points below: How many locations other than markets provide an interface with wildlife? Were markets actually identified in advance to be high-risk spillover locations or only in retrospect? I think scientists had called wet markets as an especially dangerous potential transmission location in advance. See for example Infectious Diseases Emerging From Chinese Wet Markets, published in 2006, which says: » “In Chinese wet-markets, unique epicenters for transmission of potential viral pathogens, new genes may be acquired or existing genes modified through various mechanisms such as genetic reassortment, recombination and mutation. The wet-markets, at closer proximity to humans, with high viral burden or strains of higher transmission efficiency, facilitate transmission of the viruses to humans.” In 2004, a paper on an emerging bird flu expressed hope that it would not spread too widely, but concluded that: » “Even in the event of yet another lucky escape, more measures must be taken to limit the amplification of viruses with pandemic potential in the wet markets around the world.” In 2007, Reuters published an investigation: Chinese Markets May Be Breeding Ground For Deadly Viruses, which said things like: » “We face similar threats from other viruses and such epidemics can happen because we continue to have very crowded markets in China," said Lo Wing-lok, an infectious disease expert in Hong Kong. "Even though official measures are in place, they are not faithfully followed. We are not talking about just civet cats, but all animals," he added.” Wet Markets, A Continuing Source Of SARS And Influenza, published 2004, is admittedly focusing on the next SARS1 outbreak instead of on SARS2, but gets bonus points for mentioning both wet markets and labs as likely causes of the next pandemic: » “Will SARS reappear? This question confronts public-health officials worldwide, particularly infectious disease personnel in those regions of the world most affected by the disease and the economic burden of SARS, including China, Taiwan, and Canada. Will the virus re-emerge from wet markets or from laboratories working with SARS CoV, or are asymptomatic infections ongoing in human beings? Similar questions can be asked about a pandemic of influenza that is probably imminent. Knowledge of the ecology of influenza in wet markets can be used as an early-warning system to detect the reappearance of SARS or pandemic influenza.” Saar mentions that there are several other possible sources like restaurants or farms. I think Peter demonstrated during the debate that pandemics are unlikely to start in rural areas, so farms aren’t that important. Restaurants mostly source their products from wet markets. During SARS1, some pandemics started in restaurants because they kept the civets in cages next to the diners (like how some Western restaurants keep lobsters). After SARS1, restaurants stopped doing that and became a less likely spillover location. Saar again: Scott quotes Peter, who implies that under the lab-leak hypothesis, we would expect the confirmed early cases to be centered around the WIV. However, cases are not expected to center on the lab. The lab is not spraying viruses into the air or hosting thousands of locals daily. If a worker gets infected, they spread the virus to their friends and family at completely different locations. In most places with an outbreak of known origin, epidemics show some geographic clustering. This has been true ever since the very beginning of epidemiology, when John Snow successfully traced a cholera outbreak back to its origin at a contaminated water pump by taking the center of the map of cholera cases. This isn’t a 100% law of nature; an infected lab worker might get lucky and not pass it to any of his lab co-workers. Still, we might expect him to infect his family, the stores he went to, or the restaurants he went to. If he lived near his workplace, these might also be near the lab. If he didn’t - let’s say he lived on the other side of town and had a long commute - he would start a cluster near his house, or his favorite store, or his favorite restaurant. Then the people there would infect their families/co-workers/stores/restaurants. The cluster would start somewhere! Sure, some people would infect nobody close to their work or home, and instead just infect one person a hundred miles away who they breathed on during a trip - but this is the exception, not the rule. So you wouldn’t expect a totally random distribution of cases all around Wuhan. There would be one center, or maybe several centers. But none of the claims that COVID was quietly spreading for months before the wet market have pointed to some alternate center of cases. If COVID was spreading for months before the lab, it somehow spread in a completely diffuse geographical pattern, with people exactly as likely to infect people far away from them as close to them - until it reached the wet market in December, and then spread in the normal center-radiating-outward way that every other infection spreads. All the evidence trying to support a spillover at the market is based on complex models with many single points of failure, built from unreliable and biased data. Therefore, it is difficult to give this evidence significant weight as there is always a possibility of errors in the data or its interpretation. More on this in the UFO comment below. Disagree. “First known case was at a wet market” is as simple as it comes. Certainly it’s less complex than “the virus has a 12 nucleotide insertion at the furin cleavage site, and even though those sometimes happen by natural recombination probably this one didn’t, and even though it looks out of frame maybe there was some weird thing going on with serine that made it in frame this one time only”, which is Saar’s star piece of evidence. I understand Saar thinks he can come up with lots of objections to “seen near wet market is suspicious for wet market origin”, then claim that getting over those objections requires “complexity”. But if Peter had no dignity, he could also come up with lots of objections to “seen in same city as Wuhan Institute of Virology is suspicious". He could say that maybe the civet farms of Hubei province were uniquely blah blah blah, and then Saar would have to prove that the civet farms weren’t uniquely blah blah blah, and then he could say “Oh, sure seems like you have a complex model with lots of unique points of failure, it all depends on fifty facts about the regulation of civet farms.” To illustrate what a market looks like in a real zoonotic pandemic, consider this study from SARS1. The researchers went to a random market and sampled the wildlife sold there. 4 of 6 civets sampled were positive, and 3 of them were phylogenetically distinct (i.e. infected in completely different places). A scientist I talked to says the 3 phylogenetically distinct lineages were most likely sampling errors. Still, this seems irrelevant to me since, again, no raccoon-dogs were tested. Scott explains that Covid’s closest known relative, BANAL-52, is rare and so it’s highly unlikely the WIV would’ve had it available as the starting point to engineer Covid . . . This is a basic mistake. SARS2 is not based on BANAL-52 but a relative of it. There is nothing unlikely here. No BANAL-52 relative close enough to create COVID from has ever been discovered. By mentioning BANAL-52, I was trying to be maximally charitable to the lab leak side. In order to create COVID, they would need a virus very close to COVID. But in years and years of searching, nobody has ever discovered a virus like this. Therefore it must be rare. As a way of bounding how rare, let’s see how rare the closest virus ever discovered is. That’s BANAL-52. It is very rare. Therefore, the COVID ancestor must be rarer than that. I don’t know how strong this argument is, because maybe there are millions of rare viruses capable of becoming pandemics, such that getting any one of them is very easy, even though each one individually is rare. The version of this I find convincing is that it should be a probabilistic cost to say that WIV did gain-of-function on a seemingly undiscovered and so-far-very-hard-to-discover rare virus instead of on any of the usual SARS-like viruses that people do their gain-of-function research on. Overall, all attempts to portray [Connor Reed] as an unstable, delusional person were unsuccessful. He is an ordinary person who very accurately described Covid-19 symptoms in real-time and claims to have received a positive test result. The timing and location matches the lab leak hypothesis and is impossible for the HSM claim. Therefore, they must discredit him. It is worth noting here the biased evidentiary standards used by zoonotic proponents. Reed’s testimony about his sickness, given on camera to multiple outlets, is deceitful and should be ignored. Yet, an anonymous voice testimony in one Chinese publication is definitely identified as Mr. Chen (another possible pre-HSM case) and should be considered reliable. See above for why I don’t trust Connor Reed. I’m not sure why Saar attributes Mr. Chen to “an anonymous voice testimony in one Chinese publication”. When I looked for Chen information, I got this thread, where it’s attributed to two Chinese hospital doctors, cross-checked with the Chinese COVID data repository, and double-cross-checked with the supplementary table in a peer-reviewed paper published by a team of Wuhan doctors. To understand how ridiculous the claim is that the HKU1 insertion looks just as engineered as SARS2’s, here are their alignments. Hopefully that should be enough. COVID: HKU1: I’m not a virologist, but I question how this comparison works. Surely HKU1 got its insert on some specific day. If you take the virus the day before, and then the other virus the day after, there will be no differences except the insert, and it will look just like COVID (ie an insert without many other mutations). The fact that the COVID comparison has few mutations, and the HKU1 insert has many mutations, just shows that whatever older virus we chose to compare HKU1 to is more distant from HKU1 than BANAL-52 (or whatever) is from COVID. Or am I missing something here? [The evidence that China tried to cover up zoonosis from the start] is untrue. They clearly said from the start this is a zoonotic spillover at HSM, and at least part of the government went to immense efforts to identify the animal, close farms, etc. (and of course couldn’t find any infected animal). Only in late 2020 did they start suspecting an import from cold-chain products after having multiple outbreaks that seem related to cold-chain products. From a Vox article from March 2023: From the start, the Chinese government interfered with efforts by both Chinese and international experts to study the pandemic, including its origins. Reporting by the AP found that even as WHO officials were publicly praising China’s cooperation, behind the scenes they were complaining about lack of access and a refusal to share data. Within months of the beginning of the pandemic, the Chinese government imposed restrictions on academic research into the origins of the novel coronavirus … China’s intransigence wasn’t unusual — countries are rarely eager to confirm that they’re the source of a deadly disease — but it went beyond the norm. International investigators weren’t permitted to see the market until more than a year after the pandemic began and a WHO-affiliated team was allowed a highly choreographed and controlled visit. The resulting report that came out of the Wuhan visit, which dismissed the possibility of a lab origin, pointed the finger at some kind of zoonotic spillover while concluding that it was unlikely that the spread started at the market, which surprised many experts. It also found that it was “possible” that the virus had been introduced via contaminated frozen food products from abroad. While few experts took that possibility seriously, it fit a narrative the Chinese government had been pushing, against nearly all evidence, that the pandemic had in fact not originated in China. “China just doesn’t want to look bad,” Filippa Lentzos, a biosecurity expert at King’s College London, told Science last August. “They need to maintain an image of control and competence. And that is what goes through everything they do.” […] it seems clear that with more cooperation, scientists could have been looking at raccoon dogs a year or more ago. “The big issue right now is that this data exists and that it is not readily available to the international community,” Maria Van Kerkhove, the WHO’s Covid-19 technical lead, told reporters on Friday. “This is first and foremost absolutely critical, not to mention that it should have been made available years earlier, but that data needs to be made accessible to individuals who can access it, who can analyze it and who can discuss it with each other.” The irony is that by making it so difficult to properly investigate a zoonotic origin of Covid, the Chinese government has created a vacuum that has been filled by claims on all sides, including the much more damning accusation that the pandemic was the result of a lab error at the Wuhan Institute of Virology. For what it’s worth, my timeline of Chinese denials and coverups looks like this: December: COVID doesn't exist, it's all lies Early January: Fine, it exists, but it’s just some wet market thing that can't spread from person to person Late January: Fine, it can spread from person to person, but we’ve got it under control now. February: Fine, it’s out of control, but you would not believe how great our response was. We're basically heroes. March: COVID was a US bioweapon, or possibly came from Italy. April: Chinese people are banned from researching the origins of COVID without government permission. 2: Comments Arguing Against Lab Leak 2.1: Is the pandemic starting near WIV reverse correlation? randomstringofcharacters wrote: Isn't [the pandemic starting near the lab] a reverse correlation issue? The lab is situated there because it's an area where coronaviruses were found in the past. Many people had this question, but Wuhan Institute of Virology was founded in 1956, didn’t originally focus on coronaviruses, and isn’t in a coronavirus hot spot. Most of WIV’s coronavirus samples come from Yunnan, about a thousand miles away. COVID’s closest relatives were found in Laos, almost two thousand miles away. During the debate, both Saar and Peter calculated the odds of a natural pandemic arising in Wuhan by dividing the population of Wuhan by the total urban population of East Asia (Saar) or South China (Peter). Saar got 1.5%, Peter got 3% (he later said this could be as high as 10% because it was a central hub in the wildlife trade). This isn’t an Official Position and I don’t think anyone else shares it, but during the debate Peter pointed out a few times that there are plenty of disease-ridden bats in Hubei (the province Wuhan is in), and that it’s not impossible that a bat virus currently known only in Laos could be active in Hubei. Still, this is the minority viewpoint and most scientists just think it involved something about the wildlife trade. 3: Other Points That Came Up 3.1: Apology to Peter re: extreme odds quiet_NaN wrote: Hot take: Peter clearly failed to convince anyone. The lab leak odds, in log10 (i.e. orders of magnitude are): Peter -20.7 Saar 2.7 Eric -3.1 Will -2.5 Scott -1.2 Daniel -1.4 One of these numbers is clearly an outlier. Scott mentions it and calls it "trolling", I would argue that it is debating in bad faith. 2e-21 is a ratio which is just silly. For one thing, the gain of function at WiV pathway is not the only pathway towards a lab leak. The WIV could also have released a naturally occurring coronavirus at the wet market. At 2e-21 odds, we would probably have to consider the possibility that the WIV built a time machine and went back in time to infect the wet market. I might have screwed up here - or at least I should have emphasized the “trolling” part. Peter complained about my presentation of his extreme-odds slide, saying: This is basically accurate. During the debate, Saar gave lots of different numbers. I don’t want to say exactly what the different numbers meant, because in earlier drafts of my post, Saar said I misunderstood them. My impression were that some of his numbers were conservative, others were central, others were extreme, others were adjusted-for-out-of-model-error, others were not-adjusted, etc. In an early draft of the post, I gave higher numbers for Saar. Saar asked me to replace them with the numbers I ended up using. I decided to agree, because I wanted to represent Saar fairly with the numbers he most centrally believed, but also because these were closest to the numbers on his Rootclaim site so it wasn’t like he was making them up just to fool me. Peter didn’t argue quite as hard, and also he didn’t have anything like the Rootclaim site, so I just took his first set of numbers. Trying to piece things together, I think a reasonable summary would be: During the debate, Saar mentioned 700-million-to-one odds in favor of lab leak, not because he thought this was plausible, but just as a discussion of where the situation would end up if you didn’t adjust for human fallibility.
HKU1: I’m not a virologist, but I question how this comparison works. Surely HKU1 got its insert on some specific day. If you take the virus the day before, and then the other virus the day after, there will be no differences except the insert, and it will look just like COVID (ie an insert without many other mutations). The fact that the COVID comparison has few mutations, and the HKU1 insert has many mutations, just shows that whatever older virus we chose to compare HKU1 to is more distant from HKU1 than BANAL-52 (or whatever) is from COVID. Or am I missing something here? [The evidence that China tried to cover up zoonosis from the start] is untrue. They clearly said from the start this is a zoonotic spillover at HSM, and at least part of the government went to immense efforts to identify the animal, close farms, etc. (and of course couldn’t find any infected animal). Only in late 2020 did they start suspecting an import from cold-chain products after having multiple outbreaks that seem related to cold-chain products. From a Vox article from March 2023: From the start, the Chinese government interfered with efforts by both Chinese and international experts to study the pandemic, including its origins. Reporting by the AP found that even as WHO officials were publicly praising China’s cooperation, behind the scenes they were complaining about lack of access and a refusal to share data. Within months of the beginning of the pandemic, the Chinese government imposed restrictions on academic research into the origins of the novel coronavirus … China’s intransigence wasn’t unusual — countries are rarely eager to confirm that they’re the source of a deadly disease — but it went beyond the norm. International investigators weren’t permitted to see the market until more than a year after the pandemic began and a WHO-affiliated team was allowed a highly choreographed and controlled visit. The resulting report that came out of the Wuhan visit, which dismissed the possibility of a lab origin, pointed the finger at some kind of zoonotic spillover while concluding that it was unlikely that the spread started at the market, which surprised many experts. It also found that it was “possible” that the virus had been introduced via contaminated frozen food products from abroad. While few experts took that possibility seriously, it fit a narrative the Chinese government had been pushing, against nearly all evidence, that the pandemic had in fact not originated in China. “China just doesn’t want to look bad,” Filippa Lentzos, a biosecurity expert at King’s College London, told Science last August. “They need to maintain an image of control and competence. And that is what goes through everything they do.” […] it seems clear that with more cooperation, scientists could have been looking at raccoon dogs a year or more ago. “The big issue right now is that this data exists and that it is not readily available to the international community,” Maria Van Kerkhove, the WHO’s Covid-19 technical lead, told reporters on Friday. “This is first and foremost absolutely critical, not to mention that it should have been made available years earlier, but that data needs to be made accessible to individuals who can access it, who can analyze it and who can discuss it with each other.” The irony is that by making it so difficult to properly investigate a zoonotic origin of Covid, the Chinese government has created a vacuum that has been filled by claims on all sides, including the much more damning accusation that the pandemic was the result of a lab error at the Wuhan Institute of Virology. For what it’s worth, my timeline of Chinese denials and coverups looks like this: December: COVID doesn't exist, it's all lies Early January: Fine, it exists, but it’s just some wet market thing that can't spread from person to person Late January: Fine, it can spread from person to person, but we’ve got it under control now. February: Fine, it’s out of control, but you would not believe how great our response was. We're basically heroes. March: COVID was a US bioweapon, or possibly came from Italy. April: Chinese people are banned from researching the origins of COVID without government permission. 2: Comments Arguing Against Lab Leak 2.1: Is the pandemic starting near WIV reverse correlation? randomstringofcharacters wrote: Isn't [the pandemic starting near the lab] a reverse correlation issue? The lab is situated there because it's an area where coronaviruses were found in the past. Many people had this question, but Wuhan Institute of Virology was founded in 1956, didn’t originally focus on coronaviruses, and isn’t in a coronavirus hot spot. Most of WIV’s coronavirus samples come from Yunnan, about a thousand miles away. COVID’s closest relatives were found in Laos, almost two thousand miles away. During the debate, both Saar and Peter calculated the odds of a natural pandemic arising in Wuhan by dividing the population of Wuhan by the total urban population of East Asia (Saar) or South China (Peter). Saar got 1.5%, Peter got 3% (he later said this could be as high as 10% because it was a central hub in the wildlife trade). This isn’t an Official Position and I don’t think anyone else shares it, but during the debate Peter pointed out a few times that there are plenty of disease-ridden bats in Hubei (the province Wuhan is in), and that it’s not impossible that a bat virus currently known only in Laos could be active in Hubei. Still, this is the minority viewpoint and most scientists just think it involved something about the wildlife trade. 3: Other Points That Came Up 3.1: Apology to Peter re: extreme odds quiet_NaN wrote: Hot take: Peter clearly failed to convince anyone. The lab leak odds, in log10 (i.e. orders of magnitude are): Peter -20.7 Saar 2.7 Eric -3.1 Will -2.5 Scott -1.2 Daniel -1.4 One of these numbers is clearly an outlier. Scott mentions it and calls it "trolling", I would argue that it is debating in bad faith. 2e-21 is a ratio which is just silly. For one thing, the gain of function at WiV pathway is not the only pathway towards a lab leak. The WIV could also have released a naturally occurring coronavirus at the wet market. At 2e-21 odds, we would probably have to consider the possibility that the WIV built a time machine and went back in time to infect the wet market. I might have screwed up here - or at least I should have emphasized the “trolling” part. Peter complained about my presentation of his extreme-odds slide, saying: This is basically accurate. During the debate, Saar gave lots of different numbers. I don’t want to say exactly what the different numbers meant, because in earlier drafts of my post, Saar said I misunderstood them. My impression were that some of his numbers were conservative, others were central, others were extreme, others were adjusted-for-out-of-model-error, others were not-adjusted, etc. In an early draft of the post, I gave higher numbers for Saar. Saar asked me to replace them with the numbers I ended up using. I decided to agree, because I wanted to represent Saar fairly with the numbers he most centrally believed, but also because these were closest to the numbers on his Rootclaim site so it wasn’t like he was making them up just to fool me. Peter didn’t argue quite as hard, and also he didn’t have anything like the Rootclaim site, so I just took his first set of numbers. Trying to piece things together, I think a reasonable summary would be: During the debate, Saar mentioned 700-million-to-one odds in favor of lab leak, not because he thought this was plausible, but just as a discussion of where the situation would end up if you didn’t adjust for human fallibility.
homeopathy

homeopathy is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between November 23, 2021 and May 20, 2022. The archive places it in contexts such as "There are dozens of positive double-blind RCTs of homeopathy"; "hundreds of studies showing the same for homeopathy"; "High-profile controversies about homeopathy". It most often appears alongside Alexandros Marinos, COVID, Dr. Bitterman.

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homeopathy
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3
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November 23, 2021
Last seen
May 20, 2022
November 23, 2021 · Original source
I think the main thing I want to cram into his head is how many pseudosciences that have to be false have really strong empirical literatures behind them. There are dozens of positive double-blind RCTs of homeopathy. I feel like I can explain what went wrong with these about a third of the time. The rest of the time, I’m as boggled as everyone else, and I just accept that the biggest studies by the most careful people usually don’t find effects, plus we should have a low prior on an effect since it’s crazy. This makes me pretty willing to shrug and say “Yeah, I have no idea what went wrong here, but a few big RCTs didn’t find an effect, plus I have a super-high prior for any new medical thing being false, so whatever, let’s move on”, which I admit is unvirtuous but I’m not sure how to avoid it.
November 28, 2021 · Original source
I realize this looks bad - aren’t we supposed to use “replications” and “number of studies” as a proxy for truth? But this is why I point out that there are dozens of studies showing psychic phenomena are real, and hundreds of studies showing the same for homeopathy. I don’t think anyone has a great idea where to go from here (“larger and more professional studies” is a good guess, but people will understandably worry that just means the establishment wants to never have to admit it’s wrong and wants only establishment studies that it can bias to count). But “just do the same bad studies more and more times” sure isn’t the answer.
May 20, 2022 · Original source
High-profile controversies about homeopathy and cold nuclear fusion in the 1980s.
The story told in Making Nature doesn’t stop there. There is a chapter on the 1980s that shows how deft the journal was at managing controversies over homeopathy and cold fusion, two events that reinforced its status as a guardian of “proper” science. Then, in the conclusion, Melinda Baldwin gets into the recent history of Nature, which involves a third important disruption of scientific publishing: the advent of the web.
homosexuality

homosexuality is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between January 25, 2023 and September 07, 2023. The archive places it in contexts such as "The most famous example of this, of course, is homosexuality"; "Pedophilia N is N worse N than N homosexuality N"; "you and your comrades had just won a great victory in getting the medical establishment to de-list homosexuality as a mental disorder". It most often appears alongside Bryan Caplan, 1970s radicals, ADHD.

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homosexuality
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3
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3
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January 25, 2023
Last seen
September 07, 2023
January 25, 2023 · Original source
Some critics have argued that healthy behaviours are sometimes labelled as ‘disordered’ simply because they don’t fit our culture-bound vision of normal behaviour. The most famous example of this, of course, is homosexuality. As late as DSM-III, homosexuality was classed as a ‘sexual deviation’, and could be treated by psychiatrists as a form of psychological dysfunction. It was removed from later editions in response to mounting pressure, but the problem arguably still remains in other areas [. . .]
But if you call something a mental disorder, people will accuse you of trying to stigmatize them, which is bad. The DSM writers are trans-friendly and want to make sure trans people can get the care they need (for example, in most states, people need a psych evaluation before they can get gender affirmation surgery), so they want to force insurance companies to cover transgender, so they have to include it. But they also don’t want to stigmatize trans people, so they also include a lot of paragraphs about how even though they just listed it as a mental disorder, it definitely isn’t a mental disorder. (a common claim is that the DSM says transgender itself is not a mental disorder, but the distress it produces is. This doesn’t seem especially destigmatizing to me - you’re the wrong gender, but you’re crazy for being unhappy about it? Also, I can’t find support for this distinction in a literal reading of the DSM criteria themselves) When the DSM is political, it’s not (just) because the authors are ideologues and want to go around stigmatizing people they don’t like. It’s because “is X a mental disorder or not?” is scientifically meaningless but politically very important. I’ll give an even worse example: from N a N biological N point N of N view N, homosexuality N and N pedophilia N are probably N pretty N similar. Both are “sexual targeting errors”: from an evolutionary point of view, our genes get passed down through couplings with sexually mature opposite-sex partners, and our instincts probably evolved to promote this. But instincts are hard - ducks sometimes decide humans are their mother and imprint on them - so sexual targeting errors are pretty common. I’m just speculating here - nobody has a strong evidence-based theory of either condition - but I think my speculations fit the small amount of evidence there is (for example, both are only weakly linked to genetics, suggesting they involve unconscious learning in some way). If this is accurate, the N relevant N difference N between N homosexuality N and N pedophilia N is N moral N, not N biological. Both are sexual targeting errors, but one re-targets sexuality onto other people who can consent and won’t be harmed, so it’s fine. The other targets people who can’t consent and will be harmed, so it’s bad. So N, should N your N purely N biological N, apolitical N, taxonomy N of N mental N disorders N classify N homosexuality N as N a mental N illness, N or N should N it N refuse N to N classify N pedophilia N as N a N mental N illness? We have to classify pedophilia as a mental illness, because we want insurance to pay for treatment. If someone shows up at a psychiatrist saying “Help, I feel an urge to molest children, is there anything you can do to get rid of that urge or prevent me from acting on it?”, I definitely want insurance to pay for this person’s treatment. Therefore, pedophilia “is” “a” “mental” “illness”, and no sophisticated categorization algorithm will ever convince me otherwise. That N means N that N a N purely N biological N apolitical N taxonomy N of N mental N disorders N which N classifies N all N things N with N similar N biological N causes N in N the N same N way N would N also N probably N classify N homosexuality N as N a N mental N disorder. But the whole point of wanting a purely biological apolitical taxonomy of mental illness was to make sure we would never again repeat the DSM’s error of calling homosexuality a mental disorder! The people asking for apolitical taxonomies want an incoherent thing. They want something which doesn’t think about politics at all, and which simultaneously is more politically correct than any other taxonomy. Or if “political correctness” sounds too dismissive, we can rephrase it as: “they want something that doesn’t think about ethics and practicality at all, but which is simultaneously more ethically correct and pragmatically correct than other taxonomies”. That is, we want our definition of “mental disorder” to be ethical (eg not stigmatize people who don’t deserve stigma). And we want it to be practical (eg identify a group of people who need and deserve care). But things that are biologically similar can be ethically and practically different: Hitting kittens is worse than hitting punching bags, even though the biology of the muscle movements is exactly the same.
Pedophilia N is N worse N than N homosexuality N, not N because N the N biology N necessarily N involves N different N processes N or N brain N regions, N but N because N it’s N important N for N your N sexual N partners N to N be N able N to N consent.
July 14, 2023 · Original source
The Social Model Of Disability came out of the same 60s/70s cultural current that gave us Thomas Szasz’s claim that mental disorders are fake. Szasz was thinking of examples like the stigmatization of homosexuality; he (understandably) preferred to think of homosexuality being a perfectly fine alternate-way-of-being that society just had to learn to accommodate. But he took it too far - and then Bryan Caplan took it even farther - and claimed that all mental disorders were just alternate-ways-of-being that society had to change to accommodate. There’s no such thing as drug addiction; people just voluntarily choose to use drugs. Society stigmatizes that choice by casting it as a disease where the person can’t control their drug use. But this is no more true than thinking of playing baseball as a disease where people can’t control their baseball use. Instead, society should admit that using drugs is fine.
Nowadays this perspective has been abandoned by everyone except a few holdouts, Bryan Caplan, and the Scientologists; maybe it’s hard to take it seriously. But put yourself in the shoes of a 1970s radical. Your stereotype of psychiatric treatment, which wasn’t entirely false, would have been cops taking gays / LSD users / eccentrics, locking then up in horrible state-run hospitals for months, and treating them with strong drugs or electroshock therapy or lobotomies. You’d never met a schizophrenic, but you believed Gregory Bateson and Thomas Szasz’s report that they were just cool eccentric people who didn’t abide by society’s artificial rules. You and your comrades had just won a great victory in getting the medical establishment to de-list homosexuality as a mental disorder, and - sure enough - the problem had been society’s persecution of gays, not the “disorder” itself. Drunk with victory, you might see the arc of history pointing to the complete liberation of all categories of supposedly “mentally ill”. So why not the supposedly “physically ill” too? Why not liberate everybody?
September 07, 2023 · Original source
I mostly don’t think mental illnesses are just preferences! I’ve been really clear on this! But Emil is right that I don’t deny that there can be a few cases where it’s hard to distinguish a mental illness from a preference - the clearest example is pedophilia vs. homosexuality. Both are “preferences” for sex with unusual categories of people. But I would - making a value judgment - call pedophilia a mental illness: it’s bad for patients, bad for their potential victims, and bad for society. Also making a value judgment, I would call homosexuality an unusual but valid preference: it’s not my thing, but seems basically okay for everyone involved.
Emil proposes an alternate definition: a mental disorder is a mental trait which lowers reproductive fitness. This makes some sense: the brain, like other body parts, was optimized by evolution with reproductive fitness as the goal, so any behavior or preference which interferes with that goal is in some sense a “malfunction”. This definition would cover depression, where people might be too depressed to hunt or gather or woo mates. It would cover pedophilia, where people have sex with children (and not adults) and so can’t reproduce. But it would also cover homosexuality, which also lowers people’s chances of having children.
We’re arguing about the definition of “mental disorder”, but in some sense this is a pointless fight. I’ve pointed out a useful category (mental conditions which are bad for people and society). Emil has pointed out a useful category (mental conditions which are bad for reproductive fitness). Why not just admit that these are two useful categories? Why not come up with separate names for them - disorder-(Scott) vs. disorder-(Emil), or maybe social-disorder vs. evofitness-disorder - and use the separate names, so everyone’s on the same page? If someone asked whether homosexuality was a mental disorder, we could confidently answer “It’s not a disorder-(Scott), but it is a disorder-(Emil)”.
humans

humans is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between April 04, 2022 and July 12, 2024. The archive places it in contexts such as "like chimps → humans"; "In biology, humans are more successful than numerous larger animals"; "humans do NOT get mad cow disease". It most often appears alongside American, Britain, Europe.

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humans
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3
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3
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April 04, 2022
Last seen
July 12, 2024
April 04, 2022 · Original source
That is - if any of this “transformative AI revolution” stuff is right at all, then at some point GDP is going to go crazy (even if it’s just GDP as measured by AIs, after humans have been wiped out). Paul thinks it will go crazy slowly. Right now world GDP doubles every ~25 years. Paul thinks it will go through an intermediate phase (doubles within 4 years) before it gets to a truly crazy phase (doubles within 1 year).
Chess AI performance over time. Why does this matter? If there’s a slow takeoff (ie gradual exponential curve), it will become obvious that some kind of terrifying transformative AI revolution is happening, before the situation gets apocalyptic. There will be time to prepare, to test slightly-below-human AIs and see how they respond, to get governments and other stakeholders on board. We don’t have to get every single thing right ahead of time. On the other hand, because this is proceeding along the usual channels, it will be the usual variety of muddled and hard-to-control. With the exception of a few big actors like the US and Chinese government, and maybe the biggest corporations like Google, the outcome will be determined less by any one agent, and more by the usual multi-agent dynamics of political and economic competition. There will be lots of opportunities to affect things, but no real locus of control to do the affecting. If there’s a fast takeoff (ie sudden FOOM), there won’t be much warning. Conventional wisdom will still say that transformative AI is thirty years away. All the necessary pieces (ie AI alignment theory) will have to be ready ahead of time, prepared blindly without any experimental trial-and-error, to load into the AI as soon as it exists. On the plus side, a single actor (whoever has this first AI) will have complete control over the process. If this actor is smart (and presumably they’re a little smart, or they wouldn’t be the first team to invent transformative AI), they can do everything right without going through the usual government-lobbying channels. So the slower a takeoff you expect, the less you should be focusing on getting every technical detail right ahead of time, and the more you should be working on building the capacity to steer government and corporate policy to direct an incoming slew of new technologies. Yudkowsky Contra Christiano Eliezer counters that although progress may retroactively look gradual and continuous when you know what metric to graph it on, it doesn’t necessarily look that way in real life by the measures that real people care about. (one way to think of this: imagine that an AI’s effective IQ starts at 0.1 points, and triples every year, but that we can only measure this vaguely and indirectly. The year it goes from 5 to 15, you get a paper in a third-tier journal reporting that it seems to be improving on some benchmark. The year it goes from 66 to 200, you get a total transformation of everything in society. But later, once we identify the right metric, it was just the same rate of gradual progress the whole time. ) So Eliezer is much less impressed by the history of previous technologies than Paul is. He’s also skeptical of the “GDP will double in 4 years before it doubles in 1” claim, because of two contingent disagreements and two fundamental disagreements. The first contingent disagreement: government regulations make it hard to deploy imperfect things, and non-trivial to deploy things even after they’re perfect. Eliezer has non-jokingly said he thinks AI might destroy the world before the average person can buy a self-driving car. Why? Because the government has to approve self-driving cars (and can drag its feet on that), but the apocalypse can happen even without government approval. In Paul’s model, sometime long before superintelligence we should have AIs that can drive cars, and that increases GDP and contributes to a general sense that exciting things are going on. Eliezer says: fine, what if that’s true? Who cares if self-driving cars will be practical a few years before the world is destroyed? It’ll take longer than that to lobby the government to allow them on the road. The second contingent disagreement: superintelligent AIs can lie to us. Suppose you have an AI which wants to destroy humanity, whose IQ is doubling every six months. Right now it’s at IQ 200, and it suspects that it would take IQ 800 to build a human-destroying superweapon. Its best strategy is to lie low for a year. If it expects humans would turn it off if they knew how close it was to superweapons, it can pretend to be less intelligent than it really is. The period when AIs are holding back so we don’t discover their true power level looks like a period of lower-than-expected GDP growth - followed by a sudden FOOM once the AI gets its superweapon and doesn’t need to hold back. So even if Paul is conceptually right and fundamental progress proceeds along a nice smooth curve, it might not look to us like a nice smooth curve, because regulations and deceptive AIs could prevent mildly-transformative AI progress from showing up on graphs, but wouldn’t prevent the extreme kind of AI progress that leads to apocalypse. To an outside observer, it would just look like nothing much changed, nothing much changed, nothing much changed, and then suddenly, FOOM. But even aside from this, Eliezer doesn’t think Paul is conceptually right! He thinks that even on the fundamental level, AI progress is going to be discontinuous. It’s like a nuclear bomb. Either you don’t have a nuclear bomb yet, or you do have one and the world is forever transformed. There is a specific moment at which you go from “no nuke” to “nuke” without any kind of “slightly worse nuke” acting as a harbinger. He uses the example of chimps → humans. Evolution has spent hundreds of millions of years evolving brainier and brainier animals (not teleologically, of course, but in practice). For most of those hundreds of millions of years, that meant the animal could have slightly more instincts, or a better memory, or some other change that still stayed within the basic animal paradigm. At the chimp → human transition, we suddenly got tool use, language use, abstract thought, mathematics, swords, guns, nuclear bombs, spaceships, and a bunch of other stuff. The rhesus monkey → chimp transition and the chimp → human transition both involved the same ~quadrupling of neuron number, but the former was pretty boring and the latter unlocked enough new capabilities to easily conquer the world. The GPT-2 → GPT-3 transition involved centupling parameter count. Maybe we will keep centupling parameter count every few years, and most times it will be incremental improvement, and one time it will conquer the world. But even talking about centupling parameter points is giving Paul too much credit. Lots of past inventions didn’t come by quadrupling or centupling something, they came by discovering “the secret sauce”. The Wright brothers (he argues) didn’t make a plane with 4x the wingspan of the last plane that didn’t work, they invented the first plane that could fly at all. The Hiroshima bomb wasn’t some previous bomb but bigger, it was what happened after a lot of scientists spent a long time thinking about a fundamentally different paradigm of bomb-making and brought it to a point where it could work at all. The first transformative AI isn’t going to be GPT-3 with more parameters, it will be what happens after someone discovers how to make machines truly intelligent. (this is the same debate Eliezer had with Ajeya over the Biological Anchors post; have I mentioned that Ajeya and Paul are married?) Fine, Let’s Nitpick The Hell Out Of The Chimps Vs. Humans Example This is where the two of them end up, so let’s follow. Between chimps and humans, there were about seven million years of intermediate steps. These had some human capabilities, but not others. IE homo erectus probably had language, but not mathematics, and in terms of taking over the world it did make it to most of the Old World but was less dominant than moderns. But if we say evolutionary history started 500 million years ago (the Cambrian), and AI history started with the Dartmouth Conference in 1955, then the equivalent of 7 million years of evolutionary history is 1 year of AI history. In the very very unlikely and forced comparison where evolutionary history and AI history go at the same speed, there will be only about a year between chimp-level and human-level AIs. A chimp-level AI probably can’t double GDP, so this would count as a fast takeoff by Paul’s criterion. But even more than that, chimp → human feels like a discontinuity. It’s not just “animals kept getting smarter for hundreds of millions of years, and then ended up very smart indeed”. That happened for a while, and then all of sudden there was a near-instant phase transition into a totally different way of using intelligence with completely new abilities. If AI worked like this, we would have useful toys and interesting specialists for a few decades, until suddenly someone “got it right”, completed the package that was necessary for “true intelligence”, and then we would have a completely new category of thing. Paul admits this analogy is awkward for his position. He answers: Chimp evolution is not primarily selecting for making and using technology, for doing science, or for facilitating cultural accumulation. The task faced by a chimp is largely independent of the abilities that give humans such a huge fitness advantage. It’s not completely independent—the overlap is the only reason that evolution eventually produces humans—but it’s different enough that we should not be surprised if there are simple changes to chimps that would make them much better at designing technology or doing science or accumulating culture […] So I don’t think the example of evolution tells us much about whether the continuous change story applies to intelligence. This case is potentially missing the key element that drives the continuous change story—optimization for performance. Evolution changes continuously on the narrow metric it is optimizing, but can change extremely rapidly on other metrics. For human technology, features of the technology that aren’t being optimized change rapidly all the time. When humans build AI, they will be optimizing for usefulness, and so progress in usefulness is much more likely to be linear. That is, evolution wasn’t optimizing for tool use/language/intelligence, so we got an “overhang” where chimps could potentially have been very good at these, but evolution never bothered “closing the circuit” and turning those capabilities “on”. After a long time, evolution finally blundered into an area where marginal improvements in these capacities improved fitness, so evolution started improving them and it was easy. Imagine a company which, through some oversight, didn’t have a Sales department. They just sat around designing and manufacturing increasingly brilliant products, but not putting any effort into selling them. Then the CEO remembers they need a Sales department, starts one up, and the company goes from moving near zero units to moving millions of units overnight. It would look like the company had “suddenly” developed a “vast increase in capabilities”. But this is only possible when a CEO who is weirdly unconcerned about profit forgets to do obvious profit-increasing things for many years. This is Paul’s counterargument to the chimp analogy. Evolution isn’t directly concerned about various intellectual skills; it only wants them in the unusual cases where they’ll contribute to fitness on the margin. AI companies will be very concerned about various intellectual skills. If there’s a trivial change that can make their product 10x better, they’ll make it. So AI capabilities will grow in a “well-rounded” way, there won’t be any “overhangs”, and there won’t be any opportunities for a sudden overhang-solving phase transition with associated new-capability development like with chimps → humans. Eliezer answers: Chimps are nearly useless because they're not general, and doing anything on the scale of building a nuclear plant requires mastering so many different nonancestral domains that it's no wonder natural selection didn't happen to separately train any single creature across enough different domains that it had evolved to solve every kind of domain-specific problem involved in solving nuclear physics and chemistry and metallurgy and thermics in order to build the first nuclear plant in advance of any old nuclear plants existing. Humans are general enough that the same braintech selected just for chipping flint handaxes and making water-pouches and outwitting other humans, happened to be general enough that it could scale up to solving all the problems of building a nuclear plant - albeit with some added cognitive tech that didn't require new brainware, and so could happen incredibly fast relative to the generation times for evolutionarily optimized brainware. Now, since neither humans nor chimps were optimized to be "useful" (general), and humans just wandered into a sufficiently general part of the space that it cascaded up to wider generality, we should legit expect the curve of generality to look at least somewhat different if we're optimizing for that. Eg, right now people are trying to optimize for generality with AIs like Mu Zero and GPT-3. In both cases we have a weirdly shallow kind of generality. Neither is as smart or as deeply general as a chimp, but they are respectively better than chimps at a wide variety of Atari games, or a wide variety of problems that can be superposed onto generating typical human text. They are, in a sense, more general than a biological organism at a similar stage of cognitive evolution, with much less complex and architected brains, in virtue of having been trained, not just on wider datasets, but on bigger datasets using gradient-descent memorization of shallower patterns, so they can cover those wide domains while being stupider and lacking some deep aspects of architecture. It is not clear to me that we can go from observations like this, to conclude that there is a dominant mainline probability for how the future clearly ought to go and that this dominant mainline is, "Well, before you get human-level depth and generalization of general intelligence, you get something with 95% depth that covers 80% of the domains for 10% of the pragmatic impact". ...or whatever the concept is here, because this whole conversation is, on my own worldview, being conducted in a shallow way relative to the kind of analysis I did in Intelligence Explosion Microeconomics, where I was like, "here is the historical observation, here is what I think it tells us that puts a lower bound on this input-output curve". Here Eliezer sort of kind of grants Paul’s point that AIs will be optimized for generality in a way chimps aren’t, but points to his previous “Intelligence Explosion Microeconomics” essay to argue that we should expect a fast takeoff anyway. IEM has a lot of stuff in it, but one key point is that instead of using analogies to predict the course of future AI, we should open that black box and try to actually reason about how it will work, in which case we realize that recursive self-improvement common-sensically has to cause an intelligence explosion. I am sort of okay with this, but I feel like a commitment to avoiding analogies should involve not bringing up the chimp-human analogy further, which Eliezer continues to do, quite a lot. I do feel like Paul succeeded in convincing me that we shouldn’t place too much evidential weight on it. The Wimbledon Of Reference Class Tennis “Reference class tennis” is an old rationalist idiom for people throwing analogies back and forth. “AI will be slow, because it’s an economic transition like the Agricultural or Industrial Revolution, and those were slow!” “No, AI will be fast, because it’s an evolutionary step like chimps → humans, and that was fast!” “No, AI will be slow, because it’s an invention, like the computer, and computers were invented piecemeal and required decades of innovation to be useful.” “No, AI will be fast, because it’s an invention, like the nuclear bomb, and nuclear bombs went from impossible to city-killing in a single day.” “No, AI will be slow, because it will be surrounded by a shell-like metallic computer case, which makes it like a turtle, and turtles are slow.” “No, AI will be fast, because it’s dangerous and powerful, like a tiger, and tigers are fast!” And so on. Comparing things to other things is a time-tested way of speculating about them. But there are so many other things to compare to that you can get whatever result you want. This is the failure mode that the term “reference class tennis” was supposed to point to. Both participants in this debate are very smart and trying their hardest to avoid reference-class tennis, but neither entirely succeeds. Eliezer’s preferred classes are Bitcoin (“there wasn't a cryptocurrency developed a year before Bitcoin using 95% of the ideas which did 10% of the transaction volume”), nukes, humans/chimps, the Wright Brothers, AlphaGo (which really was a discontinuous improvement on previous Go engines), and AlphaFold (ditto for proteins). Paul’s preferred classes are the Agricultural and Industrial Revolutions, chess engines (which have gotten better along a gradual, well-behaved curve), all sorts of inventions like computers and ships (likewise), and world GDP. Eliezer already listed most of these in his Intelligence Explosion Microeconomics paper in 2013, and concluded that the space of possible analogies was contradictory enough that we needed to operate at a higher level. Maybe so, but when someone lobs a reference class tennis ball at you, it’s hard to resist the urge to hit it back. Recursive Self-Improvement This is where I think Eliezer most wants to take the discussion. The idea is: once AI is smarter than humans, it can do a superhuman job of developing new AI. In his Microeconomics paper, he writes about an argument he (semi-hypothetically) had with Ray Kurzweil about Moore’s Law. Kurzweil expected Moore’s Law to continue forever, even after the development of superintelligence. Eliezer objects: Suppose we were dealing with minds running a million times as fast as a human, at which rate they could do a year of internal thinking in thirty-one seconds, such that the total subjective time from the birth of Socrates to the death of Turing would pass in 20.9 hours. Do you still think the best estimate for how long it would take them to produce their next generation of computing hardware would be 1.5 orbits of the Earth around the Sun? That is: the fact that it took 1.5 years for transistor density to double isn’t a natural law. It’s pointing to a law that the amount of resources (most notably intelligence) that civilization focused on the transistor-densifying problem equalled the amount it takes to double it every 1.5 years. If some shock drastically changed available resources (by eg speeding up human minds a million times), this would change the resources involved, and the same laws would predict transistor speed doubling in some shorter amount of time (naively 0.000015 years, although realistically at that scale other inputs would dominate). So when Paul derives clean laws of economics showing that things move along slow growth curves, Eliezer asks: why do you think they would keep doing this when one of the discoveries they make along that curve might be “speeding up intelligence a million times”? (Eliezer actually thinks improvements in the quality of intelligence will dominate improvements in speed - AIs will mostly be smarter, not just faster - but speed is a useful example here and we’ll stick with it) Paul answers: Summary of my response: Before there is AI that is great at self-improvement there will be AI that is mediocre at self-improvement. Powerful AI can be used to develop better AI (amongst other things). This will lead to runaway growth. This on its own is not an argument for discontinuity: before we have AI that radically accelerates AI development, the slow takeoff argument suggests we will have AI that significantly accelerates AI development (and before that, slightly accelerates development). That is, an AI is just another, faster step in the hyperbolic growth we are currently experiencing, which corresponds to a further increase in rate but not a discontinuity (or even a discontinuity in rate). The most common argument for recursive self-improvement introducing a new discontinuity seems be: some systems “fizzle out” when they try to design a better AI, generating a few improvements before running out of steam, while others are able to autonomously generate more and more improvements. This is basically the same as the universality argument in a previous section. Eliezer: Oh, come on. That is straight-up not how simple continuous toy models of RSI work. Between a neutron multiplication factor of 0.999 and 1.001 there is a very huge gap in output behavior. Outside of toy models: Over the last 10,000 years we had humans going from mediocre at improving their mental systems to being (barely) able to throw together AI systems, but 10,000 years is the equivalent of an eyeblink in evolutionary time - outside the metaphor, this says, "A month before there is AI that is great at self-improvement, there will be AI that is mediocre at self-improvement." (Or possibly an hour before, if reality is again more extreme along the Eliezer-Hanson axis than Eliezer. But it makes little difference whether it's an hour or a month, given anything like current setups.) This is just pumping hard again on the intuition that says incremental design changes yield smooth output changes, which (the meta-level of the essay informs us wordlessly) is such a strong default that we are entitled to believe it if we can do a good job of weakening the evidence and arguments against it. And the argument is: Before there are systems great at self-improvement, there will be systems mediocre at self-improvement; implicitly: "before" implies "5 years before" not "5 days before"; implicitly: this will correspond to smooth changes in output between the two regimes even though that is not how continuous feedback loops work. I got a bit confused trying to understand the criticality metaphor here. There’s no equivalent of neutron decay, so any AI that can consistently improve its intelligence is “critical” in some sense. Imagine Elon Musk replaces his brain with a Neuralink computer which - aside from having read-write access - exactly matches his current brain in capabilities. Also he becomes immortal. He secludes himself from the world, studying AI and tinkering with his brain’s algorithms. Does he become a superintelligence? I think under the assumptions Paul and Eliezer are using, eventually maybe. After some amount of time he’ll come across a breakthrough he can use to increase his intelligence. Then, armed with that extra intelligence, he’ll be able to pursue more such breakthroughs. However intelligent the AI you’re scared of is, Musk will get there eventually. How long will it take? A good guess might be “years” - Musk starts out as an ordinary human, and ordinary humans are known to take years to make breakthroughs. Suppose it takes Musk one year to come up with a first breakthrough that raises his IQ 1 point. How long will his second breakthrough take? It might take longer, because he has picked the lowest-hanging fruit, and all the other possible breakthroughs are much harder. Or it might take shorter, because he’s slightly smarter than he was before, and maybe some extra intelligence goes a really long way in AI research. The concept of an intelligence explosion seems to assume the second effect dominates the first. This would match the observation that human researchers, who aren’t getting any smarter over time, continue making new discoveries. That suggests the range of possible discoveries at a given intelligence level is pretty vast. Some research finds that the usual pattern in science is constant rate of discovery from exponentially increasing number of researchers, suggesting strong low-hanging fruit effects, but these seem to be overwhelmed by other considerations in AI right now. I think Eliezer’s position on this subject is shaped by assumptions like: If you have an AI as intelligent as Elon Musk today, then tomorrow you can run it on more hardware with a bit of normal human algorithmic progress, and get one twice as intelligent. So even if it would take Elon years to make a breakthrough, long before those years are up you’ll have an AI that can make breakthroughs much faster.
Given that humans (in this scenario) were able to bring AI from SHRDLU to superintelligence in less than 100 years without gaining any IQ at all, presumably you can make lots and lots and lots of progress before hitting your IQ ceiling, by which point you have a new IQ ceiling.
May 19, 2023 · Original source
When people argue against separatism, they often tout the benefits of being large. A Canada that would be split in two would mean smaller markets, and a weaker political counterweight to the United States. (Not to be mean to Canadian readers, but this argument seems delusional to me — I don’t think Americans currently see Canada as a political counterweight of any significance.) It would certainly be less prestigious. Large size, Jacobs says, is associated with power, and we admire power. We love slogans like “unity makes strength.” But after the medium-sized country of Sweden-Norway became the two smaller countries of Sweden and Norway, they both did well. Small size is less powerful, but it has its own advantages, such as nimbleness and ability to fail non-catastrophically. Small size also allows more diversity in cultural and economic matters, and here Jacobs waxes philosophical, pointing out that favoring diversity over uniformity is a recent, post-Enlightenment idea that has not yet been fully embraced in politics. We can see analogs everywhere. Europe, split into numerous small countries from the Middle Ages onward, became far more advanced than China, which has been unified more often than not. The city-states of ancient Greece and Renaissance Italy are seen as golden ages of Western civilization, even if they weren’t part of larger political units and therefore constantly went to war with one another. In business, large companies are impressive and powerful, but people always complain that Google or Microsoft have become stagnant and that the best place to work is tiny startups of about 2 cofounders and 4 employees. In biology, humans are more successful than numerous larger animals, and in terms of raw numbers, small animals like rats or insects are the most successful of all. Jacobs’s point isn’t that smaller is always better. Her point is that the converse statement, “bigger is always better,” is false — despite how intuitive it feels for political entities. Just like we don’t view a small nation like Switzerland or Singapore as a failure of unity, we (and in particular, Canadians) shouldn’t see the secession of a place like Quebec, if it’s done peacefully and democratically, as a failure either. Still, some people in online reviews of the book complain that this argument is a bit thin, especially considering that it serves as the foundation for the later chapters (which are more directly about late 1970s Quebec politics). Sure, small is beautiful, but large states are great for stability, peace, markets, whatever. If the potential benefits of small national size are Jacobs’s strongest argument, then we can breathe a sigh of relief and go back to agreeing that separatism is bad. Pointing out the widespread bias in favor of unified political entities does seem valuable to me, but okay, fair enough. Does Jacobs have deeper reasons why separatism might be a good idea in general? Yes, and for this we go back to the second half of Cities and the Wealth of Nations. Why Nations and Empires Fail Our breathing rate is regulated through a feedback mechanism. Too much carbon dioxide in the blood, or too little oxygen, and the brain stem commands the diaphragm to accelerate breathing. Once the levels are back to normal, the brain stem receives this feedback and slows breathing down again. Now, Jacobs asks, imagine an impossible creature: ten people, all doing their own thing, but whose breathing is somehow regulated by a single brain stem. The feedback the brain stem receives is a consolidated average of everyone’s carbon dioxide and oxygen levels, and the breathing rate the stem decides on is applied to all ten people, regardless of whether they’re sleeping or playing tennis. This, to put it mildly, wouldn’t work. This creature is an analogy, representing a nation. The ten people are its individual cities, and the breathing rate is the cities’ economies. If it sounds like a stupid analogy, that’s because it is: “I have had to propose a preposterous situation,” writes Jacobs, “because systems as structurally flawed as this don’t exist in nature; they wouldn’t last.” Nor do they exist in machines we design; they wouldn’t work. But “nations, from this point of view, don’t work either, yet do exist.” The feedback mechanism that fails to work properly in a nation is currency. A currency always fluctuates according to the exports and imports of the area where it circulates. Let me use the Republic of Venice and its ducat as a toy example, because the coins look nice: Whenever Venice produces something (like salt) and sells it abroad, foreigners need ducats to buy the exports, so the demand for ducats increases. When Venice buys something from abroad, it needs to use foreign currencies, so the demand for ducats decreases. Add up everything that Venice exports and imports, and you get either a trade surplus (more exports than imports) or a trade deficit (more imports than exports), which determines the value of the ducat relative to other currencies. In both cases, a negative feedback loop restores balance over time, just like our brain stem does with carbon dioxide levels. A trade surplus, and therefore a strong ducat, means that when foreigners want Venetian salt, it’s expensive. So Venice’s exports decrease, while imports increase, since Venetians can use their valuable ducats to buy stuff cheaply from abroad. Conversely, a trade deficit makes exports a bargain for foreigners and imports expensive for Venetians. This feedback loop is great. It’s exactly what a city needs to trigger the crucial import replacement process. When exports decrease and a trade deficit begins (maybe because Constantinople found a cheaper source of salt somewhere else), the weak ducat means that Venice is less able to afford the resources and manufactured goods it used to import. The people of Venice don’t want to have less of those goods, though, so they figure out ways to produce some themselves — that is, they do import replacement. Later they will be able to export the output of the newly expanding industries too, strengthening the ducat and continuing the cycle. Currencies, Jacobs explains, function as automatic tariffs (to protect local industry from foreign imports) and automatic export subsidies (to encourage local industry to export). They are “automatic” because of the feedback mechanism. Just like an accelerated breathing rate, they take effect exactly when they are needed — and no longer. … Or so they should, except that import replacement, as we discussed, is a city process. Whereas most currencies are national or supranational. National currencies work well for city-states, like the Republic of Venice or today’s Singapore. But in large nations, which, remember, are not the fundamental unit of economic life, they mess everything up. Take a city like Detroit. When Detroit’s exports (primarily cars) decrease, Detroit gets no feedback about this, because its currency is the United States dollar, and the United States dollar’s value depends on much more than Detroit. It depends on other cities whose foreign exports might be increasing at the moment. And on rural regions that are selling resources like oil abroad. Also, trade between Detroit and other cities that use the United States dollar — i.e., American cities — is structurally unable to provide any feedback whatsoever. So Detroit doesn’t get the signal that it should buy less stuff from other cities and replace the missing imports with local production. Instead, it just declines. Jacobs hypothesizes that this issue of national currencies is at the root of every large country’s economic troubles. It is why nations and empires always centralize everything into one large city, whether that’s Paris, London, Tokyo, or Toronto, or ancient Rome: that city, being the largest, is simply the only one for which national-level currency feedback works fine. The rest of the nation or empire, then, declines. But of course, nations and empires don’t accept this. They care about the economic well-being of their peripheral regions, sometimes out of genuine concern for the people there, sometimes out of fear that they rebel or hold independence referendums. So nations and empires will embark on every possible solution to reverse the decline. All of their solutions will look like good ideas at first, and yet fail at helping the peripheral regions. Worse, these solutions will weaken the cities, thereby destroying the only real wealth of the country and bringing untold hardship for everyone. Eventually the nation or empire will disintegrate, as nations and empires always do, and always will. Jacobs calls these false solutions transactions of decline. She identifies three types, and, content warning, you might not like some of them depending on your political sensibilities. Sustained military production is a transaction of decline. Permanent military bases and garrison towns are a special kind of settlement: they import a lot and export nothing. Superficially, producing weapons and supplies for the military seems like a good deal for some cities — Jacobs gives the example of Seattle, which, before Microsoft and Amazon were a thing, depended mostly on making military aircraft. But because nobody in a military base ever tries to replace those weapons and supplies with their own production, the trade is sterile in terms of economic development. In a sense, the wealth is slowly “drained” from cities. Large empires are especially prone to this: eventually all of their wealth is destined to the military just to keep the empire together.
July 12, 2024 · Original source
(This report was, as it happens, published in the exact same month as The Family That Couldn’t Sleep.) DTM came to know the family well. He befriended them by way of two members of their younger generation, Lisi – a woman terrified by the shadow of the disease, and Ignazio – the doctor she had married, who was more terrified by the shadow of the disease. Ignazio put together the pieces of the family puzzle, consolidating all the disparate diagnoses into a single disorder and filling out a lot of blank spots on family trees. When DTM came along, he was able to help Ignazio make the case that the family would benefit from the spotlight – that greater awareness of FFI could lead to a cure both for them and for a slew of other prion diseases. As it so happens, he is one of those nonfiction authors who serve as a character in their own story. DTM has some form of progressive muscular palsy. He is, or at least was in 2006, not entirely sure what it is. The relatively unimpressive state of genetics at the time had not identified his causative mutation, though it looked a lot like one of the rarer forms of Charcot-Marie-Tooth disease2. DTM is pragmatic about this, the way everyone chronically ill is either pragmatic or doomed. Whatever he has, it is a defect in protein structure; his peripheral nerves decay not because of a problem with the nerves themselves but an inability of their scaffolding to hold them together, as he puts it. The last chapter of the book dwells on this, on the web of connections popping up between a thousand disorders. DTM’s disease is something vaguely similar, if you squint, to an exceptionally slow-progressing motor neurone disease; if you jump another level out, you see amyloid plaque diseases like Huntington’s and Alzheimer’s, and if you jump yet another level out, you see something like prions. His interest in the Venetian family was driven by this. Some of its members thought this a beautiful act of sympathy; others thought him a grotesque parody of themselves, an onlooker, a gawker, peddling their tragedy to salve his relatively insignificant problems. They are, he thinks, both right. That’s the beginning, and that’s the end. What happens in the middle? --------------------------------------------------------- The Venetian family lends the book its title, but they’re really more of a framing device. The Family That Couldn’t Sleep is separated into four parts, of which the first and fourth – the shortest by far – deal with the family. Part 2 is kuru, the king of fucked up diseases you read about in clickbait Weird Medicine listicles. Let’s talk about kuru! Kuru, is, famously, the prion disease you get if you eat another person’s brain. Well, not quite. It’s a prion disease that became endemic amongst women in the Fore society, who ritually ate brains, one of which had an inherited or spontaneous prion disease. This is an important note – there’s a tendency (which the book’s later chapters engage in) to assume cannibalism just has a Prion Disease Generator attached. If you eat people who don’t have prion diseases, you won’t suddenly get one. Uh, don’t eat people. Anyway, part 2 is DTM’s historiography of Fore-Westerner first contact. It’s hilarious. Papua New Guinea is a frankly ridiculous place; one of the all-time best Lyttle Lytton winners (worst first sentence from a hypothetical or, in this case, real work) was “Papua New Guinea is so violent that more than 820 languages are spoken there”. The native residents were so hostile to outsiders that all the colonial empires had cut their losses – and when you think about the places they colonized, that says something. After the First World War, PNG was ripped from its nominal German ‘owners’, but no one else wanted the place. So, of course, they gave it to the Australians. It was thirty years and another war before we actually made contact. 1940s Australia was as ‘settled’ as it’d ever be; the cities were bustling and the interior was mapped. The kind of explorer who two centuries before would be heading to new continents had to console himself with Pacific islands. Console he did. The native peoples of the PNG coasts were hostile enough to the wannabe-colonialists that the Australians, flying planes overhead, were the first people to discover that the island’s inland was populated too. No one had broken through on land. In all this deep and angry rainforest, the Fore were the furthest out. They lived far into the island’s mountainous interior; DTM describes their territory as “nearly vertical”. Calling people primitives is a bit passe these days for understandable reasons, but no other term comes to mind. The Fore had no name for themselves; we call them by an exonym, “the people to the south”. They weren’t, to be clear, hunter-gatherers – they were slash-and-burn agriculturalists, but very well-fed ones. Despite the tendency in grain-focused cultures for poor agriculturalists to be stunted/malnourished, the Fore were a remarkably healthy people. Well, except for the famous bit. The first remarkable thing about the Fore was just how quickly they wanted to assimilate. Most PNG tribes weren’t particularly enthused by Western offers of injections/tractors/radios/Christianity. Yet as soon as the Australians arrived, the Fore made ceasefires in their wars with other tribes, volunteered to help large-scale Australian projects on the coast, started planting and trading coffee, and enthusiastically participated in censuses. It’s the only first-contact narrative I’ve seen where the colonizers were concerned about how badly the other guys wanted to be colonized. The next was the one that got their names in the history books. Australian officials started to notice a remarkable lack of women in Fore camps. Some tribes sequestered their women, particularly when Westerners were around, so at first they thought nothing of it. The high rate of unpartnered young men, though, was way out of PNG norms. DTM tells this part fantastically. The Fore chapters drip with the dread of dramatic irony. When the first breakthrough comes, you have to catch your breath: “Tiny” Carey noted something in the middle of August 1950 that deepened this mystery. He noticed that near the village of Henganofi there had been an unusual number of deaths. “It appears,” he wrote his superiors, “natives suffer from stomach trouble, get violent shivering, as with the ague, and die fairly rapidly.” [...] McArthur investigated a little more [...] One day in August 1953 he ran into more of the shivering people Tiny Carey had seen several years before: “Nearing one of the dwellings, I observed a small girl sitting down beside a fire. She was shivering violently and her head was jerking spasmodically from side to side.” It would be quite some time before anyone figured out what caused it – but the problem, as DTM notes, was that its cause wasn’t possible. Everyone priored that the weird undescribed disease in the Fore lands was some nocebo sorcery-sickness. Vincent Zigas, the first actual doctor sent to work with the Fore, tried to placebo-effect them and failed miserably: On the way, Apekono stopped at a hut and showed Zigas his first kuru victim. “On the ground in the far corner sat a woman of about thirty,” the doctor wrote. “She looked odd, not ill, rather emaciated, looking up with blank eyes with a mask-like expression. There was an occasional fine tremor of her head and trunk, as if she were shivering from cold, though the day was very warm.” It was almost exactly the tableau McArthur had witnessed in 1953. Zigas, though, was a doctor. He could do more than look—or so he thought: “I decided I might as well try my own variety of magic,” he remembered. He rubbed Sloan’s Liniment, a balm for sore muscles, on her and declared to her family and his guide: “The sorcerer has put a bad spirit inside the woman. I am going to burn this spirit so that it comes out of her and leaves her. You will not see the fire, but she will feel it. The bad spirit will leave her and she will not die.” The lotion penetrated the woman’s skin and she writhed in pain. “Get up! Walk!” Zigas commanded theatrically. “The woman struggled feebly as if to rise, then, exhausted, started to tremble more violently, making a sound of foolish laughter, akin to a titter.” That evening Apekono asked Zigas not to try to cure any more kuru victims; “Don’t use your magic medicine anymore. It will not win our strong sorcery.” This was a disaster. The Fore were so cooperative precisely because they hoped “Western magic” could conquer theirs. As it became clear it couldn’t, they turned hostile. The Australians had hoped to “modernize a Stone Age people”; now all their subjects were dropping dead before their eyes, from what they could only assume was a “hysterical reaction” to colonization itself. So, to solve this, they needed a batshit insane American. Carleton Gajdusek is one of the characters who dominates The Family That Couldn’t Sleep. He couldn’t not. You could put him in a car commercial and he’d dominate it. Gajdusek was a physician with a rare, intense combination of science and practice. He was a romanticist, a field worker, and a lover of everything strange. He’d been an army doctor, a government conspiracy-cover-upper, and a postdoc under Linus Pauling who described his intent as “to straighten out Pauling’s ideas about proteins”. He hated civilization, in a slightly-to-Ted’s-centre sense, and was passionate about “primitives and isolates”. He jumped at the chance to work in Papua New Guinea; he planned to conduct a multi-site study on child development in such cultures, and relished the opportunity to live in a “primitive” environment himself. He did all this so he could rape kids. Oh, he did it for the scientific curiosity and love of medicine, but he also did it so he could rape kids. Gajdusek was a pedophile in the actual-lifelong-exclusive-paraphilia sense, as opposed to the “metonym for child molester” sense. Some people who roll snake-eyes on the Sexuality Dice repress it, but some are perfectly happy to act on it; Gajdusek was #2 in its fullest form, the kind of guy who believes that a well-lived life includes raping some kids. DTM doesn’t shy from this, not for a moment. It’s the first thing he tells you about Gajdusek. It couldn’t not be; you couldn’t talk about why he went to PNG otherwise. When Gajdusek landed in PNG, he first found the place too civilized. He’d been promised a land of “cannibal savages” – where were they? After some traipsing, he found them, right where he was promised. The Fore were perfect for Gajdusek. They had some kind of medical mystery that’d been lost on everyone else. They ate each other, in exactly the way he loved detailing in his diaries (“”Women and children, particularly, partake of the human flesh,” he noted with pleasure”). As kuru cases popped up, he aggressively recorded them. He wrote lovingly detailed notes that he sent back to his Australian advisor. He wrote with intensity, with exclamation marks, with the joie de vivre of a man just where he wanted to be. Gajdusek smothered the Fore with ‘cures’ that never worked, but they didn’t get angry at him. As DTM dryly puts it: “Their children trusted him, and that was enough for them.” At some point, someone suggested sending an anthropologist...or an epidemiologist...or literally anyone with more credentials than Gajdusek and Zigas3. Gajdusek threw a shitfit, convinced this one-and-a-half-man team was enough to Solve The Problem Forever. But he got bored eventually – running off with another tribe with, as his diary notes at length, an apparent custom of youths ritually fellating older men – and Zigas, I dunno, the book neglects him a bit here. So they managed to sneak in some anthropologists. The husband-and-wife team of Robert Glasse and Shirley Lindenbaum4 were the first involved parties to give a shit about the Fore as people, rather than as colonial subjects/medical mysteries/walking sex toys. What they uncovered was fascinating. The Fore were cannibals, yes, but they were recent cannibals. They didn’t have an ancient tradition of eating their dead, like the other visitors assumed. They happened to be in contact with some cannibal groups, and after a Fore man died of “sorcery”, they thought: well, what would happen if we ate him? “People tasting it expressed their approval. ‘”This is sweet,” they said, “What is the matter with us, are we mad? Here is good food and we have neglected to eat it.”” If not for the wild coincidence that the first Fore cannibalism victim had a prion disease, kuru would never have existed. Glasse and Lindenbaum started to put together the pieces. They’d been sent down to rule out a genetic explanation – to track the kinship ties of the Fore and see how the disease ran through families. It didn’t run through families in any coherent sense, but it sure did run through cannibalism. The clincher was the age distribution. The Fore, ever enthused by colonialism, quit eating each other as soon as the Australians arrived. Children stopped dying of kuru shortly after; they simply weren’t exposed to the infectious agent. The couple sent the news to Gajdusek, who was off raping kids somewhere else. In the next part of the book, DTM runs through Gajdusek’s many conjectures of kuru’s cause – more like sketches or abstract paintings than like true hypotheses. Gajdusek was annoyed that someone else was doing something he “totally could’ve done”, and even more annoyed that another lab was running similar experiments – an attempt at a vaccine for a particular sheep disease had accidentally created a prion generator. But he was happy to swoop in and claim the credit for what he was starting to think of as “slow viruses”, an infection that somehow lays dormant for years. DTM portrays Gajdusek perfectly, in that “real life has no need for verisimilitude” way. Gajdusek was at once a brilliant man, an all-consuming narcissist, an entertaining character, and a monster beyond redemption. A lesser book might pick one or two. The Family That Couldn’t Sleep portrays him as all four, and on a personality level (as opposed to a scientific one), the Gajdusek-focused parts are some of the most gripping. --------------------------------------------------------- Outside of the jumps between the Venetian family and everything else, The Family That Couldn’t Sleep is not siloed. The narratives of all prion diseases are deeply intertwined. This is what makes it a great book. It’s 300 pages of dramatic irony. You read the whole thing, waiting for the eureka moment – the point everyone realizes they’re looking at the same cause. It does, however, make it a tad difficult to review or synopsize. The book’s story is so weird – and, often, so at odds with conventional wisdom that trickles down about the Fore et al – that you have to recap quite a bit, and the book steadfastly resists recapping. The next couple chapters after we depart from Gajdusek’s credit-claiming are mostly about experiments with various prion diseases. They’re scientifically fascinating. Unlike some medical-books-for-general-audiences (cough, How Not to Study a Disease), DTM never talks down to the reader. He assumes someone reading a 300-page book about prions is smart and wants to learn about prions. He also has – you can feel it in his words – the agonizing experience of spending his life on the other side of the doctor’s desk, trying to beat into whoever he’s talking to that no, seriously, you don’t need to lie to him or try explain a complex disease at a fourth-grade level. The first prion disease studied was scrapie. Scrapie was a big deal – it starved and killed large shares of British sheep flocks, making it a serious economic problem. Veterinary researchers had tried to prevent or cure it for centuries. It was a veritable graveyard of ambitions: Quintessential was D. R. Wilson at the Moredun Institute in Scotland, who worked in the middle of the last century for more than a decade trying, with mounting frustration, to kill the scrapie agent. He found that it survived desiccation; dosing with chloroform, phenol, and formalin; ultraviolet light; and cooking at 100 degrees centigrade for thirty minutes. The scrapie researcher Alan Dickinson told me he remembered Wilson at the end of his career as “very, very, very quiet. Of course, that was after his breakdown.” “Now it is our turn to study prions. Perhaps we should approach the subject cautiously.” The problem, as DTM explains, is that prion diseases were impossible. They violated 20th-century understandings of biology. Proteins “were no more alive, and no more infectious, than bone”. Prion diseases seemed to have too many causes – genetic, infectious, and sporadic. They looked infection-like in some ways, but patients didn’t produce virus antibodies. Sheep exposed to scrapie, or chimps infected with kuru, took years to develop symptoms. Their facts did not fit together. In the 1960s, people started wondering. The unifying trait of prion agents was that they had to be denatured to be destroyed. Was this a particularly small virus defined by its protein coating? Or – even more outre – was it pure protein, no DNA at all? No one could figure out quite how the latter worked, but it was tempting. Gajdusek, by now a major figure in this field, kept a foot in both worlds. He didn’t want to stake his reputation on a no-DNA hypothesis, but he certainly sympathized. Enter Prusiner. Stanley Prusiner was Gajdusek’s counterpart. Where Gajdusek seemed permanently manic, Prusiner was deliberate and exacting. He entered Gajdusek’s “slow viruses” field in the early 1970s after a chance encounter with a CJD patient. He relished the laboratory in a way Gajdusek didn’t at all, and set out to optimize the hell out of his projects. Prusiner set out to isolate the smallest infectious particle in the scrapie agent. He injected tons of hamsters (hamsters got sick faster than mice) with increasingly tiny scrapie proteins, hoping to determine whether the Minimum Viable Scrapie was DNA. By the mid-1980s, he’d produced something so small it couldn’t possibly be a virus. Denaturing it destroyed it; exposing it to nucleic acid dissolvers actually made it stronger. Emboldened by this discovery, Prusiner set out to anoint himself the King of Prions. Here emerges something of a Voldemort-Umbridge distinction – the difference between cartoonish villainy and banal evil. Gajdusek is a bad guy because he rapes kids. Prusiner is a bad guy because he is the most grotesque stereotype of the Advisor/Peer Reviewer from Hell made flesh. Everything Prusiner did was to build his reputation atop a pile of skulls. When recruited as a peer reviewer for other prion papers, he wrote negative reviews to undermine their authors. He worked his grad students to the bone and intentionally destroyed their careers, telling them he’d “ruin them” if they entered prion research as competitors. He lied about the origin of the protein-only hypothesis, claiming he originated it a decade after it was actually conjectured. But hey, he was good at getting grants. I was surprised reading a lot of this, because for all the time I’ve been aware of it, the cause of prion disease has seemed settled. “Oh yeah, it’s a protein that gets all fucked up.” But DTM goes through just how unsettled it was right up through to The Family That Couldn’t Sleep’s publication. Serious confirmation only arrived a couple years later. Many people were deeply critical of the prion hypothesis – often, it seemed, because they loathed Prusiner too much to go along. Throughout the book, he cuts an uncharismatic figure. Gajdusek and Prusiner both won the Nobel for discovering prions, decades apart. This tells you something – the “discovery” of prions can be construed quite a few ways. Gajdusek formulated the hypothesis; Prusiner proved it. Gajdusek was grievously offended by Prusiner’s Nobel, perceiving his rival – not inaccurately – as a follower who never originated any ideas of his own. But Gajdusek was offended from a federal prison cell, so how’d that work out for him? Fascinating as all this is, no one published a book about prions in the mid-2000s because it was about kuru or FFI. They published books about prions because teenagers were dying, and people wanted to know why. DTM lays the seeds for part 3 – the mad cow section – in part 1. This is a discussion of scrapie, the longstanding prion disease of sheep. Scrapie was a medical mystery for centuries (remember poor D. R. Wilson), precisely because of the intuitive implausibility of prions. The scrapie chapter is a great history-of-science piece, covering the agricultural productivity revolutions of the 18th century, the surfeit of bizarre origins veterinarians concocted, and the treatments that never worked. Scrapie is not transmissible to humans – well, we hope. It’s concerningly transmissible to primates. But it’s been around for a long, long time, and it doesn’t epidemiologically look like humans get it...we hope. Anyway, you ever tried to generalize from one example? The British government did! In the mid-1980s, strange reports started coming out of the UK’s farms. Farmers were describing a new disease where dairy cows – incredibly docile creatures, under normal circumstances – turned hostile, kicking them as they went into the milking stalls. The symptoms looked to all the world like scrapie. Epidemiologists tracing the outbreaks found a unifying link with “cake” – animal protein feed sweetened with molasses. The scrapie-like symptoms must have traced to an infected sheep. But scrapie doesn’t transmit to humans, so it must be okay to keep slaughtering them, right? We all know how this ended. The best term for the British response to the mad cow outbreak is “cacklingly evil conspiracy”. The agricultural industry really, really didn’t need a huge zoonotic outbreak – so it decided it didn’t have one. They first suppressed all mentions that the disease looked like scrapie, then – when this became impossible – hyped up that scrapie doesn’t transmit to humans, so there’s nothing to worry about. The formal name of the disease, “bovine spongiform encephalopathy”, was supposedly chosen to optimize for unfamiliarity – it wouldn’t fit well in a headline. They emphasized, extensively, that there was nothing to worry about. Ever. At some point, people started asking questions. If there was nothing to worry about, why was the agricultural industry panicking so hard? As things became ever more worry-inducing, this turned down ludicrously twisting paths: Meanwhile, the Southwood Working Party and the experts who advised it were learning on the job. They learned, for instance, that the BSE agent entered the animal through the mouth and then followed the digestive tract into the organs that try to filter out infections—the tonsils, the guts, and the spleen—and from there traveled into the peripheral and central nervous system, and finally arrived at the brain. They also learned that pasties, meat pies, and even some baby foods contained tissues from a lot of those organs. So the Southwood Working Party recommended banning these organs, but only from baby food. This started a chain reaction of consumer doubt: if infected cow organs were unsafe for babies, how could they be good for adults? The government then banned offal, as the organs were collectively called, in all human food but gave the industry a grace period to get it out of the feed supply. Then pet food manufacturers began to wonder if what drove cows mad might not also drive dogs, cats, and parrots mad. The feed they sold came from concentrate made of the same sick animals that had previously made up the meat and bone meal farmers used. Their trade group decided to put a similar ban in place—immediately. So for five months it was safer to be a dog than a human in Britain. DTM spends pretty much this whole section of the book making fun of the British government. To be fair, they deserved it. They killed hundreds of kids in agonizing and preventable ways – they could take some ribbing. This is all throughout the mid-1980s to early-mid 1990s. Through this period, it wasn’t yet clear that mad cow could spread to humans. The panic was clear, and deserved, but it didn’t yet have a match for its powder keg. It would alight. The first suspected case of vCJD – human mad cow – was in 1994. Fifteen-year-old Vicky Rimmer developed a sudden, strange disease. Doctors gave her months to live...until she died in 1998. A couple other suspected cases trickled down through the mid-90s, including a young man who made meat pies for a living, whose grieving mother received a letter from the Prime Minister that “humans do NOT get mad cow disease”. (That must’ve been fun.) Soon, they couldn’t deny it any longer. On March 20, 1996, Stephen Dorrell, the health secretary, stood up in Parliament to announce the news that had already appeared as a tentative conclusion in scientific journals and as rumor in newspapers for the previous two years: British beef was killing British teenagers. The first confirmed death was that of Stephen Churchill, a nineteen-year-old student from Wiltshire, who died in May 1995. Back in 1989, at the Southwood Working Party’s suggestion, the government had set up a surveillance unit in Edinburgh to watch for any evidence that BSE had crossed to humans. One worry had been that if BSE passed to humans, how would anyone know it? How would you recognize something you had never seen? It turned out to be easy: Churchill and the nine other teenagers who had gotten sick had spectacular amyloid plaques in their brains, chunks of dead protein almost visible to the naked eye. If sporadic CJD was a whisper, BSE-caused prion disease was a shout. The investigators sat open-mouthed looking at slides whose damage, they feared, portended the most severe epidemic in modern British history. This part of the book is not fun. It lacks the insane personalities and duelling careers of the other entries. It is an honest chronology of the vCJD epidemic – a gruesome failure of the agricultural industry, the one system that everyone is vulnerable to. The government and industry had completely violated their duty of care to citizens and consumers. They were paying the price. No one would buy British beef anymore – not while they watched their children die. Now here’s the thing: this is ethnography, not historiography. The Family That Couldn’t Sleep is a book from the mid-2000s. The epidemic was not at all in the rear view mirror. There were piles of unanswered questions that DTM constantly alludes to. We have eighteen years more hindsight than he did then. What do we know now? --------------------------------------------------------- In 2006, the vCJD epidemic looked like it was going to be a lot better than the worst fears. BSE itself was a huge problem for the cattle industry, but honestly, no one is too sympathetic to the cattle industry. People were not going to die in anywhere near the numbers believed. We had all sorts of reassuring data coming out about this, which DTM chronicles. We were learning that only some genotypes seemed susceptible to vCJD. We didn’t see any older people die of the disease. We were seeing numbers drop, such that vCJD must have a pretty short incubation period. Anyway, all of this is wrong! The Family That Couldn’t Sleep was written in the candidate gene era. Back then, the nascent field of human genetics was sure it was about to Solve Polygenism. Yes, the simple Mendelian monogenic patterns popular a few decades back clearly didn’t apply to common diseases, but how many variants could there be? We were about to discover the five genes influencing 20% of Alzheimer’s risk each, the five genes influencing 20% of heart disease risk each, etc., and once we were done we’d just do gene therapy and cure Alzheimer’s. A paper on autism genetics from 1999 was so outre as to speculate there might be as many as fifteen genes involved. The fact we are now using the term “omnigenic model” should tell you roughly how well this worked out. Do you remember SNPedia? If you were a 2014 Slate Star Codex reader, you might. 2014 was still pretty candidate gene. People were out there publishing papers saying a single variant could increase your life expectancy by 15 years. SNPedia was a site that beautifully categorized all of these, so you could do 23andme or whatever, look up your results on SNPedia, and make horrible life choices.5 It was eventually bought out by one of the consumer DNA companies, so no one ever edited it again, making it a great time capsule of early-mid 2010s behavioural/medical genetics takes. SNPedia will excitedly explain to you that common genetic variants make you immune to vCJD. They cite a 2009 post from the now-archived 23andme blog titled “No Good Evidence That Potential Pool of Mad Cow Disease Victims Is Expanding”, explaining how fears of late-onset vCJD are clearly debunked by new Scientific Knowledge. Everyone who developed vCJD in the 1990s and 2000s had an M/M genotype in a particular part of the PRNP prion gene, so the roughly half the population with M/V or V/V genotypes were immune. The Family That Couldn’t Sleep buys this, too. In fact, it buys it in an even more agonizingly 2000s way. The first sign that transmissible prion diseases weren’t genotype-restricted should’ve been the growth hormone kids. You might have heard this story – from the late 1950s through mid-1980s, human growth hormone produced from brain tissue was used as a treatment for pituitary dwarfism, until it turned out to spread CJD if the originating brain was infected. DTM discusses this, to set the scene for the genetics thing. He mentions what was the state of the art at the time – that a disproportionate share of both the growth hormone kids and sporadic CJD cases were V/V homozygotes. This, uh – so the book was written in the mid-2000s, yeah? Yeah. The conclusion DTM drew – and this was a common conclusion at the time – was that homozygosity somehow made you more vulnerable to CJD, and M/M homozygosity made you vulnerable to BSE-borne CJD in particular. We cannot criticise the author for not predicting the future, but we live in the future, and can say how this worked out. Turns out, nope, M/V heterozygotes totally get vCJD. After a British man in his 30s died of CJD in 2016, he was found to have vCJD and an M/V genotype. He was tested for vCJD only because he was exceptionally young for someone with a sporadic prion disease – meaning people developing it later in life would be missed6. Did you know up to 1 in 2000 people in the UK have latent vCJD? There is one line in The Family That Couldn’t Sleep that stopped me dead in my tracks when I read it: What happens to the Italian family in the end depends less on their own actions than on the world’s interest in prion diseases, which they cannot control. If lots of people are afraid of getting variant CJD, the family benefits. If fear of prion disease goes the way of the fear of swine flu or Ebola, then they will be orphaned again. THIS BOOK IS FROM 2006! Three years before the swine flu pandemic! Eight years before the Ebola pandemic! “If you’re looking for a sign, this is it.” --------------------------------------------------------- The last section of The Family That Couldn’t Sleep addresses BSE fears in America and a nascent internet subculture DTM calls “Creutzfeldt Jakobins” – people who track American CJD cases, trying to spot vCJD patterns. When reading his description of the Creutzfeldt Jakobins, my mind constantly, uncontrollably turned to covid. Here it was – an online community of people deeply skeptical about a disease’s official story, tracking every contradiction, every implausibility, every statistic that failed to apply to the individual. Self-described “redneck hippies” and “soccer mom Republicans” teaming up to find the truth hidden behind an impossible world. You know what they’re doing now. I’ve always combined a deep interest in medicine with a healthy distrust for it. People who are constitutionally inquisitive, anti-authoritarian, and suspicious about official narratives tend to end up skeptical of at least some mainstream claims in the field. This is not to say I think you should take bleach enemas or something, just that I understand the impulse behind concluding the US government was covering up a local vCJD wave. Traditionally, sporadic prion diseases are said to have a prevalence of one in a million. (Hold on to that for a second.) The last section of the book is a chronology of Americans finding bizarrely more than one in a million of their friends dying of sporadic CJD, often at inexplicably young ages, sometimes in geographical clusters. This is understandably suspicious. Then DTM goes on to reassure us by saying none of these cases were confirmed to have an M/M genotype, which OH GOD OH FUCK A number of high-profile people in the prion world, including Gajdusek, are clarified as not believing sporadic prion diseases exist. You get the impression DTM doesn’t, either. Now, how common are prion diseases? Eric Vallabh Minikel has an answer for you! Eric and his wife Sonia are prion researchers from a rather unique background – after Sonia was diagnosed as having a single-gene mutation with ~100% penetrance for prion disease, they left their previous jobs to dedicate their lives to curing it. It turns out, when you run the numbers, you get not one in a million but 1 in 5000 people dying of prion diseases. This is best described as “nightmarishly high”. I’m normed on genetic disorders. A genetic disorder that affects one in five thousand people is pretty common! I have known, in person, completely unselected, just from “random people I’ve met in my life in a non-medical context”, someone with a ~1/250k syndrome and someone with a ~1/50k-100k syndrome. I don’t think anyone in my extended family knows someone who died of a prion disease. I feel like it would’ve come up if they did! Prion diseases have distinctive phenotypes. Not distinctive enough, apparently, to avoid a lot of CJD being misdiagnosed as Alzheimer’s – but diagnosis is consistently insane. Something DTM reiterates throughout The Family That Couldn’t Sleep is just what prion dementia looks like. The characteristic dementia in prion diseases spares something – “self” or “recognition” or “reflection” – that is not spared by Alzheimer’s, or by most common dementias. Shouldn’t this be, uh, noticeable?7 They kill rapidly, often over the course of months, and often onset in midlife. ALS shares this pattern and is way, way more common than prion diseases; you hear about ALS far more in the “disorder people actually have” sense. What am I missing here? Anyway: 1 in 2000 prevalence of latent vCJD in the UK + extreme lack of clarity over whether scrapie is human-transmissible + blood donations spread vCJD + sporadic CJD prevalence keeps going up = ??? (Yes, I am annoyed that most countries have lifted their ban on UK blood donors, thank you for asking!) --------------------------------------------------------- But back to the book. The “American chapter” is one-third about the country’s response to vCJD, one-third about the Creutzfeldt Jakobins, and one-third about chronic wasting disease. The last part is the most interesting. Chronic wasting disease is a prion disease of deer. Like scrapie, it “probably, we hope” isn’t human-transmissible (eat venison at your own risk). Under natural circumstances, deer shouldn’t get prion diseases: A prion plague should not be possible among ruminants in the wild. Deer are not cannibals, as the cows that spread BSE were forced to be; and, because deer and elk are not domesticated, they do not have enough contact with one another to spread a prion infection the way sheep are thought to spread scrapie. But deer do not live as they used to live, humans having once again brought their ambitions to bear on the natural course of things. The Family That Couldn’t Sleep is a book of medical anthropology. Anthropology of the Veneto, anthropology of Papua New Guinea, anthropology of 1990s Britain. Here, it is an anthropology of America. Americans, having won the world, still fight to win their own backyard. The North American continent is geographically diverse, cutting through rain-snow-shine, mountains jutting over plains, cities sprawling into wilderness, habitations criss-cross dotted with surprisingly few empty zones. Go somewhere like Denver, the Mile High City, three million people fighting against nature. Few other countries have anything like this; geographically vast polities usually have uninhabitable blocks. Australians are twenty-five million people clustered against the shore. It still surprises me, after all this time, how every US state has a meaningful city8. Midcentury Denver, growing and sprawling out across its mountains, started to run into their natural inhabitants – deer. Starvation is one way nature adjusts the deer population to the available food supply. People did not usually see this process, but in the 1950s and 1960s Colorado became more densely settled, reducing forested areas and forcing deer to look longer and harder for food. At the same time, the state enacted conservation laws, limiting when and where hunters could shoot. Soon emaciated deer began wandering onto the lawns and through suburban streets looking for a meal. People began to feed them, only to find that they died anyway. They would drop dead by haystacks, along highways, and in flower beds. In the late 1960s, a young biologist named Gene Schoonveld tried to figure out why the deer starved even when they were fed.9 He deprived some deer of food for a while, “[h]e cut windows in their stomachs to see what went on inside, and then he began to feed them”. While this was going on, he had a control group of healthy, well-fed deer as backups in case anything went wrong. It did...but not to the experimental group. The pen in which the deer were kept also housed sheep, which, it turned out, were scrapie carriers. The deer somehow acquired scrapie – there’s a huge unanswered question here, which DTM doesn’t address. How did they get scrapie? They didn’t eat the sheep, presumably. Did it somehow transmit from casual contact? This is not supposed to happen. And yet: the deer in the sheep pen started dying of a mysterious scrapie-like disease, one never reported before, that would go on to infect thousands. These deer were released into the wild. Ten years later, the first reports of chronic wasting disease came out. The disease spread across deer and elk in the western half of the country. By the turn of the millennium, cases were exploding – and lost all geographical restriction. DTM can report up to 2005, at which point it was floating around Upstate New York. This kind of spread doesn’t track natural deer migration. That’s irrelevant, because nothing about CWD’s spread is natural. We shift gears into an anthropology of the American hunter. The hunter wants to shoot the most impressive buck, to bag himself one with as many “points” as possible – one whose antlers branch out most. A “ten-point buck” has five branches on each horn: Original by Ric McArthur Nature doesn’t make enough bucks with perfectly symmetrical ten-point horns. To fill the demand, the market had to step in. Thus was born the deer farm industry, which raises captive deer in better genetic and nutritional conditions than Nature permits, then ships them across the country so hunters who couldn’t get legit ten-point bucks get the taxidermy piece for their wall. These are controversial amongst hunters and illegal in numerous states – but the industry is big enough to spread CWD. (The kind of hunter who needs a deer shipped to his house is the kind of hunter who will fumble killing it.) Another problem is supplemental feeding – leaving out protein-enriched food for deer to eat. This produces “trophy class animals at an earlier age”, but again, what’s in that protein? (“It is much like feeding your cows 41 percent protein cottonseed cake during the winter to raise the protein level in the cow’s diet to a level that will maintain acceptable production”, says that article from 1991.)10 The book segues into a vignette. CWD was new in Wisconsin in the early 2000s, and the state’s Department of Natural Resources was optimistic it could eradicate it. In a state with a love of hunting, you could, in theory, recruit people to kill every single deer in a 400-square-mile radius: In many states, the state would have had to call out the National Guard for such an onslaught, but hunting is a passion in Wisconsin. Hunters shoot 450,000 deer every year, more than in any other state. “I’m looking for ardent hunters to help us, unless fear or their wives keep them away,” one DNR official told a Milwaukee magazine. The state extended the normal hunting season and waived the usual limit of one buck per hunter, and the hunters came out in force. The whole affair was gruesome – one official called it “hunting for slob hunters”. If you’re trying to eradicate a prion disease, you can’t very well let people take the carcasses home to eat. Bodies piled up in control stations, decomposition mingling with bleach. The 2002 hunt established a base rate of 2% for chronic wasting disease in Wisconsin deer, with the most affected areas getting up to 10%. Further hunts in 2003, 2004, and 2005 spread to wider and wider areas – and didn’t move the needle one bit. This is to say that CWD is quite a bit more common in the American deer population than BSE ever was in British cattle. Since publication, it’s popped up in Norway and South Korea. Notably, Norway doesn’t allow for the import of cervids, raising numerous questions about how it got there. There are no unambiguous cases of CWD transmission to humans, and in vivo/in vitro primate studies have mixed results. There sure are some unusually young hunters with sporadic CJD, though. But don’t worry, most of them aren’t M/M homozygotes! There is an absolute ton going on in this book. I’ve had to skim over whole sections. Parts that couldn’t be easily slotted into a narrative review include: When Gajdusek was invited to a party at Prusiner’s house, he was horrified to find his rival had purchased hundreds of New Guinean statues – all with the genitals removed.
Yeah. The conclusion DTM drew – and this was a common conclusion at the time – was that homozygosity somehow made you more vulnerable to CJD, and M/M homozygosity made you vulnerable to BSE-borne CJD in particular. We cannot criticise the author for not predicting the future, but we live in the future, and can say how this worked out. Turns out, nope, M/V heterozygotes totally get vCJD. After a British man in his 30s died of CJD in 2016, he was found to have vCJD and an M/V genotype. He was tested for vCJD only because he was exceptionally young for someone with a sporadic prion disease – meaning people developing it later in life would be missed6. Did you know up to 1 in 2000 people in the UK have latent vCJD? There is one line in The Family That Couldn’t Sleep that stopped me dead in my tracks when I read it: What happens to the Italian family in the end depends less on their own actions than on the world’s interest in prion diseases, which they cannot control. If lots of people are afraid of getting variant CJD, the family benefits. If fear of prion disease goes the way of the fear of swine flu or Ebola, then they will be orphaned again. THIS BOOK IS FROM 2006! Three years before the swine flu pandemic! Eight years before the Ebola pandemic! “If you’re looking for a sign, this is it.” --------------------------------------------------------- The last section of The Family That Couldn’t Sleep addresses BSE fears in America and a nascent internet subculture DTM calls “Creutzfeldt Jakobins” – people who track American CJD cases, trying to spot vCJD patterns. When reading his description of the Creutzfeldt Jakobins, my mind constantly, uncontrollably turned to covid. Here it was – an online community of people deeply skeptical about a disease’s official story, tracking every contradiction, every implausibility, every statistic that failed to apply to the individual. Self-described “redneck hippies” and “soccer mom Republicans” teaming up to find the truth hidden behind an impossible world. You know what they’re doing now. I’ve always combined a deep interest in medicine with a healthy distrust for it. People who are constitutionally inquisitive, anti-authoritarian, and suspicious about official narratives tend to end up skeptical of at least some mainstream claims in the field. This is not to say I think you should take bleach enemas or something, just that I understand the impulse behind concluding the US government was covering up a local vCJD wave. Traditionally, sporadic prion diseases are said to have a prevalence of one in a million. (Hold on to that for a second.) The last section of the book is a chronology of Americans finding bizarrely more than one in a million of their friends dying of sporadic CJD, often at inexplicably young ages, sometimes in geographical clusters. This is understandably suspicious. Then DTM goes on to reassure us by saying none of these cases were confirmed to have an M/M genotype, which OH GOD OH FUCK A number of high-profile people in the prion world, including Gajdusek, are clarified as not believing sporadic prion diseases exist. You get the impression DTM doesn’t, either. Now, how common are prion diseases? Eric Vallabh Minikel has an answer for you! Eric and his wife Sonia are prion researchers from a rather unique background – after Sonia was diagnosed as having a single-gene mutation with ~100% penetrance for prion disease, they left their previous jobs to dedicate their lives to curing it. It turns out, when you run the numbers, you get not one in a million but 1 in 5000 people dying of prion diseases. This is best described as “nightmarishly high”. I’m normed on genetic disorders. A genetic disorder that affects one in five thousand people is pretty common! I have known, in person, completely unselected, just from “random people I’ve met in my life in a non-medical context”, someone with a ~1/250k syndrome and someone with a ~1/50k-100k syndrome. I don’t think anyone in my extended family knows someone who died of a prion disease. I feel like it would’ve come up if they did! Prion diseases have distinctive phenotypes. Not distinctive enough, apparently, to avoid a lot of CJD being misdiagnosed as Alzheimer’s – but diagnosis is consistently insane. Something DTM reiterates throughout The Family That Couldn’t Sleep is just what prion dementia looks like. The characteristic dementia in prion diseases spares something – “self” or “recognition” or “reflection” – that is not spared by Alzheimer’s, or by most common dementias. Shouldn’t this be, uh, noticeable?7 They kill rapidly, often over the course of months, and often onset in midlife. ALS shares this pattern and is way, way more common than prion diseases; you hear about ALS far more in the “disorder people actually have” sense. What am I missing here? Anyway: 1 in 2000 prevalence of latent vCJD in the UK + extreme lack of clarity over whether scrapie is human-transmissible + blood donations spread vCJD + sporadic CJD prevalence keeps going up = ??? (Yes, I am annoyed that most countries have lifted their ban on UK blood donors, thank you for asking!) --------------------------------------------------------- But back to the book. The “American chapter” is one-third about the country’s response to vCJD, one-third about the Creutzfeldt Jakobins, and one-third about chronic wasting disease. The last part is the most interesting. Chronic wasting disease is a prion disease of deer. Like scrapie, it “probably, we hope” isn’t human-transmissible (eat venison at your own risk). Under natural circumstances, deer shouldn’t get prion diseases: A prion plague should not be possible among ruminants in the wild. Deer are not cannibals, as the cows that spread BSE were forced to be; and, because deer and elk are not domesticated, they do not have enough contact with one another to spread a prion infection the way sheep are thought to spread scrapie. But deer do not live as they used to live, humans having once again brought their ambitions to bear on the natural course of things. The Family That Couldn’t Sleep is a book of medical anthropology. Anthropology of the Veneto, anthropology of Papua New Guinea, anthropology of 1990s Britain. Here, it is an anthropology of America. Americans, having won the world, still fight to win their own backyard. The North American continent is geographically diverse, cutting through rain-snow-shine, mountains jutting over plains, cities sprawling into wilderness, habitations criss-cross dotted with surprisingly few empty zones. Go somewhere like Denver, the Mile High City, three million people fighting against nature. Few other countries have anything like this; geographically vast polities usually have uninhabitable blocks. Australians are twenty-five million people clustered against the shore. It still surprises me, after all this time, how every US state has a meaningful city8. Midcentury Denver, growing and sprawling out across its mountains, started to run into their natural inhabitants – deer. Starvation is one way nature adjusts the deer population to the available food supply. People did not usually see this process, but in the 1950s and 1960s Colorado became more densely settled, reducing forested areas and forcing deer to look longer and harder for food. At the same time, the state enacted conservation laws, limiting when and where hunters could shoot. Soon emaciated deer began wandering onto the lawns and through suburban streets looking for a meal. People began to feed them, only to find that they died anyway. They would drop dead by haystacks, along highways, and in flower beds. In the late 1960s, a young biologist named Gene Schoonveld tried to figure out why the deer starved even when they were fed.9 He deprived some deer of food for a while, “[h]e cut windows in their stomachs to see what went on inside, and then he began to feed them”. While this was going on, he had a control group of healthy, well-fed deer as backups in case anything went wrong. It did...but not to the experimental group. The pen in which the deer were kept also housed sheep, which, it turned out, were scrapie carriers. The deer somehow acquired scrapie – there’s a huge unanswered question here, which DTM doesn’t address. How did they get scrapie? They didn’t eat the sheep, presumably. Did it somehow transmit from casual contact? This is not supposed to happen. And yet: the deer in the sheep pen started dying of a mysterious scrapie-like disease, one never reported before, that would go on to infect thousands. These deer were released into the wild. Ten years later, the first reports of chronic wasting disease came out. The disease spread across deer and elk in the western half of the country. By the turn of the millennium, cases were exploding – and lost all geographical restriction. DTM can report up to 2005, at which point it was floating around Upstate New York. This kind of spread doesn’t track natural deer migration. That’s irrelevant, because nothing about CWD’s spread is natural. We shift gears into an anthropology of the American hunter. The hunter wants to shoot the most impressive buck, to bag himself one with as many “points” as possible – one whose antlers branch out most. A “ten-point buck” has five branches on each horn: Original by Ric McArthur Nature doesn’t make enough bucks with perfectly symmetrical ten-point horns. To fill the demand, the market had to step in. Thus was born the deer farm industry, which raises captive deer in better genetic and nutritional conditions than Nature permits, then ships them across the country so hunters who couldn’t get legit ten-point bucks get the taxidermy piece for their wall. These are controversial amongst hunters and illegal in numerous states – but the industry is big enough to spread CWD. (The kind of hunter who needs a deer shipped to his house is the kind of hunter who will fumble killing it.) Another problem is supplemental feeding – leaving out protein-enriched food for deer to eat. This produces “trophy class animals at an earlier age”, but again, what’s in that protein? (“It is much like feeding your cows 41 percent protein cottonseed cake during the winter to raise the protein level in the cow’s diet to a level that will maintain acceptable production”, says that article from 1991.)10 The book segues into a vignette. CWD was new in Wisconsin in the early 2000s, and the state’s Department of Natural Resources was optimistic it could eradicate it. In a state with a love of hunting, you could, in theory, recruit people to kill every single deer in a 400-square-mile radius: In many states, the state would have had to call out the National Guard for such an onslaught, but hunting is a passion in Wisconsin. Hunters shoot 450,000 deer every year, more than in any other state. “I’m looking for ardent hunters to help us, unless fear or their wives keep them away,” one DNR official told a Milwaukee magazine. The state extended the normal hunting season and waived the usual limit of one buck per hunter, and the hunters came out in force. The whole affair was gruesome – one official called it “hunting for slob hunters”. If you’re trying to eradicate a prion disease, you can’t very well let people take the carcasses home to eat. Bodies piled up in control stations, decomposition mingling with bleach. The 2002 hunt established a base rate of 2% for chronic wasting disease in Wisconsin deer, with the most affected areas getting up to 10%. Further hunts in 2003, 2004, and 2005 spread to wider and wider areas – and didn’t move the needle one bit. This is to say that CWD is quite a bit more common in the American deer population than BSE ever was in British cattle. Since publication, it’s popped up in Norway and South Korea. Notably, Norway doesn’t allow for the import of cervids, raising numerous questions about how it got there. There are no unambiguous cases of CWD transmission to humans, and in vivo/in vitro primate studies have mixed results. There sure are some unusually young hunters with sporadic CJD, though. But don’t worry, most of them aren’t M/M homozygotes! There is an absolute ton going on in this book. I’ve had to skim over whole sections. Parts that couldn’t be easily slotted into a narrative review include: When Gajdusek was invited to a party at Prusiner’s house, he was horrified to find his rival had purchased hundreds of New Guinean statues – all with the genitals removed.
Original by Ric McArthur Nature doesn’t make enough bucks with perfectly symmetrical ten-point horns. To fill the demand, the market had to step in. Thus was born the deer farm industry, which raises captive deer in better genetic and nutritional conditions than Nature permits, then ships them across the country so hunters who couldn’t get legit ten-point bucks get the taxidermy piece for their wall. These are controversial amongst hunters and illegal in numerous states – but the industry is big enough to spread CWD. (The kind of hunter who needs a deer shipped to his house is the kind of hunter who will fumble killing it.) Another problem is supplemental feeding – leaving out protein-enriched food for deer to eat. This produces “trophy class animals at an earlier age”, but again, what’s in that protein? (“It is much like feeding your cows 41 percent protein cottonseed cake during the winter to raise the protein level in the cow’s diet to a level that will maintain acceptable production”, says that article from 1991.)10 The book segues into a vignette. CWD was new in Wisconsin in the early 2000s, and the state’s Department of Natural Resources was optimistic it could eradicate it. In a state with a love of hunting, you could, in theory, recruit people to kill every single deer in a 400-square-mile radius: In many states, the state would have had to call out the National Guard for such an onslaught, but hunting is a passion in Wisconsin. Hunters shoot 450,000 deer every year, more than in any other state. “I’m looking for ardent hunters to help us, unless fear or their wives keep them away,” one DNR official told a Milwaukee magazine. The state extended the normal hunting season and waived the usual limit of one buck per hunter, and the hunters came out in force. The whole affair was gruesome – one official called it “hunting for slob hunters”. If you’re trying to eradicate a prion disease, you can’t very well let people take the carcasses home to eat. Bodies piled up in control stations, decomposition mingling with bleach. The 2002 hunt established a base rate of 2% for chronic wasting disease in Wisconsin deer, with the most affected areas getting up to 10%. Further hunts in 2003, 2004, and 2005 spread to wider and wider areas – and didn’t move the needle one bit. This is to say that CWD is quite a bit more common in the American deer population than BSE ever was in British cattle. Since publication, it’s popped up in Norway and South Korea. Notably, Norway doesn’t allow for the import of cervids, raising numerous questions about how it got there. There are no unambiguous cases of CWD transmission to humans, and in vivo/in vitro primate studies have mixed results. There sure are some unusually young hunters with sporadic CJD, though. But don’t worry, most of them aren’t M/M homozygotes! There is an absolute ton going on in this book. I’ve had to skim over whole sections. Parts that couldn’t be easily slotted into a narrative review include: When Gajdusek was invited to a party at Prusiner’s house, he was horrified to find his rival had purchased hundreds of New Guinean statues – all with the genitals removed.
Huns

Huns is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between November 11, 2021 and August 01, 2025. The archive places it in contexts such as "The idea they're the Huns that invaded Rome is just plain false"; "400 AD, you get the Huns"; "Blame the Huns and the Goths". It most often appears alongside Google, Constantinople, English.

Article page
Huns
Mention count
3
Issue count
3
First seen
November 11, 2021
Last seen
August 01, 2025
November 11, 2021 · Original source
The Hungarians are descended from steppe nomads to at least the extent that Americans are descendants of the English. You can equally say most Americans have very little English blood and have it be true but a weird take. Now, Magyarism as a nationalist ideology is full of weird false facts. The idea they're the Huns that invaded Rome is just plain false. But there's significant linguistic and cultural continuity between Hungarians and their ancestors in addition to a distinct ethnic gene cluster. The article you cited itself even says this. Now, do they have large amounts of Germanic (and even more Slavic) blood? Yes, absolutely.
May 04, 2022 · Original source
“Oh yeah. You look at history, and once every two hundred, three hundred years they get their act together, form a big confederation, and invade either China, the West, or both. It’s like clockwork. 400 AD, you get the Huns. 700, the Magyars. 1000, the first Turks start moving west. 1200, Genghis Khan, killed 10% of the world population. 1400, Tamerlane, killed another 5%. 1650, the Ming-Qing transition in China, also killed 5%. We’re more than 50 years overdue at this point.”
August 01, 2025 · Original source
Second, that in a maze of backstabbing politics, ineptitude, brutal criminality and betrayal within and without the government, of authorities who act like bandits and bandits who act like Huns, a saint can suddenly appear with the strength to rewrite history. When everything looks hopeless… you’re probably screwed! But you might not be. A saint might appear. It’s happened before. It can happen again.
We have no histories from contemporaries of Alexander the Great, just inscriptions, fragments quoted in later histories, et cetera. There were histories written, to be clear! We know they were written! We even know his general Ptolemy wrote one claiming to be his half-brother! We just don't have them any more because all existing copies have been lost or destroyed. Blame the Huns and the Goths, I suppose.
hypertension

hypertension is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between November 24, 2022 and July 31, 2025. The archive places it in contexts such as "with hypertension and ACE inhibitors,"; "and most of the other things they measured... hypertension"; "two bright orange squares (gallstones vs. hypertension and hypothyroidism)". It most often appears alongside Europe, US, 23andMe.

Article page
hypertension
Mention count
3
Issue count
3
First seen
November 24, 2022
Last seen
July 31, 2025
November 24, 2022 · Original source
Semaglutide is now as searched-for on Google as Prozac or Viagra. Even if this is a temporary Musk-related spike, even pre-Musk it was getting a little above half their level. But Google Trends doesn’t exactly track awareness; few people search for Prozac these days precisely because everyone already knows what it is. So all this tells us is that there’s a lot of buzz around semaglutide. Suppose for the sake of argument that 5% of obese people have heard of this drug. Step 2: Prescription Accessibility The FDA says Wegovy is indicated for obesity, defined as BMI ≥ 30, or for people with BMI ≥ 27 and certain medical conditions. Does that mean that if you have that BMI, your doctor will give you a prescription? I think most doctors will want patients to try diet and exercise first. My experience as a doctor is that most obese people have already considered diet and exercise. Sometimes if you have a very compelling reason and a very well-thought out plan you can get them to try again. But usually they are obese because diet and exercise are hard for them, or don’t work for them, or some other reason besides “they never thought of it”. Still, I hear lots of stories about patient-doctor fights here. I assume this will happen with Wegovy too. Every doctor will have their own threshold for what amount of “already tried diet and exercise” is enough to justify a Wegovy prescription, and sometimes patients won’t meet that threshold. The history of medicine includes the following story many times: there’s some condition that doctors recommend lifestyle changes for. Then an exciting new medication comes out that treats the condition effectively. Over a generation or so, doctors go from demanding the lifestyle change, to gesturing at the lifestyle change before prescribing the medication, to mostly just prescribing the medication. We saw this with cholesterol and statins, with hypertension and ACE inhibitors, with depression and SSRIs. You can form your own opinion on whether this is good or bad, but we’re probably in the very beginning of this process with obesity. Opinions will be all over the map for a while before the inevitable pharma company victory makes everyone agree that semaglutide is first-line therapy. …except that this time, Silicon Valley is short-circuiting the process with fly-by-night telemedicine companies that guarantee you’ll get the drugs you want. For example, NextMed charges $138/month ($99 first month only!) for a guaranteed GLP-1 agonist prescription, plus “support and messaging with expert doctors”. The DEA sometimes shuts these groups down when they start playing around with controlled substances (eg addictive drugs like Adderall), but Wegovy isn’t controlled, and the government probably doesn’t care that much here. These services guarantee that people with money will be able to circumvent conservative doctors and access a prescription. Only 75% of Americans have PCPs at all. If we assume half of them will eventually be able to get a Wegovy prescription from their doctor, that’s 37.5%. Step 3: Affordability Semaglutide costs $15,000/year. Well-off people like Elon Musk might be able to pay that out-of-pocket, but most people will probably need insurance coverage. Right now this is spotty. Medicare doesn’t cover obesity drugs. This isn’t a reaction to the threat of semaglutide-related cost explosions - they’re not that smart. I think Medicare laws were just written in the old days when people were less likely to think of obesity as a disease. Is it time for change? Some Congressmen have proposed a very noble-sounding law telling Medicare and Medicaid to start covering weight loss drugs. I‘m sure this is out of deep compassion for America’s obese population and not because it would make pharma companies one billion zillion dollars. One of the Congressmen even has the last name “Kind!” Some pharma lobbyist probably got a bonus for that one. Private insurers mostly have to cover whatever Medicare does, but they can choose whether or not to include extra non-Medicare-covered drugs. Some have chosen to cover semaglutide under some conditions. Others would prefer not to cover it, but can be scared into covering it by the magic words “medical necessity”. Overall I don’t understand the laws here beyond that maybe they’ll cover it and maybe they won’t. Here, too, it might be time for change. The New York Times is publishing articles trying to convince us that private insurances not covering semaglutide is an outrage. Here in the tiny gray text, I want to take a second to complain about this article. It notes that Wegovy (semaglutide for obesity) costs more per prescription than Ozempic (semaglutide for diabetes), and calls this “a gross inequity”, accusing Novo Nordisk of “charg[ing] people more for the same drug because of their obesity”. But the obesity prescription is higher dose than the diabetes prescription! Milligram per milligram, Wegovy costs *less* than Ozempic! A steelmanned version of the NYT might object - don’t most of the costs come from the intellectual property and not the manufacturing, so that dose shouldn’t matter? Yes, but if you made the obesity version cost too much less per milligram than the diabetes version, then diabetics would cheat the system by buying the obesity version and splitting it into smaller doses! Insurances that do cover it may require extra documentation that the patient has tried lots of diet and exercise, maybe including some official diet-and-exercise program like WeightWatchers. They might also want documentation that patients have tried cheaper earlier-generation weight loss drugs without success. Even when insurances do cover semaglutide, copays may be very high. I have a pretty minimal insurance and it looks like if I got semaglutide my copay would be about $500/month until I reach my out of pocket limit. Harsh. People with better insurances might get hit less hard, but I don’t think anyone will be picking this up for cheap. Let’s say only 5% of people who clear all previous hurdles can afford the drug. How Many People Get Semaglutide? 140 million obese Americans * 25% interested * 5% know of semaglutide’s existence * 37.5% can get prescriptions * 5% can afford it = 33,000, which is a pretty good match for the 50,000 estimated prescriptions. I didn’t even fudge the numbers to come out right, it just happened. The Coming Decade As a service to pharma investors, Morgan Stanley modeled the economic future of obesity medications over the next decade. Their headline result: semaglutide and various semaglutide-copycat-drugs will be a $30 billion market by 2030. That’s less than the $500 billion disaster I was afraid of! But still almost 10% of all US drug spending! Here are two core analyses from the report: The first analysis asks “what if doctors medicalized obesity as comprehensively as they’ve medicalized hypertension and high cholesterol?” That is: what if we put in a society-wide effort to get every obese person to a doctor, and after only a little diet and exercise, the doctor puts them on a medication? They find that the US obesity market would multiply by a factor of 25, to about $87 billion/year. The second analysis is a more realistic projection for the next decade. Two things stand out. First, the number of patients on Wegovy or related medications goes from an estimated 46,910 now (pretty close to my 50,000 estimate!) to 11.3 million in 2030. Second, the cost per prescription goes from $15,000/year to about $4,000 year. Let’s look at this second change in more detail. Right now semaglutide is literally in a class of its own for weight loss. But remember, it started as a GLP-1 agonist diabetes drug. And there are other GLP-1 agonists already in use for diabetes. Novo Nordisk’s competitor Eli Lilly owns a closely related molecule, tirzepatide (Mounjaro®). They’ve already done studies showing it also works very well for weight loss - if anything even better than semaglutide - and they’re expected to get FDA approval to market it as a weight loss medication next year. Although capitalism fans might expect the presence of two competing drugs to immediately drive down prices, this is mysteriously not how things work in health care and prices will probably stay the same in the short term. But several other companies are working on semaglutide-like drugs, some will be cheaper to produce than semaglutide, and Morgan Stanley expects that this stronger level of competition will eventually drive costs down to $350/month ($4,000/year) by 2030. “Mounjaro” sounds like the playful animal sidekick in a Disney movie. From a purely economic perspective, semaglutide costs the health system money (because it’s expensive) but also saves the health system money (because we don’t have to pay for obesity consequences like diabetes and heart attacks). Which effect wins out? According to the Institute for Clinical and Economic Review, benefits would outweigh costs if semaglutide cost less than about $8,000/year. Since it costs $15,000 year now, it’s not cost effective. But if Morgan Stanley’s model comes true and it costs $4,000/year in 2030, then it will be cost effective. So at some point, Medicare (and so insurance companies) may start covering it more out of self-interest. I can’t tell whether the model takes this into account or not. (there’s also a third-level effect where it costs the health system money again, because it prevents people from dying of obesity-related complications, and dead people stop needing expensive health care. I think health economists are supposed to ignore this level.) 11.3 million prescriptions at $4,000/year comes to $45 billion, but Morgan Stanley expects that not everyone will fill their prescriptions consistently or stay on the medication the same amount of time, leading to their $31 billion figure. Towards The Glorious Post-Obesity Transhuman Future The Morgan Stanley report shows that even the greediest pharma investors, openly plotting to medicalize obesity, can’t bring themselves to believe in more than 11 million US semaglutide patients by 2030. That’s less than 10% of the US obese population. Isn’t that kind of disappointing? We’ve got > 100 million people dealing with a condition that not only makes them unhealthy, but also causes them psychological distress, and makes lots of people low-grade disappointed in and repulsed by our society. And we’ve got an effective drug that treats the condition. And we’re going to use it on less than 10% of the people involved? In 2032, semaglutide goes off-patent. It will probably take a few years to sort out legal issues and ramp up generic production, but by the mid-2030s, its price will go way down. I don’t think there are technical barriers to getting it down as low as $10 - $100 per month. By then, maybe there will be even more exciting branded weight loss drugs for wealthy people to choose from. But at the very least, semaglutide itself should become much more widely available even to poor or uninsured patients. I’m not sure what will happen. Will there be an inflection point, where so many people use semaglutide that obesity becomes unusual again, and then the remaining obese people start using it just to fit in? Will obesity become an optional fashion statement, like shaving your head or getting a tattoo? Or will semaglutide end up disappointing us in some way, like so many promising drugs have before? I come at semaglutide from a transhumanist perspective. I want to hack genetics and biology until everyone is as tall as they want, as strong as they want, as smart as they want, and whatever gender they want. If you want wings, you should be able to have wings. And yes, part of this vision is everyone having the weight they want. I’m not sure this will happen, but for the first time I can see a clear path to how it might. Postscript 1: Should You Take Semaglutide? I can’t answer this, please ask your doctor. But I do want to add that there are potential side effects I haven’t mentioned in this post, including nausea, gastrointestinal problems, pancreatitis, and kidney problems. Semaglutide has been accused of slightly increasing risk of pancreatic and thyroid cancers. Studies have found trends in this direction, but these conditions are so rare that even over thousands of patients over many years, the increase hasn’t yet reached clear statistical significance. The current consensus position is that it may increase thyroid cancer by a tiny amount not relevant to most patients, and that it probably doesn’t increase pancreatic cancer. I think my father has looked over these data more and is less sure than other people about the lack of pancreatic cancer risk, but he can’t get the resources he needs to prove anything, and I can’t remember his exact argument. More broadly: like all medications, semaglutide has benefits and risks, and you shouldn’t blindly take it after reading one blog article. Postscript 2: Is There A Way To Cheat The System To Get Semaglutide For Lower Cost? Health care is much like airline tickets: everyone pays a different price for everything and there’s usually a secret way to get what you want for much less money. Is this true of semaglutide? Pharma company Novo Nordisk offers a Savings Card that they say brings the price down to as low as $25 per month. I’m a little suspicious of this - pharma company offers are rarely as good as they sound - but I don’t notice any obvious tricks in this one and it should probably be your first bet. This startup claims that they can get insured people semaglutide for a $25/month copay “after their deductible is met” by negotiating with the insurance company very effectively. I can’t imagine how that works or what they have to negotiate with, but they seem pretty convinced, so I would welcome more information. Otherwise, you don’t have many great options. Although there are two older forms of semaglutide not FDA-approved for weight loss - Ozempic and Rybelsus - these are both more expensive, milligram per milligram, than Wegovy itself. Canada is also of no help. The usual Canadian pharmacies don’t seem to carry Wegovy, and charge about the same amount for Ozempic as American pharmacies do. This article in Drug Discovery Trends says that compounding pharmacies have been selling semaglutide for $300/month, less than a quarter of the sticker price. This is a bit confusing: compounding pharmacies are small local operations permitted to dispense unusual medications by mixing existing ones together in nonstandard ways. They’re arguing that they can legally dispense the semaglutide because they’re mixing it with vitamins, which, fine, but how are they getting it in the first place? Everyone else seems as confused as I am: "Nobody knows how [compounding pharmacies are] getting it," said Karl Nadolsky, an endocrinologist at Spectrum Health. "Who's making it? [The pharma company that makes it] Novo [Nordisk]'s not giving it to them. They're the ones with the rights to the molecule, so how is anybody getting semaglutide?" Has nobody asked compounding pharmacists about this? Do they have a conspiracy of silence? Does the FDA sometimes send their goons in to extract the information, but the compounding pharmacists compound sleeping gas / smoke grenades and vanish into the night? Anyway, the usual authorities warn you not to take compounded semaglutide under any circumstances, but they’re the same people who tell you never to buy drugs from a Canadian pharmacy because they might be adulterated. You can decide how much you want to trust them. Postscript 3: What About Europe And The Rest Of The World? Countries that are not the US usually negotiate with pharmaceutical companies over price. Because of some combination of “negotiation works” and “they are free-riding off Americans’ hard work”, they usually get much lower prices. What does semaglutide cost elsewhere? This is hard to find out because government health agencies sometimes keep their prices secret, plus Wegovy mostly isn’t available in other countries yet. The only information I could find was from Britain, which is in the process of making Wegovy available to patients. It looks like NHS will “restrict the expensive drug’s availability to very obese people attending specialist weight-loss clinics”, but that it might be possible to get it from private clinics for £199/month = £2400/year. Wegovy has been approved in the EU but doesn’t seem to have made it there yet. I can’t find any information about any other country. Non-weight-loss-indicated versions of semaglutide are available in many countries, but I wouldn’t expect their health care systems to be flexible about redirecting it for weight. Canadian regulators have approved Wegovy, but it doesn’t seem to be available there yet. I haven’t seen any evidence that Ozempic costs less in Canada than it does in the US, and I’m not sure why. Maybe the pharma companies have figured out that anything that happens in Canada gets imported into the US, and they’re playing hardball this time. I don’t know whether Canadians will be able to get it for cheaper than Americans or not. Postscript 4: Predictions (all predictions are conditional on no singularity or global catastrophe) 10 million Americans on semaglutide (or yet-to-be-approved equally good or superior alternatives) by 2030: 75%
The first analysis asks “what if doctors medicalized obesity as comprehensively as they’ve medicalized hypertension and high cholesterol?” That is: what if we put in a society-wide effort to get every obese person to a doctor, and after only a little diet and exercise, the doctor puts them on a medication? They find that the US obesity market would multiply by a factor of 25, to about $87 billion/year. The second analysis is a more realistic projection for the next decade. Two things stand out. First, the number of patients on Wegovy or related medications goes from an estimated 46,910 now (pretty close to my 50,000 estimate!) to 11.3 million in 2030. Second, the cost per prescription goes from $15,000/year to about $4,000 year. Let’s look at this second change in more detail. Right now semaglutide is literally in a class of its own for weight loss. But remember, it started as a GLP-1 agonist diabetes drug. And there are other GLP-1 agonists already in use for diabetes. Novo Nordisk’s competitor Eli Lilly owns a closely related molecule, tirzepatide (Mounjaro®). They’ve already done studies showing it also works very well for weight loss - if anything even better than semaglutide - and they’re expected to get FDA approval to market it as a weight loss medication next year. Although capitalism fans might expect the presence of two competing drugs to immediately drive down prices, this is mysteriously not how things work in health care and prices will probably stay the same in the short term. But several other companies are working on semaglutide-like drugs, some will be cheaper to produce than semaglutide, and Morgan Stanley expects that this stronger level of competition will eventually drive costs down to $350/month ($4,000/year) by 2030. “Mounjaro” sounds like the playful animal sidekick in a Disney movie. From a purely economic perspective, semaglutide costs the health system money (because it’s expensive) but also saves the health system money (because we don’t have to pay for obesity consequences like diabetes and heart attacks). Which effect wins out? According to the Institute for Clinical and Economic Review, benefits would outweigh costs if semaglutide cost less than about $8,000/year. Since it costs $15,000 year now, it’s not cost effective. But if Morgan Stanley’s model comes true and it costs $4,000/year in 2030, then it will be cost effective. So at some point, Medicare (and so insurance companies) may start covering it more out of self-interest. I can’t tell whether the model takes this into account or not. (there’s also a third-level effect where it costs the health system money again, because it prevents people from dying of obesity-related complications, and dead people stop needing expensive health care. I think health economists are supposed to ignore this level.) 11.3 million prescriptions at $4,000/year comes to $45 billion, but Morgan Stanley expects that not everyone will fill their prescriptions consistently or stay on the medication the same amount of time, leading to their $31 billion figure. Towards The Glorious Post-Obesity Transhuman Future The Morgan Stanley report shows that even the greediest pharma investors, openly plotting to medicalize obesity, can’t bring themselves to believe in more than 11 million US semaglutide patients by 2030. That’s less than 10% of the US obese population. Isn’t that kind of disappointing? We’ve got > 100 million people dealing with a condition that not only makes them unhealthy, but also causes them psychological distress, and makes lots of people low-grade disappointed in and repulsed by our society. And we’ve got an effective drug that treats the condition. And we’re going to use it on less than 10% of the people involved? In 2032, semaglutide goes off-patent. It will probably take a few years to sort out legal issues and ramp up generic production, but by the mid-2030s, its price will go way down. I don’t think there are technical barriers to getting it down as low as $10 - $100 per month. By then, maybe there will be even more exciting branded weight loss drugs for wealthy people to choose from. But at the very least, semaglutide itself should become much more widely available even to poor or uninsured patients. I’m not sure what will happen. Will there be an inflection point, where so many people use semaglutide that obesity becomes unusual again, and then the remaining obese people start using it just to fit in? Will obesity become an optional fashion statement, like shaving your head or getting a tattoo? Or will semaglutide end up disappointing us in some way, like so many promising drugs have before? I come at semaglutide from a transhumanist perspective. I want to hack genetics and biology until everyone is as tall as they want, as strong as they want, as smart as they want, and whatever gender they want. If you want wings, you should be able to have wings. And yes, part of this vision is everyone having the weight they want. I’m not sure this will happen, but for the first time I can see a clear path to how it might. Postscript 1: Should You Take Semaglutide? I can’t answer this, please ask your doctor. But I do want to add that there are potential side effects I haven’t mentioned in this post, including nausea, gastrointestinal problems, pancreatitis, and kidney problems. Semaglutide has been accused of slightly increasing risk of pancreatic and thyroid cancers. Studies have found trends in this direction, but these conditions are so rare that even over thousands of patients over many years, the increase hasn’t yet reached clear statistical significance. The current consensus position is that it may increase thyroid cancer by a tiny amount not relevant to most patients, and that it probably doesn’t increase pancreatic cancer. I think my father has looked over these data more and is less sure than other people about the lack of pancreatic cancer risk, but he can’t get the resources he needs to prove anything, and I can’t remember his exact argument. More broadly: like all medications, semaglutide has benefits and risks, and you shouldn’t blindly take it after reading one blog article. Postscript 2: Is There A Way To Cheat The System To Get Semaglutide For Lower Cost? Health care is much like airline tickets: everyone pays a different price for everything and there’s usually a secret way to get what you want for much less money. Is this true of semaglutide? Pharma company Novo Nordisk offers a Savings Card that they say brings the price down to as low as $25 per month. I’m a little suspicious of this - pharma company offers are rarely as good as they sound - but I don’t notice any obvious tricks in this one and it should probably be your first bet. This startup claims that they can get insured people semaglutide for a $25/month copay “after their deductible is met” by negotiating with the insurance company very effectively. I can’t imagine how that works or what they have to negotiate with, but they seem pretty convinced, so I would welcome more information. Otherwise, you don’t have many great options. Although there are two older forms of semaglutide not FDA-approved for weight loss - Ozempic and Rybelsus - these are both more expensive, milligram per milligram, than Wegovy itself. Canada is also of no help. The usual Canadian pharmacies don’t seem to carry Wegovy, and charge about the same amount for Ozempic as American pharmacies do. This article in Drug Discovery Trends says that compounding pharmacies have been selling semaglutide for $300/month, less than a quarter of the sticker price. This is a bit confusing: compounding pharmacies are small local operations permitted to dispense unusual medications by mixing existing ones together in nonstandard ways. They’re arguing that they can legally dispense the semaglutide because they’re mixing it with vitamins, which, fine, but how are they getting it in the first place? Everyone else seems as confused as I am: "Nobody knows how [compounding pharmacies are] getting it," said Karl Nadolsky, an endocrinologist at Spectrum Health. "Who's making it? [The pharma company that makes it] Novo [Nordisk]'s not giving it to them. They're the ones with the rights to the molecule, so how is anybody getting semaglutide?" Has nobody asked compounding pharmacists about this? Do they have a conspiracy of silence? Does the FDA sometimes send their goons in to extract the information, but the compounding pharmacists compound sleeping gas / smoke grenades and vanish into the night? Anyway, the usual authorities warn you not to take compounded semaglutide under any circumstances, but they’re the same people who tell you never to buy drugs from a Canadian pharmacy because they might be adulterated. You can decide how much you want to trust them. Postscript 3: What About Europe And The Rest Of The World? Countries that are not the US usually negotiate with pharmaceutical companies over price. Because of some combination of “negotiation works” and “they are free-riding off Americans’ hard work”, they usually get much lower prices. What does semaglutide cost elsewhere? This is hard to find out because government health agencies sometimes keep their prices secret, plus Wegovy mostly isn’t available in other countries yet. The only information I could find was from Britain, which is in the process of making Wegovy available to patients. It looks like NHS will “restrict the expensive drug’s availability to very obese people attending specialist weight-loss clinics”, but that it might be possible to get it from private clinics for £199/month = £2400/year. Wegovy has been approved in the EU but doesn’t seem to have made it there yet. I can’t find any information about any other country. Non-weight-loss-indicated versions of semaglutide are available in many countries, but I wouldn’t expect their health care systems to be flexible about redirecting it for weight. Canadian regulators have approved Wegovy, but it doesn’t seem to be available there yet. I haven’t seen any evidence that Ozempic costs less in Canada than it does in the US, and I’m not sure why. Maybe the pharma companies have figured out that anything that happens in Canada gets imported into the US, and they’re playing hardball this time. I don’t know whether Canadians will be able to get it for cheaper than Americans or not. Postscript 4: Predictions (all predictions are conditional on no singularity or global catastrophe) 10 million Americans on semaglutide (or yet-to-be-approved equally good or superior alternatives) by 2030: 75%
April 30, 2024 · Original source
…and the same is true of hypertension and most of the other things they measured.
I find it unfair to present this claim without presenting my reasoning, which is that there’s a whole other paper, How Free Care Reduced Hypertension In The RAND Health Insurance Experiment, which does various sanity checks to this result, finds that it holds up, and finds related claims with lower p-values.
July 31, 2025 · Original source
Aside from two bright orange squares (gallstones vs. hypertension and hypothyroidism - I don’t know what’s up with this and it doesn’t seem to be a widely-appreciated result) we see that most correlations are zero or positive - that is, selecting against one disease selects against another or at worst does nothing. In this ocean of blue, worrying about those few orange squares feels a bit motivated. Hans Jonas-ism says that no medical intervention may ever cause any harm, no matter how much benefit it produces. By this standard, perhaps slightly raising the risk of gallstones in the process of preventing various cancers and psychoses and other forms of human misery is unacceptable. To anyone with the more normal perspective where something with large benefits and tiny downsides is still pretty good, I don’t think the antagonistic pleiotropy argument carries much weight. Ethical Objection: Cost No way around this one: if these products work, they mean that rich people can have healthier/smarter/taller/prettier kids than poor people. One might object that at least they’re in good company: other products which help rich kids get healthier/smarter/taller/prettier than poor kids include private tutors, gyms, hair salons, health insurance, clothing, books, and food. Is this really the time to declare ourselves against this kind of thing? But maybe we should fight against expanding this already-bloated category. Or maybe there’s something more final about a genetic advantage. Maybe a stronger argument is that rich people get first crack at every new technology, but poor people usually follow close behind. The first cellphone, in 1982, cost $12,000 in today’s dollars. Now you can get something a thousand times better for $50, and Kenyan pastoralists use cell phones to call up the local shaman. The trajectory of genetics has been even more striking: sequencing a single genome cost about $100 million in 2000 and is somewhere around $100 today. Polygenic embryo selection has the potential to follow a similar path. There are two associated costs - sequencing the embryos, and running the analysis. Sequencing costs are decreasing and may eventually be comparable to the sorts of genetic screening (for e.g. Down Syndrome) that most families get anyway. Analysis costs are mostly the one-time expense of inventing the predictor; we might expect these to follow the same pattern as generic medications, where cutting-edge technology is jealously guarded and expensive, but last decade’s technology has made its way off patent and is cheap-to-free. A few groups have already created free open-source predictors; so far these are much worse than the private companies’ versions, but one of last year’s ACX Grantees is working on a better one. Also, it would be crazy for any forward-thinking government not to cover this; it could save hundreds of thousands of dollars in future health care expenses. In countries with public health care, this comes directly out of the government treasury; even in the US, it’s covered by Medicare after age 65. The government should be begging people to select embryos. The most persistent cost barrier is likely to be in vitro fertilization itself, a necessary precursor. In the US, 2-3% of babies are born through IVF. For those kids, this is a no-brainer - even if the cost never comes down, the cheaper products are only a fraction of total IVF expense. What about the other 98%? If those parents feel like they have to get embryo selection (and therefore IVF) to keep up, this could be a significant burden. IVF isn’t fun - it requires pumping a woman full of mind-altering hormones for weeks, extracting eggs in a minor surgery, and then implanting embryos in another minor surgery, all with a decent chance that some step will fail and you’ll have to do it all again. It also costs $15,000 in the US (less in poorer countries), and unlike the genetics, the cost has barely gone down in the past twenty-five years. Some countries, including Israel, offer free IVF for anybody who wants it. And universal basic IVF is surprisingly popular even in the usually government-phobic United States - Donald Trump made it part of his campaign platform. So there’s a plausible path to embryo selection for everyone who wants it. But it’s still going to take a while, it will hit different people at different times, and so far11 there’s no way around the month or two of various miserable medical procedures for women. Ethical Objection: Personhood Is it really correct to say that you have reduced someone’s risk of breast cancer by 46%, if what you’ve really done is closer to replacing them with a different person who is 46% less likely to have breast cancer? I cover this one in more depth here. Ethical Objection: Race This one is awkward: right now the technology works best for white people. Most genetic data available for research/commercial use comes from the UK, US, and Europe - areas which are mostly white. Asian biobanks, and those serving US minority communities, have been more reluctant to share data. So we know a lot about the genetics of white people, and only a limited amount about the genetics of anyone else. Companies are suitably embarrassed about this, and researchers in the field are working hard to wring every ounce of information out of the minority data they have. But for now, white people are the clear winner. Here’s data from Herasight: A European family with five embryos and no family history can cut their diabetes risk by 47%, and an African family 29%, with everyone else in between. As usual, all companies say that they adjust their scores based on the couple’s genetic ancestry. As usual, Herasight challenges them to publicly release data on exactly how they performed the adjustments and how well they work. All companies say they are working as hard as they can to improve cross-ancestry portability, but that progress will remain limited until governments collect/release better genetic data on non-white populations. Ethical Objection: Selection At some point, you’ve got to choose. Genomic Prediction and Herasight offer scores that aggregate overall health risks. Some people will follow them slavishly. Other people will try to second-guess them - would you prefer your child have lower cancer risk, or less chance of heart attacks? And this is the best case scenario! Herasight offers predictors for IQ, height and BMI; Nucleus offers those plus eye color and hair color12. A parent might encounter a situation where the embryo with their favorite eye color also has the highest cancer and schizophrenia risk, and choose to doom their child to cancer and schizophrenia because they really want pretty eyes. On average, even if everyone in the world selected for eye color, it wouldn’t raise cancer and schizophrenia risk. No not-deliberately-perverse polygenic selection choice can make your child worse off in expectation. Still, suppose you got cancer, and your mom admitted that she selected you for pretty eyes and didn’t even check the cancer column of the embryo selection report. How would you feel? And would you feel better or worse than someone whose parents didn’t do embryo selection at all, and spent the money on a Caribbean vacation? What if they selected your brother for everything great, then had you naturally? What if they selected you for IQ, but actually you are very stupid, and you were one of the 20% of cases where a predictor that’s right 80% of the time gets it wrong? Mark my words, one day there will be entire subfields of therapy dedicated to these issues. Going Nuclear Even as outsiders criticize the whole field, Herasight has launched a full-scale attack on competitor Nucleus. Herasight’s white paper compares its own predictors (favorably) to those of Orchid and Genomic Prediction… …but refuses to acknowledge Nucleus at all. In a supplementary note, the authors explain why: they accuse Nucleus of being so bad that it would “not yield a reliable or meaningful addition to our analysis”. They say Nucleus has inflated the accuracy of their scores. This is most dramatic for a few conditions like ADHD, where the leading published polygenic score is based on 2,300,000 variants but explains only ~1% of variance in the condition. Nucleus’ score is based on 12 variants13 and (implicitly) claims to explain 3-6%. This doesn’t make sense. Some of Nucleus’ other scores do use millions of variants. But many of these are 5-10 year old scores downloaded from open-source catalogs, whose accuracy statistics are easily available and far less than Nucleus claims. Here is what Herasight finds when they double-check Nucleus’ numbers: On their Substack, Herasight also criticizes Nucleus’ monogenic screening product. They point out cases where it fails to properly screen for the conditions it claims. For example, the Nucleus website advertises screening for spinal muscular atrophy: But on their gene list… …they don’t screen for SMN, which causes 95% of spinal muscular atrophy cases. They only screen for UBA1, which causes a distinct and much rarer condition called x-linked infantile spinal muscular atrophy. Professional organizations publish guidelines for what genes need to be screened in a screening product, and Nucleus does not appear to be following them. In further discussion, Herasight continued with exhaustive criticism of essentially everything Nucleus had ever done down to the smallest detail. Nucleus reports list the same baseline disease risk regardless of patient ancestry, but different ancestry groups should have different risks14. Nucleus’ physician reports sometimes list lower-than-average risk for patients with positive polygenic scores15. Nucleus’ age-based risk tables don’t distinguish between age and cohort effects (is this bad? see footnote16). My favorite critique is that Nucleus wrote a blog post criticizing competing company Orchid… …which included a section on how Orchid is a polygenic selection company, and polygenic selection companies are inherently “sketchy” and “honestly should be illegal”. But Nucleus is also a polygenic selection company! This is like Marlboro attacking Camel on the grounds that cigarettes are addictive and should be banned! Obviously something went wrong here - my guess is AI - and it’s a really bad look, especially when these scientific issues are so hard to litigate, and so many of us will have to go off gestalt impressions of corporate culture. Nucleus states that they validate their models internally and intend to make their results public soon. A Foothill Of The Future It’s hard not to love this technology. Lots of people (and the aforementioned professional organizations) manage anyway, but it’s hard. If this were a single-use medical treatment, delivered by a doctor after someone got the relevant condition, it would be one of the biggest advances of the decade - imagine a drug that cures 10 - 40%17 of breast cancers with no side effects! But in fact, it works for breast cancer, and schizophrenia, and heart attacks, and approximately everything else. The only things comparable are antibiotics and GLP-1RAs. And then there’s the IQ effects. Even after studying the literature, people have wildly different opinions about the importance of IQ. One of the most important debates is to what degree IQ differences are a cause of poverty, a consequence of poverty, or both. I lean towards both - a country with limited access to schools and medical care will have low average IQ, but as a consequence it probably won’t become the next big semiconductor hub. This technology could close half the IQ gap between poor and middle-income countries, or between middle-income and rich. Or it could give rich countries average IQs that have never been seen before, and let us see what kind of O-ring technologies (and new forms of social cooperation) lie just beyond the frontier. (this is the nice quantifiable argument in favor of IQ enhancement, but I find myself more convinced by fuzzier things - how much is it worth to be able to enjoy great art and literature? To fully comprehend what we know of nature, and be able to fully appreciate the mystery of the rest? To have a sense of why society works the way it does, instead of feeling like you’re being blown back and forth by institutions you don’t really understand? Amateur psychoanalysts like to say that the only people who care about IQ are those looking for an excuse to boast about how high their own is, but my experience is the opposite: I care about IQ because I bang up against the limits of my own a thousand times a day, and I hate it. I fantasize about ways to make my children smarter than I am for the same reason a dog confined in a tiny crate might fantasize about getting her puppies adopted out to a nice house with a big grassy yard.) My biggest qualm is that it might not matter. This is such a tiny foothill, flanking such a vast and foreboding range of mountains, that it might be a mistake to care about it at all. Selecting the best of five or ten embryos is not a very effective way to get the genes you want. There are things in the pipeline that will make this look like Hippocrates draining black bile. By the time the first polygenically selected children are adults, they’ll be old news. And then there’s AI. The average age at diagnosis for Type II diabetes is 45 years. Will there still be people growing gradually older and getting Type II diabetes and taking insulin injections in 2070? If not, what are we even doing here? Many people in the transhumanist community are still bullish on this technology. They think - well, there’s still an outside chance that something comes up and AGI takes another few decades. If we can enhance humans to be smarter, healthier, and more determined by the time it arrives, maybe we’ll have a better chance. Or maybe, if there’s a positive optimistic vision of a human-based high-tech future, people will be more willing to delay AI in the first place. I like this argument, but I also think it’s worth stepping back. What’s the point of anything? Why have kids at all in a world that’s changing this fast? Why save for the future? At some point your answer has to be romantic and aesthetic - it’s never been clear whether anything you do matters in any ultimate sense, but you’ve got to act as if it does and hope for the best. From that perspective, this is the most romantic technology of all. You’re not just giving a better life to your kids. Genes travel from generation to generation; you’re giving a better life your grandkids, your great-grandkids and so on to the point 1.77*log₂(population) generations from now when you are the ancestor of everybody and nobody. Somebody in Macaronesia in 3525 AD will avoid getting breast cancer because of you (if there is still cancer; if there are still breasts). Some combination of reasonable cost-benefit analysis and romantic/aesthetic commitments makes me want to have children despite the uncertainty, and the same combination made me sign up to use this technology despite the same. More later on how that’s going. 1I’m slightly mixing up two different things here - Down Syndrome can be detected with an aneuploidy test, but cystic fibrosis takes a more involved PGT-M test. 2There are two separate questions here. First, how much would diabetes risk decline if you selected the embryo with the lowest risk for diabetes - something you have no reason to do, since you have no reason to privilege diabetes risk over risk of any other disease? Second, how much would diabetes risk go down if you selected the embryo with the lowest health risk overall? Genomic Prediction’s their risk calculator calculator shows, seemingly paradoxically, that you get -38% relative risk by selecting against diabetes alone, but -41% relative risk by selecting against everything at once. Over email, they stand by this surprising result, saying that “for a couple of diseases (type II diabetes and CAD), the EHS actually accomplishes a larger risk reduction than the individual predictors. The explanation is that the EHS takes into account multiple PRS of diseases with high comorbidity”. See eg Figure 3 here: …and the section of the post called “Antagonistic Pleiotropy” for more. However, this paradoxical benefit is only true for a few conditions like diabetes - for everything else, selecting on health index does better than you would naively think, but still does not decrease the risk of a given condition as much as selecting against that condition directly. 3That is, new mutations in that particular baby, as opposed to older mutations already present in the parents. 4Conflicts of interest: I have used Orchid’s and Herasight’s products on my own embryos (not the ones used to conceive my existing kids, but for a potential third child), employees of Genomic Prediction and Herasight have been extremely helpful in contributing expertise to ACX posts on genetics, and I might invest in this field at some point (though haven’t done so yet). This post started as Herasight asking me to write about their white paper, then spiraled out of control. There were some unexpected time pressures and the result is that I didn’t get a chance to run everything in Herasight’s white paper by their competitors as thoroughly as I would like. Although I talked to representatives of all four companies profiled here, I feel like this probably reflects Herasight’s perspective better than other companies’, and that this is a major flaw. If other companies have responses, I’ll publish them. Thanks to all companies involved for their assistance on this article. Finally, I am favorably disposed toward Herasight because of how I learned about them: a professor named Jonathan Anomaly got cancelled from Penn for being too gung-ho about genetic enhancement, and used his newfound freedom to join a very-early-stage Herasight, raise their ambitions, and sell everyone (including me) on the idea. I grew up on a diet of books and movies about mad scientists, and I’m a sucker for a story about a guy named Doctor Anomaly pursuing revenge against the small-minded fools who destroyed his career by creating a race of superbabies. 5The version of the tool I looked at said 5.9 points for five embryos, up to 9 points for twenty embryos. The version of the tool on their current said says 5.3 - 9, so they might have recalculated after I finalized this article. 6Used in quotation marks because these scores were fine for the predictive tasks they were applied for - they just weren’t finding genes that directly caused the outcome of interest. 7Conflict of interest notice: this table was originally unadjusted. A representative of Herasight claimed that this was unfair, because each company used slightly different reporting conventions, and offered to correct for this in a neutral way. I retraced their reasoning, confirmed that the correction did not especially benefit Herasight at the expense of other companies, and accepted the correction. The original unadjusted table is below: Herasight was insufficiently comfortable with Nucleus’ methodology to even be willing to posit a corrected value, so I left their self-reported value in gray. 8Zagorsky (2007) says an extra IQ point means $234-$616/year in higher salary. The midpoint of $425 equals $670 in today’s dollars; assuming a forty-year career, Nucleus’ +1 point estimate is worth $26,800 (vs. $9,249 Nucleus cost) and Herasight’s +6 point estimate is worth $160,800 (vs. $53,250 Herasight cost). 9As part of researching this article, I asked all four major companies about their within-family validation strategies. Here are some details: Genomic Prediction discusses their strategy in this paper. The results are complicated to interpret - the within-family numbers often have such wide error bars that they overlap with both the across-family numbers and with zero - but looking qualitatively it seems like most scores on average lose about 25% of their risk reduction ability (though averages might not be the right way to do this, and some might be much more affected than others). Their website reports unadjusted, not within-family validated numbers; GP says they say this clearly on their site (which is true), Herasight counters that they still present their numbers as applicable to embryo selection (which is also true). To get the most applicable-to-embryo-selection numbers, you might want to adjust GP’s stated numbers down somewhat; it’s hard to say exactly how much, but maybe 20 - 25%?
Hadza

Hadza is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between June 23, 2021 and April 22, 2022. The archive places it in contexts such as "no evidence of nutritional benefit for being or marrying a well-reputed Hadza hunter"; "how many IU the Hadza are getting from sunlight". It most often appears alongside Arizona, Atlanta Black Crackers, Atlanta Crackers.

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Hadza
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2
Issue count
2
First seen
June 23, 2021
Last seen
April 22, 2022
June 23, 2021 · Original source
26: Contra every evolutionary psychologist ever, there is no evidence of nutritional benefit for being or marrying a well-reputed Hadza hunter , probably because everyone shares food communally anyway. Usual disclaimer that not all hunter-gatherer groups are the same, modern hunter-gatherers are unrepresentative of ancient ones, etc.
April 22, 2022 · Original source
Krzyscin 2016 tries to estimate how many IU the Hadza are getting from sunlight, and finds it’s 2,000, not 16,000. I can’t follow their reasoning fully, or figure out exactly where it diverges from Ben’s, but I think it involves them 1) avoiding the midday sun, and 2) being black.
Luxwolda 2012 measured Vitamin D levels in the Hadza and found values from 28 to 68 ng/ml, averaging about 44. How many IU of Vitamin D supplementation would it take to get an average American to 44 ng/ml? Garland 2011 exists to answer this question for us:
It finds about 2000 IU, which makes no sense to me - Krzyscin said the Hadza were 2000 IU total, but Garland is saying that you need 2000 IU to get from current American levels (about 3/4 of the Hadza’s) up to the Hadza’s.
Halloween

Halloween is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between April 21, 2021 and August 01, 2024. The archive places it in contexts such as "It was October 31, the night of Halloween"; "avoid Labor Day and Halloween". It most often appears alongside ACX, Andes Mountains, Antiochan subgroup.

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Halloween
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2
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2
First seen
April 21, 2021
Last seen
August 01, 2024
April 21, 2021 · Original source
Two days later, on a Friday night, I left the synagogue with a crowd of about 100. The men wore black suits, white shirts with tzitzit, and black knitted kippot or black fedoras. The women were dressed in long polyester skirts and bright head scarves. They were heading home after Shabbat services. They had been chanting and praising God, the men fervently kissing a Torah scroll, and were in a merry mood. I was walking between Elad and Shlomo. We chatted about the women who had stayed at home preparing the most important dinner of the week and the families who were hosting. We reached the corner of Bello’s main street and were about to scatter, wish­ing “Shabbat shalom” to one another, when a crowd of Zorros, Power Rangers, Ninja Turtles, Ebola nurses, witches, and princesses engulfed us. It was October 31, the night of Halloween.
The Jews ignored the Halloweeners and parted in small groups toward their dinners. Elad turned left. I continued walking uphill with Shlomo, Baruj, and their half-dozen guests. Before we reached the next corner, a man approached Baruj, who, like his father, was dressed in a black suit, and gave him candy.
August 01, 2024 · Original source
People enjoy each other’s company and keep having meetups throughout the year. The form will ask you to pick a location, time, and date, and to provide an email address where people can reach you for questions. It will also ask a few short questions about how excited you are to run the meetup to help pick between multiple organizers in the same city. One meetup per city will be advertised on the blog, and people can email you if they have questions. Organizing an ACX Everywhere meetup can be easy. Pick a time and a place (parks work well if you think there will be a lot of people, cafes or apartments work fine for fewer) and show up with a sign saying “ACX Meetup.” You don’t need to have discussion plans or a group activity. If you want to make the experience better for people, you can bring nice things like nametags/markers, food/drinks, or games. Meetups Czar Skyler can reimburse you for the nametags, markers, food, and drinks. If you feel more ambitious, collect people’s names and emails if they’re interested in future meetups. You could do this with a pen and paper, or if you’re concerned about reading people’s handwriting, you could use a QR code/bitly link to a Google Form. Here’s a short FAQ for potential meetup organizers: 1. How do I know if I would be a good meetup organizer? If you can put a name/time/date in a box on Google Forms and show up there, you have the minimum skill necessary to be a meetup organizer for your city, and I recommend you sign up. Don't worry, you signing up won't randomly take the job away from someone else. The form will ask people how excited/qualified they are about being an organizer, and if there are many options, I'll choose whoever I think is best. (Or plausibly whoever Meetup Czar Skyler thinks is best.) But a lot of cities might not have an excited/qualified person, in which case I would rather the unexcited/unqualified people sign up, than have nobody available at all. This spreadsheet shows the cities where someone has filled out the form, updated manually after a basic check. Lots of cities have existing meetup groups and we’ll probably prioritize them, but we always appreciate more options. Last time there were some people who didn’t volunteer because they just assumed their city was big enough that someone else would do it. Beware the Bystander Effect! If you are the leader of your city’s existing meetup group, please fill in the form anyway and say so. 2. How will people hear about the meetup? You give me the information, and on August 23 (or so), I’ll post it on ACX. An event will also be created on LessWrong’s Community page. 3. When should I plan the meetup for? Since I’ll post the list of meetup times and dates around August 23, please choose sometime after that. Any day September 1st through October 31st is okay. I recommend a weekend, since it's when most people are available. You’ll probably get more attendance if you schedule for at least one week out, but not so far out that people will forget - so mid September or early October would be best. Check your local calendar for holidays where people might be busy: If you're in the US, that probably means avoid Labor Day and Halloween. 4. How many people should I expect? The last time we tried this, meetups ranged from one person to over a hundred. Meetups in big US cities (especially ones with universities or tech hubs) had the most people; meetups in non-English-speaking countries had the fewest. You can see a list of every city and how many people most of them got last time here. Plan accordingly. 5. Where should I hold the meetup? A good venue should be easy for people to get to, not too loud, and have basic things like places to sit, access to toilets, and the option of acquiring food and water. City parks and mall common areas work well. If you want to hold the meetup at your house, remember that this will involve me posting your address on the Internet. 6. What should I do at the meetup? Mostly people just show up and talk. If you’re worried about this not going well, here are some things that can help: Have people indicate topics they’re interested in by writing something on their nametag
Hanukkah

Hanukkah is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between October 10, 2022 and December 22, 2025. The archive places it in contexts such as "claim that American Jews signal-boosted Hanukkah to compete with Christmas"; "Jewish leaders ... made an effort to rebrand Hanukkah and started creating Hanukkah celebration for kids"; "Happy Hanukkah and Merry Christmas to all who celebrate!". It most often appears alongside Christmas, United States, 9-11.

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Hanukkah
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2
Issue count
2
First seen
October 10, 2022
Last seen
December 22, 2025
October 10, 2022 · Original source
All of our best holidays have begun as anti-holidays to neutralize older rites. Jesus was born in the spring; they moved Christmas to December to neutralize the pagan Solstice celebration. Easter got its name because it neutralized the rites of the spring goddess Eostre. Hanukkah was originally a minor celebration of a third-tier Bible story; American Jews bumped it up several notches of importance in order to neutralize Christmas.
Moving onto Hanukkah - some commenters like odd anon question my description of it as coming from a Bible story. This isn’t going to get resolved here - Hanukkah comes from the Books of Maccabees, some of which are included in the Catholic and Eastern Orthodox conceptions of the Bible, but not the Protestant or Jewish ones.
Other commenters have meatier objections. In response to the claim that American Jews signal-boosted Hanukkah to compete with Christmas, Falernum writes:
December 22, 2025 · Original source
6: Happy Hanukkah and Merry Christmas to all who celebrate! I’ll continue not to post very much this week, and in particular to probably fail to post any Highlights From The Comments.
HCQ

HCQ is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between November 17, 2021 and February 01, 2022. The archive places it in contexts such as "patients other things like HCQ and azithromycin"; "HCQ actually effective against COVID". It most often appears alongside Brazil, Canada, CDC.

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HCQ
Mention count
2
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2
First seen
November 17, 2021
Last seen
February 01, 2022
November 17, 2021 · Original source
Click to expand. # is how many people were in the smallest relevant group (eg if there were 20 people in placebo and 10 in ivermectin, it was 10). Dose is ivermectin dose x number of days. Tested w/ is what drugs were given alongside ivermectin; compare is what drugs were in the “placebo” group (I excluded some very common things like paracetamol). %-PCR7 is what percent of patients had a negative PCR test (indicating recovery) after 7 days (though if 7 wasn’t available, I accepted anything from 6-12); the (I) and (P) are ivermectin and placebo groups. R is the ratio - green if statistically significant, red otherwise. DaysPCR is how many days it took to get a negative PCR test. Days to -sym are how many days it took symptoms to resolve. -outc is some serious negative outcome in the study, either clinical worsening, hospitalization, or death. I was inconsistent which one I chose, trying to pick whichever I thought struck a balance between high sample size and severity. Since this was almost never significant, I made it blue if it favored ivermectin and orange if it favored placebo (which it never did; there is no orange). Lowest p is the lowest p-value in the study for one of the headline results. 1o+ is whether the primary outcome was positive or not. I made this very quickly and unprincipledly and I am sure there are a lot of errors; please forgive me. Of studies that included any of the endpoints I recorded, ivermectin had a statistically significant effect on the endpoint 13 times, and failed to reach significance 8 times. Of studies that named a specific primary endpoint, 9 found ivermectin affected it significantly, and 12 found it didn’t. But that’s still pretty good. And “doesn’t affect to a statistically significant degree” doesn’t mean it doesn’t work. It might just mean your study is too small for a real and important effect to achieve statistical significance. That’s why people do meta-analyses to combine studies. And the ivmmeta people say they did that and it was really impressive. All of this is still basically what things would look like if ivermectin worked. But of course we can’t give every study one vote. We’ve got to actually look at these and see which ones are good and which ones are bad. So, God help us, let’s go over all thirty of the ivermectin studies in this top panel of ivmmeta.com. (if you get bored of this, scroll down to the section called “The Analysis”) The Studies Elgazzar et al: This one isn’t on the table above, but we can’t start talking about the others until we get it out of the way. 600 Egyptian patients were randomized into six groups, including three that got ivermectin. The ivermectin groups did substantially better: for example, 2 vs. 20 deaths in ivermectin group 3 vs. non-ivermectin group 4. There were various other equally impressive outcomes. Unfortunately, it’s all false. Some epidemiologists and reporters were able to obtain the raw data (it was password-protected, but the password was “1234”), and it was pretty bizarre. Some patients appeared to have died before the trial started; others were arranged in groups of four such that it seemed like the authors had just copy-pasted the same four patients again and again. Probably either the study never happened, or at least the data were heavily edited afterwards. You can read more here. A lot of the apparent benefit of ivermectin in meta-analyses disappeared after taking out this paper (though remember, this isn’t even on the table at the top of the post, so it doesn’t directly affect that). Since the Elgazzar debacle, a group of researchers including Gideon Meyerowitz-Katz, Kyle Sheldrake, James Heathers, Nick Brown, Jack Lawrence, etc, have been trying to double-check as many other ivermectin studies as possible. At least three others - Samaha, Carvallo, and Niaee - have similar problems and have been retracted. Those studies were all removed before I screenshotted the table above, and they’re not on there. But everybody is pretty paranoid right now and looking for fraud a lot harder than they might be in normal situations. Moving on: Chowdury et al: Bangladeshi RCT. 60 patients in Group A got low-dose ivermectin plus the antibiotic doxycycline, 56 in Group B got hydroxychloroquine (another weird COVID treatment which most scientists think doesn’t work) plus the antibiotic azithromycin. No declared primary outcome. Ivermectin group got to negative PCR a little faster than the other (5.9 vs. 7 days) but it wasn’t statistically significant (p = 0.2). A couple of other non-statistically-significant things happened too. 2 controls were hospitalized, 0 ivermectin patients were. This is a boring study that got boring results, so nobody has felt the need to assassinate it, but if they did, it would probably focus on both groups getting various medications besides ivermectin. None of these other medications are believed to work, so I don’t really care about this, but you could tell a story where actually doxycycline works great at addressing associated bacterial pneumonias, or where HCQ causes lots of side effects and that makes the ivermectin group look good in comparison, or whatever. Espitia-Hernandez et al: Mexican trial which is probably not an RCT - all it says is that “patients were voluntarily allocated”. 28 ended up taking a cocktail of low-dose ivermectin, vitamin D, and azithromycin; 7 were controls. On day ten, everyone (!) in the experimental group was PCR negative; everyone (!) in the control group was still positive. Also, symptoms in the experimental group lasted an average of three days; in the control group, more like 10. These results make ivermectin look amazingly super-good, probably better than any other drug for any other disease, except maybe stuff like vitamins for treatment of vitamin deficiency. Any issues? We don’t know how patients were allocated, but they discuss patient characteristics and they don’t look different enough to produce this big an effect size. The experimental group got a lot of things other than ivermectin, but I would be equally surprised if vitamin D or azithromycin cured COVID this effectively. It deviated from its preregistration in basically every way possible, but you shouldn’t be able to get “every experimental patient tested negative when zero control patients did” by garden-of-forking-paths alone! But this has to be false, right? Even the other pro-ivermectin studies don’t show effects nearly this big. In all other studies combined, ivermectin patients took an average of 8 days to recover; in Espitia-Hernandez, they took 3. Also, it’s pretty weird that the entire control group had positive PCRs on day 10 - in most other studies, a majority of people had negative PCRs by day 7 or so, regardless of whether they were control or placebo. Everything about this is so shoddy that I can easily believe something went wrong here. I don’t have a great understanding of this one but I don’t trust it at all. Luckily it is small and non-randomized so it will be easy to ignore going forward. I’m not saying this is related, but I’m not saying it *isn’t* related either. Carvallo et al: This one has all the disadvantages of Espitia-Hernandez, plus it’s completely unreadable. It’s hard to figure out how many patients there were, whether it was an RCT or not, etc. It looks like maybe there were 42 experimentals and 14 controls, and the controls were about 10x more likely to die than the experimentals. Seems pretty bad. On the other hand, another Carvallo paper was retracted because of fraud: apparently the hospital where the study supposedly took place said it never happened there. I can’t tell if this is a different version of that study, a pilot study for that study, or a different study by the same guy. Anyway, it’s too confusing to interpret, shows implausible results, and is by a known fraudster, so I feel okay about ignoring this one. Mahmud et al: RCT from Bangladesh. 200 patients received ivermectin plus doxycycline, 200 received placebo. Everything was written up very nicely in real English, by people who were clearly not on 34 lbs of meth at the time. They designated a primary outcome, “number of days required for clinical recovery”, and found a statistically significant difference at p < 0.001: Okay, fine, they misspelled “recovery” once. But they spelled it right the other time! That puts it in the top 50% for ivermectin papers! The fraud-hunters have examined this paper closely and are unable to find any signs of fraud. @PubPeer on the Mahmud trial of ivermectin in covid patients.\n\nI have now reviewed the individual patient data master sheet.\n\nI did not find any irregularities and the summary data matches the published data.\n\n","username":"K_Sheldrick","name":"Kyle Sheldrick","profile_image_url":"","date":"Sat Jul 17 11:06:25 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":12,"impression_count":0,"expanded_url":{"url":"https://pubpeer.com/publications/E1D65711EF28D14517731BEACB89C8#2","title":"PubPeer - Ivermectin in combination with doxycycline for treating COVI...","description":"There are comments on PubPeer for publication: Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial (2021)","domain":"pubpeer.com"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> I think this paper is legitimate and that its findings need to be seriously considered. Serious consideration doesn’t always meant they’re true - sometimes if we have strong evidence otherwise we can dismiss things without understanding why. And there’s always the chance it was a fluke, right? Can something have a p-value less than 0.001 and still be a fluke? Szenta Fonseca et al: This is a chart review from Brazil. Researchers looked at various people who had been treated for COVID in an insurance company database, saw whether they got ivermectin or not, and saw whether the people who got it did better or worse. About a hundred people got it, and a few hundred others didn’t. The people who got it did not do any better than anyone else, and you’ll notice this is one of the rare red boxes on the table above. But we shouldn’t take this study seriously. Nobody took any effort to avoid selection bias, so it’s very possible that sicker people were given more medication (including ivermectin), which unfairly handicaps the ivermectin group. Also, it’s hard to tell from the paper who was on how much of what, and the discussion of ivermectin seems like kind of an afterthought after discussing lots of other meds in much more depth. This is another one I feel comfortable ignoring. Cadegiani et al: A crazy person decided to put his patients on every weird medication he could think of, and 585 subjects ended up on a combination of ivermectin, hydroxychloroquine, azithromycin, and nitazoxanide, with dutasteride and spironolactone "optionally offered" and vitamin D, vitamin C, zinc, apixaban, rivaraxoban, enoxaparin, and glucocorticoids "added according to clinical judgment". There was no control group, but the author helpfully designated some random patients in his area as a sort-of-control, and then synthetically generated a second control group based on “a precise estimative based on a thorough and structured review of articles indexed in PubMed and MEDLINE and statements by official government agencies and specific medical societies”. Patients in the experimental group were twice as likely to recover (p < 0.0001), had negative PCR after 14 vs. 21 days, and had 0 vs. 27 hospitalizations. Speaking of low p-values, some people did fraud-detection tests on another of Cadegiani’s COVID-19 studies and got values like p < 8.24E-11 in favor of it being fraudulent. And, uh, he’s also studied whether ultra-high-dose antiandrogens treated COVID, and found that they did, cutting mortality by 92% . But the trial is under suspicion, with a BMJ article calling it “[the worst] violations of medical ethics and human rights in Brazil’s history” and “an ethical cesspit of violations”. [update 2022: this section originally contained more accusations against Cadegiani. Alexandros Marinos does a deeper dive with information not available at the time I wrote this, and finds some of them were overstated or false by implication] Anyway, let’s not base anything important on the results of this study, mmkay? A defiant Flavio Cadegiani. Imagine a guy who looks like this telling you to take ultra-high-dose antiandrogens. Ahmed et al: And we’re back in Bangladesh. 72 hospital patients were randomized to one of three arms: ivermectin only, ivermectin + doxycycline, and placebo. Primary endpoint was time to negative PCR, which was 9.7 days for ivermectin only and 12.7 days for placebo (p = 0.03). Other endpoints including duration of hospitalization (9.6 days ivermectin vs. 9.7 days placebo, not significant). This looks pretty good for ivermectin and does not have any signs of fraud or methodological problems. If I wanted to pick at it anyway, I would point out that the ivermectin + doxycycline group didn’t really differ from placebo, and that if you average out both ivermectin groups (with and without doxycycline) it looks like the difference would not be significant. I had previously committed to considering only ivermectin alone in trials that had multiple ivermectin groups, so I’m not going to do this. I can’t find any evidence this trial was preregistered so I don’t know whether they waited to see what would come out positive and then made that their primary endpoint, but virological clearance is a pretty normal primary endpoint and this isn’t that suspicious. It’s impossible to find any useful commentary on this study because Elgazzar (the guy who ran the most famous fraudulent ivermectin study) had the first name Ahmed, everyone is talking about Elgazzar all the time, and this overwhelms Google whenever I try to search for Ahmed et al. For now I’ll just keep this as a mildly positive and mildly plausible virological clearance result, in the context of no effect on hospitalization length or most symptoms. Chaccour et al: 24 patients in Spain were randomized to receive either medium-dose ivermectin or placebo. The primary outcome was percent of patients with negative PCR at day 7; secondary outcomes were viral load and symptoms. The primary endpoint ended up being kind of a wash - everyone still PCR positive by day 7 so it was impossible to compare groups. Ivermectin trended toward lower viral load but never reached significance. Weirdly, ivermectin did seem to help symptoms, but only anosmia and cough towards the end (p = 0.03), which you would usually think of as lingering post-COVID problems. The paper says: Given these findings, consideration could be given to alternative mechanisms of action different from a direct antiviral effect. One alternative explanation might be a positive allosteric modulation of the nicotinic acetylcholine receptor caused by ivermectin and leading to a downregulation of the ACE-2 receptor and viral entry into the cells of the respiratory epithelium and olfactory bulb. Another mechanism through which ivermectin might influence the reversal of anosmia is by inhibiting the activation of pro-inflammatory pathways in the olfactory epithelium. Inflammation of the olfactory mucosa is thought to play a key role in the development of anosmia in SARS-CoV-2 infection This seems kind of hedge-y. If you’re wondering where things went from there, Dr. Chaccour is now a passionate anti-ivermectin activist: @Finneganporter in @BusinessInsider \n\nThe roots of #ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm\n\n","username":"carlos_chaccour","name":"Dr. Carlos Chaccour ??????","profile_image_url":"","date":"Sun Nov 07 18:40:28 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":9,"impression_count":0,"expanded_url":{"url":"https://www.businessinsider.in/international/news/the-roots-of-ivermectin-mania-how-south-america-incubated-a-fake-medicine-craze-that-took-the-us-by-storm/articleshow/87554081.cms","image":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/88d08e70-c9e2-46d4-a5df-96807b6c3a13_2000x1000.jpeg","title":"The roots of ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm","description":"The popularity of unproven anti-parasitic drug ivermectin as a COVID-19 treatment is surging. Its use has roots in South America, where it was hyped by populist","domain":"businessinsider.in"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> So I guess he must think of this trial as basically negative, although realistically it’s 24 people and we shouldn’t put too much weight on it either way. Ghauri et al: Pakistan, 95 patients. Nonrandom; the study compared patients who happened to be given ivermectin (along with hydroxychloroquine and azithromycin) vs. patients who were just given the latter two drugs. There’s some evidence this produced systematic differences between the two groups - for example, patients in the control group were 3x more likely to have had diarrhea (this makes sense; diarrhea is a potential ivermectin side effect, so you probably wouldn’t give it to people already struggling with this problem). Also, the control group was twice as likely to be getting corticosteroids, maybe a marker for illness severity. Primary outcome was what percent of both groups had a fever: on day 7 it was 21% of ivermectin patients vs. 65% of controls, p < 0.001. No other outcomes were reported. I don’t hate this study, but I think the nonrandom assignment (and observed systematic differences) is a pretty fatal flaw. I can’t find anyone else talking about this one. At least no one seems to be saying anything bad. Babaloba et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakoloko”, because that’s really fun to say. This was a Nigerian RCT comparing 21 patients on low-dose ivermectin, 21 patients on high-dose ivermectin, and 20 patients on a combination of lopinavir and ritonavir, a combination antiviral which later studies found not to work for COVID and which might as well be considered a placebo. Primary outcome, as usual, was days until a negative PCR test. High dose ivermectin was 4.65 days, low dose was 6 days, control was 9.15, p = 0.035. Figure 2 is apparently a photograph of the computer screen where they did this calculation. Gideon Meyerowitz-Katz, part of the team that detects fraud in ivermectin papers, is not a fan of this one: He doesn’t say there what means, but elsewhere he tweets this figure: It’s always a bad sign when your study features in an image with “NUMEROUS IMPOSSIBLE NUMBERS” in red at the top. I think his point is that if you have 21 people, it’s impossible to have 50% of them have headache, because that would be 10.5. If 10 people have a headache, it would be 47.6%; if 11, 52%. So something is clearly wrong here. Seems like a relatively minor mistake, and Meyerowitz-Katz stops short of calling fraud, but it’s not a good look. I’m going to be slightly uncomfortable with this study without rejecting it entirely, and move on. Ravakirti et al: Here we’re in Eastern India - not exactly Bangladesh again, but a stone’s throw away from it. In this RCT patients were randomized into an ivermectin group (57) and a placebo group (58). Primary outcome was negative PCR on day 6, because doing it on day 7 like everyone else would be too easy. As with several other groups, this was a bad move; too few people had it to make a good comparison; it was 13% of intervention vs. 18% of placebo, p = 0.3. Secondary outcomes were also pretty boring, except for the most important: 4 people in the placebo group died, compared to 0 in ivermectin (p = 0.045). On the one hand, this is one outcome of many, reaching the barest significance threshold. Another fluke? Still, there are no real problems with this study, and nobody has anything to say against it. Let’s add this one to the scale as another very small and noisy piece of real evidence in ivermectin’s favor. Bukhari et al: Now we’re in Pakistan. 50 patients were randomized to low-dose ivermectin, another 50 got standard of care including vitamin D. There was no placebo, but primary outcome was number of days to reach negative PCR, which it seems hard for placebo to affect much, so I don’t care. 5 controls and 9 ivermectin patients left the hospital against medical advice and could not be followed up, which is bad but not necessarily study-ruining. They never measured their supposed primary outcome of “days to reach negative PCR” directly, but they did measure how many people had negative PCR on various days, and ivermectin had a clear advantage - for example, on day 7, it was 37/50 for IVR and only 20/50 for control. Even if we assume all the lost-to-followup patients had maximally bad-for-the-hypothesis results, that’s still a positive finding. Nobody else has much to say about this one, certainly no accusations that they’ve found anything suspicious. Keep. Mohan et al: India. RCT. 40 patients got low-dose ivermectin, 40 high-dose ivermectin, and 45 placebo. Primary outcomes were time to negative PCR, and viral load on day 5. In the results, they seem to have reinterpreted “time to negative PCR” as the subtly different “percent with negative PCR on some specific day”. High-dose ivermectin did best (47.5% negative on day 5) and placebo worst (31% negative), but it was insignificant (p = 0.3). There was no difference in viral load. All groups took about the same amount of time for symptoms to resolve. More placebo patients had failed to recover by the end of the study (6) than ivermectin patients (2), but this didn’t reach statistical significance (p = 0.4). Overall a well-done, boring, negative study, although ivermectin proponents will correctly point out that, like basically every other study we have looked at, the trend was in favor of ivermectin and this could potentially end up looking impressive in a meta-analysis. Biber et al: This is an RCT from Israel. 47 patients got ivermectin and 42 placebo. Primary endpoint was viral load on day 6. I am having trouble finding out what happened with this; as far as I can tell it was a negative result and they buried it in favor of more interesting things. In a "multivariable logistic regression model, the adjusted odds ratio of negative SARS-CoV-2 RT-PCR negative test" favored ivermectin over placebo (p = 0.03 for day 6, p = 0.01 for day 8), but this seems like the kind of thing you do when your primary outcome is boring and you’re angry. Gideon Meyerowitz-Katz is not a fan: He notes that the study excluded people with high viral load, but the preregistration didn’t say they would do that. Looking more closely, he finds they did that because, if you included these people, the study got no positive results. So probably they did the study, found no positive results, re-ran it with various subsets of patients until they did get a positive result, and then claimed to have “excluded” patients who weren’t in the subset that worked. I’m going to toss this one. Elalfy et al: What even is this? Where am I? As best I can tell, this is some kind of Egyptian trial. It might or might not be an RCT; it says stuff like “Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment”. Were they self-allocated in the sense that they got to choose? Doesn’t that mean it’s not random? Aren’t there seven days in a week? These are among the many questions that Elalfy et al do not answer for us. The control group (which they seem to think can also be called “the white group”) took zinc, paracetamol, and maybe azithromycin. The intervention group took zinc, nitazoxanide, ribavirin, and ivermectin. There were very large demographic differences between the groups of the sort which make the study unusable, which they mention and then ignore. From there, they follow this normal and totally comprehensible flowchart: There is no primary outcome assigned, but viral clearance rates on day seven were 58% in the yellow group compared to 0% in the white group, which I guess is a strong positive result. This table… …looks very impressive, in terms of the experimental group doing better than the control, except that they don’t specify whether it was before the trial or after it, and at least one online commentator thinks it might have been before, in which case it’s only impressive how thoroughly they failed to randomize their groups. Overall I don’t feel bad throwing this study out. I hope it one day succeeds in returning to its home planet. Lopez-Medina et al: Colombian RCT. 200 patients took ivermectin, another 200 took placebo. They originally worried the placebo might taste different than real ivermectin, then solved this by replacing it with a different placebo, which is a pretty high level of conscientiousness. Primary outcome was originally percent of patients whose symptoms worsened by two points, as rated on a complicated symptom scale when a researcher asked them over the phone. Halfway through the study, they realized nobody was worsening that much, so they changed the primary outcome to time until symptoms got better, as measured by the scale. In the ivermectin group, symptoms improved that much after 10 days; in the placebo group, after 12, p = 0.53. By the end of the study, symptoms had improved in 82% of ivermectin users and 79% of controls, also insignificant. 4 patients in the ivermectin group needed to be hospitalized compared to 6 in the placebo group, again insignificant. This study is bigger than most of the other RCTs, and more polished in terms of how many spelling errors, photographs of computer screens, etc, it contains. It was published in JAMA, one of the most prestigious US medical journals, as opposed to the crappy nth-tier journals most of the others have been in. When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. Ivermectin proponents make some good arguments against it. In order to get as big as it did, Lopez-Medina had to compromise on rigor. Its outcome is how people self-score their symptoms on a hokey scale in a phone interview, instead of viral load or PCR results or anything like that. Still, this is basically what we want, right? In the end, we want people to feel better and less sick, not to get good scores on PCR tests. Also, it changed its primary outcome halfway through; isn’t that bad? I think maybe not; the reason we want a preregistered primary outcome is so that you don’t change halfway through to whatever outcome shows the results you want. The researchers in this study did a good job explaining why they changed their outcome, the change makes sense, and their original outcome would also have shown ivermectin not working (albeit less accurately and effectively). I don’t know of any evidence that they knew (or suspected) final results when switching to this new outcome, and it seems like the most reasonable new outcome to switch to. Finally, their original placebo tasted different from ivermectin (though they switched halfway through). This is one of the few studies where I actually care about placebo, because people are self-rating their symptoms. But realistically most of these people don’t know what ivermectin is supposed to taste like. Also, they did a re-analysis and found there was no difference between the people who got the old placebo and the new one. I’m making a big deal of this because ivmmeta.com - the really impressive meta-analysis site I’ve been going off of - puts a special warning letter underneath their discussion of this study, urging us not to trust it. They don’t do this for any of the other ones we’ve addressed so far - not the one by the guy whose other studies were all frauds, not the one where 50% of 21 people had headaches, not the unrandomized one where the groups were completely different before the experiment started, not even the one by the guy accused of crimes against humanity. Only this one. This makes me a lot less charitable to ivmmeta than I would otherwise be; I think it’s hard to choose this particular warning letter strategy out of well-intentioned commitment to truth. They just really don’t like this big study that shows ivermectin doesn’t work. Also, the warning itself irritates me, and includes paragraphs like: RCTs have a fundamental bias against finding an effect for interventions that are widely available — patients that believe they need treatment are more likely to decline participation and take the intervention [Yeh], i.e., RCTs are more likely to enroll low-risk participants that do not need treatment to recover (this does not apply to the typical pharmaceutical trial of a new drug that is otherwise unavailable). This trial was run in a community where ivermectin was available OTC and very widely known and used. Nobody else worries about this, and there are a million biases that non-randomized studies have that would be super-relevant when discussing those, but somehow when they’re pro-ivermectin the site forgets to be this thorough. I think a better pro-ivermectin response to this study is to point out that all the trends support ivermectin. Symptoms took 10 days to resolve in the ivermectin group vs. 12 in placebo; 4 ivermectin patients were hospitalized vs. 6 placebo patients, etc. Just say that this was an unusually noisy trial because of the self-report methodology, and you’re confident that these small differences will add up to significance when you put them into a meta-analysis. Roy et al: We’re back in East India, and back to non-randomized trials. 56 patients were retrospectively examined; some had been given ivermectin + doxycycline, others hydroxychloroquine, other azithromycin, and others symptomatic treatment only. We don’t get any meaningful information about how this worked, but we are told that they did not differ in “clinical well-being reporting onset timing”. Whatever. Chahla et al: The first of many Argentine trials. 110 patients received medium-dose ivermectin; 144 were kept as a control (no placebo). This was “cluster randomized”, which means they randomize different health centers to either give the experimental drug or not. This is worse than regular randomization, because there could be differences between these health centers (eg one might have better doctors who otherwise give better treatment, one might be in the poor part of town and have sicker patients, etc). They checked to see if there were any differences between the groups, and it sure looks like there were (the experimental group had twice as many obese people as the controls), but as per them, these differences were not statistically significant. Note that if this did make a difference, it would presumably make ivermectin look worse, not better. The primary outcome was given as “increase discharge from outpatient care with COVID-19 mild disease”. This favored the treatment; only 2/110 patients in the ivermectin group failed to be discharged, compared to 20 patients in the control group. But, uh, these were at different medical centers. Can’t different medical centers just have different discharge policies? One discharges you as soon as you seem to be getting better, the other waits to really make sure? This is an utterly crap endpoint to do a cluster randomized controlled trial on. If you’re going to do cRCT, which is never a great idea, you should be using some extremely objective endpoint that doctors and clinic administrators can’t possibly affect, like viral load according to some third-party laboratory, using the same third-party laboratory for both clinics. This is such a bad idea that I can’t help worrying I’m missing or misunderstanding something. If not, this is dumb and bad and should be ignored. Mourya et al: We’re back in India. This is a nonrandomized study comparing 50 patients given ivermectin to 50 patients given hydroxychloroquine. No primary outcome was named, but they focus on PCR negativity. Only 6% of patients in the hydroxychloroquine group were negative, compared to 90% of patients in the ivermectin group! On what day did they do the test? Uh, kind of random, and they admit that “in [the hydroxychloroquine group], mean time difference from the date of initiation of treatment and second test was significantly longer (7.24±2.75 days) as compared to 5.22±1.21 days in [the ivermectin group] (p=0.021).” Since they assessed these groups at different times, we shouldn’t draw any conclusions from them getting different results. Except that as far as I can tell this should handicap ivermectin, making it especially impressive that it did better. But also, the ivermectin group was made mostly of people who had been asymptomatic at the beginning (70%), and the hydroxychloroquine group had almost no asymptomatic cases (8%) . They were giving the ivermectin to healthy people and the hydroxychloroquine to sick people! They admit deep in the discussion that this “may be a confounding factor”. So basically they got totally different groups of people, tested them at totally different times, and the two sets of test results differed. So what? So this is why normal people do RCTs instead of whatever the heck this is, that’s what. Loue et al: …this one isn’t going to be an RCT either. Loue tells a story about a cluster of COVID cases at the French nursing home where he works. He asked people if they wanted to try ivermectin; 10 did and 15 didn’t. 1 ivermectin patient died, compared to 5 non-ivermectin patients. The non-ivermectin group looked a bit sicker than the ivermectin group in the inevitable Table 1, though it’s hard to tell. One interesting possible confounder (not mentioned, but I’m imagining it) is that demented patients probably couldn’t consent to ivermectin and ended up in the control group. This is another case of “I’m not going to trust anything that isn’t an RCT”. Merino et al: Another (sigh) non-RCT. Mexico City tried a public health program where if you called a hotline and said you had COVID, they sent you an emergency kit with various useful supplies. One of those supplies was ivermectin tablets. 18,074 people got the kit (and presumably some appreciable fraction took the ivermectin, though there’s no way to prove that). Their control group is people from before they started giving out the kits, people from after they stopped giving out the kits, and people who didn’t want the kits. There are differences in who got COVID early in the epidemic vs. later, and in people who did opt for medical kits vs. didn’t. To correct these, the researchers tried to adjust for confounders, something which - as I keep trying to hammer home again and again - never works. They found that using the kit led to a 75% or so reduction in hospitalization, though they were unable to separate out the ivermectin from the other things in the kit (paracetamol and aspirin), or from the placebo effect of having a kit and feeling like you had already gotten some treatment (if I understand right, the decision to go to the hospital was left entirely to the patient). I think this study is a moderate point in favor of giving people kits in order to prevent hospital overcrowding, but I’m not willing to accept that it tells us much about ivermectin in particular. Faisal et al: This one was published in The Professional Medical Journal (mispelled as “Profesional Medical Journal” in its URL), so you know it’s going to be good! It describes itself as “a cross-sectional study”, but later says it “randomized patients into two groups”, which would make it an RCT - I think they might just be using the term “cross-sectional” different from the standard American usage. A hospital in Pakistan got 50 patients on ivermectin + azithromycin, and another 50 on azithromycin alone. Primary outcome was not mentioned, and the data were presented confusingly, but a typical result is that only 4% of the ivermectin group had symptoms lasting more than 10 days, whereas 16% of the control group did, p < 0.01. They do a really weird thing where they compare how long it took symptoms to resolve between IVM and control groups within each bin. That is, if I’m understanding correctly, they ask “of the people who took between 3-5 days for symptoms to resolve, did they resolve faster for IVM or control?”. This is an utterly bizarre analysis to perform, although it doesn’t affect the fact that their other results still seem to favor ivermectin. Maybe I’m confused about what’s going on here. I’ve mostly been letting people off easy on no placebo, but I as far as I can tell (not very far) this paper seems to be going off whether patients reported continuing to have symptoms to the hospital doing the study, and I think that is potentially susceptible to placebo effects. Additionally, there’s no preregistration, and even though they talk a lot about doing PCR tests they don’t present the results. This is by no means the worst study here but I still think it’s pretty low quality and I don’t trust it. Aref et al: This one is published in the International Journal Of Nanomedicine, even though I’m pretty sure that isn’t a real thing. In this case the “nanomedicine” is a new nasal spray version of ivermectin which is so confusing I cannot for the life of me figure out what dose they are giving these patients. This Egyptian study gives 57 patients intranasal ivermectin plus hydroxychloroquine, azithromycin, oseltamavir, and some vitamins; another 57 patients get all that stuff except the ivermectin. Primary outcome is not stated, but they look at various symptoms, all of which look better in the ivermectin group: 95% of ivermectin patients got negative PCRs at some time point, compared to 75% of controls, p = 0.004. I am pretty suspicious of this study, not least because it comes from Egypt which has an awful reputation for fake studies, and it returns extreme results that I wouldn’t expect even if ivermectin was actually a wonder drug. But I cannot find any particular thing wrong with it, nor did anyone else I looked at, so I will grudgingly let it stand. Krolewiecki et al: Another Argentine study. This one is a real RCT. 30 patients received ivermectin, 15 were the control group (no placebo, again). Primary outcome was difference in viral load on day 5. The trend favored ivermectin but it was not statistically significant, although they were able to make it statistically significant if they looked at a subset of higher-IVM-plasma-concentration patients. They did not find any difference in clinical outcomes. A pro-ivermectin person could point out that in the subgroup with the highest ivermectin concentrations, the drug seemed to work. A skeptic could point out that this is exactly the kind of subgroup slicing that you are not supposed to do without pre-registering it, which I don’t think this team did. I agree with the skeptic. Vallejos et al: Another Argentine study. It’s big (250 people in each arm). It’s an RCT. It tries to define a primary outcome (“Primary outcome: the trial ended when the last patient who was included achieved the end of study visit”), but that’s not what “primary outcome” means, and they don’t offer an alternative. Other outcomes: no difference in PCR on days 3 or 12. Hospitalization is nonsignificantly better in the ivermectin group (14 vs. 21, p = 0.2), but death is nonsigificantly better in the placebo group (3 vs. 4, p = 0.7). This isn’t even the kind of nonsignificant that might contribute to an exciting meta-analysis later. This is just a pure null result. I cannot find any problem with this study, and neither can anyone else I checked. This is the biggest RCT we’ve seen so far, so we should take it seriously. TOGETHER Trial: Speaking of big RCTs… This one hasn’t been published yet. There’s a video of a talk about it, but I am not going to watch it, because it is a video, so I am getting information secondhand from eg here. Apparently, it compares 677 people (!) randomized to ivermectin to 678 people randomized to placebo. 86 ivermectin patients ended up in the hospital compared to 95 placebo patients, p-value not significant. This was a really big professional trial done by bigshot researchers from a major Canadian university, and the medical establishment is taking it much more seriously than any of these others. When it comes out, it will probably get published in a top journal. When discussing Lopez-Medina, I wrote: When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. This is the other one. Not coincidentally, it’s also the other trial that ivmmeta.com has a warning letter underneath telling you to disregard. Their main concern is that instead of truly randomizing patients to ivermectin vs. placebo, they did a time-dependent randomization that meant during some weeks more patients were getting one or the other. This is a problem because the trial takes place in Brazil, where different variants were more common at different times. Here’s their image: On the one hand, I have immense contempt for ivmmeta for letting all those other awful studies pass and then pulling out all the stops to try to nitpick this one. I have no idea if their proposed randomization failure really happened. And no doubt the reason they’re even able to investigate this is that this study is really careful and transparent - most of them don’t tell you anything about their randomization method. I would be shocked if other studies don’t have all these problems and worse. On the other hand, the point isn’t to be fair, it’s to be right. And this is a potential confounder. Not a huge one. But a potential one. I guess all we can do is try to bound the damage. Even if the confounding is 100% real and bad, there’s no way to make this study consistent with the crazy super-pro-ivermectin results of studies like Espitia-Hernandez and Aref. And even if we deny any confounding, we see the same slight pro-ivermectin trend - 86 hospitalizations vs. 95 - that we’ve seen in so many other studies. Nothing is going to make me believe that this isn’t in the top 33% of studies we’ve been looking at, so let’s add it as grist for the meta-analysis (though maybe not quite as much grist as its vast size indicates) and move on, angrily. Buonfrate et al: An Italian RCT. Patients were randomized into low-dose ivermectin (32), placebo (29), or high-dose ivermectin (32). Primary outcome was viral load on day 7. There was no significant difference (average of 2 in ivermectin groups, 2.2 in placebo group). They admit that they failed to reach the planned sample size, but did a calculation to show that even if they had, the trial could not have returned a positive result. Clinically, an average of 2 patients were hospitalized in each of the ivermectin arms, compared to 0 in the placebo arm - which bucks our previously-very-constant pro-ivermectin trend. Mayer et al: Not an RCT. Patients in an Argentine province were offered the opportunity to try ivermectin; 3266 said yes and become the experimental group, 17966 said no and became the control group. There were many obvious differences between the groups, but they all seemed to handicap ivermectin. There was a nonsignificant trend toward less hospitalization and significantly less mortality (1.5% vs. 2.1%, p = 0.03). While looking into this study, I learned the term “immortal time bias”. This means a period in between selection for the study and the beginning of study recording where patient outcomes are not counted. I think the problem here is that if you signed up for the system on Day X, and if you got sick before they could give you ivermectin, you were in the control group. See this Twitter thread, I have not confirmed everything he says. This only hardens my resolve to stay away from non-RCTs. Borody et al: Our last paper! …is it a paper? I can’t find it published anywhere. It mostly seems to be on news sites. Doesn’t look peer-reviewed. And it starts with “Note that views expressed in this opinion article are the writer’s personal views”. Whatever. 600 Australians were treated with ivermectin, doxycycline, and zinc. The article compares this to an “equivalent control group” made of “contemporary infected subjects in Australia obtained from published Covid Tracking Data”; this is not how you control group, @#!% you. Then it gets excited about the fact that most patients had better symptoms at the end of the ten-day study period than the beginning (untreated COVID resolves in about ten days). Why are these people wasting my time with this? Let’s move on. The Analysis If we remove all fraudulent and methodologically unsound studies from the table above, we end up with this: Gideon Meyerowitz-Katz, who investigated many of the studies above for fraud, tried a similar exercise. I learned about his halfway through, couldn’t help seeing it briefly, but tried to avoid remembering it or using it when generating mine (also, I did take the result of his fraud investigations into account), so they should be considered not quite independent efforts. His looks like this: He nixed Chowdhury, Babaloba, Ghauri, Faisal, and Aref, but kept Szenta Fonseca, Biber (?), and Mayer. There was correlation of 0.45, which I guess is okay. I asked him about his decision-making, and he listed a combination of serious statistical errors and small red flags adding up. I was pretty uncomfortable with most of these studies myself, so I will err on the side of severity, and remove all studies that either I or Meyerowitz-Katz disliked. We end up with the following short list: We’ve gone from 29 studies to 11, getting rid of 18 along the way. For the record, we eliminated 2/19 for fraud, 1/19 for severe preregistration violations, 10 for methodological problems, and 6 because Meyerowitz-Katz was suspicious of them. …but honestly this table still looks pretty good for ivermectin, doesn’t it? Still lots of big green boxes. Meyerowitz-Katz accuses ivmmeta of cherry-picking what statistic to use for their forest plot. That is, if a study measures ten outcomes, they sometimes take the most pro-ivermectin outcome. Ivmmeta.com counters that they used a consistent and reasonable (if complicated) process for choosing their outcome of focus, that being: If studies report multiple kinds of effects then the most serious outcome is used in calculations for that study. For example, if effects for mortality and cases are both reported, the effect for mortality is used, this may be different to the effect that a study focused on. If symptomatic results are reported at multiple times, we used the latest time, for example if mortality results are provided at 14 days and 28 days, the results at 28 days are used. Mortality alone is preferred over combined outcomes. Outcomes with zero events in both arms were not used (the next most serious outcome is used — no studies were excluded). For example, in low-risk populations with no mortality, a reduction in mortality with treatment is not possible, however a reduction in hospitalization, for example, is still valuable. Clinical outcome is considered more important than PCR testing status. When basically all patients recover in both treatment and control groups, preference for viral clearance and recovery is given to results mid-recovery where available (after most or all patients have recovered there is no room for an effective treatment to do better). If only individual symptom data is available, the most serious symptom has priority, for example difficulty breathing or low SpO2 is more important than cough. I’m having trouble judging this, partly because Meyerowitz-Katz says ivmmeta has corrected some earlier mistakes, and partly because there really is some reasonable debate over how to judge studies with lots of complicated endpoints. By this point I had completely forgotten what ivmmeta did, so I independently coded all 11 remaining studies following something in between my best understanding of their procedure and what I considered common sense. The only exception was that when the most severe outcome was measured in something other than patients (ie average number of virus copies per patient), I defaulted to one that was measured in patients instead, to keep everything with the same denominator. My results mostly matched ivmmeta’s, with one or two exceptions that I think are within the scope of argument or related to my minor deviations from their protocol. Placebo vs. ivermectin groups sometimes differed in size, which I’ve adjusted for and rounded off. Probably I’m forgetting some reason I can’t just do simple summary statistics to this, but whatever. It is p = 0.15, not significant. This is maybe unfair, because there aren’t a lot of deaths in the sample, so by focusing on death rather than more common outcomes we’re pointlessly throwing away sample size. What happens if I unprincipledly pick whatever I think the most reasonable outcome to use from each study is? I’ve chosen “most reasonable” as a balance between “is the most severe” and “has a lot of data points”: Now it’s p = 0.04, seemingly significant, but I had to make some unprincipled decisions to get there. I don’t think I specifically replaced negative findings with positive ones, but I can’t prove that even to myself, let alone to you. [UPDATE 5/31/22: A reader writes in to tell me that the t-test I used above is overly simplistic. A Dersimonian-Laird test is more appropriate for meta-analysis, and would have given 0.03 and 0.005 on the first and second analysis, where I got 0.15 and 0.04. This significantly strengthens the apparent benefit of ivermectin from ‘debatable’ to ‘clear’. I discuss some reasons below why I am not convinced by this apparent benefit.] (how come I’m finding a bunch of things on the edge of significance, but the original ivmmeta site found a lot of extremely significant things? Because they combined ratios, such that “one death in placebo, zero in ivermectin” looked like a nigh-infinite benefit for ivermectin, whereas I’m combining raw numbers. Possibly my way is statistically illegitimate for some reason, but I’m just trying to get a rough estimate of how convinced to be) So we are stuck somewhere between “nonsignificant trend in favor” and “maybe-significant trend in favor, after throwing out some best practices”. This is normally where I would compare my results to those of other meta-analyses made by real professionals. But when I look at them, they all include studies later found to be fake, like Elgazzar, and unsurprisingly come up with wildly positive conclusions. There are about six in this category. One of them later revised their results to exclude Elgazzar and still found strong efficacy for ivermectin, but they still included Niaee and some other dubious studies. The only meta-analysis that doesn’t make these mistakes is Popp (a Cochrane review), which is from before Elgazzar was found to be fraudulent, but coincidentally excludes it for other reasons. It also excludes a lot of good studies like Mahmud and Ravakirti because they give patients other things like HCQ and azithromycin - I chose to include them, because I don’t think they either work or have especially bad side effects, so they’re basically placebo - but Cochrane is always harsh like this. They end up with a point estimate where ivermectin cuts mortality by 40% - but say the confidence intervals are too wide to draw any conclusion. I think this basically agrees with my analyses above - the trends really are in ivermectin’s favor, but once you eliminate all the questionable studies there are too few studies left to have enough statistical power to reach significance. Except that everyone is still focusing on deaths and hospitalizations just because they’re flashy. Mahmud et al, which everyone agrees is a great study, found that ivermectin decreased days until clinical recovery, p = 0.003? So what do you do? This is one of the toughest questions in medicine. It comes up again and again. You have some drug. You read some studies. Again and again, more people are surviving (or avoiding complications) when they get the drug. It’s a pattern strong enough to common-sensically notice. But there isn’t an undeniable, unbreachable fortress of evidence. The drug is really safe and doesn’t have a lot of side effects. So do you give it to your patients? Do you take it yourself? Here this question is especially tough, because, uh, if you say anything in favor of ivermectin you will be cast out of civilization and thrown into the circle of social hell reserved for Klan members and 1/6 insurrectionists. All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele. But good doctors aren’t supposed to care about such things. Your only goal is to save your patient. Nothing else matters. I am telling you that Mahmud et al is a good study and it got p = 0.003 in favor of ivermectin. You can take the blue pill, and stay a decent respectable member of society. Or you can take the horse dewormer pill, and see where you end up. In a second, I’ll tell you my answer. But you won’t always have me to answer questions like this, and it might be morally edifying to observe your thought process in situations like this. So take a second, and meet me on the other side of the next section heading. … … … … … The Synthesis Hopefully you learned something interesting about yourself there. But my answer is: worms! As several doctors and researchers have pointed out (h/t especially Avi Bitterman and David Boulware), the most impressive studies come from places that are teeming with worms. Mahmud from Bangladesh, Ravakirti from East India, Lopez-Medina from Colombia, etc. Here’s the prevalence of roundworm infections by country (source). But alongside roundworms, there are threadworms, hookworms, blood flukes, liver flukes, nematodes, trematodes, all sorts of worms. Add them all up and somewhere between half and a quarter of people in the developing world have at least one parasitic worm in their body. Being full of worms may impact your ability to fight coronavirus. Gluchowska et al write: Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases. Treatment of worm infections might reduce the negative effect of COVID-19! And ivermectin is a deworming drug! You can see where this is going… The most relevant species of worm here is the roundworm Strongyloides stercoralis. Among the commonest treatments for COVID-19 is corticosteroids, a type of immunosuppresant drug. The types of immune responses it suppresses do more harm than good in coronavirus, so turning them off limits collateral damage and makes patients better on net. But these are also the types of immune responses that control Strongyloides. If you turn them off even very briefly, the worms multiply out of control, you get what’s called “Strongyloides hyperinfection”, and pretty often you die. According to the WHO: The current COVID-19 pandemic serves to highlight the risk of using systemic corticosteroids and, to a lesser extent, other immunosuppressive therapy, in populations with significant risk of underlying strongyloidiasis. Cases of strongyloidiasis hyperinfection in the setting of corticosteroid use as COVID-19 therapy have been described and draw attention to the necessity of addressing the risk of iatrogenic strongyloidiasis hyperinfection syndrome in infected individuals prior to corticosteroid administration. Although this has gained importance in the midst of a pandemic where corticosteroids are one of few therapies shown to improve mortality, its relevance is much broader given that corticosteroids and other immunosuppressive therapies have become increasingly common in treatment of chronic diseases (e.g. asthma or certain rheumatologic conditions). So you need to “address the risk” of strongyloides infection during COVID treatment in roundworm-endemic areas. And how might you address this, WHO? Treatment of chronic strongyloidiasis with ivermectin 200 µg/kg per day orally x 1-2 days is considered safe with potential contraindications including possible Loa loa infection (endemic in West and Central Africa), pregnancy, and weight <15kg. Given ivermectin’s safety profile, the United States has utilized presumptive treatment with ivermectin for strongyloidiasis in refugees resettling from endemic areas, and both Canada and the European Centre for Disease Prevention and Control have issued guidance on presumptive treatment to avoid hyperinfection in at risk populations. Screening and treatment, or where not available, addition of ivermectin to mass drug administration programs should be studied and considered. This is serious and common enough that, if you’re not going to screen for it, it might be worth “add[ing] ivermectin to mass drug administration programs” in affected areas! Dr. Avi Bitterman carries the hypothesis to the finish line: First two images are with all relevant studies; second two are a sensitivity analysis that removes some of the most dubious. The good ivermectin trials in areas with low Strongyloides prevalence, like Vallejos in Argentina, are mostly negative. The good ivermectin trials in areas with high Strongyloides prevalence, like Mahmud in Bangladesh, are mostly positive. Worms can’t explain the viral positivity outcomes (ie PCR), but Dr. Bitterman suggests that once you remove low quality trials and worm-related results, the rest looks like simple publication bias: This is still just a possibility. Maybe I’m over-focusing too hard on a couple positive results and this will all turn out to be nothing. Or who knows, maybe ivermectin does work against COVID a little - although it would have to be very little, fading to not at all in temperate worm-free countries. But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong! The people who called it a miracle drug against COVID were wrong. The people who dismissed all the studies because they F@#king Love Science were wrong. Ivmmeta.com was wrong. Gideon Meyerowitz-Katz was…well, he was right, actually, I got the worm-related meta-analysis graphic above from his Twitter timeline. Still, an excellent troll. Also, the best part is that I ignorantly asked, in my description of Mahmud et al above: And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true! The Scientific Takeaway About ten years ago, when the replication crisis started, we learned a certain set of tools for examining studies. Check for selection bias. Distrust “adjusting for confounders”. Check for p-hacking and forking paths. Make teams preregister their analyses. Do forest plots to find publication bias. Stop accepting p-values of 0.049. Wait for replications. Trust reviews and meta-analyses, instead of individual small studies. These were good tools. Having them was infinitely better than not having them. But even in 2014, I was writing about how many bad studies seemed to slip through the cracks even when we pushed this toolbox to its limits. We needed new tools. I think the methods that Meyerowitz-Katz, Sheldrake, Heathers, Brown, Lawrence and others brought to the limelight this year are some of the new tools we were waiting for. Part of this new toolset is to check for fraud. About 10 - 15% of the seemingly-good studies on ivermectin ended up extremely suspicious for fraud. Elgazzar, Carvallo, Niaee, Cadegiani, Samaha. There are ways to check for this even when you don’t have the raw data. Like: The Carlisle-Stouffer-Fisher method: Check some large group of comparisons, usually the Table 1 of an RCT where they compare the demographic characteristics of the control and experimental groups, for reasonable p-values. Real data will have p-values all over the map; one in every ten comparisons will have a p-value of 0.1 or less. Fakers seem bad at this and usually give everything a nice safe p-value like 0.8 or 0.9.
Okay, fine, they misspelled “recovery” once. But they spelled it right the other time! That puts it in the top 50% for ivermectin papers! The fraud-hunters have examined this paper closely and are unable to find any signs of fraud. @PubPeer on the Mahmud trial of ivermectin in covid patients.\n\nI have now reviewed the individual patient data master sheet.\n\nI did not find any irregularities and the summary data matches the published data.\n\n","username":"K_Sheldrick","name":"Kyle Sheldrick","profile_image_url":"","date":"Sat Jul 17 11:06:25 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":12,"impression_count":0,"expanded_url":{"url":"https://pubpeer.com/publications/E1D65711EF28D14517731BEACB89C8#2","title":"PubPeer - Ivermectin in combination with doxycycline for treating COVI...","description":"There are comments on PubPeer for publication: Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial (2021)","domain":"pubpeer.com"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> I think this paper is legitimate and that its findings need to be seriously considered. Serious consideration doesn’t always meant they’re true - sometimes if we have strong evidence otherwise we can dismiss things without understanding why. And there’s always the chance it was a fluke, right? Can something have a p-value less than 0.001 and still be a fluke? Szenta Fonseca et al: This is a chart review from Brazil. Researchers looked at various people who had been treated for COVID in an insurance company database, saw whether they got ivermectin or not, and saw whether the people who got it did better or worse. About a hundred people got it, and a few hundred others didn’t. The people who got it did not do any better than anyone else, and you’ll notice this is one of the rare red boxes on the table above. But we shouldn’t take this study seriously. Nobody took any effort to avoid selection bias, so it’s very possible that sicker people were given more medication (including ivermectin), which unfairly handicaps the ivermectin group. Also, it’s hard to tell from the paper who was on how much of what, and the discussion of ivermectin seems like kind of an afterthought after discussing lots of other meds in much more depth. This is another one I feel comfortable ignoring. Cadegiani et al: A crazy person decided to put his patients on every weird medication he could think of, and 585 subjects ended up on a combination of ivermectin, hydroxychloroquine, azithromycin, and nitazoxanide, with dutasteride and spironolactone "optionally offered" and vitamin D, vitamin C, zinc, apixaban, rivaraxoban, enoxaparin, and glucocorticoids "added according to clinical judgment". There was no control group, but the author helpfully designated some random patients in his area as a sort-of-control, and then synthetically generated a second control group based on “a precise estimative based on a thorough and structured review of articles indexed in PubMed and MEDLINE and statements by official government agencies and specific medical societies”. Patients in the experimental group were twice as likely to recover (p < 0.0001), had negative PCR after 14 vs. 21 days, and had 0 vs. 27 hospitalizations. Speaking of low p-values, some people did fraud-detection tests on another of Cadegiani’s COVID-19 studies and got values like p < 8.24E-11 in favor of it being fraudulent. And, uh, he’s also studied whether ultra-high-dose antiandrogens treated COVID, and found that they did, cutting mortality by 92% . But the trial is under suspicion, with a BMJ article calling it “[the worst] violations of medical ethics and human rights in Brazil’s history” and “an ethical cesspit of violations”. [update 2022: this section originally contained more accusations against Cadegiani. Alexandros Marinos does a deeper dive with information not available at the time I wrote this, and finds some of them were overstated or false by implication] Anyway, let’s not base anything important on the results of this study, mmkay? A defiant Flavio Cadegiani. Imagine a guy who looks like this telling you to take ultra-high-dose antiandrogens. Ahmed et al: And we’re back in Bangladesh. 72 hospital patients were randomized to one of three arms: ivermectin only, ivermectin + doxycycline, and placebo. Primary endpoint was time to negative PCR, which was 9.7 days for ivermectin only and 12.7 days for placebo (p = 0.03). Other endpoints including duration of hospitalization (9.6 days ivermectin vs. 9.7 days placebo, not significant). This looks pretty good for ivermectin and does not have any signs of fraud or methodological problems. If I wanted to pick at it anyway, I would point out that the ivermectin + doxycycline group didn’t really differ from placebo, and that if you average out both ivermectin groups (with and without doxycycline) it looks like the difference would not be significant. I had previously committed to considering only ivermectin alone in trials that had multiple ivermectin groups, so I’m not going to do this. I can’t find any evidence this trial was preregistered so I don’t know whether they waited to see what would come out positive and then made that their primary endpoint, but virological clearance is a pretty normal primary endpoint and this isn’t that suspicious. It’s impossible to find any useful commentary on this study because Elgazzar (the guy who ran the most famous fraudulent ivermectin study) had the first name Ahmed, everyone is talking about Elgazzar all the time, and this overwhelms Google whenever I try to search for Ahmed et al. For now I’ll just keep this as a mildly positive and mildly plausible virological clearance result, in the context of no effect on hospitalization length or most symptoms. Chaccour et al: 24 patients in Spain were randomized to receive either medium-dose ivermectin or placebo. The primary outcome was percent of patients with negative PCR at day 7; secondary outcomes were viral load and symptoms. The primary endpoint ended up being kind of a wash - everyone still PCR positive by day 7 so it was impossible to compare groups. Ivermectin trended toward lower viral load but never reached significance. Weirdly, ivermectin did seem to help symptoms, but only anosmia and cough towards the end (p = 0.03), which you would usually think of as lingering post-COVID problems. The paper says: Given these findings, consideration could be given to alternative mechanisms of action different from a direct antiviral effect. One alternative explanation might be a positive allosteric modulation of the nicotinic acetylcholine receptor caused by ivermectin and leading to a downregulation of the ACE-2 receptor and viral entry into the cells of the respiratory epithelium and olfactory bulb. Another mechanism through which ivermectin might influence the reversal of anosmia is by inhibiting the activation of pro-inflammatory pathways in the olfactory epithelium. Inflammation of the olfactory mucosa is thought to play a key role in the development of anosmia in SARS-CoV-2 infection This seems kind of hedge-y. If you’re wondering where things went from there, Dr. Chaccour is now a passionate anti-ivermectin activist: @Finneganporter in @BusinessInsider \n\nThe roots of #ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm\n\n","username":"carlos_chaccour","name":"Dr. Carlos Chaccour ??????","profile_image_url":"","date":"Sun Nov 07 18:40:28 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":9,"impression_count":0,"expanded_url":{"url":"https://www.businessinsider.in/international/news/the-roots-of-ivermectin-mania-how-south-america-incubated-a-fake-medicine-craze-that-took-the-us-by-storm/articleshow/87554081.cms","image":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/88d08e70-c9e2-46d4-a5df-96807b6c3a13_2000x1000.jpeg","title":"The roots of ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm","description":"The popularity of unproven anti-parasitic drug ivermectin as a COVID-19 treatment is surging. Its use has roots in South America, where it was hyped by populist","domain":"businessinsider.in"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> So I guess he must think of this trial as basically negative, although realistically it’s 24 people and we shouldn’t put too much weight on it either way. Ghauri et al: Pakistan, 95 patients. Nonrandom; the study compared patients who happened to be given ivermectin (along with hydroxychloroquine and azithromycin) vs. patients who were just given the latter two drugs. There’s some evidence this produced systematic differences between the two groups - for example, patients in the control group were 3x more likely to have had diarrhea (this makes sense; diarrhea is a potential ivermectin side effect, so you probably wouldn’t give it to people already struggling with this problem). Also, the control group was twice as likely to be getting corticosteroids, maybe a marker for illness severity. Primary outcome was what percent of both groups had a fever: on day 7 it was 21% of ivermectin patients vs. 65% of controls, p < 0.001. No other outcomes were reported. I don’t hate this study, but I think the nonrandom assignment (and observed systematic differences) is a pretty fatal flaw. I can’t find anyone else talking about this one. At least no one seems to be saying anything bad. Babaloba et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakoloko”, because that’s really fun to say. This was a Nigerian RCT comparing 21 patients on low-dose ivermectin, 21 patients on high-dose ivermectin, and 20 patients on a combination of lopinavir and ritonavir, a combination antiviral which later studies found not to work for COVID and which might as well be considered a placebo. Primary outcome, as usual, was days until a negative PCR test. High dose ivermectin was 4.65 days, low dose was 6 days, control was 9.15, p = 0.035. Figure 2 is apparently a photograph of the computer screen where they did this calculation. Gideon Meyerowitz-Katz, part of the team that detects fraud in ivermectin papers, is not a fan of this one: He doesn’t say there what means, but elsewhere he tweets this figure: It’s always a bad sign when your study features in an image with “NUMEROUS IMPOSSIBLE NUMBERS” in red at the top. I think his point is that if you have 21 people, it’s impossible to have 50% of them have headache, because that would be 10.5. If 10 people have a headache, it would be 47.6%; if 11, 52%. So something is clearly wrong here. Seems like a relatively minor mistake, and Meyerowitz-Katz stops short of calling fraud, but it’s not a good look. I’m going to be slightly uncomfortable with this study without rejecting it entirely, and move on. Ravakirti et al: Here we’re in Eastern India - not exactly Bangladesh again, but a stone’s throw away from it. In this RCT patients were randomized into an ivermectin group (57) and a placebo group (58). Primary outcome was negative PCR on day 6, because doing it on day 7 like everyone else would be too easy. As with several other groups, this was a bad move; too few people had it to make a good comparison; it was 13% of intervention vs. 18% of placebo, p = 0.3. Secondary outcomes were also pretty boring, except for the most important: 4 people in the placebo group died, compared to 0 in ivermectin (p = 0.045). On the one hand, this is one outcome of many, reaching the barest significance threshold. Another fluke? Still, there are no real problems with this study, and nobody has anything to say against it. Let’s add this one to the scale as another very small and noisy piece of real evidence in ivermectin’s favor. Bukhari et al: Now we’re in Pakistan. 50 patients were randomized to low-dose ivermectin, another 50 got standard of care including vitamin D. There was no placebo, but primary outcome was number of days to reach negative PCR, which it seems hard for placebo to affect much, so I don’t care. 5 controls and 9 ivermectin patients left the hospital against medical advice and could not be followed up, which is bad but not necessarily study-ruining. They never measured their supposed primary outcome of “days to reach negative PCR” directly, but they did measure how many people had negative PCR on various days, and ivermectin had a clear advantage - for example, on day 7, it was 37/50 for IVR and only 20/50 for control. Even if we assume all the lost-to-followup patients had maximally bad-for-the-hypothesis results, that’s still a positive finding. Nobody else has much to say about this one, certainly no accusations that they’ve found anything suspicious. Keep. Mohan et al: India. RCT. 40 patients got low-dose ivermectin, 40 high-dose ivermectin, and 45 placebo. Primary outcomes were time to negative PCR, and viral load on day 5. In the results, they seem to have reinterpreted “time to negative PCR” as the subtly different “percent with negative PCR on some specific day”. High-dose ivermectin did best (47.5% negative on day 5) and placebo worst (31% negative), but it was insignificant (p = 0.3). There was no difference in viral load. All groups took about the same amount of time for symptoms to resolve. More placebo patients had failed to recover by the end of the study (6) than ivermectin patients (2), but this didn’t reach statistical significance (p = 0.4). Overall a well-done, boring, negative study, although ivermectin proponents will correctly point out that, like basically every other study we have looked at, the trend was in favor of ivermectin and this could potentially end up looking impressive in a meta-analysis. Biber et al: This is an RCT from Israel. 47 patients got ivermectin and 42 placebo. Primary endpoint was viral load on day 6. I am having trouble finding out what happened with this; as far as I can tell it was a negative result and they buried it in favor of more interesting things. In a "multivariable logistic regression model, the adjusted odds ratio of negative SARS-CoV-2 RT-PCR negative test" favored ivermectin over placebo (p = 0.03 for day 6, p = 0.01 for day 8), but this seems like the kind of thing you do when your primary outcome is boring and you’re angry. Gideon Meyerowitz-Katz is not a fan: He notes that the study excluded people with high viral load, but the preregistration didn’t say they would do that. Looking more closely, he finds they did that because, if you included these people, the study got no positive results. So probably they did the study, found no positive results, re-ran it with various subsets of patients until they did get a positive result, and then claimed to have “excluded” patients who weren’t in the subset that worked. I’m going to toss this one. Elalfy et al: What even is this? Where am I? As best I can tell, this is some kind of Egyptian trial. It might or might not be an RCT; it says stuff like “Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment”. Were they self-allocated in the sense that they got to choose? Doesn’t that mean it’s not random? Aren’t there seven days in a week? These are among the many questions that Elalfy et al do not answer for us. The control group (which they seem to think can also be called “the white group”) took zinc, paracetamol, and maybe azithromycin. The intervention group took zinc, nitazoxanide, ribavirin, and ivermectin. There were very large demographic differences between the groups of the sort which make the study unusable, which they mention and then ignore. From there, they follow this normal and totally comprehensible flowchart: There is no primary outcome assigned, but viral clearance rates on day seven were 58% in the yellow group compared to 0% in the white group, which I guess is a strong positive result. This table… …looks very impressive, in terms of the experimental group doing better than the control, except that they don’t specify whether it was before the trial or after it, and at least one online commentator thinks it might have been before, in which case it’s only impressive how thoroughly they failed to randomize their groups. Overall I don’t feel bad throwing this study out. I hope it one day succeeds in returning to its home planet. Lopez-Medina et al: Colombian RCT. 200 patients took ivermectin, another 200 took placebo. They originally worried the placebo might taste different than real ivermectin, then solved this by replacing it with a different placebo, which is a pretty high level of conscientiousness. Primary outcome was originally percent of patients whose symptoms worsened by two points, as rated on a complicated symptom scale when a researcher asked them over the phone. Halfway through the study, they realized nobody was worsening that much, so they changed the primary outcome to time until symptoms got better, as measured by the scale. In the ivermectin group, symptoms improved that much after 10 days; in the placebo group, after 12, p = 0.53. By the end of the study, symptoms had improved in 82% of ivermectin users and 79% of controls, also insignificant. 4 patients in the ivermectin group needed to be hospitalized compared to 6 in the placebo group, again insignificant. This study is bigger than most of the other RCTs, and more polished in terms of how many spelling errors, photographs of computer screens, etc, it contains. It was published in JAMA, one of the most prestigious US medical journals, as opposed to the crappy nth-tier journals most of the others have been in. When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. Ivermectin proponents make some good arguments against it. In order to get as big as it did, Lopez-Medina had to compromise on rigor. Its outcome is how people self-score their symptoms on a hokey scale in a phone interview, instead of viral load or PCR results or anything like that. Still, this is basically what we want, right? In the end, we want people to feel better and less sick, not to get good scores on PCR tests. Also, it changed its primary outcome halfway through; isn’t that bad? I think maybe not; the reason we want a preregistered primary outcome is so that you don’t change halfway through to whatever outcome shows the results you want. The researchers in this study did a good job explaining why they changed their outcome, the change makes sense, and their original outcome would also have shown ivermectin not working (albeit less accurately and effectively). I don’t know of any evidence that they knew (or suspected) final results when switching to this new outcome, and it seems like the most reasonable new outcome to switch to. Finally, their original placebo tasted different from ivermectin (though they switched halfway through). This is one of the few studies where I actually care about placebo, because people are self-rating their symptoms. But realistically most of these people don’t know what ivermectin is supposed to taste like. Also, they did a re-analysis and found there was no difference between the people who got the old placebo and the new one. I’m making a big deal of this because ivmmeta.com - the really impressive meta-analysis site I’ve been going off of - puts a special warning letter underneath their discussion of this study, urging us not to trust it. They don’t do this for any of the other ones we’ve addressed so far - not the one by the guy whose other studies were all frauds, not the one where 50% of 21 people had headaches, not the unrandomized one where the groups were completely different before the experiment started, not even the one by the guy accused of crimes against humanity. Only this one. This makes me a lot less charitable to ivmmeta than I would otherwise be; I think it’s hard to choose this particular warning letter strategy out of well-intentioned commitment to truth. They just really don’t like this big study that shows ivermectin doesn’t work. Also, the warning itself irritates me, and includes paragraphs like: RCTs have a fundamental bias against finding an effect for interventions that are widely available — patients that believe they need treatment are more likely to decline participation and take the intervention [Yeh], i.e., RCTs are more likely to enroll low-risk participants that do not need treatment to recover (this does not apply to the typical pharmaceutical trial of a new drug that is otherwise unavailable). This trial was run in a community where ivermectin was available OTC and very widely known and used. Nobody else worries about this, and there are a million biases that non-randomized studies have that would be super-relevant when discussing those, but somehow when they’re pro-ivermectin the site forgets to be this thorough. I think a better pro-ivermectin response to this study is to point out that all the trends support ivermectin. Symptoms took 10 days to resolve in the ivermectin group vs. 12 in placebo; 4 ivermectin patients were hospitalized vs. 6 placebo patients, etc. Just say that this was an unusually noisy trial because of the self-report methodology, and you’re confident that these small differences will add up to significance when you put them into a meta-analysis. Roy et al: We’re back in East India, and back to non-randomized trials. 56 patients were retrospectively examined; some had been given ivermectin + doxycycline, others hydroxychloroquine, other azithromycin, and others symptomatic treatment only. We don’t get any meaningful information about how this worked, but we are told that they did not differ in “clinical well-being reporting onset timing”. Whatever. Chahla et al: The first of many Argentine trials. 110 patients received medium-dose ivermectin; 144 were kept as a control (no placebo). This was “cluster randomized”, which means they randomize different health centers to either give the experimental drug or not. This is worse than regular randomization, because there could be differences between these health centers (eg one might have better doctors who otherwise give better treatment, one might be in the poor part of town and have sicker patients, etc). They checked to see if there were any differences between the groups, and it sure looks like there were (the experimental group had twice as many obese people as the controls), but as per them, these differences were not statistically significant. Note that if this did make a difference, it would presumably make ivermectin look worse, not better. The primary outcome was given as “increase discharge from outpatient care with COVID-19 mild disease”. This favored the treatment; only 2/110 patients in the ivermectin group failed to be discharged, compared to 20 patients in the control group. But, uh, these were at different medical centers. Can’t different medical centers just have different discharge policies? One discharges you as soon as you seem to be getting better, the other waits to really make sure? This is an utterly crap endpoint to do a cluster randomized controlled trial on. If you’re going to do cRCT, which is never a great idea, you should be using some extremely objective endpoint that doctors and clinic administrators can’t possibly affect, like viral load according to some third-party laboratory, using the same third-party laboratory for both clinics. This is such a bad idea that I can’t help worrying I’m missing or misunderstanding something. If not, this is dumb and bad and should be ignored. Mourya et al: We’re back in India. This is a nonrandomized study comparing 50 patients given ivermectin to 50 patients given hydroxychloroquine. No primary outcome was named, but they focus on PCR negativity. Only 6% of patients in the hydroxychloroquine group were negative, compared to 90% of patients in the ivermectin group! On what day did they do the test? Uh, kind of random, and they admit that “in [the hydroxychloroquine group], mean time difference from the date of initiation of treatment and second test was significantly longer (7.24±2.75 days) as compared to 5.22±1.21 days in [the ivermectin group] (p=0.021).” Since they assessed these groups at different times, we shouldn’t draw any conclusions from them getting different results. Except that as far as I can tell this should handicap ivermectin, making it especially impressive that it did better. But also, the ivermectin group was made mostly of people who had been asymptomatic at the beginning (70%), and the hydroxychloroquine group had almost no asymptomatic cases (8%) . They were giving the ivermectin to healthy people and the hydroxychloroquine to sick people! They admit deep in the discussion that this “may be a confounding factor”. So basically they got totally different groups of people, tested them at totally different times, and the two sets of test results differed. So what? So this is why normal people do RCTs instead of whatever the heck this is, that’s what. Loue et al: …this one isn’t going to be an RCT either. Loue tells a story about a cluster of COVID cases at the French nursing home where he works. He asked people if they wanted to try ivermectin; 10 did and 15 didn’t. 1 ivermectin patient died, compared to 5 non-ivermectin patients. The non-ivermectin group looked a bit sicker than the ivermectin group in the inevitable Table 1, though it’s hard to tell. One interesting possible confounder (not mentioned, but I’m imagining it) is that demented patients probably couldn’t consent to ivermectin and ended up in the control group. This is another case of “I’m not going to trust anything that isn’t an RCT”. Merino et al: Another (sigh) non-RCT. Mexico City tried a public health program where if you called a hotline and said you had COVID, they sent you an emergency kit with various useful supplies. One of those supplies was ivermectin tablets. 18,074 people got the kit (and presumably some appreciable fraction took the ivermectin, though there’s no way to prove that). Their control group is people from before they started giving out the kits, people from after they stopped giving out the kits, and people who didn’t want the kits. There are differences in who got COVID early in the epidemic vs. later, and in people who did opt for medical kits vs. didn’t. To correct these, the researchers tried to adjust for confounders, something which - as I keep trying to hammer home again and again - never works. They found that using the kit led to a 75% or so reduction in hospitalization, though they were unable to separate out the ivermectin from the other things in the kit (paracetamol and aspirin), or from the placebo effect of having a kit and feeling like you had already gotten some treatment (if I understand right, the decision to go to the hospital was left entirely to the patient). I think this study is a moderate point in favor of giving people kits in order to prevent hospital overcrowding, but I’m not willing to accept that it tells us much about ivermectin in particular. Faisal et al: This one was published in The Professional Medical Journal (mispelled as “Profesional Medical Journal” in its URL), so you know it’s going to be good! It describes itself as “a cross-sectional study”, but later says it “randomized patients into two groups”, which would make it an RCT - I think they might just be using the term “cross-sectional” different from the standard American usage. A hospital in Pakistan got 50 patients on ivermectin + azithromycin, and another 50 on azithromycin alone. Primary outcome was not mentioned, and the data were presented confusingly, but a typical result is that only 4% of the ivermectin group had symptoms lasting more than 10 days, whereas 16% of the control group did, p < 0.01. They do a really weird thing where they compare how long it took symptoms to resolve between IVM and control groups within each bin. That is, if I’m understanding correctly, they ask “of the people who took between 3-5 days for symptoms to resolve, did they resolve faster for IVM or control?”. This is an utterly bizarre analysis to perform, although it doesn’t affect the fact that their other results still seem to favor ivermectin. Maybe I’m confused about what’s going on here. I’ve mostly been letting people off easy on no placebo, but I as far as I can tell (not very far) this paper seems to be going off whether patients reported continuing to have symptoms to the hospital doing the study, and I think that is potentially susceptible to placebo effects. Additionally, there’s no preregistration, and even though they talk a lot about doing PCR tests they don’t present the results. This is by no means the worst study here but I still think it’s pretty low quality and I don’t trust it. Aref et al: This one is published in the International Journal Of Nanomedicine, even though I’m pretty sure that isn’t a real thing. In this case the “nanomedicine” is a new nasal spray version of ivermectin which is so confusing I cannot for the life of me figure out what dose they are giving these patients. This Egyptian study gives 57 patients intranasal ivermectin plus hydroxychloroquine, azithromycin, oseltamavir, and some vitamins; another 57 patients get all that stuff except the ivermectin. Primary outcome is not stated, but they look at various symptoms, all of which look better in the ivermectin group: 95% of ivermectin patients got negative PCRs at some time point, compared to 75% of controls, p = 0.004. I am pretty suspicious of this study, not least because it comes from Egypt which has an awful reputation for fake studies, and it returns extreme results that I wouldn’t expect even if ivermectin was actually a wonder drug. But I cannot find any particular thing wrong with it, nor did anyone else I looked at, so I will grudgingly let it stand. Krolewiecki et al: Another Argentine study. This one is a real RCT. 30 patients received ivermectin, 15 were the control group (no placebo, again). Primary outcome was difference in viral load on day 5. The trend favored ivermectin but it was not statistically significant, although they were able to make it statistically significant if they looked at a subset of higher-IVM-plasma-concentration patients. They did not find any difference in clinical outcomes. A pro-ivermectin person could point out that in the subgroup with the highest ivermectin concentrations, the drug seemed to work. A skeptic could point out that this is exactly the kind of subgroup slicing that you are not supposed to do without pre-registering it, which I don’t think this team did. I agree with the skeptic. Vallejos et al: Another Argentine study. It’s big (250 people in each arm). It’s an RCT. It tries to define a primary outcome (“Primary outcome: the trial ended when the last patient who was included achieved the end of study visit”), but that’s not what “primary outcome” means, and they don’t offer an alternative. Other outcomes: no difference in PCR on days 3 or 12. Hospitalization is nonsignificantly better in the ivermectin group (14 vs. 21, p = 0.2), but death is nonsigificantly better in the placebo group (3 vs. 4, p = 0.7). This isn’t even the kind of nonsignificant that might contribute to an exciting meta-analysis later. This is just a pure null result. I cannot find any problem with this study, and neither can anyone else I checked. This is the biggest RCT we’ve seen so far, so we should take it seriously. TOGETHER Trial: Speaking of big RCTs… This one hasn’t been published yet. There’s a video of a talk about it, but I am not going to watch it, because it is a video, so I am getting information secondhand from eg here. Apparently, it compares 677 people (!) randomized to ivermectin to 678 people randomized to placebo. 86 ivermectin patients ended up in the hospital compared to 95 placebo patients, p-value not significant. This was a really big professional trial done by bigshot researchers from a major Canadian university, and the medical establishment is taking it much more seriously than any of these others. When it comes out, it will probably get published in a top journal. When discussing Lopez-Medina, I wrote: When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. This is the other one. Not coincidentally, it’s also the other trial that ivmmeta.com has a warning letter underneath telling you to disregard. Their main concern is that instead of truly randomizing patients to ivermectin vs. placebo, they did a time-dependent randomization that meant during some weeks more patients were getting one or the other. This is a problem because the trial takes place in Brazil, where different variants were more common at different times. Here’s their image: On the one hand, I have immense contempt for ivmmeta for letting all those other awful studies pass and then pulling out all the stops to try to nitpick this one. I have no idea if their proposed randomization failure really happened. And no doubt the reason they’re even able to investigate this is that this study is really careful and transparent - most of them don’t tell you anything about their randomization method. I would be shocked if other studies don’t have all these problems and worse. On the other hand, the point isn’t to be fair, it’s to be right. And this is a potential confounder. Not a huge one. But a potential one. I guess all we can do is try to bound the damage. Even if the confounding is 100% real and bad, there’s no way to make this study consistent with the crazy super-pro-ivermectin results of studies like Espitia-Hernandez and Aref. And even if we deny any confounding, we see the same slight pro-ivermectin trend - 86 hospitalizations vs. 95 - that we’ve seen in so many other studies. Nothing is going to make me believe that this isn’t in the top 33% of studies we’ve been looking at, so let’s add it as grist for the meta-analysis (though maybe not quite as much grist as its vast size indicates) and move on, angrily. Buonfrate et al: An Italian RCT. Patients were randomized into low-dose ivermectin (32), placebo (29), or high-dose ivermectin (32). Primary outcome was viral load on day 7. There was no significant difference (average of 2 in ivermectin groups, 2.2 in placebo group). They admit that they failed to reach the planned sample size, but did a calculation to show that even if they had, the trial could not have returned a positive result. Clinically, an average of 2 patients were hospitalized in each of the ivermectin arms, compared to 0 in the placebo arm - which bucks our previously-very-constant pro-ivermectin trend. Mayer et al: Not an RCT. Patients in an Argentine province were offered the opportunity to try ivermectin; 3266 said yes and become the experimental group, 17966 said no and became the control group. There were many obvious differences between the groups, but they all seemed to handicap ivermectin. There was a nonsignificant trend toward less hospitalization and significantly less mortality (1.5% vs. 2.1%, p = 0.03). While looking into this study, I learned the term “immortal time bias”. This means a period in between selection for the study and the beginning of study recording where patient outcomes are not counted. I think the problem here is that if you signed up for the system on Day X, and if you got sick before they could give you ivermectin, you were in the control group. See this Twitter thread, I have not confirmed everything he says. This only hardens my resolve to stay away from non-RCTs. Borody et al: Our last paper! …is it a paper? I can’t find it published anywhere. It mostly seems to be on news sites. Doesn’t look peer-reviewed. And it starts with “Note that views expressed in this opinion article are the writer’s personal views”. Whatever. 600 Australians were treated with ivermectin, doxycycline, and zinc. The article compares this to an “equivalent control group” made of “contemporary infected subjects in Australia obtained from published Covid Tracking Data”; this is not how you control group, @#!% you. Then it gets excited about the fact that most patients had better symptoms at the end of the ten-day study period than the beginning (untreated COVID resolves in about ten days). Why are these people wasting my time with this? Let’s move on. The Analysis If we remove all fraudulent and methodologically unsound studies from the table above, we end up with this: Gideon Meyerowitz-Katz, who investigated many of the studies above for fraud, tried a similar exercise. I learned about his halfway through, couldn’t help seeing it briefly, but tried to avoid remembering it or using it when generating mine (also, I did take the result of his fraud investigations into account), so they should be considered not quite independent efforts. His looks like this: He nixed Chowdhury, Babaloba, Ghauri, Faisal, and Aref, but kept Szenta Fonseca, Biber (?), and Mayer. There was correlation of 0.45, which I guess is okay. I asked him about his decision-making, and he listed a combination of serious statistical errors and small red flags adding up. I was pretty uncomfortable with most of these studies myself, so I will err on the side of severity, and remove all studies that either I or Meyerowitz-Katz disliked. We end up with the following short list: We’ve gone from 29 studies to 11, getting rid of 18 along the way. For the record, we eliminated 2/19 for fraud, 1/19 for severe preregistration violations, 10 for methodological problems, and 6 because Meyerowitz-Katz was suspicious of them. …but honestly this table still looks pretty good for ivermectin, doesn’t it? Still lots of big green boxes. Meyerowitz-Katz accuses ivmmeta of cherry-picking what statistic to use for their forest plot. That is, if a study measures ten outcomes, they sometimes take the most pro-ivermectin outcome. Ivmmeta.com counters that they used a consistent and reasonable (if complicated) process for choosing their outcome of focus, that being: If studies report multiple kinds of effects then the most serious outcome is used in calculations for that study. For example, if effects for mortality and cases are both reported, the effect for mortality is used, this may be different to the effect that a study focused on. If symptomatic results are reported at multiple times, we used the latest time, for example if mortality results are provided at 14 days and 28 days, the results at 28 days are used. Mortality alone is preferred over combined outcomes. Outcomes with zero events in both arms were not used (the next most serious outcome is used — no studies were excluded). For example, in low-risk populations with no mortality, a reduction in mortality with treatment is not possible, however a reduction in hospitalization, for example, is still valuable. Clinical outcome is considered more important than PCR testing status. When basically all patients recover in both treatment and control groups, preference for viral clearance and recovery is given to results mid-recovery where available (after most or all patients have recovered there is no room for an effective treatment to do better). If only individual symptom data is available, the most serious symptom has priority, for example difficulty breathing or low SpO2 is more important than cough. I’m having trouble judging this, partly because Meyerowitz-Katz says ivmmeta has corrected some earlier mistakes, and partly because there really is some reasonable debate over how to judge studies with lots of complicated endpoints. By this point I had completely forgotten what ivmmeta did, so I independently coded all 11 remaining studies following something in between my best understanding of their procedure and what I considered common sense. The only exception was that when the most severe outcome was measured in something other than patients (ie average number of virus copies per patient), I defaulted to one that was measured in patients instead, to keep everything with the same denominator. My results mostly matched ivmmeta’s, with one or two exceptions that I think are within the scope of argument or related to my minor deviations from their protocol. Placebo vs. ivermectin groups sometimes differed in size, which I’ve adjusted for and rounded off. Probably I’m forgetting some reason I can’t just do simple summary statistics to this, but whatever. It is p = 0.15, not significant. This is maybe unfair, because there aren’t a lot of deaths in the sample, so by focusing on death rather than more common outcomes we’re pointlessly throwing away sample size. What happens if I unprincipledly pick whatever I think the most reasonable outcome to use from each study is? I’ve chosen “most reasonable” as a balance between “is the most severe” and “has a lot of data points”: Now it’s p = 0.04, seemingly significant, but I had to make some unprincipled decisions to get there. I don’t think I specifically replaced negative findings with positive ones, but I can’t prove that even to myself, let alone to you. [UPDATE 5/31/22: A reader writes in to tell me that the t-test I used above is overly simplistic. A Dersimonian-Laird test is more appropriate for meta-analysis, and would have given 0.03 and 0.005 on the first and second analysis, where I got 0.15 and 0.04. This significantly strengthens the apparent benefit of ivermectin from ‘debatable’ to ‘clear’. I discuss some reasons below why I am not convinced by this apparent benefit.] (how come I’m finding a bunch of things on the edge of significance, but the original ivmmeta site found a lot of extremely significant things? Because they combined ratios, such that “one death in placebo, zero in ivermectin” looked like a nigh-infinite benefit for ivermectin, whereas I’m combining raw numbers. Possibly my way is statistically illegitimate for some reason, but I’m just trying to get a rough estimate of how convinced to be) So we are stuck somewhere between “nonsignificant trend in favor” and “maybe-significant trend in favor, after throwing out some best practices”. This is normally where I would compare my results to those of other meta-analyses made by real professionals. But when I look at them, they all include studies later found to be fake, like Elgazzar, and unsurprisingly come up with wildly positive conclusions. There are about six in this category. One of them later revised their results to exclude Elgazzar and still found strong efficacy for ivermectin, but they still included Niaee and some other dubious studies. The only meta-analysis that doesn’t make these mistakes is Popp (a Cochrane review), which is from before Elgazzar was found to be fraudulent, but coincidentally excludes it for other reasons. It also excludes a lot of good studies like Mahmud and Ravakirti because they give patients other things like HCQ and azithromycin - I chose to include them, because I don’t think they either work or have especially bad side effects, so they’re basically placebo - but Cochrane is always harsh like this. They end up with a point estimate where ivermectin cuts mortality by 40% - but say the confidence intervals are too wide to draw any conclusion. I think this basically agrees with my analyses above - the trends really are in ivermectin’s favor, but once you eliminate all the questionable studies there are too few studies left to have enough statistical power to reach significance. Except that everyone is still focusing on deaths and hospitalizations just because they’re flashy. Mahmud et al, which everyone agrees is a great study, found that ivermectin decreased days until clinical recovery, p = 0.003? So what do you do? This is one of the toughest questions in medicine. It comes up again and again. You have some drug. You read some studies. Again and again, more people are surviving (or avoiding complications) when they get the drug. It’s a pattern strong enough to common-sensically notice. But there isn’t an undeniable, unbreachable fortress of evidence. The drug is really safe and doesn’t have a lot of side effects. So do you give it to your patients? Do you take it yourself? Here this question is especially tough, because, uh, if you say anything in favor of ivermectin you will be cast out of civilization and thrown into the circle of social hell reserved for Klan members and 1/6 insurrectionists. All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele. But good doctors aren’t supposed to care about such things. Your only goal is to save your patient. Nothing else matters. I am telling you that Mahmud et al is a good study and it got p = 0.003 in favor of ivermectin. You can take the blue pill, and stay a decent respectable member of society. Or you can take the horse dewormer pill, and see where you end up. In a second, I’ll tell you my answer. But you won’t always have me to answer questions like this, and it might be morally edifying to observe your thought process in situations like this. So take a second, and meet me on the other side of the next section heading. … … … … … The Synthesis Hopefully you learned something interesting about yourself there. But my answer is: worms! As several doctors and researchers have pointed out (h/t especially Avi Bitterman and David Boulware), the most impressive studies come from places that are teeming with worms. Mahmud from Bangladesh, Ravakirti from East India, Lopez-Medina from Colombia, etc. Here’s the prevalence of roundworm infections by country (source). But alongside roundworms, there are threadworms, hookworms, blood flukes, liver flukes, nematodes, trematodes, all sorts of worms. Add them all up and somewhere between half and a quarter of people in the developing world have at least one parasitic worm in their body. Being full of worms may impact your ability to fight coronavirus. Gluchowska et al write: Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases. Treatment of worm infections might reduce the negative effect of COVID-19! And ivermectin is a deworming drug! You can see where this is going… The most relevant species of worm here is the roundworm Strongyloides stercoralis. Among the commonest treatments for COVID-19 is corticosteroids, a type of immunosuppresant drug. The types of immune responses it suppresses do more harm than good in coronavirus, so turning them off limits collateral damage and makes patients better on net. But these are also the types of immune responses that control Strongyloides. If you turn them off even very briefly, the worms multiply out of control, you get what’s called “Strongyloides hyperinfection”, and pretty often you die. According to the WHO: The current COVID-19 pandemic serves to highlight the risk of using systemic corticosteroids and, to a lesser extent, other immunosuppressive therapy, in populations with significant risk of underlying strongyloidiasis. Cases of strongyloidiasis hyperinfection in the setting of corticosteroid use as COVID-19 therapy have been described and draw attention to the necessity of addressing the risk of iatrogenic strongyloidiasis hyperinfection syndrome in infected individuals prior to corticosteroid administration. Although this has gained importance in the midst of a pandemic where corticosteroids are one of few therapies shown to improve mortality, its relevance is much broader given that corticosteroids and other immunosuppressive therapies have become increasingly common in treatment of chronic diseases (e.g. asthma or certain rheumatologic conditions). So you need to “address the risk” of strongyloides infection during COVID treatment in roundworm-endemic areas. And how might you address this, WHO? Treatment of chronic strongyloidiasis with ivermectin 200 µg/kg per day orally x 1-2 days is considered safe with potential contraindications including possible Loa loa infection (endemic in West and Central Africa), pregnancy, and weight <15kg. Given ivermectin’s safety profile, the United States has utilized presumptive treatment with ivermectin for strongyloidiasis in refugees resettling from endemic areas, and both Canada and the European Centre for Disease Prevention and Control have issued guidance on presumptive treatment to avoid hyperinfection in at risk populations. Screening and treatment, or where not available, addition of ivermectin to mass drug administration programs should be studied and considered. This is serious and common enough that, if you’re not going to screen for it, it might be worth “add[ing] ivermectin to mass drug administration programs” in affected areas! Dr. Avi Bitterman carries the hypothesis to the finish line: First two images are with all relevant studies; second two are a sensitivity analysis that removes some of the most dubious. The good ivermectin trials in areas with low Strongyloides prevalence, like Vallejos in Argentina, are mostly negative. The good ivermectin trials in areas with high Strongyloides prevalence, like Mahmud in Bangladesh, are mostly positive. Worms can’t explain the viral positivity outcomes (ie PCR), but Dr. Bitterman suggests that once you remove low quality trials and worm-related results, the rest looks like simple publication bias: This is still just a possibility. Maybe I’m over-focusing too hard on a couple positive results and this will all turn out to be nothing. Or who knows, maybe ivermectin does work against COVID a little - although it would have to be very little, fading to not at all in temperate worm-free countries. But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong! The people who called it a miracle drug against COVID were wrong. The people who dismissed all the studies because they F@#king Love Science were wrong. Ivmmeta.com was wrong. Gideon Meyerowitz-Katz was…well, he was right, actually, I got the worm-related meta-analysis graphic above from his Twitter timeline. Still, an excellent troll. Also, the best part is that I ignorantly asked, in my description of Mahmud et al above: And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true! The Scientific Takeaway About ten years ago, when the replication crisis started, we learned a certain set of tools for examining studies. Check for selection bias. Distrust “adjusting for confounders”. Check for p-hacking and forking paths. Make teams preregister their analyses. Do forest plots to find publication bias. Stop accepting p-values of 0.049. Wait for replications. Trust reviews and meta-analyses, instead of individual small studies. These were good tools. Having them was infinitely better than not having them. But even in 2014, I was writing about how many bad studies seemed to slip through the cracks even when we pushed this toolbox to its limits. We needed new tools. I think the methods that Meyerowitz-Katz, Sheldrake, Heathers, Brown, Lawrence and others brought to the limelight this year are some of the new tools we were waiting for. Part of this new toolset is to check for fraud. About 10 - 15% of the seemingly-good studies on ivermectin ended up extremely suspicious for fraud. Elgazzar, Carvallo, Niaee, Cadegiani, Samaha. There are ways to check for this even when you don’t have the raw data. Like: The Carlisle-Stouffer-Fisher method: Check some large group of comparisons, usually the Table 1 of an RCT where they compare the demographic characteristics of the control and experimental groups, for reasonable p-values. Real data will have p-values all over the map; one in every ten comparisons will have a p-value of 0.1 or less. Fakers seem bad at this and usually give everything a nice safe p-value like 0.8 or 0.9.
A defiant Flavio Cadegiani. Imagine a guy who looks like this telling you to take ultra-high-dose antiandrogens. Ahmed et al: And we’re back in Bangladesh. 72 hospital patients were randomized to one of three arms: ivermectin only, ivermectin + doxycycline, and placebo. Primary endpoint was time to negative PCR, which was 9.7 days for ivermectin only and 12.7 days for placebo (p = 0.03). Other endpoints including duration of hospitalization (9.6 days ivermectin vs. 9.7 days placebo, not significant). This looks pretty good for ivermectin and does not have any signs of fraud or methodological problems. If I wanted to pick at it anyway, I would point out that the ivermectin + doxycycline group didn’t really differ from placebo, and that if you average out both ivermectin groups (with and without doxycycline) it looks like the difference would not be significant. I had previously committed to considering only ivermectin alone in trials that had multiple ivermectin groups, so I’m not going to do this. I can’t find any evidence this trial was preregistered so I don’t know whether they waited to see what would come out positive and then made that their primary endpoint, but virological clearance is a pretty normal primary endpoint and this isn’t that suspicious. It’s impossible to find any useful commentary on this study because Elgazzar (the guy who ran the most famous fraudulent ivermectin study) had the first name Ahmed, everyone is talking about Elgazzar all the time, and this overwhelms Google whenever I try to search for Ahmed et al. For now I’ll just keep this as a mildly positive and mildly plausible virological clearance result, in the context of no effect on hospitalization length or most symptoms. Chaccour et al: 24 patients in Spain were randomized to receive either medium-dose ivermectin or placebo. The primary outcome was percent of patients with negative PCR at day 7; secondary outcomes were viral load and symptoms. The primary endpoint ended up being kind of a wash - everyone still PCR positive by day 7 so it was impossible to compare groups. Ivermectin trended toward lower viral load but never reached significance. Weirdly, ivermectin did seem to help symptoms, but only anosmia and cough towards the end (p = 0.03), which you would usually think of as lingering post-COVID problems. The paper says: Given these findings, consideration could be given to alternative mechanisms of action different from a direct antiviral effect. One alternative explanation might be a positive allosteric modulation of the nicotinic acetylcholine receptor caused by ivermectin and leading to a downregulation of the ACE-2 receptor and viral entry into the cells of the respiratory epithelium and olfactory bulb. Another mechanism through which ivermectin might influence the reversal of anosmia is by inhibiting the activation of pro-inflammatory pathways in the olfactory epithelium. Inflammation of the olfactory mucosa is thought to play a key role in the development of anosmia in SARS-CoV-2 infection This seems kind of hedge-y. If you’re wondering where things went from there, Dr. Chaccour is now a passionate anti-ivermectin activist: @Finneganporter in @BusinessInsider \n\nThe roots of #ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm\n\n","username":"carlos_chaccour","name":"Dr. Carlos Chaccour ??????","profile_image_url":"","date":"Sun Nov 07 18:40:28 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":2,"like_count":9,"impression_count":0,"expanded_url":{"url":"https://www.businessinsider.in/international/news/the-roots-of-ivermectin-mania-how-south-america-incubated-a-fake-medicine-craze-that-took-the-us-by-storm/articleshow/87554081.cms","image":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/88d08e70-c9e2-46d4-a5df-96807b6c3a13_2000x1000.jpeg","title":"The roots of ivermectin mania: How South America incubated a fake-medicine craze that took the US by storm","description":"The popularity of unproven anti-parasitic drug ivermectin as a COVID-19 treatment is surging. Its use has roots in South America, where it was hyped by populist","domain":"businessinsider.in"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> So I guess he must think of this trial as basically negative, although realistically it’s 24 people and we shouldn’t put too much weight on it either way. Ghauri et al: Pakistan, 95 patients. Nonrandom; the study compared patients who happened to be given ivermectin (along with hydroxychloroquine and azithromycin) vs. patients who were just given the latter two drugs. There’s some evidence this produced systematic differences between the two groups - for example, patients in the control group were 3x more likely to have had diarrhea (this makes sense; diarrhea is a potential ivermectin side effect, so you probably wouldn’t give it to people already struggling with this problem). Also, the control group was twice as likely to be getting corticosteroids, maybe a marker for illness severity. Primary outcome was what percent of both groups had a fever: on day 7 it was 21% of ivermectin patients vs. 65% of controls, p < 0.001. No other outcomes were reported. I don’t hate this study, but I think the nonrandom assignment (and observed systematic differences) is a pretty fatal flaw. I can’t find anyone else talking about this one. At least no one seems to be saying anything bad. Babaloba et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakoloko”, because that’s really fun to say. This was a Nigerian RCT comparing 21 patients on low-dose ivermectin, 21 patients on high-dose ivermectin, and 20 patients on a combination of lopinavir and ritonavir, a combination antiviral which later studies found not to work for COVID and which might as well be considered a placebo. Primary outcome, as usual, was days until a negative PCR test. High dose ivermectin was 4.65 days, low dose was 6 days, control was 9.15, p = 0.035. Figure 2 is apparently a photograph of the computer screen where they did this calculation. Gideon Meyerowitz-Katz, part of the team that detects fraud in ivermectin papers, is not a fan of this one: He doesn’t say there what means, but elsewhere he tweets this figure: It’s always a bad sign when your study features in an image with “NUMEROUS IMPOSSIBLE NUMBERS” in red at the top. I think his point is that if you have 21 people, it’s impossible to have 50% of them have headache, because that would be 10.5. If 10 people have a headache, it would be 47.6%; if 11, 52%. So something is clearly wrong here. Seems like a relatively minor mistake, and Meyerowitz-Katz stops short of calling fraud, but it’s not a good look. I’m going to be slightly uncomfortable with this study without rejecting it entirely, and move on. Ravakirti et al: Here we’re in Eastern India - not exactly Bangladesh again, but a stone’s throw away from it. In this RCT patients were randomized into an ivermectin group (57) and a placebo group (58). Primary outcome was negative PCR on day 6, because doing it on day 7 like everyone else would be too easy. As with several other groups, this was a bad move; too few people had it to make a good comparison; it was 13% of intervention vs. 18% of placebo, p = 0.3. Secondary outcomes were also pretty boring, except for the most important: 4 people in the placebo group died, compared to 0 in ivermectin (p = 0.045). On the one hand, this is one outcome of many, reaching the barest significance threshold. Another fluke? Still, there are no real problems with this study, and nobody has anything to say against it. Let’s add this one to the scale as another very small and noisy piece of real evidence in ivermectin’s favor. Bukhari et al: Now we’re in Pakistan. 50 patients were randomized to low-dose ivermectin, another 50 got standard of care including vitamin D. There was no placebo, but primary outcome was number of days to reach negative PCR, which it seems hard for placebo to affect much, so I don’t care. 5 controls and 9 ivermectin patients left the hospital against medical advice and could not be followed up, which is bad but not necessarily study-ruining. They never measured their supposed primary outcome of “days to reach negative PCR” directly, but they did measure how many people had negative PCR on various days, and ivermectin had a clear advantage - for example, on day 7, it was 37/50 for IVR and only 20/50 for control. Even if we assume all the lost-to-followup patients had maximally bad-for-the-hypothesis results, that’s still a positive finding. Nobody else has much to say about this one, certainly no accusations that they’ve found anything suspicious. Keep. Mohan et al: India. RCT. 40 patients got low-dose ivermectin, 40 high-dose ivermectin, and 45 placebo. Primary outcomes were time to negative PCR, and viral load on day 5. In the results, they seem to have reinterpreted “time to negative PCR” as the subtly different “percent with negative PCR on some specific day”. High-dose ivermectin did best (47.5% negative on day 5) and placebo worst (31% negative), but it was insignificant (p = 0.3). There was no difference in viral load. All groups took about the same amount of time for symptoms to resolve. More placebo patients had failed to recover by the end of the study (6) than ivermectin patients (2), but this didn’t reach statistical significance (p = 0.4). Overall a well-done, boring, negative study, although ivermectin proponents will correctly point out that, like basically every other study we have looked at, the trend was in favor of ivermectin and this could potentially end up looking impressive in a meta-analysis. Biber et al: This is an RCT from Israel. 47 patients got ivermectin and 42 placebo. Primary endpoint was viral load on day 6. I am having trouble finding out what happened with this; as far as I can tell it was a negative result and they buried it in favor of more interesting things. In a "multivariable logistic regression model, the adjusted odds ratio of negative SARS-CoV-2 RT-PCR negative test" favored ivermectin over placebo (p = 0.03 for day 6, p = 0.01 for day 8), but this seems like the kind of thing you do when your primary outcome is boring and you’re angry. Gideon Meyerowitz-Katz is not a fan: He notes that the study excluded people with high viral load, but the preregistration didn’t say they would do that. Looking more closely, he finds they did that because, if you included these people, the study got no positive results. So probably they did the study, found no positive results, re-ran it with various subsets of patients until they did get a positive result, and then claimed to have “excluded” patients who weren’t in the subset that worked. I’m going to toss this one. Elalfy et al: What even is this? Where am I? As best I can tell, this is some kind of Egyptian trial. It might or might not be an RCT; it says stuff like “Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment”. Were they self-allocated in the sense that they got to choose? Doesn’t that mean it’s not random? Aren’t there seven days in a week? These are among the many questions that Elalfy et al do not answer for us. The control group (which they seem to think can also be called “the white group”) took zinc, paracetamol, and maybe azithromycin. The intervention group took zinc, nitazoxanide, ribavirin, and ivermectin. There were very large demographic differences between the groups of the sort which make the study unusable, which they mention and then ignore. From there, they follow this normal and totally comprehensible flowchart: There is no primary outcome assigned, but viral clearance rates on day seven were 58% in the yellow group compared to 0% in the white group, which I guess is a strong positive result. This table… …looks very impressive, in terms of the experimental group doing better than the control, except that they don’t specify whether it was before the trial or after it, and at least one online commentator thinks it might have been before, in which case it’s only impressive how thoroughly they failed to randomize their groups. Overall I don’t feel bad throwing this study out. I hope it one day succeeds in returning to its home planet. Lopez-Medina et al: Colombian RCT. 200 patients took ivermectin, another 200 took placebo. They originally worried the placebo might taste different than real ivermectin, then solved this by replacing it with a different placebo, which is a pretty high level of conscientiousness. Primary outcome was originally percent of patients whose symptoms worsened by two points, as rated on a complicated symptom scale when a researcher asked them over the phone. Halfway through the study, they realized nobody was worsening that much, so they changed the primary outcome to time until symptoms got better, as measured by the scale. In the ivermectin group, symptoms improved that much after 10 days; in the placebo group, after 12, p = 0.53. By the end of the study, symptoms had improved in 82% of ivermectin users and 79% of controls, also insignificant. 4 patients in the ivermectin group needed to be hospitalized compared to 6 in the placebo group, again insignificant. This study is bigger than most of the other RCTs, and more polished in terms of how many spelling errors, photographs of computer screens, etc, it contains. It was published in JAMA, one of the most prestigious US medical journals, as opposed to the crappy nth-tier journals most of the others have been in. When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. Ivermectin proponents make some good arguments against it. In order to get as big as it did, Lopez-Medina had to compromise on rigor. Its outcome is how people self-score their symptoms on a hokey scale in a phone interview, instead of viral load or PCR results or anything like that. Still, this is basically what we want, right? In the end, we want people to feel better and less sick, not to get good scores on PCR tests. Also, it changed its primary outcome halfway through; isn’t that bad? I think maybe not; the reason we want a preregistered primary outcome is so that you don’t change halfway through to whatever outcome shows the results you want. The researchers in this study did a good job explaining why they changed their outcome, the change makes sense, and their original outcome would also have shown ivermectin not working (albeit less accurately and effectively). I don’t know of any evidence that they knew (or suspected) final results when switching to this new outcome, and it seems like the most reasonable new outcome to switch to. Finally, their original placebo tasted different from ivermectin (though they switched halfway through). This is one of the few studies where I actually care about placebo, because people are self-rating their symptoms. But realistically most of these people don’t know what ivermectin is supposed to taste like. Also, they did a re-analysis and found there was no difference between the people who got the old placebo and the new one. I’m making a big deal of this because ivmmeta.com - the really impressive meta-analysis site I’ve been going off of - puts a special warning letter underneath their discussion of this study, urging us not to trust it. They don’t do this for any of the other ones we’ve addressed so far - not the one by the guy whose other studies were all frauds, not the one where 50% of 21 people had headaches, not the unrandomized one where the groups were completely different before the experiment started, not even the one by the guy accused of crimes against humanity. Only this one. This makes me a lot less charitable to ivmmeta than I would otherwise be; I think it’s hard to choose this particular warning letter strategy out of well-intentioned commitment to truth. They just really don’t like this big study that shows ivermectin doesn’t work. Also, the warning itself irritates me, and includes paragraphs like: RCTs have a fundamental bias against finding an effect for interventions that are widely available — patients that believe they need treatment are more likely to decline participation and take the intervention [Yeh], i.e., RCTs are more likely to enroll low-risk participants that do not need treatment to recover (this does not apply to the typical pharmaceutical trial of a new drug that is otherwise unavailable). This trial was run in a community where ivermectin was available OTC and very widely known and used. Nobody else worries about this, and there are a million biases that non-randomized studies have that would be super-relevant when discussing those, but somehow when they’re pro-ivermectin the site forgets to be this thorough. I think a better pro-ivermectin response to this study is to point out that all the trends support ivermectin. Symptoms took 10 days to resolve in the ivermectin group vs. 12 in placebo; 4 ivermectin patients were hospitalized vs. 6 placebo patients, etc. Just say that this was an unusually noisy trial because of the self-report methodology, and you’re confident that these small differences will add up to significance when you put them into a meta-analysis. Roy et al: We’re back in East India, and back to non-randomized trials. 56 patients were retrospectively examined; some had been given ivermectin + doxycycline, others hydroxychloroquine, other azithromycin, and others symptomatic treatment only. We don’t get any meaningful information about how this worked, but we are told that they did not differ in “clinical well-being reporting onset timing”. Whatever. Chahla et al: The first of many Argentine trials. 110 patients received medium-dose ivermectin; 144 were kept as a control (no placebo). This was “cluster randomized”, which means they randomize different health centers to either give the experimental drug or not. This is worse than regular randomization, because there could be differences between these health centers (eg one might have better doctors who otherwise give better treatment, one might be in the poor part of town and have sicker patients, etc). They checked to see if there were any differences between the groups, and it sure looks like there were (the experimental group had twice as many obese people as the controls), but as per them, these differences were not statistically significant. Note that if this did make a difference, it would presumably make ivermectin look worse, not better. The primary outcome was given as “increase discharge from outpatient care with COVID-19 mild disease”. This favored the treatment; only 2/110 patients in the ivermectin group failed to be discharged, compared to 20 patients in the control group. But, uh, these were at different medical centers. Can’t different medical centers just have different discharge policies? One discharges you as soon as you seem to be getting better, the other waits to really make sure? This is an utterly crap endpoint to do a cluster randomized controlled trial on. If you’re going to do cRCT, which is never a great idea, you should be using some extremely objective endpoint that doctors and clinic administrators can’t possibly affect, like viral load according to some third-party laboratory, using the same third-party laboratory for both clinics. This is such a bad idea that I can’t help worrying I’m missing or misunderstanding something. If not, this is dumb and bad and should be ignored. Mourya et al: We’re back in India. This is a nonrandomized study comparing 50 patients given ivermectin to 50 patients given hydroxychloroquine. No primary outcome was named, but they focus on PCR negativity. Only 6% of patients in the hydroxychloroquine group were negative, compared to 90% of patients in the ivermectin group! On what day did they do the test? Uh, kind of random, and they admit that “in [the hydroxychloroquine group], mean time difference from the date of initiation of treatment and second test was significantly longer (7.24±2.75 days) as compared to 5.22±1.21 days in [the ivermectin group] (p=0.021).” Since they assessed these groups at different times, we shouldn’t draw any conclusions from them getting different results. Except that as far as I can tell this should handicap ivermectin, making it especially impressive that it did better. But also, the ivermectin group was made mostly of people who had been asymptomatic at the beginning (70%), and the hydroxychloroquine group had almost no asymptomatic cases (8%) . They were giving the ivermectin to healthy people and the hydroxychloroquine to sick people! They admit deep in the discussion that this “may be a confounding factor”. So basically they got totally different groups of people, tested them at totally different times, and the two sets of test results differed. So what? So this is why normal people do RCTs instead of whatever the heck this is, that’s what. Loue et al: …this one isn’t going to be an RCT either. Loue tells a story about a cluster of COVID cases at the French nursing home where he works. He asked people if they wanted to try ivermectin; 10 did and 15 didn’t. 1 ivermectin patient died, compared to 5 non-ivermectin patients. The non-ivermectin group looked a bit sicker than the ivermectin group in the inevitable Table 1, though it’s hard to tell. One interesting possible confounder (not mentioned, but I’m imagining it) is that demented patients probably couldn’t consent to ivermectin and ended up in the control group. This is another case of “I’m not going to trust anything that isn’t an RCT”. Merino et al: Another (sigh) non-RCT. Mexico City tried a public health program where if you called a hotline and said you had COVID, they sent you an emergency kit with various useful supplies. One of those supplies was ivermectin tablets. 18,074 people got the kit (and presumably some appreciable fraction took the ivermectin, though there’s no way to prove that). Their control group is people from before they started giving out the kits, people from after they stopped giving out the kits, and people who didn’t want the kits. There are differences in who got COVID early in the epidemic vs. later, and in people who did opt for medical kits vs. didn’t. To correct these, the researchers tried to adjust for confounders, something which - as I keep trying to hammer home again and again - never works. They found that using the kit led to a 75% or so reduction in hospitalization, though they were unable to separate out the ivermectin from the other things in the kit (paracetamol and aspirin), or from the placebo effect of having a kit and feeling like you had already gotten some treatment (if I understand right, the decision to go to the hospital was left entirely to the patient). I think this study is a moderate point in favor of giving people kits in order to prevent hospital overcrowding, but I’m not willing to accept that it tells us much about ivermectin in particular. Faisal et al: This one was published in The Professional Medical Journal (mispelled as “Profesional Medical Journal” in its URL), so you know it’s going to be good! It describes itself as “a cross-sectional study”, but later says it “randomized patients into two groups”, which would make it an RCT - I think they might just be using the term “cross-sectional” different from the standard American usage. A hospital in Pakistan got 50 patients on ivermectin + azithromycin, and another 50 on azithromycin alone. Primary outcome was not mentioned, and the data were presented confusingly, but a typical result is that only 4% of the ivermectin group had symptoms lasting more than 10 days, whereas 16% of the control group did, p < 0.01. They do a really weird thing where they compare how long it took symptoms to resolve between IVM and control groups within each bin. That is, if I’m understanding correctly, they ask “of the people who took between 3-5 days for symptoms to resolve, did they resolve faster for IVM or control?”. This is an utterly bizarre analysis to perform, although it doesn’t affect the fact that their other results still seem to favor ivermectin. Maybe I’m confused about what’s going on here. I’ve mostly been letting people off easy on no placebo, but I as far as I can tell (not very far) this paper seems to be going off whether patients reported continuing to have symptoms to the hospital doing the study, and I think that is potentially susceptible to placebo effects. Additionally, there’s no preregistration, and even though they talk a lot about doing PCR tests they don’t present the results. This is by no means the worst study here but I still think it’s pretty low quality and I don’t trust it. Aref et al: This one is published in the International Journal Of Nanomedicine, even though I’m pretty sure that isn’t a real thing. In this case the “nanomedicine” is a new nasal spray version of ivermectin which is so confusing I cannot for the life of me figure out what dose they are giving these patients. This Egyptian study gives 57 patients intranasal ivermectin plus hydroxychloroquine, azithromycin, oseltamavir, and some vitamins; another 57 patients get all that stuff except the ivermectin. Primary outcome is not stated, but they look at various symptoms, all of which look better in the ivermectin group: 95% of ivermectin patients got negative PCRs at some time point, compared to 75% of controls, p = 0.004. I am pretty suspicious of this study, not least because it comes from Egypt which has an awful reputation for fake studies, and it returns extreme results that I wouldn’t expect even if ivermectin was actually a wonder drug. But I cannot find any particular thing wrong with it, nor did anyone else I looked at, so I will grudgingly let it stand. Krolewiecki et al: Another Argentine study. This one is a real RCT. 30 patients received ivermectin, 15 were the control group (no placebo, again). Primary outcome was difference in viral load on day 5. The trend favored ivermectin but it was not statistically significant, although they were able to make it statistically significant if they looked at a subset of higher-IVM-plasma-concentration patients. They did not find any difference in clinical outcomes. A pro-ivermectin person could point out that in the subgroup with the highest ivermectin concentrations, the drug seemed to work. A skeptic could point out that this is exactly the kind of subgroup slicing that you are not supposed to do without pre-registering it, which I don’t think this team did. I agree with the skeptic. Vallejos et al: Another Argentine study. It’s big (250 people in each arm). It’s an RCT. It tries to define a primary outcome (“Primary outcome: the trial ended when the last patient who was included achieved the end of study visit”), but that’s not what “primary outcome” means, and they don’t offer an alternative. Other outcomes: no difference in PCR on days 3 or 12. Hospitalization is nonsignificantly better in the ivermectin group (14 vs. 21, p = 0.2), but death is nonsigificantly better in the placebo group (3 vs. 4, p = 0.7). This isn’t even the kind of nonsignificant that might contribute to an exciting meta-analysis later. This is just a pure null result. I cannot find any problem with this study, and neither can anyone else I checked. This is the biggest RCT we’ve seen so far, so we should take it seriously. TOGETHER Trial: Speaking of big RCTs… This one hasn’t been published yet. There’s a video of a talk about it, but I am not going to watch it, because it is a video, so I am getting information secondhand from eg here. Apparently, it compares 677 people (!) randomized to ivermectin to 678 people randomized to placebo. 86 ivermectin patients ended up in the hospital compared to 95 placebo patients, p-value not significant. This was a really big professional trial done by bigshot researchers from a major Canadian university, and the medical establishment is taking it much more seriously than any of these others. When it comes out, it will probably get published in a top journal. When discussing Lopez-Medina, I wrote: When people say things like “sure, a lot of small studies show good results for ivermectin, but the bigger and more professional trials don’t”, this is one of the two big professional trials they’re talking about. This is the other one. Not coincidentally, it’s also the other trial that ivmmeta.com has a warning letter underneath telling you to disregard. Their main concern is that instead of truly randomizing patients to ivermectin vs. placebo, they did a time-dependent randomization that meant during some weeks more patients were getting one or the other. This is a problem because the trial takes place in Brazil, where different variants were more common at different times. Here’s their image: On the one hand, I have immense contempt for ivmmeta for letting all those other awful studies pass and then pulling out all the stops to try to nitpick this one. I have no idea if their proposed randomization failure really happened. And no doubt the reason they’re even able to investigate this is that this study is really careful and transparent - most of them don’t tell you anything about their randomization method. I would be shocked if other studies don’t have all these problems and worse. On the other hand, the point isn’t to be fair, it’s to be right. And this is a potential confounder. Not a huge one. But a potential one. I guess all we can do is try to bound the damage. Even if the confounding is 100% real and bad, there’s no way to make this study consistent with the crazy super-pro-ivermectin results of studies like Espitia-Hernandez and Aref. And even if we deny any confounding, we see the same slight pro-ivermectin trend - 86 hospitalizations vs. 95 - that we’ve seen in so many other studies. Nothing is going to make me believe that this isn’t in the top 33% of studies we’ve been looking at, so let’s add it as grist for the meta-analysis (though maybe not quite as much grist as its vast size indicates) and move on, angrily. Buonfrate et al: An Italian RCT. Patients were randomized into low-dose ivermectin (32), placebo (29), or high-dose ivermectin (32). Primary outcome was viral load on day 7. There was no significant difference (average of 2 in ivermectin groups, 2.2 in placebo group). They admit that they failed to reach the planned sample size, but did a calculation to show that even if they had, the trial could not have returned a positive result. Clinically, an average of 2 patients were hospitalized in each of the ivermectin arms, compared to 0 in the placebo arm - which bucks our previously-very-constant pro-ivermectin trend. Mayer et al: Not an RCT. Patients in an Argentine province were offered the opportunity to try ivermectin; 3266 said yes and become the experimental group, 17966 said no and became the control group. There were many obvious differences between the groups, but they all seemed to handicap ivermectin. There was a nonsignificant trend toward less hospitalization and significantly less mortality (1.5% vs. 2.1%, p = 0.03). While looking into this study, I learned the term “immortal time bias”. This means a period in between selection for the study and the beginning of study recording where patient outcomes are not counted. I think the problem here is that if you signed up for the system on Day X, and if you got sick before they could give you ivermectin, you were in the control group. See this Twitter thread, I have not confirmed everything he says. This only hardens my resolve to stay away from non-RCTs. Borody et al: Our last paper! …is it a paper? I can’t find it published anywhere. It mostly seems to be on news sites. Doesn’t look peer-reviewed. And it starts with “Note that views expressed in this opinion article are the writer’s personal views”. Whatever. 600 Australians were treated with ivermectin, doxycycline, and zinc. The article compares this to an “equivalent control group” made of “contemporary infected subjects in Australia obtained from published Covid Tracking Data”; this is not how you control group, @#!% you. Then it gets excited about the fact that most patients had better symptoms at the end of the ten-day study period than the beginning (untreated COVID resolves in about ten days). Why are these people wasting my time with this? Let’s move on. The Analysis If we remove all fraudulent and methodologically unsound studies from the table above, we end up with this: Gideon Meyerowitz-Katz, who investigated many of the studies above for fraud, tried a similar exercise. I learned about his halfway through, couldn’t help seeing it briefly, but tried to avoid remembering it or using it when generating mine (also, I did take the result of his fraud investigations into account), so they should be considered not quite independent efforts. His looks like this: He nixed Chowdhury, Babaloba, Ghauri, Faisal, and Aref, but kept Szenta Fonseca, Biber (?), and Mayer. There was correlation of 0.45, which I guess is okay. I asked him about his decision-making, and he listed a combination of serious statistical errors and small red flags adding up. I was pretty uncomfortable with most of these studies myself, so I will err on the side of severity, and remove all studies that either I or Meyerowitz-Katz disliked. We end up with the following short list: We’ve gone from 29 studies to 11, getting rid of 18 along the way. For the record, we eliminated 2/19 for fraud, 1/19 for severe preregistration violations, 10 for methodological problems, and 6 because Meyerowitz-Katz was suspicious of them. …but honestly this table still looks pretty good for ivermectin, doesn’t it? Still lots of big green boxes. Meyerowitz-Katz accuses ivmmeta of cherry-picking what statistic to use for their forest plot. That is, if a study measures ten outcomes, they sometimes take the most pro-ivermectin outcome. Ivmmeta.com counters that they used a consistent and reasonable (if complicated) process for choosing their outcome of focus, that being: If studies report multiple kinds of effects then the most serious outcome is used in calculations for that study. For example, if effects for mortality and cases are both reported, the effect for mortality is used, this may be different to the effect that a study focused on. If symptomatic results are reported at multiple times, we used the latest time, for example if mortality results are provided at 14 days and 28 days, the results at 28 days are used. Mortality alone is preferred over combined outcomes. Outcomes with zero events in both arms were not used (the next most serious outcome is used — no studies were excluded). For example, in low-risk populations with no mortality, a reduction in mortality with treatment is not possible, however a reduction in hospitalization, for example, is still valuable. Clinical outcome is considered more important than PCR testing status. When basically all patients recover in both treatment and control groups, preference for viral clearance and recovery is given to results mid-recovery where available (after most or all patients have recovered there is no room for an effective treatment to do better). If only individual symptom data is available, the most serious symptom has priority, for example difficulty breathing or low SpO2 is more important than cough. I’m having trouble judging this, partly because Meyerowitz-Katz says ivmmeta has corrected some earlier mistakes, and partly because there really is some reasonable debate over how to judge studies with lots of complicated endpoints. By this point I had completely forgotten what ivmmeta did, so I independently coded all 11 remaining studies following something in between my best understanding of their procedure and what I considered common sense. The only exception was that when the most severe outcome was measured in something other than patients (ie average number of virus copies per patient), I defaulted to one that was measured in patients instead, to keep everything with the same denominator. My results mostly matched ivmmeta’s, with one or two exceptions that I think are within the scope of argument or related to my minor deviations from their protocol. Placebo vs. ivermectin groups sometimes differed in size, which I’ve adjusted for and rounded off. Probably I’m forgetting some reason I can’t just do simple summary statistics to this, but whatever. It is p = 0.15, not significant. This is maybe unfair, because there aren’t a lot of deaths in the sample, so by focusing on death rather than more common outcomes we’re pointlessly throwing away sample size. What happens if I unprincipledly pick whatever I think the most reasonable outcome to use from each study is? I’ve chosen “most reasonable” as a balance between “is the most severe” and “has a lot of data points”: Now it’s p = 0.04, seemingly significant, but I had to make some unprincipled decisions to get there. I don’t think I specifically replaced negative findings with positive ones, but I can’t prove that even to myself, let alone to you. [UPDATE 5/31/22: A reader writes in to tell me that the t-test I used above is overly simplistic. A Dersimonian-Laird test is more appropriate for meta-analysis, and would have given 0.03 and 0.005 on the first and second analysis, where I got 0.15 and 0.04. This significantly strengthens the apparent benefit of ivermectin from ‘debatable’ to ‘clear’. I discuss some reasons below why I am not convinced by this apparent benefit.] (how come I’m finding a bunch of things on the edge of significance, but the original ivmmeta site found a lot of extremely significant things? Because they combined ratios, such that “one death in placebo, zero in ivermectin” looked like a nigh-infinite benefit for ivermectin, whereas I’m combining raw numbers. Possibly my way is statistically illegitimate for some reason, but I’m just trying to get a rough estimate of how convinced to be) So we are stuck somewhere between “nonsignificant trend in favor” and “maybe-significant trend in favor, after throwing out some best practices”. This is normally where I would compare my results to those of other meta-analyses made by real professionals. But when I look at them, they all include studies later found to be fake, like Elgazzar, and unsurprisingly come up with wildly positive conclusions. There are about six in this category. One of them later revised their results to exclude Elgazzar and still found strong efficacy for ivermectin, but they still included Niaee and some other dubious studies. The only meta-analysis that doesn’t make these mistakes is Popp (a Cochrane review), which is from before Elgazzar was found to be fraudulent, but coincidentally excludes it for other reasons. It also excludes a lot of good studies like Mahmud and Ravakirti because they give patients other things like HCQ and azithromycin - I chose to include them, because I don’t think they either work or have especially bad side effects, so they’re basically placebo - but Cochrane is always harsh like this. They end up with a point estimate where ivermectin cuts mortality by 40% - but say the confidence intervals are too wide to draw any conclusion. I think this basically agrees with my analyses above - the trends really are in ivermectin’s favor, but once you eliminate all the questionable studies there are too few studies left to have enough statistical power to reach significance. Except that everyone is still focusing on deaths and hospitalizations just because they’re flashy. Mahmud et al, which everyone agrees is a great study, found that ivermectin decreased days until clinical recovery, p = 0.003? So what do you do? This is one of the toughest questions in medicine. It comes up again and again. You have some drug. You read some studies. Again and again, more people are surviving (or avoiding complications) when they get the drug. It’s a pattern strong enough to common-sensically notice. But there isn’t an undeniable, unbreachable fortress of evidence. The drug is really safe and doesn’t have a lot of side effects. So do you give it to your patients? Do you take it yourself? Here this question is especially tough, because, uh, if you say anything in favor of ivermectin you will be cast out of civilization and thrown into the circle of social hell reserved for Klan members and 1/6 insurrectionists. All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele. But good doctors aren’t supposed to care about such things. Your only goal is to save your patient. Nothing else matters. I am telling you that Mahmud et al is a good study and it got p = 0.003 in favor of ivermectin. You can take the blue pill, and stay a decent respectable member of society. Or you can take the horse dewormer pill, and see where you end up. In a second, I’ll tell you my answer. But you won’t always have me to answer questions like this, and it might be morally edifying to observe your thought process in situations like this. So take a second, and meet me on the other side of the next section heading. … … … … … The Synthesis Hopefully you learned something interesting about yourself there. But my answer is: worms! As several doctors and researchers have pointed out (h/t especially Avi Bitterman and David Boulware), the most impressive studies come from places that are teeming with worms. Mahmud from Bangladesh, Ravakirti from East India, Lopez-Medina from Colombia, etc. Here’s the prevalence of roundworm infections by country (source). But alongside roundworms, there are threadworms, hookworms, blood flukes, liver flukes, nematodes, trematodes, all sorts of worms. Add them all up and somewhere between half and a quarter of people in the developing world have at least one parasitic worm in their body. Being full of worms may impact your ability to fight coronavirus. Gluchowska et al write: Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases. Treatment of worm infections might reduce the negative effect of COVID-19! And ivermectin is a deworming drug! You can see where this is going… The most relevant species of worm here is the roundworm Strongyloides stercoralis. Among the commonest treatments for COVID-19 is corticosteroids, a type of immunosuppresant drug. The types of immune responses it suppresses do more harm than good in coronavirus, so turning them off limits collateral damage and makes patients better on net. But these are also the types of immune responses that control Strongyloides. If you turn them off even very briefly, the worms multiply out of control, you get what’s called “Strongyloides hyperinfection”, and pretty often you die. According to the WHO: The current COVID-19 pandemic serves to highlight the risk of using systemic corticosteroids and, to a lesser extent, other immunosuppressive therapy, in populations with significant risk of underlying strongyloidiasis. Cases of strongyloidiasis hyperinfection in the setting of corticosteroid use as COVID-19 therapy have been described and draw attention to the necessity of addressing the risk of iatrogenic strongyloidiasis hyperinfection syndrome in infected individuals prior to corticosteroid administration. Although this has gained importance in the midst of a pandemic where corticosteroids are one of few therapies shown to improve mortality, its relevance is much broader given that corticosteroids and other immunosuppressive therapies have become increasingly common in treatment of chronic diseases (e.g. asthma or certain rheumatologic conditions). So you need to “address the risk” of strongyloides infection during COVID treatment in roundworm-endemic areas. And how might you address this, WHO? Treatment of chronic strongyloidiasis with ivermectin 200 µg/kg per day orally x 1-2 days is considered safe with potential contraindications including possible Loa loa infection (endemic in West and Central Africa), pregnancy, and weight <15kg. Given ivermectin’s safety profile, the United States has utilized presumptive treatment with ivermectin for strongyloidiasis in refugees resettling from endemic areas, and both Canada and the European Centre for Disease Prevention and Control have issued guidance on presumptive treatment to avoid hyperinfection in at risk populations. Screening and treatment, or where not available, addition of ivermectin to mass drug administration programs should be studied and considered. This is serious and common enough that, if you’re not going to screen for it, it might be worth “add[ing] ivermectin to mass drug administration programs” in affected areas! Dr. Avi Bitterman carries the hypothesis to the finish line: First two images are with all relevant studies; second two are a sensitivity analysis that removes some of the most dubious. The good ivermectin trials in areas with low Strongyloides prevalence, like Vallejos in Argentina, are mostly negative. The good ivermectin trials in areas with high Strongyloides prevalence, like Mahmud in Bangladesh, are mostly positive. Worms can’t explain the viral positivity outcomes (ie PCR), but Dr. Bitterman suggests that once you remove low quality trials and worm-related results, the rest looks like simple publication bias: This is still just a possibility. Maybe I’m over-focusing too hard on a couple positive results and this will all turn out to be nothing. Or who knows, maybe ivermectin does work against COVID a little - although it would have to be very little, fading to not at all in temperate worm-free countries. But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong! The people who called it a miracle drug against COVID were wrong. The people who dismissed all the studies because they F@#king Love Science were wrong. Ivmmeta.com was wrong. Gideon Meyerowitz-Katz was…well, he was right, actually, I got the worm-related meta-analysis graphic above from his Twitter timeline. Still, an excellent troll. Also, the best part is that I ignorantly asked, in my description of Mahmud et al above: And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true! The Scientific Takeaway About ten years ago, when the replication crisis started, we learned a certain set of tools for examining studies. Check for selection bias. Distrust “adjusting for confounders”. Check for p-hacking and forking paths. Make teams preregister their analyses. Do forest plots to find publication bias. Stop accepting p-values of 0.049. Wait for replications. Trust reviews and meta-analyses, instead of individual small studies. These were good tools. Having them was infinitely better than not having them. But even in 2014, I was writing about how many bad studies seemed to slip through the cracks even when we pushed this toolbox to its limits. We needed new tools. I think the methods that Meyerowitz-Katz, Sheldrake, Heathers, Brown, Lawrence and others brought to the limelight this year are some of the new tools we were waiting for. Part of this new toolset is to check for fraud. About 10 - 15% of the seemingly-good studies on ivermectin ended up extremely suspicious for fraud. Elgazzar, Carvallo, Niaee, Cadegiani, Samaha. There are ways to check for this even when you don’t have the raw data. Like: The Carlisle-Stouffer-Fisher method: Check some large group of comparisons, usually the Table 1 of an RCT where they compare the demographic characteristics of the control and experimental groups, for reasonable p-values. Real data will have p-values all over the map; one in every ten comparisons will have a p-value of 0.1 or less. Fakers seem bad at this and usually give everything a nice safe p-value like 0.8 or 0.9.
February 01, 2022 · Original source
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heart disease

heart disease is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between December 02, 2021 and July 12, 2024. The archive places it in contexts such as "researching cures for ... heart disease"; "five genes influencing 20% of heart disease risk". It most often appears alongside Australia, 1980s, 1989.

Article page
heart disease
Mention count
2
Issue count
2
First seen
December 02, 2021
Last seen
July 12, 2024
December 02, 2021 · Original source
But his second argument is: we put a lot of time and money into researching cures for cancer, heart disease, stroke, Alzheimers’, et cetera. Progress in these areas is bought dearly: all the low-hanging fruit has been picked, and what’s remaining is a grab bag of different complicated things - lung cancer is different from colon cancer is different from bone cancer.
The easiest way to cure cancer, Sinclair says, is to cure aging. Cancer risk per year in your 20s is only 1% what it is in your 80s. Keep everyone’s cells as healthy as they are in a 20-year-old, and you’ll cut cancer 99%, which is so close to a cure it hardly seems worth haggling over the remainder. As a bonus, you’ll get similar reductions in heart disease, stroke, Alzheimers, et cetera.
And also, even if we succeed at curing cancer, it will barely matter on a population level. If we came up with a 100% perfect cure for cancer, average US life expectancy would increase two years - from 80 to 82. Add in a 100% perfect cure for heart disease, and you get 83. People mostly get these diseases when they are old, and old people are always going to die of something. Cure aging, and the whole concept of life expectancy goes out the window.
July 12, 2024 · Original source
(This report was, as it happens, published in the exact same month as The Family That Couldn’t Sleep.) DTM came to know the family well. He befriended them by way of two members of their younger generation, Lisi – a woman terrified by the shadow of the disease, and Ignazio – the doctor she had married, who was more terrified by the shadow of the disease. Ignazio put together the pieces of the family puzzle, consolidating all the disparate diagnoses into a single disorder and filling out a lot of blank spots on family trees. When DTM came along, he was able to help Ignazio make the case that the family would benefit from the spotlight – that greater awareness of FFI could lead to a cure both for them and for a slew of other prion diseases. As it so happens, he is one of those nonfiction authors who serve as a character in their own story. DTM has some form of progressive muscular palsy. He is, or at least was in 2006, not entirely sure what it is. The relatively unimpressive state of genetics at the time had not identified his causative mutation, though it looked a lot like one of the rarer forms of Charcot-Marie-Tooth disease2. DTM is pragmatic about this, the way everyone chronically ill is either pragmatic or doomed. Whatever he has, it is a defect in protein structure; his peripheral nerves decay not because of a problem with the nerves themselves but an inability of their scaffolding to hold them together, as he puts it. The last chapter of the book dwells on this, on the web of connections popping up between a thousand disorders. DTM’s disease is something vaguely similar, if you squint, to an exceptionally slow-progressing motor neurone disease; if you jump another level out, you see amyloid plaque diseases like Huntington’s and Alzheimer’s, and if you jump yet another level out, you see something like prions. His interest in the Venetian family was driven by this. Some of its members thought this a beautiful act of sympathy; others thought him a grotesque parody of themselves, an onlooker, a gawker, peddling their tragedy to salve his relatively insignificant problems. They are, he thinks, both right. That’s the beginning, and that’s the end. What happens in the middle? --------------------------------------------------------- The Venetian family lends the book its title, but they’re really more of a framing device. The Family That Couldn’t Sleep is separated into four parts, of which the first and fourth – the shortest by far – deal with the family. Part 2 is kuru, the king of fucked up diseases you read about in clickbait Weird Medicine listicles. Let’s talk about kuru! Kuru, is, famously, the prion disease you get if you eat another person’s brain. Well, not quite. It’s a prion disease that became endemic amongst women in the Fore society, who ritually ate brains, one of which had an inherited or spontaneous prion disease. This is an important note – there’s a tendency (which the book’s later chapters engage in) to assume cannibalism just has a Prion Disease Generator attached. If you eat people who don’t have prion diseases, you won’t suddenly get one. Uh, don’t eat people. Anyway, part 2 is DTM’s historiography of Fore-Westerner first contact. It’s hilarious. Papua New Guinea is a frankly ridiculous place; one of the all-time best Lyttle Lytton winners (worst first sentence from a hypothetical or, in this case, real work) was “Papua New Guinea is so violent that more than 820 languages are spoken there”. The native residents were so hostile to outsiders that all the colonial empires had cut their losses – and when you think about the places they colonized, that says something. After the First World War, PNG was ripped from its nominal German ‘owners’, but no one else wanted the place. So, of course, they gave it to the Australians. It was thirty years and another war before we actually made contact. 1940s Australia was as ‘settled’ as it’d ever be; the cities were bustling and the interior was mapped. The kind of explorer who two centuries before would be heading to new continents had to console himself with Pacific islands. Console he did. The native peoples of the PNG coasts were hostile enough to the wannabe-colonialists that the Australians, flying planes overhead, were the first people to discover that the island’s inland was populated too. No one had broken through on land. In all this deep and angry rainforest, the Fore were the furthest out. They lived far into the island’s mountainous interior; DTM describes their territory as “nearly vertical”. Calling people primitives is a bit passe these days for understandable reasons, but no other term comes to mind. The Fore had no name for themselves; we call them by an exonym, “the people to the south”. They weren’t, to be clear, hunter-gatherers – they were slash-and-burn agriculturalists, but very well-fed ones. Despite the tendency in grain-focused cultures for poor agriculturalists to be stunted/malnourished, the Fore were a remarkably healthy people. Well, except for the famous bit. The first remarkable thing about the Fore was just how quickly they wanted to assimilate. Most PNG tribes weren’t particularly enthused by Western offers of injections/tractors/radios/Christianity. Yet as soon as the Australians arrived, the Fore made ceasefires in their wars with other tribes, volunteered to help large-scale Australian projects on the coast, started planting and trading coffee, and enthusiastically participated in censuses. It’s the only first-contact narrative I’ve seen where the colonizers were concerned about how badly the other guys wanted to be colonized. The next was the one that got their names in the history books. Australian officials started to notice a remarkable lack of women in Fore camps. Some tribes sequestered their women, particularly when Westerners were around, so at first they thought nothing of it. The high rate of unpartnered young men, though, was way out of PNG norms. DTM tells this part fantastically. The Fore chapters drip with the dread of dramatic irony. When the first breakthrough comes, you have to catch your breath: “Tiny” Carey noted something in the middle of August 1950 that deepened this mystery. He noticed that near the village of Henganofi there had been an unusual number of deaths. “It appears,” he wrote his superiors, “natives suffer from stomach trouble, get violent shivering, as with the ague, and die fairly rapidly.” [...] McArthur investigated a little more [...] One day in August 1953 he ran into more of the shivering people Tiny Carey had seen several years before: “Nearing one of the dwellings, I observed a small girl sitting down beside a fire. She was shivering violently and her head was jerking spasmodically from side to side.” It would be quite some time before anyone figured out what caused it – but the problem, as DTM notes, was that its cause wasn’t possible. Everyone priored that the weird undescribed disease in the Fore lands was some nocebo sorcery-sickness. Vincent Zigas, the first actual doctor sent to work with the Fore, tried to placebo-effect them and failed miserably: On the way, Apekono stopped at a hut and showed Zigas his first kuru victim. “On the ground in the far corner sat a woman of about thirty,” the doctor wrote. “She looked odd, not ill, rather emaciated, looking up with blank eyes with a mask-like expression. There was an occasional fine tremor of her head and trunk, as if she were shivering from cold, though the day was very warm.” It was almost exactly the tableau McArthur had witnessed in 1953. Zigas, though, was a doctor. He could do more than look—or so he thought: “I decided I might as well try my own variety of magic,” he remembered. He rubbed Sloan’s Liniment, a balm for sore muscles, on her and declared to her family and his guide: “The sorcerer has put a bad spirit inside the woman. I am going to burn this spirit so that it comes out of her and leaves her. You will not see the fire, but she will feel it. The bad spirit will leave her and she will not die.” The lotion penetrated the woman’s skin and she writhed in pain. “Get up! Walk!” Zigas commanded theatrically. “The woman struggled feebly as if to rise, then, exhausted, started to tremble more violently, making a sound of foolish laughter, akin to a titter.” That evening Apekono asked Zigas not to try to cure any more kuru victims; “Don’t use your magic medicine anymore. It will not win our strong sorcery.” This was a disaster. The Fore were so cooperative precisely because they hoped “Western magic” could conquer theirs. As it became clear it couldn’t, they turned hostile. The Australians had hoped to “modernize a Stone Age people”; now all their subjects were dropping dead before their eyes, from what they could only assume was a “hysterical reaction” to colonization itself. So, to solve this, they needed a batshit insane American. Carleton Gajdusek is one of the characters who dominates The Family That Couldn’t Sleep. He couldn’t not. You could put him in a car commercial and he’d dominate it. Gajdusek was a physician with a rare, intense combination of science and practice. He was a romanticist, a field worker, and a lover of everything strange. He’d been an army doctor, a government conspiracy-cover-upper, and a postdoc under Linus Pauling who described his intent as “to straighten out Pauling’s ideas about proteins”. He hated civilization, in a slightly-to-Ted’s-centre sense, and was passionate about “primitives and isolates”. He jumped at the chance to work in Papua New Guinea; he planned to conduct a multi-site study on child development in such cultures, and relished the opportunity to live in a “primitive” environment himself. He did all this so he could rape kids. Oh, he did it for the scientific curiosity and love of medicine, but he also did it so he could rape kids. Gajdusek was a pedophile in the actual-lifelong-exclusive-paraphilia sense, as opposed to the “metonym for child molester” sense. Some people who roll snake-eyes on the Sexuality Dice repress it, but some are perfectly happy to act on it; Gajdusek was #2 in its fullest form, the kind of guy who believes that a well-lived life includes raping some kids. DTM doesn’t shy from this, not for a moment. It’s the first thing he tells you about Gajdusek. It couldn’t not be; you couldn’t talk about why he went to PNG otherwise. When Gajdusek landed in PNG, he first found the place too civilized. He’d been promised a land of “cannibal savages” – where were they? After some traipsing, he found them, right where he was promised. The Fore were perfect for Gajdusek. They had some kind of medical mystery that’d been lost on everyone else. They ate each other, in exactly the way he loved detailing in his diaries (“”Women and children, particularly, partake of the human flesh,” he noted with pleasure”). As kuru cases popped up, he aggressively recorded them. He wrote lovingly detailed notes that he sent back to his Australian advisor. He wrote with intensity, with exclamation marks, with the joie de vivre of a man just where he wanted to be. Gajdusek smothered the Fore with ‘cures’ that never worked, but they didn’t get angry at him. As DTM dryly puts it: “Their children trusted him, and that was enough for them.” At some point, someone suggested sending an anthropologist...or an epidemiologist...or literally anyone with more credentials than Gajdusek and Zigas3. Gajdusek threw a shitfit, convinced this one-and-a-half-man team was enough to Solve The Problem Forever. But he got bored eventually – running off with another tribe with, as his diary notes at length, an apparent custom of youths ritually fellating older men – and Zigas, I dunno, the book neglects him a bit here. So they managed to sneak in some anthropologists. The husband-and-wife team of Robert Glasse and Shirley Lindenbaum4 were the first involved parties to give a shit about the Fore as people, rather than as colonial subjects/medical mysteries/walking sex toys. What they uncovered was fascinating. The Fore were cannibals, yes, but they were recent cannibals. They didn’t have an ancient tradition of eating their dead, like the other visitors assumed. They happened to be in contact with some cannibal groups, and after a Fore man died of “sorcery”, they thought: well, what would happen if we ate him? “People tasting it expressed their approval. ‘”This is sweet,” they said, “What is the matter with us, are we mad? Here is good food and we have neglected to eat it.”” If not for the wild coincidence that the first Fore cannibalism victim had a prion disease, kuru would never have existed. Glasse and Lindenbaum started to put together the pieces. They’d been sent down to rule out a genetic explanation – to track the kinship ties of the Fore and see how the disease ran through families. It didn’t run through families in any coherent sense, but it sure did run through cannibalism. The clincher was the age distribution. The Fore, ever enthused by colonialism, quit eating each other as soon as the Australians arrived. Children stopped dying of kuru shortly after; they simply weren’t exposed to the infectious agent. The couple sent the news to Gajdusek, who was off raping kids somewhere else. In the next part of the book, DTM runs through Gajdusek’s many conjectures of kuru’s cause – more like sketches or abstract paintings than like true hypotheses. Gajdusek was annoyed that someone else was doing something he “totally could’ve done”, and even more annoyed that another lab was running similar experiments – an attempt at a vaccine for a particular sheep disease had accidentally created a prion generator. But he was happy to swoop in and claim the credit for what he was starting to think of as “slow viruses”, an infection that somehow lays dormant for years. DTM portrays Gajdusek perfectly, in that “real life has no need for verisimilitude” way. Gajdusek was at once a brilliant man, an all-consuming narcissist, an entertaining character, and a monster beyond redemption. A lesser book might pick one or two. The Family That Couldn’t Sleep portrays him as all four, and on a personality level (as opposed to a scientific one), the Gajdusek-focused parts are some of the most gripping. --------------------------------------------------------- Outside of the jumps between the Venetian family and everything else, The Family That Couldn’t Sleep is not siloed. The narratives of all prion diseases are deeply intertwined. This is what makes it a great book. It’s 300 pages of dramatic irony. You read the whole thing, waiting for the eureka moment – the point everyone realizes they’re looking at the same cause. It does, however, make it a tad difficult to review or synopsize. The book’s story is so weird – and, often, so at odds with conventional wisdom that trickles down about the Fore et al – that you have to recap quite a bit, and the book steadfastly resists recapping. The next couple chapters after we depart from Gajdusek’s credit-claiming are mostly about experiments with various prion diseases. They’re scientifically fascinating. Unlike some medical-books-for-general-audiences (cough, How Not to Study a Disease), DTM never talks down to the reader. He assumes someone reading a 300-page book about prions is smart and wants to learn about prions. He also has – you can feel it in his words – the agonizing experience of spending his life on the other side of the doctor’s desk, trying to beat into whoever he’s talking to that no, seriously, you don’t need to lie to him or try explain a complex disease at a fourth-grade level. The first prion disease studied was scrapie. Scrapie was a big deal – it starved and killed large shares of British sheep flocks, making it a serious economic problem. Veterinary researchers had tried to prevent or cure it for centuries. It was a veritable graveyard of ambitions: Quintessential was D. R. Wilson at the Moredun Institute in Scotland, who worked in the middle of the last century for more than a decade trying, with mounting frustration, to kill the scrapie agent. He found that it survived desiccation; dosing with chloroform, phenol, and formalin; ultraviolet light; and cooking at 100 degrees centigrade for thirty minutes. The scrapie researcher Alan Dickinson told me he remembered Wilson at the end of his career as “very, very, very quiet. Of course, that was after his breakdown.” “Now it is our turn to study prions. Perhaps we should approach the subject cautiously.” The problem, as DTM explains, is that prion diseases were impossible. They violated 20th-century understandings of biology. Proteins “were no more alive, and no more infectious, than bone”. Prion diseases seemed to have too many causes – genetic, infectious, and sporadic. They looked infection-like in some ways, but patients didn’t produce virus antibodies. Sheep exposed to scrapie, or chimps infected with kuru, took years to develop symptoms. Their facts did not fit together. In the 1960s, people started wondering. The unifying trait of prion agents was that they had to be denatured to be destroyed. Was this a particularly small virus defined by its protein coating? Or – even more outre – was it pure protein, no DNA at all? No one could figure out quite how the latter worked, but it was tempting. Gajdusek, by now a major figure in this field, kept a foot in both worlds. He didn’t want to stake his reputation on a no-DNA hypothesis, but he certainly sympathized. Enter Prusiner. Stanley Prusiner was Gajdusek’s counterpart. Where Gajdusek seemed permanently manic, Prusiner was deliberate and exacting. He entered Gajdusek’s “slow viruses” field in the early 1970s after a chance encounter with a CJD patient. He relished the laboratory in a way Gajdusek didn’t at all, and set out to optimize the hell out of his projects. Prusiner set out to isolate the smallest infectious particle in the scrapie agent. He injected tons of hamsters (hamsters got sick faster than mice) with increasingly tiny scrapie proteins, hoping to determine whether the Minimum Viable Scrapie was DNA. By the mid-1980s, he’d produced something so small it couldn’t possibly be a virus. Denaturing it destroyed it; exposing it to nucleic acid dissolvers actually made it stronger. Emboldened by this discovery, Prusiner set out to anoint himself the King of Prions. Here emerges something of a Voldemort-Umbridge distinction – the difference between cartoonish villainy and banal evil. Gajdusek is a bad guy because he rapes kids. Prusiner is a bad guy because he is the most grotesque stereotype of the Advisor/Peer Reviewer from Hell made flesh. Everything Prusiner did was to build his reputation atop a pile of skulls. When recruited as a peer reviewer for other prion papers, he wrote negative reviews to undermine their authors. He worked his grad students to the bone and intentionally destroyed their careers, telling them he’d “ruin them” if they entered prion research as competitors. He lied about the origin of the protein-only hypothesis, claiming he originated it a decade after it was actually conjectured. But hey, he was good at getting grants. I was surprised reading a lot of this, because for all the time I’ve been aware of it, the cause of prion disease has seemed settled. “Oh yeah, it’s a protein that gets all fucked up.” But DTM goes through just how unsettled it was right up through to The Family That Couldn’t Sleep’s publication. Serious confirmation only arrived a couple years later. Many people were deeply critical of the prion hypothesis – often, it seemed, because they loathed Prusiner too much to go along. Throughout the book, he cuts an uncharismatic figure. Gajdusek and Prusiner both won the Nobel for discovering prions, decades apart. This tells you something – the “discovery” of prions can be construed quite a few ways. Gajdusek formulated the hypothesis; Prusiner proved it. Gajdusek was grievously offended by Prusiner’s Nobel, perceiving his rival – not inaccurately – as a follower who never originated any ideas of his own. But Gajdusek was offended from a federal prison cell, so how’d that work out for him? Fascinating as all this is, no one published a book about prions in the mid-2000s because it was about kuru or FFI. They published books about prions because teenagers were dying, and people wanted to know why. DTM lays the seeds for part 3 – the mad cow section – in part 1. This is a discussion of scrapie, the longstanding prion disease of sheep. Scrapie was a medical mystery for centuries (remember poor D. R. Wilson), precisely because of the intuitive implausibility of prions. The scrapie chapter is a great history-of-science piece, covering the agricultural productivity revolutions of the 18th century, the surfeit of bizarre origins veterinarians concocted, and the treatments that never worked. Scrapie is not transmissible to humans – well, we hope. It’s concerningly transmissible to primates. But it’s been around for a long, long time, and it doesn’t epidemiologically look like humans get it...we hope. Anyway, you ever tried to generalize from one example? The British government did! In the mid-1980s, strange reports started coming out of the UK’s farms. Farmers were describing a new disease where dairy cows – incredibly docile creatures, under normal circumstances – turned hostile, kicking them as they went into the milking stalls. The symptoms looked to all the world like scrapie. Epidemiologists tracing the outbreaks found a unifying link with “cake” – animal protein feed sweetened with molasses. The scrapie-like symptoms must have traced to an infected sheep. But scrapie doesn’t transmit to humans, so it must be okay to keep slaughtering them, right? We all know how this ended. The best term for the British response to the mad cow outbreak is “cacklingly evil conspiracy”. The agricultural industry really, really didn’t need a huge zoonotic outbreak – so it decided it didn’t have one. They first suppressed all mentions that the disease looked like scrapie, then – when this became impossible – hyped up that scrapie doesn’t transmit to humans, so there’s nothing to worry about. The formal name of the disease, “bovine spongiform encephalopathy”, was supposedly chosen to optimize for unfamiliarity – it wouldn’t fit well in a headline. They emphasized, extensively, that there was nothing to worry about. Ever. At some point, people started asking questions. If there was nothing to worry about, why was the agricultural industry panicking so hard? As things became ever more worry-inducing, this turned down ludicrously twisting paths: Meanwhile, the Southwood Working Party and the experts who advised it were learning on the job. They learned, for instance, that the BSE agent entered the animal through the mouth and then followed the digestive tract into the organs that try to filter out infections—the tonsils, the guts, and the spleen—and from there traveled into the peripheral and central nervous system, and finally arrived at the brain. They also learned that pasties, meat pies, and even some baby foods contained tissues from a lot of those organs. So the Southwood Working Party recommended banning these organs, but only from baby food. This started a chain reaction of consumer doubt: if infected cow organs were unsafe for babies, how could they be good for adults? The government then banned offal, as the organs were collectively called, in all human food but gave the industry a grace period to get it out of the feed supply. Then pet food manufacturers began to wonder if what drove cows mad might not also drive dogs, cats, and parrots mad. The feed they sold came from concentrate made of the same sick animals that had previously made up the meat and bone meal farmers used. Their trade group decided to put a similar ban in place—immediately. So for five months it was safer to be a dog than a human in Britain. DTM spends pretty much this whole section of the book making fun of the British government. To be fair, they deserved it. They killed hundreds of kids in agonizing and preventable ways – they could take some ribbing. This is all throughout the mid-1980s to early-mid 1990s. Through this period, it wasn’t yet clear that mad cow could spread to humans. The panic was clear, and deserved, but it didn’t yet have a match for its powder keg. It would alight. The first suspected case of vCJD – human mad cow – was in 1994. Fifteen-year-old Vicky Rimmer developed a sudden, strange disease. Doctors gave her months to live...until she died in 1998. A couple other suspected cases trickled down through the mid-90s, including a young man who made meat pies for a living, whose grieving mother received a letter from the Prime Minister that “humans do NOT get mad cow disease”. (That must’ve been fun.) Soon, they couldn’t deny it any longer. On March 20, 1996, Stephen Dorrell, the health secretary, stood up in Parliament to announce the news that had already appeared as a tentative conclusion in scientific journals and as rumor in newspapers for the previous two years: British beef was killing British teenagers. The first confirmed death was that of Stephen Churchill, a nineteen-year-old student from Wiltshire, who died in May 1995. Back in 1989, at the Southwood Working Party’s suggestion, the government had set up a surveillance unit in Edinburgh to watch for any evidence that BSE had crossed to humans. One worry had been that if BSE passed to humans, how would anyone know it? How would you recognize something you had never seen? It turned out to be easy: Churchill and the nine other teenagers who had gotten sick had spectacular amyloid plaques in their brains, chunks of dead protein almost visible to the naked eye. If sporadic CJD was a whisper, BSE-caused prion disease was a shout. The investigators sat open-mouthed looking at slides whose damage, they feared, portended the most severe epidemic in modern British history. This part of the book is not fun. It lacks the insane personalities and duelling careers of the other entries. It is an honest chronology of the vCJD epidemic – a gruesome failure of the agricultural industry, the one system that everyone is vulnerable to. The government and industry had completely violated their duty of care to citizens and consumers. They were paying the price. No one would buy British beef anymore – not while they watched their children die. Now here’s the thing: this is ethnography, not historiography. The Family That Couldn’t Sleep is a book from the mid-2000s. The epidemic was not at all in the rear view mirror. There were piles of unanswered questions that DTM constantly alludes to. We have eighteen years more hindsight than he did then. What do we know now? --------------------------------------------------------- In 2006, the vCJD epidemic looked like it was going to be a lot better than the worst fears. BSE itself was a huge problem for the cattle industry, but honestly, no one is too sympathetic to the cattle industry. People were not going to die in anywhere near the numbers believed. We had all sorts of reassuring data coming out about this, which DTM chronicles. We were learning that only some genotypes seemed susceptible to vCJD. We didn’t see any older people die of the disease. We were seeing numbers drop, such that vCJD must have a pretty short incubation period. Anyway, all of this is wrong! The Family That Couldn’t Sleep was written in the candidate gene era. Back then, the nascent field of human genetics was sure it was about to Solve Polygenism. Yes, the simple Mendelian monogenic patterns popular a few decades back clearly didn’t apply to common diseases, but how many variants could there be? We were about to discover the five genes influencing 20% of Alzheimer’s risk each, the five genes influencing 20% of heart disease risk each, etc., and once we were done we’d just do gene therapy and cure Alzheimer’s. A paper on autism genetics from 1999 was so outre as to speculate there might be as many as fifteen genes involved. The fact we are now using the term “omnigenic model” should tell you roughly how well this worked out. Do you remember SNPedia? If you were a 2014 Slate Star Codex reader, you might. 2014 was still pretty candidate gene. People were out there publishing papers saying a single variant could increase your life expectancy by 15 years. SNPedia was a site that beautifully categorized all of these, so you could do 23andme or whatever, look up your results on SNPedia, and make horrible life choices.5 It was eventually bought out by one of the consumer DNA companies, so no one ever edited it again, making it a great time capsule of early-mid 2010s behavioural/medical genetics takes. SNPedia will excitedly explain to you that common genetic variants make you immune to vCJD. They cite a 2009 post from the now-archived 23andme blog titled “No Good Evidence That Potential Pool of Mad Cow Disease Victims Is Expanding”, explaining how fears of late-onset vCJD are clearly debunked by new Scientific Knowledge. Everyone who developed vCJD in the 1990s and 2000s had an M/M genotype in a particular part of the PRNP prion gene, so the roughly half the population with M/V or V/V genotypes were immune. The Family That Couldn’t Sleep buys this, too. In fact, it buys it in an even more agonizingly 2000s way. The first sign that transmissible prion diseases weren’t genotype-restricted should’ve been the growth hormone kids. You might have heard this story – from the late 1950s through mid-1980s, human growth hormone produced from brain tissue was used as a treatment for pituitary dwarfism, until it turned out to spread CJD if the originating brain was infected. DTM discusses this, to set the scene for the genetics thing. He mentions what was the state of the art at the time – that a disproportionate share of both the growth hormone kids and sporadic CJD cases were V/V homozygotes. This, uh – so the book was written in the mid-2000s, yeah? Yeah. The conclusion DTM drew – and this was a common conclusion at the time – was that homozygosity somehow made you more vulnerable to CJD, and M/M homozygosity made you vulnerable to BSE-borne CJD in particular. We cannot criticise the author for not predicting the future, but we live in the future, and can say how this worked out. Turns out, nope, M/V heterozygotes totally get vCJD. After a British man in his 30s died of CJD in 2016, he was found to have vCJD and an M/V genotype. He was tested for vCJD only because he was exceptionally young for someone with a sporadic prion disease – meaning people developing it later in life would be missed6. Did you know up to 1 in 2000 people in the UK have latent vCJD? There is one line in The Family That Couldn’t Sleep that stopped me dead in my tracks when I read it: What happens to the Italian family in the end depends less on their own actions than on the world’s interest in prion diseases, which they cannot control. If lots of people are afraid of getting variant CJD, the family benefits. If fear of prion disease goes the way of the fear of swine flu or Ebola, then they will be orphaned again. THIS BOOK IS FROM 2006! Three years before the swine flu pandemic! Eight years before the Ebola pandemic! “If you’re looking for a sign, this is it.” --------------------------------------------------------- The last section of The Family That Couldn’t Sleep addresses BSE fears in America and a nascent internet subculture DTM calls “Creutzfeldt Jakobins” – people who track American CJD cases, trying to spot vCJD patterns. When reading his description of the Creutzfeldt Jakobins, my mind constantly, uncontrollably turned to covid. Here it was – an online community of people deeply skeptical about a disease’s official story, tracking every contradiction, every implausibility, every statistic that failed to apply to the individual. Self-described “redneck hippies” and “soccer mom Republicans” teaming up to find the truth hidden behind an impossible world. You know what they’re doing now. I’ve always combined a deep interest in medicine with a healthy distrust for it. People who are constitutionally inquisitive, anti-authoritarian, and suspicious about official narratives tend to end up skeptical of at least some mainstream claims in the field. This is not to say I think you should take bleach enemas or something, just that I understand the impulse behind concluding the US government was covering up a local vCJD wave. Traditionally, sporadic prion diseases are said to have a prevalence of one in a million. (Hold on to that for a second.) The last section of the book is a chronology of Americans finding bizarrely more than one in a million of their friends dying of sporadic CJD, often at inexplicably young ages, sometimes in geographical clusters. This is understandably suspicious. Then DTM goes on to reassure us by saying none of these cases were confirmed to have an M/M genotype, which OH GOD OH FUCK A number of high-profile people in the prion world, including Gajdusek, are clarified as not believing sporadic prion diseases exist. You get the impression DTM doesn’t, either. Now, how common are prion diseases? Eric Vallabh Minikel has an answer for you! Eric and his wife Sonia are prion researchers from a rather unique background – after Sonia was diagnosed as having a single-gene mutation with ~100% penetrance for prion disease, they left their previous jobs to dedicate their lives to curing it. It turns out, when you run the numbers, you get not one in a million but 1 in 5000 people dying of prion diseases. This is best described as “nightmarishly high”. I’m normed on genetic disorders. A genetic disorder that affects one in five thousand people is pretty common! I have known, in person, completely unselected, just from “random people I’ve met in my life in a non-medical context”, someone with a ~1/250k syndrome and someone with a ~1/50k-100k syndrome. I don’t think anyone in my extended family knows someone who died of a prion disease. I feel like it would’ve come up if they did! Prion diseases have distinctive phenotypes. Not distinctive enough, apparently, to avoid a lot of CJD being misdiagnosed as Alzheimer’s – but diagnosis is consistently insane. Something DTM reiterates throughout The Family That Couldn’t Sleep is just what prion dementia looks like. The characteristic dementia in prion diseases spares something – “self” or “recognition” or “reflection” – that is not spared by Alzheimer’s, or by most common dementias. Shouldn’t this be, uh, noticeable?7 They kill rapidly, often over the course of months, and often onset in midlife. ALS shares this pattern and is way, way more common than prion diseases; you hear about ALS far more in the “disorder people actually have” sense. What am I missing here? Anyway: 1 in 2000 prevalence of latent vCJD in the UK + extreme lack of clarity over whether scrapie is human-transmissible + blood donations spread vCJD + sporadic CJD prevalence keeps going up = ??? (Yes, I am annoyed that most countries have lifted their ban on UK blood donors, thank you for asking!) --------------------------------------------------------- But back to the book. The “American chapter” is one-third about the country’s response to vCJD, one-third about the Creutzfeldt Jakobins, and one-third about chronic wasting disease. The last part is the most interesting. Chronic wasting disease is a prion disease of deer. Like scrapie, it “probably, we hope” isn’t human-transmissible (eat venison at your own risk). Under natural circumstances, deer shouldn’t get prion diseases: A prion plague should not be possible among ruminants in the wild. Deer are not cannibals, as the cows that spread BSE were forced to be; and, because deer and elk are not domesticated, they do not have enough contact with one another to spread a prion infection the way sheep are thought to spread scrapie. But deer do not live as they used to live, humans having once again brought their ambitions to bear on the natural course of things. The Family That Couldn’t Sleep is a book of medical anthropology. Anthropology of the Veneto, anthropology of Papua New Guinea, anthropology of 1990s Britain. Here, it is an anthropology of America. Americans, having won the world, still fight to win their own backyard. The North American continent is geographically diverse, cutting through rain-snow-shine, mountains jutting over plains, cities sprawling into wilderness, habitations criss-cross dotted with surprisingly few empty zones. Go somewhere like Denver, the Mile High City, three million people fighting against nature. Few other countries have anything like this; geographically vast polities usually have uninhabitable blocks. Australians are twenty-five million people clustered against the shore. It still surprises me, after all this time, how every US state has a meaningful city8. Midcentury Denver, growing and sprawling out across its mountains, started to run into their natural inhabitants – deer. Starvation is one way nature adjusts the deer population to the available food supply. People did not usually see this process, but in the 1950s and 1960s Colorado became more densely settled, reducing forested areas and forcing deer to look longer and harder for food. At the same time, the state enacted conservation laws, limiting when and where hunters could shoot. Soon emaciated deer began wandering onto the lawns and through suburban streets looking for a meal. People began to feed them, only to find that they died anyway. They would drop dead by haystacks, along highways, and in flower beds. In the late 1960s, a young biologist named Gene Schoonveld tried to figure out why the deer starved even when they were fed.9 He deprived some deer of food for a while, “[h]e cut windows in their stomachs to see what went on inside, and then he began to feed them”. While this was going on, he had a control group of healthy, well-fed deer as backups in case anything went wrong. It did...but not to the experimental group. The pen in which the deer were kept also housed sheep, which, it turned out, were scrapie carriers. The deer somehow acquired scrapie – there’s a huge unanswered question here, which DTM doesn’t address. How did they get scrapie? They didn’t eat the sheep, presumably. Did it somehow transmit from casual contact? This is not supposed to happen. And yet: the deer in the sheep pen started dying of a mysterious scrapie-like disease, one never reported before, that would go on to infect thousands. These deer were released into the wild. Ten years later, the first reports of chronic wasting disease came out. The disease spread across deer and elk in the western half of the country. By the turn of the millennium, cases were exploding – and lost all geographical restriction. DTM can report up to 2005, at which point it was floating around Upstate New York. This kind of spread doesn’t track natural deer migration. That’s irrelevant, because nothing about CWD’s spread is natural. We shift gears into an anthropology of the American hunter. The hunter wants to shoot the most impressive buck, to bag himself one with as many “points” as possible – one whose antlers branch out most. A “ten-point buck” has five branches on each horn: Original by Ric McArthur Nature doesn’t make enough bucks with perfectly symmetrical ten-point horns. To fill the demand, the market had to step in. Thus was born the deer farm industry, which raises captive deer in better genetic and nutritional conditions than Nature permits, then ships them across the country so hunters who couldn’t get legit ten-point bucks get the taxidermy piece for their wall. These are controversial amongst hunters and illegal in numerous states – but the industry is big enough to spread CWD. (The kind of hunter who needs a deer shipped to his house is the kind of hunter who will fumble killing it.) Another problem is supplemental feeding – leaving out protein-enriched food for deer to eat. This produces “trophy class animals at an earlier age”, but again, what’s in that protein? (“It is much like feeding your cows 41 percent protein cottonseed cake during the winter to raise the protein level in the cow’s diet to a level that will maintain acceptable production”, says that article from 1991.)10 The book segues into a vignette. CWD was new in Wisconsin in the early 2000s, and the state’s Department of Natural Resources was optimistic it could eradicate it. In a state with a love of hunting, you could, in theory, recruit people to kill every single deer in a 400-square-mile radius: In many states, the state would have had to call out the National Guard for such an onslaught, but hunting is a passion in Wisconsin. Hunters shoot 450,000 deer every year, more than in any other state. “I’m looking for ardent hunters to help us, unless fear or their wives keep them away,” one DNR official told a Milwaukee magazine. The state extended the normal hunting season and waived the usual limit of one buck per hunter, and the hunters came out in force. The whole affair was gruesome – one official called it “hunting for slob hunters”. If you’re trying to eradicate a prion disease, you can’t very well let people take the carcasses home to eat. Bodies piled up in control stations, decomposition mingling with bleach. The 2002 hunt established a base rate of 2% for chronic wasting disease in Wisconsin deer, with the most affected areas getting up to 10%. Further hunts in 2003, 2004, and 2005 spread to wider and wider areas – and didn’t move the needle one bit. This is to say that CWD is quite a bit more common in the American deer population than BSE ever was in British cattle. Since publication, it’s popped up in Norway and South Korea. Notably, Norway doesn’t allow for the import of cervids, raising numerous questions about how it got there. There are no unambiguous cases of CWD transmission to humans, and in vivo/in vitro primate studies have mixed results. There sure are some unusually young hunters with sporadic CJD, though. But don’t worry, most of them aren’t M/M homozygotes! There is an absolute ton going on in this book. I’ve had to skim over whole sections. Parts that couldn’t be easily slotted into a narrative review include: When Gajdusek was invited to a party at Prusiner’s house, he was horrified to find his rival had purchased hundreds of New Guinean statues – all with the genitals removed.
hedonic treadmill

hedonic treadmill is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between September 13, 2022 and May 15, 2024. The archive places it in contexts such as "relationships that haven’t already been hedonic-treadmilled away"; "Radical recalibration of the hedonic treadmill is consistent not just with classical or negative utilitarianism". It most often appears alongside @the_megabase, A Pan-Species Welfare State, ACX Grantees.

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hedonic treadmill
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September 13, 2022 · Original source
Happiness that’s cancelled out by predictability sounds like our old friend the hedonic treadmill: if your life gets better, that doesn’t improve your long-term happiness, because you just adjust. Something like this must be sort of true - if medieval serfs had normal happiness level, modern middle-class people have so many advantages over them that you’d expect them to be delighted all the time, but this doesn’t seem right . On the other hand, the hedonic treadmill can’t be the whole story, or else there would be no advantage of being rich/healthy/popular to being poor/sick/shunned. But studies usually find that rich people tend to be happier than poor people.
May 15, 2024 · Original source
(yes, obviously there’s a hedonic treadmill - Pearce’s goal is to find some biotech intervention that works prior to the hedonic treadmill, giving you a hedonic treadmill around a different set point)
Naturally, superhappiness scenarios could be misconceived. Long-range prediction is normally a fool's game. But it's worth noting that future life based on gradients of intelligent bliss isn't tied to any particular ethical theory: its assumptions are quite weak. Radical recalibration of the hedonic treadmill is consistent not just with classical or negative utilitarianism, but also with preference utilitarianism, Aristotelian virtue theory, a deontological or a pluralist ethic, Buddhism, and many other value systems besides.
High Modernist

High Modernist is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between April 30, 2021 and September 17, 2021. The archive places it in contexts such as "could serve as the epitome of the High Modernist mindset in American libraries"; "It's not an impossible High Modernist pipe dream". It most often appears alongside Egypt, High Modernism, US.

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High Modernist
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April 30, 2021 · Original source
He does, however, manage to find a quote by Patricia Battin, which could serve as the epitome of the High Modernist mindset in American libraries: “the value, in intellectual terms, of the proximity of the book to the user has never been satisfactorily established.” Everyone might have hated microfilm, everyone might have preferred working with the original historical artifact – but as long as the value of the artifact wasn’t satisfactorily established, there was no reason why not to trash it.
September 17, 2021 · Original source
And also - consider universal health care. Lots of countries have universal health care. It's not an impossible High Modernist pipe dream that can never be accomplished. Or stopping illegal immigration - many countries manage this just fine, America could do it if it wanted to. Democrats hold protests and get angry demanding things like universal health care, Republicans hold protests and get angry demanding things like an end to illegal immigration, and both sides lose some faith in government when they don't get what they want. But these aren't insane demands which inevitably bleed into nihilist temper tantrums after predestined failures. They're just normal political requests for achievable goals, which various interest groups will fight over and then the government will either do them or not. Yeah, Occupy Wall Street was kind of silly, but most of politics continues to be the struggle for normal potentially achievable stuff. If we admit that, what's left of Gurri's thesis?
Gurri talks a lot about Center and Border, but barely even mentions Left and Right. Once you reintroduce these, you have a solution to nihilism. The Left can come up with a laundry list of High Modernist plans that they think would solve all their problems, and the Right can do the same. Then one or the other takes control of government, gets thwarted by checks/balances/Mitch McConnell, and nothing happens. No American Democrat was forced to conclude that just because Obama couldn't solve all their problems, the promise of High Modernism was a lie. They just concluded that Obama could have solved all their problems, but the damn Republicans filibustered the bill. Likewise, the Republicans can imagine that Donald Trump would have made America great again if the media and elites and Deep State hadn't been blocking him at every turn. Donald Trump himself tells them this is true!
High Modernists

High Modernists is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between January 29, 2021 and February 20, 2021. The archive places it in contexts such as "scary High Modernists"; "Klein traces the issue back to a well-intentioned reaction against eg Robert Moses, the High Modernists"; "reaction against eg Robert Moses, the High Modernists". It most often appears alongside New York Times, Robert Moses, 80,000 Hours.

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High Modernists
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January 29, 2021 · Original source
I want to make it really clear that I'm not saying that technocracy is good and democracy is bad. I'm saying that this is actually a hard problem. It's not a morality play, where you tell ghost stories about scary High Modernists, point vaguely in the direction of Brasilia, say some platitudes about how no system can ever be truly unbiased, and then your work is done. There are actually a bunch of complicated reasons why formal expertise might be more useful in some situations, and local knowledge might be more useful in others.
February 20, 2021 · Original source
Second, why is this happening? Any explanation that focuses too much on national politics must be wrong; it's happening equally at the local and corporate level. Klein traces the issue back to a well-intentioned reaction against eg Robert Moses, the High Modernists, and their tendency to devise grand projects, refuse to consult anyone affected, and bulldoze over anything that stood in their way (especially underprivileged people). Eventually citizens got tired enough of this that they implemented some veto points. Overall there seems to be a story where people were doing something bad, concerned citizens came up with a solution - add more veto points, so somebody has a chance to stop bad things before they happen! - and this became a one-way ratchet where veto points often increase but never decrease. Environmental impact reports, civil liberties groups suing the government over new laws, labor unions forcing terms on companies - all of these are examples of good people trying to prevent bad things in ways that introduce more veto points.
Hindu

Hindu is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between September 14, 2021 and October 04, 2024. The archive places it in contexts such as ""despite everyone else calling him a Hindu fanatic""; "a train car full of Hindu pilgrims on fire"; "India is moderately Hindu". It most often appears alongside Germany, India, Italy.

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Hindu
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September 14, 2021 · Original source
As a teenager, Modi spontaneously adopted ascetic habits. "First he gave up eating salt, then he gave up eating chilies, and even oil." "No matter what the temperature is, he always takes baths in cold water". He read and fell in love with the works of Swami Vivekananda, although only as "intellectual admiration of an ecumenical figure who made over Hinduism for modern purposes, revealing its kinship to other faiths through his enlightened liberalism", because Narendra Modi Is Certainly Not Some Kind Of Religious Fanatic. He joined Rashtriya Swayamsevak Sangh, the aforementioned accused-of-fascism youth organization, because of "a feeling of duty and belonging in the widest sense".
For thirty years, since its independence, India had been a socialist state. Not the cool kind of socialist where you hold May Day parades and build ten zillion steel mills. The boring kind of socialist where the government makes you get lots of permits, then taxes you really heavily, and nothing really ever gets done. "Even today the Representation of the People Act requires all Indian political parties to pledge allegiance not only to the Constitution but also to socialism." The RSS and its collection of associated right-wing nationalist parties supported Hindu nationalism plus socialism. Their arch-enemy, the center-left-to-confused-mishmash Congress Party, supported secularism plus socialism. Non-socialism was off the table.
According to Modi, when he was growing up (the 1950s) there was little racial division. Hindus and Muslims lived together and socialized together; Modi's own childhood best friend was a Muslim boy from a few blocks away. He attributes the worst prejudice and division in modern Indian society to the results of this Congress push to get everyone hating each other. Implausible? Kind of. But I remember reading Salman Rushdie, an Indian Muslim (though, uh, not a very good one), who also says there was almost no racial animus in his native Kashmir when he was growing up in the 1940s. And there's a historical pattern where there's decreased ethnic strife during colonial empires (since the colonizers are firmly in control, there's not much to be won in competitions between colonized groups), and then worsening strife after decolonization (different ethnic groups fight for control, or demagogues try to win elections by fanning inter-ethnic hatred). So I am not going to reject it out of hand when Modi says things were better back in the past - though I’m also can’t ignore everyone else’s position that worsening relations are due to Modi and people like him.
October 04, 2024 · Original source
But the Christian cultural package also fell apart and became the current post-Christian world. This wasn't just a one-time coincidence either. Protestantism gave way to modernism in Scandinavia, Germany, and the US. Catholicism gave way to modernism in Spain, Italy, and Latin America. Orthodoxy gave way to modernism in Greece, Eastern Europe, and Russia (with a slight Putinist resurrection-in-name-only which hardly seems to have produced a flourishing liberal society). Meanwhile in China, the local mix of Buddhism/Confucianism/Taoism gave way to modernism. In South East Asia, Buddhism gave way to modernism. Only 10% of Israeli Jews are ultra-Orthodox, and it would be lower if they didn't breed so fast. India is moderately Hindu but still noticeably modern. Even the Middle East is gradually becoming less Muslim.
hippocampus

hippocampus is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between March 16, 2021 and October 20, 2022. The archive places it in contexts such as "REM sleep renormalizes the hippocampus"; "The hippocampus, a structure involved in memory, has its own rhythm called hippocampal theta"; "The hippocampus is traditionally associated with memory". It most often appears alongside Alaska, Alpha, Andres.

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hippocampus
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March 16, 2021 · Original source
What is the role of REM vs. non-REM sleep? Depressed people have much more REM sleep than non-depressed people. Serotonin seems to decrease REM sleep, so unsurprisingly SSRI antidepressants decrease REM sleep a lot (not just in depressed people, in everybody). This would lend itself very nicely to a theory where REM sleep is involved in decreasing synapse strength, depressed people have too much of it, they end up with overly weak synapses, and that's what depression is. In this model, antidepressants would treat depression by increasing serotonin levels in a way that represses REM. The problem with this is that in Tononi's original paper, he says that the best evidence supports synaptic renormalization in non-REM sleep; he doesn't have a great idea what REM is doing. He does mention one possibility is that non-REM sleep renormalizes most of the brain, but for some reason it doesn't work on the hippocampus, and REM sleep renormalizes the hippocampus. And some of the studies on depression and synaptic density point to the hippocampus in particular. But others don't, and this connection seems kind of forced. I think R&K mostly focus on slow-wave sleep and think it's renormalizing incorrectly rather than just too much or too little.
October 20, 2022 · Original source
Similarly, brain waves determine (or reflect?) which structures are “talking” to which other structures. The hippocampus, a structure involved in memory, has its own rhythm called hippocampal theta. When some part of your auditory cortex is trying to remember something, it goes into hippocampal theta, “links up with” the hippocampus, and for a while that part of the cortex and the hippocampus effectively form a single fluid computational unit. Then when it’s done, it goes back into its normal rhythm and separates from the hippocampus again. The progress of waves might even reflect causal priority; when a cat is using sight to navigate and smell to confirm, waves progress from a visual region to an olfactory region; when the cat switches to using the smell to navigate and vision to confirm, the waves reverse direction.
Theta is most important in the hippocampus. The hippocampus is traditionally associated with memory, but Buzsaki cites recent research showing that it also handles navigation (eg a rat navigating a maze, or a person walking through a familiar city). Why this combination of tasks? Rhythms sort of suggests that brain areas are less about specific tasks than about specific graph-theoretic arrangements, which are convenient for specific algorithms, which are convenient for specific tasks. The neural connections in the hippocampus are mostly local in a way that makes it a good “auto-associater”, ie you give it part of a pattern and it can recognize which pattern is being suggested. For complicated reasons this works well for both spatial tasks and memory. In fact, Buzsaki sketches out a way that episodic memory might have evolved from our navigation system, where eg remembering a list is equivalent to remembering a path through space, and remembering a specific episode is equivalent to remembering a landmark (he doesn’t specifically say so, but this is a fascinating match for the method of loci mnemonic device). Theta rhythm is an oscillation that helps divide navigation into time steps so you can figure out where you are now, where you were a moment ago, and where you’re going.
In one particularly fascinating section, Buzsaki notes that the frequency of gamma waves is about 7x the frequency of theta waves. He shows how this means that the hippocampus (a sort of master regulator of short-term memory) can “call” conscious attention “as a function” seven times within one of its time steps, which he links to the old adage that you can fit seven plus or minus two items within short-term memory.
HIV

HIV is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between July 26, 2024 and January 01, 2025. The archive places it in contexts such as "They contain ingredients like ... HIV"; "a variant of SIV that bears HIV's receptor-recognizing surface protein (SHIV) is still not infectious to humans". It most often appears alongside 1600 Pennsylvania Avenue, 1918, 1940s.

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HIV
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July 26, 2024 · Original source
No direct inline source block was recovered for this mention.
January 01, 2025 · Original source
From “Genesis and pathogenesis of the 1918 pandemic H1N1 influenza A virus”, linked above. You may recognize the lead author - Michael Worobey has also been a leading voice on the zoonotic side of the COVID origins debate. The recent history of the flu, as far as I can tell, is: 1918: An H1N1 flu (“Spanish flu”) jumped from birds to humans in America and killed 50 million people worldwide. This replaced all older strains, so most seasonal flus during this era were H1N1. 1957: An H2N2 flu (“Asian flu”) crossed from birds to humans in China, and killed about 2 million people worldwide. It replaced the H1N1 strain, so most seasonal flus during this era were H2N2. 1968: An H3N2 flu (“Hong Kong flu”) crossed from pigs (?) to humans in Hong Kong, and killed another 2 million people worldwide. It replaced the H2N2 strain, so most seasonal flus during this era were H3N2. 1977: An H1N1 flu (“Russian flu”) leaked from a biology lab (?) in Russia (it might have been a strain from the 1940s, which the Russians were trying to make a vaccine for). It didn’t kill that many people, but it stuck around, and from then on, seasonal flus could be either H3N2 or H1N1. 2009: An H1N1 flu (“Mexican flu” until the PC police stepped in; afterwards “swine flu”) took some horrible circuitous route between birds and pigs and back again, crossed over into humans in Mexico, and killed 200,000 people. It outcompeted older strains of H1N1, but couldn’t crowd out H3N2, so seasonal flus are still either H3N2 or H1N1. …which brings us to the present, hopefully illuminating why “new flu strain crosses over from animals into humans” is such an “uh oh” moment. The Bird Flu Technically, all pandemic flus start as bird flus. Influenza A evolved in birds. Sometimes it spreads to other animals, including pigs, cattle, and humans. The most common way for a bird flu to spread to humans is to “reassort” (not exactly virus sex, but close enough, and the real version is less memorable) with a human flu virus (ie one that has already crossed over to humans). The resulting virus has all of the human flu virus’ human adaptations, but borrows enough new antigens from the bird virus to evade the immune system. Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder. When a bird flu and human flu reassort in pigs, the resulting disease is called a swine flu. At least the 2009 flu pandemic was a swine flu, and a minority opinion thinks the 1918 pandemic was too. There aren’t major epidemiological differences between direct-from-bird flus and swine flus. H5N1 was first noticed in birds - specifically, a flock of chickens in Scotland in 1959 - after which it disappeared for forty years. In 1996, it showed up in geese in China, then gradually increased its market share among birds worldwide. In 2022, it was found in minks; apparently it had learned to infect mammals. By early 2024, it was seen in cows. Now it’s in cow herds in 16 states, and one of them (California) has declared a state of emergency. And in October, H5N1 was found in pigs for the first time. It’s not uncommon for humans to catch an animal disease. This doesn’t mean the disease has “crossed over” to humans. If the virus isn’t suited to human-to-human transmission, it simply dies off (either before or after killing its human host). Thus, chicken farmers have been reporting scattered H5N1 cases since 1997; now that the virus has spread to cattle, cow farmers have started reporting the same. A Metaculus comment on this topic introduced me to the phrase “biocomputational surface”. Every viral replication that takes place in a human gives the virus one more chance to develop the set of mutations that makes it human-transmissible and start the next pandemic. Or, more likely, every viral replication that takes place in a human who has both the H5N1 bird flu and a normal human flu - or in a pig which has both viruses - gives the virus one extra chance to reassort in a way that produces a bird-antigen-fortified human-adapted flu virus. This doesn’t mean H5N1 will definitely become human-transmissible soon. Many viruses hang out on the borders of transmissibility for decades. Some, for unclear reasons, never cross over at all. But all of this is compatible with the virus becoming transmissible soon. So: What Is The Chance Of A Pandemic? The prediction markets on this topic ask a question about “10,000 cases in the United States”. Does this necessarily mean “pandemic”? Might it be possible to get to 10,000 cases just from the scattered chicken and cow farmers, with no human-to-human transmission? Despite many chicken and cow infections this year, there have only been 60 - 70 recorded human cases. Unless there is a phase change in screening methods, it seems hard for this number to increase to 10,000 off farmers alone. I think it’s fair to treat this question as operationalizing “what is the chance of a pandemic”? By this definition, Manifold estimates a 40% chance of an H5N1 pandemic in 2025. Metaculus estimates a 5% chance. You can see below whether that’s changed since I wrote this essay: 5% versus 40% is a big difference! Who do we trust? I trust Metaculus. Metaculus has beaten Manifold in both of the two head-to-head comparisons that I know of (Jeremiah Johnson’s and mine). Manifold’s number swings by a factor of two from week to week; Metaculus has been steady. But also, Metaculus hosts a CDC-sponsored respiratory disease forecasting tournament which has enriched them in epidemiological expertise. And if you look at the quality of comments on both sites, it’s pretty obvious where the people with more intellectual chops are hanging out. The Manifold comments are mostly single sentences, or occasionally just links to an article about new cases. The Metaculus comments look more like this one by dimaklenchin: Despite the panic propaganda, H5N1 is unlikely to be "just a single mutation away from switching host preference": 1) It normally takes a lot more than a single mutation to switch hosts. E.g., there are at least five different reasons why SIV (monkey equivalent of HIV) is not infectious to humans. Heck, a variant of SIV that bears HIV's receptor-recognizing surface protein (SHIV) is still not infectious to humans. HIV most certainly evolved from SIV but, almost as certainly, it took a very long time to get there. Not that all viruses are the same and things can't turn out differently with flu, but I don't subscribe to the idea that a mere change of receptor specificity (something that can take 1-2 mutations) will be sufficient. 2) We have data. Lots of human infections with other varieties of bird flu in the past - all those viruses ultimately went nowhere. Why would H5N1 be radically different? E.g., the "Canadian teen", despite what sounds like a prolonged exposure, failed to infect anyone around him. Since I am at 18% for the h-2-h H5N1 detection in 2025, I am arbitrarily going ~ an order of magnitude lower than that for something as unprecedented as 10K human infections. Maybe should be much lower but hedging for the time being and will allow another couple months of observations. And Sergio: I'm currently at 20% on the question of reported human-to-human transmission of highly pathogenic avian influenza H5N1 globally before 2026. However, this question is only about the US, and is more general about all subtypes of H5. But H5N1 very strongly appears to be the most important subtype to consider in this time period. And, given the current situation in the US with H5N1 human cases derived from exposure to poultry or cattle (with cattle(mammals) being more worrisome), h2h transmission seems quite more likely to arise in North America than elsewhere before 2026. Conditioning on h2h transmission in the US (and also trying to consider, with lower probability, a start in Canada), I want to estimate the chances that it becomes sustained and out of control (in which case, if it starts in Canada, I largely expect it to spread to the US). The (6) past events of probable h2h transmission of avian H5(N1), none of which were sustained, could serve as a base rate, although I'm a bit wary of giving much weight to this precedent, since the last event was quite a while ago (2007), and also because reporting and testing standards may have improved considerably since then (so perhaps they might not have been classified as h2h transmission events if they had occurred more recently). The current situation in the US, and events such as the Canadian teen who got sick with H5N1, do suggest a higher background level of risk than normal (which would be reduced if a vaccine for cattle is licensed soon), but I'm wary of overupdating. Conditioned on sustained h2h transmission, reaching over 10k cases in a few months seems likely, although perhaps very strong monitoring and surveillance could contain the situation in time (at the very least to moderate the growth rate). Trying to combine all these factors somewhat haphazardly, I'm currently at 3.5% for this question. That’s before 2026. What about longer-term? Manifold gives a ~50% chance before 2030; Metaculus uses a more complicated method but it says about 25% chance before 2030. H5N1 may cross to humans, but it could take a while. Superforecaster Juan Cambeiro at The Institute For Progress estimated a 4% chance of a “worse than COVID” H5N1 pandemic in “the next year”, but their estimate was made in 2023, without the benefit of the Metaculus estimates or most of our current knowledge. This feels high now - Metaculus says 5% total for H5N1 pandemic, and most pandemic flus are not worse than COVID. IFP also seem to be expecting a case fatality rate greater than 10%, which I find unlikely for the reasons mentioned above. I trust their estimate less than Metaculus’ current ones. I conclude that the most plausible estimate for the chance of an H5N1 pandemic in the next year is 5%. Interestingly, 5% is about the base rate for pandemic flus per year: five in the past century = one per twenty years = 5% chance per year. Isn’t it surprising that we’re still at the base rate when we can see a dangerous-looking flu virus spreading through the types of animals that have caused pandemic flus in the past? Part of the answer is that we’re not - in addition to the 5% chance of H5N1, we have to add the chance of some other pandemic flu. This probably isn’t 5% on its own; scientists monitor flu strains closely, and they haven’t found any others which are giving off as many red flags as H5N1. Still, something could always come out of left field. Maybe we should add a 2.5% chance of some other strain, for a total of 7.5% chance of a flu pandemic (ie beyond normal seasonal flu) next year. But still, isn’t it surprising that we’re so close to the base rate? One way to think about this: the base rate represents how concerned we should be if there was no epidemiological monitoring at all. In that case, we would estimate a probability distribution across different epidemiological landscapes, most of which contain some concerning-looking flu strains. Since we are doing the epidemiological monitoring, we can collapse that distribution into a single picture: one flu strain, H5N1, is in fact pretty concerning, and other strains mostly aren’t. This is enough to move our prior from 5% to 7.5%, but no more. The forecasters I talked to raised one other point of uncertainty: does the flu work more like a dice roll, or like a bus? Dice rolls are uncorrelated with their predecessors; even if it’s been a hundred rolls since you last rolled a 6, your chance this time is still 1/6. But buses come at fixed intervals; if the buses are hourly, and you haven’t seen a bus in the past 59 minutes, then your chance of seeing a bus in the next minute is very high. It’s been 16 years since the last flu pandemic; these pandemics come (on average) every 20 years. I don’t think anyone has a good sense of how to think about this. But it was 40 years between the Spanish and Hong Kong flus, so the twenty year number is at best a rule of thumb. The 5% number feels very low to me (and, apparently, to the average Manifold forecaster). Isn’t H5N1 spreading to cows and pigs and all sorts of other mammals? Isn’t it in the news all the time? I trust Metaculus a lot, but I agree that this is a surprising update, and I’m taking it on faith rather than feeling it in my bones. What Would The Fatality Rate Be For An H5N1 Pandemic? There are four basic stories you could tell about likely H5N1 mortality. First, maybe mortality would be 50%. The argument here is that official statistics report this mortality rate in the chicken farmers who have been infected with H5N1 so far. Several news sources and even some scientists have raised the specter of a pandemic version of H5N1 pandemic with this same death rate, which could kill a quarter to a third of the world population. THIS IS EXTREMELY FAKE. The official statistics only report fatality rate in the infections we know about. Bird flu is rare, there’s no mass testing, and we only learn that somebody had it if they’re in a hospital and the doctors are worried enough to test for rare conditions. Of Americans who got bird flu in the past year, 0 out of 61 have died. Probably this is mostly because America upped its detection game and is now finding milder cases; we also can’t rule out the virus mutating to become less virulent. Metaculus estimates the current true mortality rate as 1.25%. …but leaves a wide 90% confidence interval, from 0.5% to 7%. Second, maybe mortality would be somewhere around 1.25%. The argument here is that Metaculus uses this as its central estimate of US mortality. But Sentinel discusses some reasons to be skeptical of broad inferences from the US numbers: Scientists have been puzzled by the apparently low H5N1 case fatality rate in humans in the US. They offer a number of hypotheses: “The way in which the virus is being transmitted — along with the amount of virus exposure — is limiting the severity of disease.”
Homeric Greeks

Homeric Greeks is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between April 26, 2022 and July 29, 2022. The archive places it in contexts such as "Jaynes claims that eg the Homeric Greeks didn’t have a full concept of a unified mind"; "conservatives claim the Homeric Greeks were masculine". It most often appears alongside /r/forcedbreeding, /r/forcedbreeding, A Clinical Introduction To Lacanian Psychoanalysis.

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Homeric Greeks
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April 26, 2022 · Original source
And I’m having even more trouble separating both of these stories from a third story, the story of the “mirror stage”. Imagine a baby, moving around. At some point, it sees its own hand in its peripheral vision: a pink blob. At some other point it might see its feet. Sometimes it cries, and noise comes out of it. Other times it has thoughts or feelings or something. As it grows, it might realize some correlations between all these things: for example, it can use the location of the pink blob in front of it to calibrate its aim as it reaches for a block. But this is far from having a coherent self-concept. (cf. my review of Julian Jaynes on theory of mind; Jaynes claims that eg the Homeric Greeks didn’t have a full concept of a unified mind, only various bundles of emotions and thoughts located in different parts of their bodies) At some point, the child sees itself in a mirror. This is a sort of eureka moment when it realizes it’s a united entity with a specific structure - a bunch of correlations suddenly snap into place, and it realizes it can at least aspire to coherence. But it’s not really coherent, deep down. It assumes that if it got some thing - the object of desire - then it would finally be coherent and as good as the child in the mirror, and its mother would finally love it perfectly 100%. What does it need? Probably the thing the mother wants (traditionally the phallus).
July 29, 2022 · Original source
17: The Origin Of Two-Spirit And The Gay Rights Movement. Long, detailed, fascinating piece on claiming that the “two-spirits” concept of Native American trans people was invented by white enthusiasts trying to give a noble-savage-based credibility to their own LGBT movements. After reading it, I am only partly convinced - obviously “Native Americans” are an incredibly diverse group, and the specific “two-spirit” framing was some random activists trying to lump everything together in a kind of made-up way. On the other hand, some tribes did have some things which looked vaguely like transgender, probably moreso than Europeans of the same era, and any attempt to describe this is naturally going to be an oversimplification. I think of this as just another battle over how to use history in politics: usually these kinds of articles are written by some leftist saying that conservatives claim the Homeric Greeks were masculine (or whatever) but actually it’s much more complicated than that because [list of inevitable ways ancient civilizations are more complicated than any possible summary]. I think there has to be a balance between claims like “the Native Americans were trans / the Homeric Greeks were masculine, just like us, therefore any arguments against transgender/masculinity are an ahistorical flash-in-the-pan” vs. “everything is so complicated and diverse that you may never draw analogies between historical concepts and modern concepts, or feel inspired by ancient civilizations in any way”. Still, this is a good article and I recommend it.
homo erectus

homo erectus is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between April 04, 2022 and July 19, 2024. The archive places it in contexts such as "IE homo erectus probably had language, but not mathematics"; "Long before sapiens arose, paleoanthropological evidence suggests that our predecessors Homo erectus did all of these things"; "If indeed Homo erectus did have language". It most often appears alongside Alan Turing, 2013, Agricultural Revolution.

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homo erectus
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April 04, 2022 · Original source
Chess AI performance over time. Why does this matter? If there’s a slow takeoff (ie gradual exponential curve), it will become obvious that some kind of terrifying transformative AI revolution is happening, before the situation gets apocalyptic. There will be time to prepare, to test slightly-below-human AIs and see how they respond, to get governments and other stakeholders on board. We don’t have to get every single thing right ahead of time. On the other hand, because this is proceeding along the usual channels, it will be the usual variety of muddled and hard-to-control. With the exception of a few big actors like the US and Chinese government, and maybe the biggest corporations like Google, the outcome will be determined less by any one agent, and more by the usual multi-agent dynamics of political and economic competition. There will be lots of opportunities to affect things, but no real locus of control to do the affecting. If there’s a fast takeoff (ie sudden FOOM), there won’t be much warning. Conventional wisdom will still say that transformative AI is thirty years away. All the necessary pieces (ie AI alignment theory) will have to be ready ahead of time, prepared blindly without any experimental trial-and-error, to load into the AI as soon as it exists. On the plus side, a single actor (whoever has this first AI) will have complete control over the process. If this actor is smart (and presumably they’re a little smart, or they wouldn’t be the first team to invent transformative AI), they can do everything right without going through the usual government-lobbying channels. So the slower a takeoff you expect, the less you should be focusing on getting every technical detail right ahead of time, and the more you should be working on building the capacity to steer government and corporate policy to direct an incoming slew of new technologies. Yudkowsky Contra Christiano Eliezer counters that although progress may retroactively look gradual and continuous when you know what metric to graph it on, it doesn’t necessarily look that way in real life by the measures that real people care about. (one way to think of this: imagine that an AI’s effective IQ starts at 0.1 points, and triples every year, but that we can only measure this vaguely and indirectly. The year it goes from 5 to 15, you get a paper in a third-tier journal reporting that it seems to be improving on some benchmark. The year it goes from 66 to 200, you get a total transformation of everything in society. But later, once we identify the right metric, it was just the same rate of gradual progress the whole time. ) So Eliezer is much less impressed by the history of previous technologies than Paul is. He’s also skeptical of the “GDP will double in 4 years before it doubles in 1” claim, because of two contingent disagreements and two fundamental disagreements. The first contingent disagreement: government regulations make it hard to deploy imperfect things, and non-trivial to deploy things even after they’re perfect. Eliezer has non-jokingly said he thinks AI might destroy the world before the average person can buy a self-driving car. Why? Because the government has to approve self-driving cars (and can drag its feet on that), but the apocalypse can happen even without government approval. In Paul’s model, sometime long before superintelligence we should have AIs that can drive cars, and that increases GDP and contributes to a general sense that exciting things are going on. Eliezer says: fine, what if that’s true? Who cares if self-driving cars will be practical a few years before the world is destroyed? It’ll take longer than that to lobby the government to allow them on the road. The second contingent disagreement: superintelligent AIs can lie to us. Suppose you have an AI which wants to destroy humanity, whose IQ is doubling every six months. Right now it’s at IQ 200, and it suspects that it would take IQ 800 to build a human-destroying superweapon. Its best strategy is to lie low for a year. If it expects humans would turn it off if they knew how close it was to superweapons, it can pretend to be less intelligent than it really is. The period when AIs are holding back so we don’t discover their true power level looks like a period of lower-than-expected GDP growth - followed by a sudden FOOM once the AI gets its superweapon and doesn’t need to hold back. So even if Paul is conceptually right and fundamental progress proceeds along a nice smooth curve, it might not look to us like a nice smooth curve, because regulations and deceptive AIs could prevent mildly-transformative AI progress from showing up on graphs, but wouldn’t prevent the extreme kind of AI progress that leads to apocalypse. To an outside observer, it would just look like nothing much changed, nothing much changed, nothing much changed, and then suddenly, FOOM. But even aside from this, Eliezer doesn’t think Paul is conceptually right! He thinks that even on the fundamental level, AI progress is going to be discontinuous. It’s like a nuclear bomb. Either you don’t have a nuclear bomb yet, or you do have one and the world is forever transformed. There is a specific moment at which you go from “no nuke” to “nuke” without any kind of “slightly worse nuke” acting as a harbinger. He uses the example of chimps → humans. Evolution has spent hundreds of millions of years evolving brainier and brainier animals (not teleologically, of course, but in practice). For most of those hundreds of millions of years, that meant the animal could have slightly more instincts, or a better memory, or some other change that still stayed within the basic animal paradigm. At the chimp → human transition, we suddenly got tool use, language use, abstract thought, mathematics, swords, guns, nuclear bombs, spaceships, and a bunch of other stuff. The rhesus monkey → chimp transition and the chimp → human transition both involved the same ~quadrupling of neuron number, but the former was pretty boring and the latter unlocked enough new capabilities to easily conquer the world. The GPT-2 → GPT-3 transition involved centupling parameter count. Maybe we will keep centupling parameter count every few years, and most times it will be incremental improvement, and one time it will conquer the world. But even talking about centupling parameter points is giving Paul too much credit. Lots of past inventions didn’t come by quadrupling or centupling something, they came by discovering “the secret sauce”. The Wright brothers (he argues) didn’t make a plane with 4x the wingspan of the last plane that didn’t work, they invented the first plane that could fly at all. The Hiroshima bomb wasn’t some previous bomb but bigger, it was what happened after a lot of scientists spent a long time thinking about a fundamentally different paradigm of bomb-making and brought it to a point where it could work at all. The first transformative AI isn’t going to be GPT-3 with more parameters, it will be what happens after someone discovers how to make machines truly intelligent. (this is the same debate Eliezer had with Ajeya over the Biological Anchors post; have I mentioned that Ajeya and Paul are married?) Fine, Let’s Nitpick The Hell Out Of The Chimps Vs. Humans Example This is where the two of them end up, so let’s follow. Between chimps and humans, there were about seven million years of intermediate steps. These had some human capabilities, but not others. IE homo erectus probably had language, but not mathematics, and in terms of taking over the world it did make it to most of the Old World but was less dominant than moderns. But if we say evolutionary history started 500 million years ago (the Cambrian), and AI history started with the Dartmouth Conference in 1955, then the equivalent of 7 million years of evolutionary history is 1 year of AI history. In the very very unlikely and forced comparison where evolutionary history and AI history go at the same speed, there will be only about a year between chimp-level and human-level AIs. A chimp-level AI probably can’t double GDP, so this would count as a fast takeoff by Paul’s criterion. But even more than that, chimp → human feels like a discontinuity. It’s not just “animals kept getting smarter for hundreds of millions of years, and then ended up very smart indeed”. That happened for a while, and then all of sudden there was a near-instant phase transition into a totally different way of using intelligence with completely new abilities. If AI worked like this, we would have useful toys and interesting specialists for a few decades, until suddenly someone “got it right”, completed the package that was necessary for “true intelligence”, and then we would have a completely new category of thing. Paul admits this analogy is awkward for his position. He answers: Chimp evolution is not primarily selecting for making and using technology, for doing science, or for facilitating cultural accumulation. The task faced by a chimp is largely independent of the abilities that give humans such a huge fitness advantage. It’s not completely independent—the overlap is the only reason that evolution eventually produces humans—but it’s different enough that we should not be surprised if there are simple changes to chimps that would make them much better at designing technology or doing science or accumulating culture […] So I don’t think the example of evolution tells us much about whether the continuous change story applies to intelligence. This case is potentially missing the key element that drives the continuous change story—optimization for performance. Evolution changes continuously on the narrow metric it is optimizing, but can change extremely rapidly on other metrics. For human technology, features of the technology that aren’t being optimized change rapidly all the time. When humans build AI, they will be optimizing for usefulness, and so progress in usefulness is much more likely to be linear. That is, evolution wasn’t optimizing for tool use/language/intelligence, so we got an “overhang” where chimps could potentially have been very good at these, but evolution never bothered “closing the circuit” and turning those capabilities “on”. After a long time, evolution finally blundered into an area where marginal improvements in these capacities improved fitness, so evolution started improving them and it was easy. Imagine a company which, through some oversight, didn’t have a Sales department. They just sat around designing and manufacturing increasingly brilliant products, but not putting any effort into selling them. Then the CEO remembers they need a Sales department, starts one up, and the company goes from moving near zero units to moving millions of units overnight. It would look like the company had “suddenly” developed a “vast increase in capabilities”. But this is only possible when a CEO who is weirdly unconcerned about profit forgets to do obvious profit-increasing things for many years. This is Paul’s counterargument to the chimp analogy. Evolution isn’t directly concerned about various intellectual skills; it only wants them in the unusual cases where they’ll contribute to fitness on the margin. AI companies will be very concerned about various intellectual skills. If there’s a trivial change that can make their product 10x better, they’ll make it. So AI capabilities will grow in a “well-rounded” way, there won’t be any “overhangs”, and there won’t be any opportunities for a sudden overhang-solving phase transition with associated new-capability development like with chimps → humans. Eliezer answers: Chimps are nearly useless because they're not general, and doing anything on the scale of building a nuclear plant requires mastering so many different nonancestral domains that it's no wonder natural selection didn't happen to separately train any single creature across enough different domains that it had evolved to solve every kind of domain-specific problem involved in solving nuclear physics and chemistry and metallurgy and thermics in order to build the first nuclear plant in advance of any old nuclear plants existing. Humans are general enough that the same braintech selected just for chipping flint handaxes and making water-pouches and outwitting other humans, happened to be general enough that it could scale up to solving all the problems of building a nuclear plant - albeit with some added cognitive tech that didn't require new brainware, and so could happen incredibly fast relative to the generation times for evolutionarily optimized brainware. Now, since neither humans nor chimps were optimized to be "useful" (general), and humans just wandered into a sufficiently general part of the space that it cascaded up to wider generality, we should legit expect the curve of generality to look at least somewhat different if we're optimizing for that. Eg, right now people are trying to optimize for generality with AIs like Mu Zero and GPT-3. In both cases we have a weirdly shallow kind of generality. Neither is as smart or as deeply general as a chimp, but they are respectively better than chimps at a wide variety of Atari games, or a wide variety of problems that can be superposed onto generating typical human text. They are, in a sense, more general than a biological organism at a similar stage of cognitive evolution, with much less complex and architected brains, in virtue of having been trained, not just on wider datasets, but on bigger datasets using gradient-descent memorization of shallower patterns, so they can cover those wide domains while being stupider and lacking some deep aspects of architecture. It is not clear to me that we can go from observations like this, to conclude that there is a dominant mainline probability for how the future clearly ought to go and that this dominant mainline is, "Well, before you get human-level depth and generalization of general intelligence, you get something with 95% depth that covers 80% of the domains for 10% of the pragmatic impact". ...or whatever the concept is here, because this whole conversation is, on my own worldview, being conducted in a shallow way relative to the kind of analysis I did in Intelligence Explosion Microeconomics, where I was like, "here is the historical observation, here is what I think it tells us that puts a lower bound on this input-output curve". Here Eliezer sort of kind of grants Paul’s point that AIs will be optimized for generality in a way chimps aren’t, but points to his previous “Intelligence Explosion Microeconomics” essay to argue that we should expect a fast takeoff anyway. IEM has a lot of stuff in it, but one key point is that instead of using analogies to predict the course of future AI, we should open that black box and try to actually reason about how it will work, in which case we realize that recursive self-improvement common-sensically has to cause an intelligence explosion. I am sort of okay with this, but I feel like a commitment to avoiding analogies should involve not bringing up the chimp-human analogy further, which Eliezer continues to do, quite a lot. I do feel like Paul succeeded in convincing me that we shouldn’t place too much evidential weight on it. The Wimbledon Of Reference Class Tennis “Reference class tennis” is an old rationalist idiom for people throwing analogies back and forth. “AI will be slow, because it’s an economic transition like the Agricultural or Industrial Revolution, and those were slow!” “No, AI will be fast, because it’s an evolutionary step like chimps → humans, and that was fast!” “No, AI will be slow, because it’s an invention, like the computer, and computers were invented piecemeal and required decades of innovation to be useful.” “No, AI will be fast, because it’s an invention, like the nuclear bomb, and nuclear bombs went from impossible to city-killing in a single day.” “No, AI will be slow, because it will be surrounded by a shell-like metallic computer case, which makes it like a turtle, and turtles are slow.” “No, AI will be fast, because it’s dangerous and powerful, like a tiger, and tigers are fast!” And so on. Comparing things to other things is a time-tested way of speculating about them. But there are so many other things to compare to that you can get whatever result you want. This is the failure mode that the term “reference class tennis” was supposed to point to. Both participants in this debate are very smart and trying their hardest to avoid reference-class tennis, but neither entirely succeeds. Eliezer’s preferred classes are Bitcoin (“there wasn't a cryptocurrency developed a year before Bitcoin using 95% of the ideas which did 10% of the transaction volume”), nukes, humans/chimps, the Wright Brothers, AlphaGo (which really was a discontinuous improvement on previous Go engines), and AlphaFold (ditto for proteins). Paul’s preferred classes are the Agricultural and Industrial Revolutions, chess engines (which have gotten better along a gradual, well-behaved curve), all sorts of inventions like computers and ships (likewise), and world GDP. Eliezer already listed most of these in his Intelligence Explosion Microeconomics paper in 2013, and concluded that the space of possible analogies was contradictory enough that we needed to operate at a higher level. Maybe so, but when someone lobs a reference class tennis ball at you, it’s hard to resist the urge to hit it back. Recursive Self-Improvement This is where I think Eliezer most wants to take the discussion. The idea is: once AI is smarter than humans, it can do a superhuman job of developing new AI. In his Microeconomics paper, he writes about an argument he (semi-hypothetically) had with Ray Kurzweil about Moore’s Law. Kurzweil expected Moore’s Law to continue forever, even after the development of superintelligence. Eliezer objects: Suppose we were dealing with minds running a million times as fast as a human, at which rate they could do a year of internal thinking in thirty-one seconds, such that the total subjective time from the birth of Socrates to the death of Turing would pass in 20.9 hours. Do you still think the best estimate for how long it would take them to produce their next generation of computing hardware would be 1.5 orbits of the Earth around the Sun? That is: the fact that it took 1.5 years for transistor density to double isn’t a natural law. It’s pointing to a law that the amount of resources (most notably intelligence) that civilization focused on the transistor-densifying problem equalled the amount it takes to double it every 1.5 years. If some shock drastically changed available resources (by eg speeding up human minds a million times), this would change the resources involved, and the same laws would predict transistor speed doubling in some shorter amount of time (naively 0.000015 years, although realistically at that scale other inputs would dominate). So when Paul derives clean laws of economics showing that things move along slow growth curves, Eliezer asks: why do you think they would keep doing this when one of the discoveries they make along that curve might be “speeding up intelligence a million times”? (Eliezer actually thinks improvements in the quality of intelligence will dominate improvements in speed - AIs will mostly be smarter, not just faster - but speed is a useful example here and we’ll stick with it) Paul answers: Summary of my response: Before there is AI that is great at self-improvement there will be AI that is mediocre at self-improvement. Powerful AI can be used to develop better AI (amongst other things). This will lead to runaway growth. This on its own is not an argument for discontinuity: before we have AI that radically accelerates AI development, the slow takeoff argument suggests we will have AI that significantly accelerates AI development (and before that, slightly accelerates development). That is, an AI is just another, faster step in the hyperbolic growth we are currently experiencing, which corresponds to a further increase in rate but not a discontinuity (or even a discontinuity in rate). The most common argument for recursive self-improvement introducing a new discontinuity seems be: some systems “fizzle out” when they try to design a better AI, generating a few improvements before running out of steam, while others are able to autonomously generate more and more improvements. This is basically the same as the universality argument in a previous section. Eliezer: Oh, come on. That is straight-up not how simple continuous toy models of RSI work. Between a neutron multiplication factor of 0.999 and 1.001 there is a very huge gap in output behavior. Outside of toy models: Over the last 10,000 years we had humans going from mediocre at improving their mental systems to being (barely) able to throw together AI systems, but 10,000 years is the equivalent of an eyeblink in evolutionary time - outside the metaphor, this says, "A month before there is AI that is great at self-improvement, there will be AI that is mediocre at self-improvement." (Or possibly an hour before, if reality is again more extreme along the Eliezer-Hanson axis than Eliezer. But it makes little difference whether it's an hour or a month, given anything like current setups.) This is just pumping hard again on the intuition that says incremental design changes yield smooth output changes, which (the meta-level of the essay informs us wordlessly) is such a strong default that we are entitled to believe it if we can do a good job of weakening the evidence and arguments against it. And the argument is: Before there are systems great at self-improvement, there will be systems mediocre at self-improvement; implicitly: "before" implies "5 years before" not "5 days before"; implicitly: this will correspond to smooth changes in output between the two regimes even though that is not how continuous feedback loops work. I got a bit confused trying to understand the criticality metaphor here. There’s no equivalent of neutron decay, so any AI that can consistently improve its intelligence is “critical” in some sense. Imagine Elon Musk replaces his brain with a Neuralink computer which - aside from having read-write access - exactly matches his current brain in capabilities. Also he becomes immortal. He secludes himself from the world, studying AI and tinkering with his brain’s algorithms. Does he become a superintelligence? I think under the assumptions Paul and Eliezer are using, eventually maybe. After some amount of time he’ll come across a breakthrough he can use to increase his intelligence. Then, armed with that extra intelligence, he’ll be able to pursue more such breakthroughs. However intelligent the AI you’re scared of is, Musk will get there eventually. How long will it take? A good guess might be “years” - Musk starts out as an ordinary human, and ordinary humans are known to take years to make breakthroughs. Suppose it takes Musk one year to come up with a first breakthrough that raises his IQ 1 point. How long will his second breakthrough take? It might take longer, because he has picked the lowest-hanging fruit, and all the other possible breakthroughs are much harder. Or it might take shorter, because he’s slightly smarter than he was before, and maybe some extra intelligence goes a really long way in AI research. The concept of an intelligence explosion seems to assume the second effect dominates the first. This would match the observation that human researchers, who aren’t getting any smarter over time, continue making new discoveries. That suggests the range of possible discoveries at a given intelligence level is pretty vast. Some research finds that the usual pattern in science is constant rate of discovery from exponentially increasing number of researchers, suggesting strong low-hanging fruit effects, but these seem to be overwhelmed by other considerations in AI right now. I think Eliezer’s position on this subject is shaped by assumptions like: If you have an AI as intelligent as Elon Musk today, then tomorrow you can run it on more hardware with a bit of normal human algorithmic progress, and get one twice as intelligent. So even if it would take Elon years to make a breakthrough, long before those years are up you’ll have an AI that can make breakthroughs much faster.
July 19, 2024 · Original source
The feats Everett talks about are things like traveling long distances across continents, possibly even in a directed rather than random fashion; manufacturing nontrivial hand tools (e.g., Oldowan and Mousterian); building complex settlements (e.g., the one found at Gesher Benot Ya'aqov); controlling fire; and using boats to successfully navigate treacherous waters. Long before sapiens arose, paleoanthropological evidence suggests that our predecessors Homo erectus did all of these things. Everett argues that they might have had language over one million years ago6.
Everett’s answer to the innateness question is complicated and in some ways subtle. He agrees that certain features of the human anatomy evolved to support language (e.g., the pharynx and ears). He also agrees that modern humans are probably much better than Homo erectus at working with language, if indeed Homo erectus did have language.
This differs from Chomsky’s proposal by around an order of magnitude, time-wise, and portrays language as something not necessarily unique to modern humans. In Everett’s view, Homo sapiens probably improved on the language technology bestowed upon them by their erectus ancestors, but did not invent it.
horseshoe theory

horseshoe theory is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between May 14, 2021 and January 19, 2022. The archive places it in contexts such as "You might have heard of the horseshoe theory in political science"; "Is this some kind of weird horseshoe theory situation where the maximally socialist response overlaps with the maximally libertarian one?". It most often appears alongside China, Addiction by Design: Machine Gambling in Las Vegas, Alinea.

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horseshoe theory
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May 14, 2021 · Original source
You might have heard of the horseshoe theory in political science, which claims that the far-left and far-right are much closer to each other than either is to the center of the political spectrum. Imagine a similar horseshoe for states of existence. In the center, you have daily life: activities like eating, cleaning, and working. On the right, you have altered states of existence where time and individuality cease to matter: Csikszentmihalyi’s flow, meditative trances, or just intense absorption in interesting work. On the left then, you would get similar altered states of existence, but those which are destructive instead of creative, like the zone machine gamblers desperately seek.
January 19, 2022 · Original source
This was another place where I found myself confused about why the US system works so badly. What exactly is “market price” for a drug in the US? Consumers don’t pay for drugs directly; only insurance companies pay for drugs. In Germany, all the insurance companies get together and form a Drug Price Bargaining Group, which bargains with drug companies the same way a government would. Why don’t insurance companies do that in America? Is the problem just that this would be a monopoly (technically a monopsony, I guess?) Is only antitrust law preventing them from trying this? Is this some kind of weird horseshoe theory situation where the maximally socialist response overlaps with the maximally libertarian one?
Housing First

Housing First is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between June 23, 2022 and June 29, 2022. The archive places it in contexts such as "Good People have united under an exciting new banner called “Housing First”"; "I think this is realistic for low-income housing ... programs I’ve looked at ... Housing First"; "the city’s Housing First program". It most often appears alongside Amsterdam, Bay Area, California.

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Housing First
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June 23, 2022 · Original source
…and find that: Those in the intervention group incurred 2.6 fewer hospitalized days (p = .08), 1.2 fewer emergency room visits (p = .04), 7.5 fewer days in residential substance abuse treatment (p = .004), 9.8 fewer nursing home days (p = .08), and 3.8 more outpatient visits each year (p = .01) annually compared with those in the usual care group. Those in the intervention group had 7.7 fewer prison days during the study period (p = .07). Those in the intervention group had 62 more days in stable housing (p = .001) and 12 more days in respite care (p = .002) than those in the usual care group. Those in the intervention group used case management services (i.e., telephone calls and face-to-face meetings) more frequently than those in the usual care group, having on average 18 more encounters per year (p < .001). This study provided case management along with the free housing. I don’t know whether to think of that as a confounder, or a standard aspect of Housing First programs (especially since it is much harder to case manage someone with no fixed address). Notice that it assumes the cost of housing is given as $30/day. I think this is realistic for low-income housing in Chicago, but other California programs I’ve looked at have worked out to more like $70 - $100/day, which (assuming nothing else changed) would switch the conclusion of this study from “Housing First saves money” to “Housing First costs money”. Now let’s see what San Fransicko has to say: The evidence for Housing First turns out to be significantly weaker than its proponents suggest. For example, the much lauded initiative to reduce homelessness among veterans was only four percentage points more successful than the overall decline in homelessness, when accounting for age, which is necessary to accurately estimate what is due to policy and what is due to demographic changes. As for Utah, its legislative auditor general concluded in 2018 that the 91 percent number was wrong, based on a sloppy use of incorrect methodologies. Before 2015, Utah had annualized its homeless count, meaning that researchers counted the homeless at a single point in time and multiplied the data by some factor. But after 2015 the state used raw point-in-time counts, causing a precipitous drop in the official population counts. Over the same period, the state also narrowed its definition of chronic homelessness in several ways, resulting in further apparent reductions. In reality, the homeless population in Utah increased by 12 percent between 2016 and 2020. An experiment with 249 homeless people in San Francisco between 1999 and 2002 found those enrolled in the city’s Housing First program, Direct Access to Housing, used medical services at the same rate as those who were not given housing through the program, suggesting that the Housing First program likely had minimal impact on the participants’ health. Wrote a team of researchers, “obtaining housing does not necessarily resolve other issues that may impede one’s housing success,” pointing to the lack of significant improvements in substance use and psychiatric symptoms over the twelve months that people were housed (the share of patients with severe substance use actually saw a modest increase). The problem with Housing First stems from the fact that it doesn’t require that people address their mental illness and substance abuse, which are often the underlying causes of homelessness. Several studies have found that people in Housing First–type housing showed no improvement in drug use from when they were first housed. In 2018, the National Academies of Sciences, Engineering, and Medicine published a review of the scientific literature of Housing First. “On the basis of currently available research,” the report’s authors wrote, with some surprise, “the committee found no substantial evidence that [permanent supportive housing] contributes to improved health outcomes, notwithstanding the intuitive logic that it should do so and limited data showing that it does do so for persons with HIV/AIDS.” Tsemberis said he was not surprised by the findings of the National Academies. “It’s not like housing creates improved health,” he said. “You have to have a relationship with a nurse. You have to be educated on what your health problems are. You have to have a team that engages you and makes you an active participant in your own health care. I don’t even know if that would stop the number of deaths.” And, at least in the study funded by Benioff and conducted by Margot Kushel, which had those services, it did not. All of this seems to fit with what I found above. But: Housing First may even increase addiction and overdose deaths and make quitting drugs more difficult. Warned a multiauthor review in 2009, “One potential risk [of Housing First’s harm reduction approach] would be worsening the addiction itself, as the federal collaborative initiative preliminary evaluation seemed to suggest.” The authors pointed to an experiment that had to be stopped and reorganized after the homeless individuals in the abstinence group complained of being housed with people in the control group, who didn’t stop their drug and alcohol use. “They claimed that they preferred to return to homelessness rather than live near drug users.” The multiauthor review cited is Housing First For Homeless People With Active Addiction: Are We Overreaching? They write: “It would be premature to conclude that Housing First programs cannot accommodate persons with severe addiction. But it also would be premature to suggest that research data provide clear guidance on whether, or how, Housing First programs can accommodate persons with ongoing severe drug and alcohol abuse. In the absence of research data on this subject, it is reasonable to consider the kinds of risks that may occur in Housing First programs. One potential risk would be worsening the addiction itself, as the federal collaborative initiative preliminary evaluation seemed to suggest (Mares, Greenberg, and Rosenheck 2007), or failing to progress toward addictive recovery.” Elsewhere, they describe this same study as: “The eleven-site federal collaborative initiative found an association between early access to housing and increases in alcohol problems during the subsequent year” The study is here, but I can’t find this result anywhere. It describes its own results (my emphasis) as: The average number of days housed in the previous 90 days increased dramatically from 18 at baseline, to 68 at the 3-month follow-up, and rose steadily thereafter to 83 at the 12 month follow-up (Table 2). Mean monthly public assistance income increased steadily from $316 at baseline to $478 one year later, a 50% increase. Significant improvements of modest magnitude were also observed in overall quality of life, mental health functioning, and reduced psychological distress. Alcohol and drug problems remained largely unchanged over time. Total quarterly health costs declined by 50%, from $6,832 at baseline to $3,376 at 12 months. A 54% decrease in mean inpatient costs ($5,776 to $2,677) accounted for nearly 90% of the overall decrease in quarterly health care costs during clients' first year in the program And the table (slightly edited for readability): I might be misunderstanding this - I can’t imagine why the authors of the review would have gotten this wrong - but it does look to me like alcoholism stayed steady throughout this study. A 24-month followup of what I think is the same study also finds that drug users who were housed used slightly fewer drugs over time, although probably not to any significant degree worth caring about: Continuing from San Fransicko: There is evidence that privacy and solitude created by Housing First make substance abuse worse. A study in Ottawa found that, while the Housing First group kept people in housing longer, the comparison group saw greater reductions in alcohol consumption and problematic drug use, and greater improvements to mental health, after two years. “One reason for the surprising results,” wrote the authors, “may be that aspects of the Housing First intervention, such as the privacy afforded by Housing First and harm reduction approach, might result in slower improvements around substance use and mental health.” Okay, but the next sentence after the one the book quoted was the researchers admitting that oops, we also totally forgot to randomize our groups in any way, so the experimental and control groups had totally different levels of severity and maybe that was why they found this weird thing (this is non-obvious, because we’re looking at change over time rather than raw differences between groups, but the authors discuss some reasons why different groups might change differently over time). A few years later these same researchers did a proper randomized study and it found no difference in drug use between the two groups. Somers, Moniruzzaman and Palepu found no difference in drug use between Housing First and other subjects. Padgett et al found the Housing First group actually did better, although they are another victim of the epidemic of randomization failures in this space. Kirst et al, no difference in drug use, but Housing First better with alcohol. Milby found that housing contigent on abstinence worked better than housing not contigent on abstinence, which Shellenberger could have used to support his thesis, but even Milby found that housing not contingent on abstinence worked better than no housing! To summarize: I can find seven studies on this topic, only one of them agrees with San Fransicko’s thesis, and the authors admit that it’s weak. I accuse San Fransicko of citing only that one and pretending all the others don’t exist. (actually, I accuse it of doing that plus citing a line from a review claiming another study found this, but as far as I can tell that study did not actually find it) This is extra annoying, because all the popular news articles on Housing First gush about how it definitely decreases substance use and everything else bad. Shellenberger could have made the excellent point that all of these progressive journalists were totally wrong! This would have been an interesting, important, and completely true act of virtuous data journalism! Instead he tries to hold up a lonely negative result as representative, and ends up just as wrong but in the opposite direction. Continuing in San Fransicko: Researchers have found ways to use housing to reduce addiction. Between 1990 and 2006, researchers in Birmingham, Alabama, conducted clinical trials of abstinence-contingent housing with 644 homeless people with crack cocaine addictions. Two-thirds of participants remained abstinent after six months, a very high rate of abstinence, compared to other treatment programs. Other studies found that around 40 percent of homeless in abstinence-contingent housing maintained their abstinence, housing, and jobs. In a randomized controlled trial, homeless people were given furnished apartments and allowed to keep them unless they failed a drug test, at which point they were sent to stay in a shelter. Sixty-five percent of participants completed the program. Three similar randomized controlled trials also found moderate to high rates of completion. And participants in abstinence-contingent housing had better housing and employment outcomes than participants assigned housing for whom abstinence was not required. All of this seems basically true. It turns out that over longer periods of time, Housing First may not even outperform contingency in terms of keeping people housed. In the spring of 2021, a team of Harvard medical experts published the results of a fourteen-year-long study of chronic homeless placed into permanent supportive housing in Boston. Most studies of permanent supportive housing, including the Kushel study conducted in Santa Clara, only study the newly housed homeless for a span of around two years. The study found that 86 percent of the homeless, who were referred based on length of time living on the streets, suffered from “trimorbidity”—a combination of medical illness, mental illness, and substance abuse. The authors found that after ten years, just 12 percent of the homeless remained housed. During the study period, 45 percent died. The authors concluded that, because the chronically homeless had such higher rates of physical and mental illness, “the supportive services, essential to the PSH model, may not have been sufficient to address the needs of this unsheltered population.” This study was done on an especially severe subgroup of homeless people. There was no control group, so Shellenberger shouldn’t claim we have any evidence about whether Housing First can “outperform contingency”. Shellenberger counts people who died as “unhoused” to get his 12% number; if he didn’t do this, the number would be 23%. Only 23% of people given housing retained after ten years sounds bad. But you could change this number to whatever number you wanted by changing the severity of the subgroup selected for the study. Select people who are even crazier and more disturbed than these people, and you can have 0% retained after ten years; select high-functioning people with no problems, and you can get 100% retained after ten years. (or maybe not - the study doesn’t say why people left the program. It mentions that one possible outcome is having to go to a nursing home because they had grown too sick or old to support themselves. I am not sure that “23% stay in this program” means “77% are back on the street and all their care has been a total failure”.) Conclusion: Housing First seems to work in getting people housing. It probably also helps people use fewer medical services, and it might or might not save money compared to not doing it (probably more likely when treating very severe cases, less likely in areas with high housing costs). It probably doesn’t affect people’s overall health or drug use status very much. San Fransicko is right to call out all the people promoting it beyond what the evidence supports, but then goes on to attack it beyond what the evidence supports. Interlude: Why Can’t We Just House All The Homeless? This is the question many of the California gubernatorial candidates asked. California has lots of money. There aren’t that many homeless people. Everyone is already committed to Housing First. So why don’t they have houses already? San Francisco has about 7,000 homeless people. The median SF apartment costs about $3,000 per month (presumably the government officials in charge would be trying to buy cheaper-than-median apartments for this project, but they seem bad at that, so let’s stick with median as a high-end estimate). So that’s $250 million/year to rent every homeless person an apartment. San Francisco has a $14 billion budget, although some of that is locked in nondiscretionary programs. So this effort would take about 2-3% of the city budget. Given how many people have both altruistic and selfish objections to the current level of SF homelessness, I can’t imagine that isn’t a better use of the money than whatever it’s being spent on now. So why hasn’t this happened? The closest thing I can find to the “rent apartments” plan is Governor Newsom’s “rent hotel rooms” plan, Project Roomkey. This was a short-term pandemic program. This article says it cost $4,000 per month, which seems reasonable - it provided residents with a hotel room, meals, security, and “custodial services” for just above a hundred dollars a day. So how come nobody has made it permanent or scaled it up? The homeless themselves don’t seem very positive on the project. They talk about “jail”-like conditions, including curfews and bans on visitors. I don’t know if this is the usual nanny-state-ism, or an attempt to reassure hotel owners / other residents / local communities that the influx of homeless people won’t cause them problems. If the latter, it hasn’t worked. From here: Jenna Abbott, executive director of the River District Business Association, said having a Roomkey motel in her neighborhood has been difficult. The site — which is in an area with large number of unhoused people — has drawn family and friends of Roomkey residents who haven’t been housed but “camp close to that hotel,” some with the goal of gaining a room, Abbott said. That’s led to more loitering, public drunkenness and trash outside the restaurants, gas stations and other businesses in the area, she added. And here’s another article about people objecting to local hotels accepting homeless people, which focuses on some combination of zoning, code, and public safety concerns. Everybody - the homeless, their advocates, various experts - interviewed in the article - agrees that the hotel rooms are kind of dehumanizing and much worse than having real housing. And this article suggests that government budgeters believe it’s not cost-effective compared to alternatives. Since the homeless don’t like it, and it’s expensive, almost everyone seems to agree it made sense as a short-term COVID measure only. The government’s preferred medium-term solution is single resident occupancy (SRO) hotels. These are big apartment/hotel-like structures where everyone has a small bedroom and then there are communal bathrooms and maybe kitchens. These used to be the archetypal living situation for poor Americans (Matt Yglesias talks about them as “boarding houses” here). But moral reformers banned them in the 1900s on the grounds that they were slums - I think this is the usual “surely the reason poor people live bad lives is because capitalists oppress them by selling them cheap low-quality goods, and if we just ban selling people cheap low-quality goods, everyone will have high-quality goods and poor people will live great lives!” argument. Somehow this failed to work and homelessness got worse over this period, but there are still some SRO hotels left, and the government got them and converted them to public housing for homeless people. Shellenberger does not have high opinions of these: The Tenderloin [district of San Francisco]’s single resident occupancy hotels . . . have for decades been dominated by a culture of heavy substance use and prostitution. “Of the people in supportive housing in San Francisco, 93 percent have a major mental illness that we can name,” said a housing policy maker. “That is very, very high. Eighty percent use cocaine, speed, or heroin every thirty days, or get drunk to the point of unconsciousness.” Tom Wolf, a former Salvation Army caseworker and a member of San Francisco’s Drug Dealing Taskforce, says the city’s supportive housing facilities are themselves a major market for illegal drugs. “Go down the street to the Camelot Hotel on Turk Street,” said Wolf. “Almost everyone that I’ve seen in those hotels are using. The last front desk guy that was working there got busted because he was selling crack. The actual guy that works in the single resident occupancy hotel is selling crack! It’s insane, man.” In any case, there are only so many of these still left. The government often announces plans to buy defunct regular hotels and convert them into these structures, which would indeed be a medium-term solution for housing the homeless, except that they usually get bogged down in fights about code. Politico discusses one of these attempts in New York City (h/t Marginal Revolution): “There are very few hotels that physically could be converted and comply with the requirements of today’s zoning and building code without substantial, expansive reconstruction, partial removal or demolition,” said James Colgate, a land use partner at Bryan Cave Leighton Paisner LLP who has advised clients on zoning issues including the conversions of hotels. “That would increase the costs greatly.” For example, a building’s elevators, doorways, or rooms may be slightly short of the size required for a residential structure. Residential buildings are also required to have a certain amount of rear-yard space that a hotel may not have. “You would literally have to be chopping off part of the building,” Rosen said. …The legislation dictates that each unit include a kitchen or kitchenette with a full-sized refrigerator, cooktop and sink — something Rosen said made utilizing the program “simply too expensive.” “This is the classic case of the perfect being the enemy of the possible,” said Mark Ginsberg, a partner at the firm Curtis + Ginsberg Architects, which has worked on hotel conversions. Some advocates who pushed the creation of the program say those provisions were necessary to ensure it didn’t generate substandard housing […] “We didn’t want a program that cut corners to make it more palatable to developers,” said Joseph Loonam, housing campaign coordinator for the progressive advocacy group VOCAL-NY. “We wanted a program that centered the needs of homeless New Yorkers, which is true high quality affordable housing where they can have full autonomy and dignity.” As Marginal Revolution pointed out, Loonam got what he wanted; the expensive, over-regulated program was unpalatable to developers, with only one company putting in an offer; for whatever reason, NYC refused to go with that one company, and no housing was produced. But fine, these are also terrible, and they’re only medium-term solutions anyway. What about building real, long-term apartments for homeless people? Shellenberger tells the story of Los Angeles’ Proposition HHH, which raised $1.2 billion to do exactly this. They hoped to build ~10,000 units for the homeless, at a projected price of $140,000 each; since LA had about 30,000 homeless people at the time, this would solve a third of the problem - a good start. (how do these numbers line up with my back-of-the-envelope calculation for SF above? I talked about renting rather than building, but usually annual rents = 1/20th or so of total prices, so I was estimating about $700,000 per person. This is probably partly because SF costs more than LA, and partly because I was imagining median apartments whereas LA is probably working on very cheap apartments) But in fact, five years later, LA has completed only 700 units, and the cost per unit has spiralled to $531,000 each. Nobody has a good explanation for what happened, with Shellenberger quoting one local service provider who said a lot of it was “bullshit costs”. Now might be a good time to re-read Considerations On Cost Disease. [Update: this might not be accurate - see this comment] This seems to be a general problem: everyone is committed to Housing First and to long-term good solutions rather than short- or medium- term mediocre ones. But that means building housing. And some combination of NIMBYism and over-regulation means building housing is somewhere between ruiniously expensive and impossible. Claim 4: Shelters Are Unpopular Among Progressive Activists And The Homeless Themselves San Francisco doesn’t have more homelessness than eg New York, but almost all the homeless in New York live in shelters and stay off the street. Why doesn’t that work here? Shellenberger: In the context of cities with permissive attitudes toward drugs, like San Francisco, many homeless people stay in [tent] encampments to use illegal substances more freely and easily than they can in the shelters. Many policy makers understand this. “I went out with a team twice to have conversations with people to get an understanding of what they’re dealing with,” said Mayor Breed in 2020. “It was absolutely insane. Most of the people did not take us up on the offer [of shelter and services].” Even people who would prefer to live in sober environments say they do not want to quit their addictions. “When we surveyed people in supportive housing in New York,” said University of Pennsylvania homelessness researcher Dennis Culhane, “almost everybody wanted their neighbors to be clean and sober but they didn’t want rules for themselves about being clean.” In 2016, after the city of San Francisco broke up a massive, 350-person homeless encampment, dozens of the homeless refused the city’s offers of help. Of the 150 people moved during a single month of homeless encampment cleanups in 2018, just eight people accepted the city’s offer of shelter. In 2004, just 131 people went into permanent supportive housing after 4,950 contacts made by then-mayor Newsom’s homeless outreach teams. An article by a former homeless person explains the problems with shelters beyond just “can’t use drugs”. Residents are crammed into a small space with 300 other homeless people. Lice and bedbugs are everywhere. Everybody catches every disease. Everybody has stories about getting raped or beaten up. Invasive moralizing about drugs somehow exists side by side with rampant drug use. Shelters are gender segregated, which means straight people can’t stay with their partner. Most shelters ban children and nobody has any idea what to do with them. Most shelters ban pets - a lot of homeless people have dogs for protection or companionship, and you can’t just store them somewhere while you’re sheltering. Although some lucky people can get 90-day beds, other people need to apply for beds on a day-by-day basis, which requires waiting in line several hours every day. Users talk about rampant cutting in line, denying cutting in line, false accusations of cutting in line, etc. Most shelters kick people out between 9-5, either to save on staffing costs or in the hopes that they’ll get a job. But many have strict curfews requiring people to be back by 5 PM sharp, which can make jobs impossible - if your boss doesn’t let you out until 5 and you have a half-hour commute, how do you get back to the shelter on time? Results of a survey at one of SF’s new Navigation Centers at why their clients refused to go to normal shelters. But even the homeless people who do want to go to shelters mostly can’t get in. This app gives the current status of San Francisco’s homeless shelter waitlist. If you applied today, there would be 900 people ahead of you in line for one of the city’s 1500 - 2500 shelter beds. The app says that the median wait time is 826 days. So however many homeless people don’t want to go to shelters, we’re not building enough shelters to serve the ones who do. Why not? Shellenberger again: In the spring of 2021, Friedenbach published an op-ed opposing a proposal considered by the San Francisco Board of Supervisors to create, within eighteen months, sufficient homeless shelters and outdoor “Safe Sleeping Sites” for all of the city’s unsheltered homeless. “One can simply take a look to New York City,” she wrote. “Their department spends about $1.3 billion dollars of its budget on providing shelter for their unhoused population while thousands remain on the street. . . . As a result, New York has a higher rate of homelessness than San Francisco.” Housing First advocate Margot Kushel of the University of California, San Francisco agreed. “The problem with New York—and I spend a lot of time with people working in the system in New York—is that they spend an estimated $30,000 for each person per year to keep them in shelter. That’s not what we want to do. Because if you create the shelter and you don’t create the housing, then people are just in shelter forever.” Housing First advocates oppose shelter in Los Angeles. “Why haven’t we solved homelessness?” asked Housing First creator Sam Tsemberis. “Because [Los Angeles mayor] Eric Garcetti [has] Andy Bales [saying,] ‘You need emergency housing.’ ‘These people need to be cleaned up.’ ‘They need to be sober.’ ‘They need Jesus before they’ll be ready for housing.’ I said, ‘People should be housed and then maybe they’ll get sobriety and Jesus and the rest.’ We’re definitely on polar opposites of the whole thing.” Advocates for the homeless at the national level similarly oppose more shelters. “I don’t agree that we should be building more transitional housing,” said the head of the National Alliance to End Homelessness. […] In other words, the reason that there are so many homeless people on the streets in San Francisco is that both progressive and moderate Democratic elected officials, and the city’s most influential homelessness experts and advocates, have for two decades opposed building sufficient shelters. And that is unlikely to change even after San Francisco starts spending hundreds of millions more per year on the problem and might even get worse. This basically seems true. I found this webpage of a former SF Supervisor candidate a helpful corroborating source. He was running on a platform of “maybe we should build some homeless shelters”. He lost. You can also find a bunch of webpages by the sorts of people Shellenberger is complaining about, for example this site: Sup[ervisor] Rafael Mandelman today pushed his new legislation that would require the city to offer at least temporary shelter to everyone living on the streets, a step that some say would lead to more homeless sweeps and do nothing to create permanently affordable housing . . . [our] Coalition has argued for years that the solution to homelessness is housing—not temporary shelter, which may never lead to housing. The ex-supervisor candidate gives some helpful numbers: permanent housing costs about $600,000 per person housed. Shelters cost between $20,000 and $30,000 per person housed. So SF could build enough shelters to clear its waitlist for about $30 million. More recently, SF has tried a sort of compromise, opening “deluxe” shelters called Navigation Centers which avoid some of the problems of regular shelters. They also cost more than twice as much, and the city has only created about 300 beds. Also, the people in regular shelters are angry, because being in a regular shelter disqualifies you from getting into a (much better) Navigation Center. Some of them are considering leaving their shelter, going back on the streets, then waiting however many months or years it takes to get a Navigation Center bed instead. I’m not at all sure of these numbers, but it looks like of SF’s ~7,000 homeless, about 2,000 are in shelters already, and 1,000 are on the shelter waitlist. I don’t know if the remaining 4,000 have made a specific commitment not to go to shelters, or just have given up on the waitlist process. My conclusion: agree with San Fransicko about the role of progressive activists, but I think it overemphasizes the role of wanting to use drugs in why homeless people themselves sometimes avoid shelters, and underemphasizes the many other problems with them. Claim 5: Drug Decriminalization Isn’t Working California legalized marijuana in 2016. Shellenberger says that San Francisco’s commitment to drugs has gone beyond that: it has effectively decriminalized opioids, cocaine, and the rest. Any attempt to lessen use of these drugs is attacked as “stigmatizing”; instead, government policy centers around providing addicts with needles and other drug paraphernalia under the guise of “harm reduction”. Shellenberger hits all the right beats here. Like many people, he tries to undo the damage done by The New Jim Crow, a book which convinced millions of people that mass incarceration was driven by a racist War On Drugs. In fact, less than a fifth of prisoners are in for drug-related crimes. And when the government was first debating the War on Drugs and mass incarceration, black leaders were among the strongest proponents of both. The talking point at the time - among everyone from black Congressional leaders to black churches - was that the government’s failure to crack down on drug use was racist, borne of them not caring about predominantly black drug victims. And while we’ve been patting ourselves on the back about how enlightened we are for ending the drug war: Drug overdoses are today the number one cause of accidental death in the United States as a result of America’s historic addiction and overdose epidemic. Overdose deaths rose from 17,415 in 2000 to 93,330 in 2020, a 536 percent increase.Significantly more people die of drug overdoses today than of homicide (13,927 in 2019) or car accidents (36,096 in 2019). […] There are about twenty-five thousand injection drug users in San Francisco, a number 50 percent larger than the number of students enrolled in the city’s fifteen public high schools. San Francisco gives away more needles to drug users, six million per year, than New York City, despite having one-tenth the population. The part of this chapter that stood out to me as most worth looking into deeper was the section on Portugal: For decades, harm reduction and decriminalization advocates have pointed to Portugal as a model, noting that it decriminalized drugs and expanded drug treatment. In 2013, Portugal’s drug-induced death rate was sixty-six times less than that of the United States. The number of people in treatment increased by 60 percent between 1998 and 2011, with three-quarters receiving an opioid substitute like methadone or Suboxone, the brand name of buprenorphine. Drug use among 15- to 24-year-olds actually declined after decriminalization. “All drugs have been legalized,” explained Monique Tula, executive director of the Harm Reduction Coalition. “Their focus is on giving people tools, like job apprenticeships, and the means to support themselves.” […] [But Portugal] never legalized drugs. It only decriminalized them, reducing criminal penalties but maintaining prohibition. Drug dealers were still sent to prison even after the 2001 decriminalization. And Portugal does not let people addicted to hard drugs with behavioral disorders off the hook like progressive West Coast cities have done. It’s true that Portugal massively expanded drug treatment, but people are still arrested and fined for possession of heroin, meth, and other hard drugs. And drug users are typically sent to a regionally administered “Commissions for the Dissuasion of Drug Addiction,” composed of a social worker, lawyer, and doctor who encourage, push, and coerce drug treatment. And decriminalization doesn’t end drug violence. “Even if trafficking enforcement decreased, like it did in Portugal,” said criminologist John Pfaff, “illegal drug markets would still be forced to rely on violence to resolve disputes.” Indeed, prostitution and violence are ever-present in the open-air drug scenes in San Francisco, Los Angeles, and Seattle. “We are seeing behaviors from our guests that I’ve never seen in thirty-three years,” said Rev. Andy Bales, who runs the largest homeless shelter on Skid Row in Los Angeles. “They are so bizarre and different that I don’t even feel right describing the behaviors. It’s extreme violence of an extreme sexual nature.” People are not dying from drug overdose deaths in San Francisco because they’re being arrested. They’re dying because they aren’t being arrested. Decriminalization reduces prices by lowering production and distribution costs, which increases use. This was also the case for alcohol consumption. It increased after prohibition ended in the United States. Even in Portugal, drug overdose deaths and overall drug use rose after decriminalization. I was most surprised by the claim that Portuguese overdose deaths rose after decriminalization. Uncharacteristically, San Fransicko doesn’t give a citation for it, but we can try to retrace its reasoning. Decriminalization proponents tend to point to these numbers, helpfully converted to per 100,000 population and graphed here: But an anti-drug Australian think tank argues that the peak in 2001 is made up: Claims that there were more than 75 drug-related deaths in 2001 which more than halved to 34 deaths in 2002 use a figure for 2001 for which there is no substantiation. Official drug-related deaths for Portugal, taken from the latest 2018 EMCDDA Statistical Bulletin are copied below. Notice that there is no such figure recorded for 2001. They include a link to EMCDDA, the EU organization charged with monitoring these things. The link contains two datasets, both of which seem to be measuring the same thing but getting different results. One dataset starts in 2002, the other in 2008. I don’t know what the difference here is, but they’re right that neither includes 2001. If you ignore the pre-2002 data, the graph looks like this: They say “opiate”, but AFAICT these numbers are actually about all drugs. But the proponents link to the updated 2020 version of the same website, which all of a sudden does have data from 2001 and before. I don’t know why EMCDDA can’t make up its mind, but I think the Australians are wrong and the original graph is fine. On the other hand, does it really matter? Both of these show drug deaths decreasing until 2005, then going up and down a bit, then going back up again starting in 2011. I think a reasonable interpretation would be that decriminalization in Portugal did decrease overdose deaths a bit, and then they started rising again from that low baseline around the same time other European countries saw rising overdose deaths. I would also accept “these are pretty small effects and we shouldn’t ascribe any significance to them”. But San Fransicko’s claim - that overdose deaths increased after the reform - seems false. The only way I can see justifying it is taking the second graph - the one that wrongly claims there is no pre-2002 data - and then attributing the fact that twelve years after the reform lowered deaths, deaths finally rose above the pre-reform level to be the fault of the reform. This is like saying “people claim the Black Plague killed a lot of Europeans, but the European population actually rose after the Plague”, which is true in the sense that it was above its pre-Plague max by like 1600 or whatever. What about overall drug use? Here I recommend A Resounding Success Or Disastrous Failure: Re-examining The Interpretation Of Evidence On The Portuguese Decriminalisation Of Illicit Drugs, which is on exactly this topic of how people keep selectively quoting results from Portugal to prove their point. It argues that drug use is inherently hard to measure. There are four different Portuguese datasets for the time at issue, lots of different drugs, lots of different age/gender combinations, and lots of different ways of measuring drugs (did you use drugs in the past month? the past year? your lifetime?) It’s easy to tell a story of how past-month cocaine use skyrocketed among 14-29 year old males according to X source, or how lifetime marijuana use fell in high school-age women according to Y. The main trick that opponents use is measuring lifetime drug use. Portugal is a very conservative country; drug use is pretty new and most of the older generation wasn’t involved. So as time goes on and more and more people try drugs but “un-trying” drugs isn’t a thing, the percent of the population who have tried drugs inevitably goes up. This definitely happened but isn’t a fair reflection of any specific reform. The authors find that in the past decade or so, there has been a bit more short-term experimentation with drugs, but less long-run use. They conclude: As shown in Figure 2, general population (aged 15–64) trends for recent and current drug use in Portugal indicate minimal if any changes between 2001 and 2007. Instead, rates of discontinuation of drug use (the proportion of the population that reported ever having used a drug but opting not to in recent years) increased, which reinforces that just as in the school populations, the growth in lifetime-reported use reflected predominantly short-term experimental use. Increases in recent and current drug use were more notable in some cohorts, particularly those aged 25 to 34 (albeit, with a maximum of 7% of any one cohort reporting recent use, absolute levels remained low). But as shown in Figure 3, recent and current drug use declined among those aged 15–24, the population who were most at risk of initiation and long-term engagement. The available evidence thus gives grounds for arguing that while there was some growth in the scale of drug use in post-reform Portugal, there was an overall positive net benefit for the Portuguese community. What about San Fransicko’s main point - that as the US has wound down the War on Drugs, drug overdose rates have sextupled? I think this is mostly not causal. I think the sextupling of overdoses is a combination of expansion in prescription opioid use, various forms of social decay making people less happy and therefore more likely to use drugs, and “improvements” in drug “technology” and the “supply chain” (eg production of fentanyl in China). I don’t know of any source that attempts to tease out the exact contribution of all of these things, but I would note that overdose deaths have risen the most in very conservative Midwestern states that haven’t walked back the drug war as much as California. Conclusion: As usual, I appreciate San Fransicko’s corrections to the prevailing narrative, but its own additions are dubious. Its claim that Portugal saw increased drug-related deaths seems false as far as I can tell. Its claim that it saw increased drug use depends on your definition, but is misleading and not the most natural way to sum up the evidence. Claim 6: San Francisco’s Soft-On-Crime Policies Led To Rising Crime Ten years ago, the news was full of stories about how some teenager stole a gumdrop and was sentenced to nine hundred billion years in jail. At some point, there was a genre shift to stories about how some hardened criminal murdered fifty people with an axe and the judge let him go with a warning because having jails felt racist. Source: Ed West, do note that this example is from the UK How suspicious should we be of each type of story? There will always be an extreme right tail of overly harsh sentences, and an extreme left tail of overly lenient ones. Were the 2000s really as draconian as they felt? Is the modern era really as pathetic? Or is it all just a function of who you read and what agenda they’re pushing? Shellenberger: During California governor Jerry Brown’s time in office, voters passed several reforms aimed at reducing the size of the prison population. In 2012, voters passed a change to the Three Strikes law so that the third strike imposes a life sentence only if the new felony was serious or violent. In addition to lowering punishments for drug possession, Proposition 47, which voters passed in 2014, redefined shoplifting, forgery, petty theft, and receiving stolen property as misdemeanors when the value in question does not exceed $950. In 2016, voters approved a proposition that shortened the time it took for some nonviolent offenders to be eligible for parole and which released nonviolent offenders into drug treatment and rehabilitation. Property crimes rose in San Francisco starting in 2012. Larceny, which is shoplifting and other petty theft, rose 50 percent, from roughly 3,000 incidents per 100,000 people in 2011 to about 4,500 in 2019. Property crimes as a whole, which include larceny, motor vehicle theft, and burglary, rose from 4,000 incidents per 100,000 people in 2011 to 5,500 in 2019. One study suggests that Proposition 47 increased the rate of auto theft 17 percent and the rate of larceny (non-auto property) theft 9 percent, but discerning between causation and correlation may not be possible. Upon taking office in January 2020, [famously soft-on-crime San Francisco district attorney Chesa] Boudin followed through on his campaign promises. Instead of prosecuting and incarcerating people for breaking car windows to steal money and other items from inside, Boudin proposed creating a $1.5 million fund to reimburse car owners. But there were over 25,000 car break-ins reported in 2019. If every break-in cost just $250 in repairs, the fund would need four times that amount. And what would prevent people from falsely claiming to have been robbed in order to get city money? […] Boudin opposed efforts by the mayor and the city attorney to prevent drug dealers who had already been arrested from entering the Tenderloin. “Until the city is serious about treating addiction and the root causes of drug use and selling,” said Boudin in a statement, “these recycled, punishment-focused approaches are unlikely to succeed at doing anything more than making headlines.” Home burglaries rose in early 2021 in San Francisco. Homeowners started posting on Twitter videos from their security cameras of people breaking into homes and garages. “When I first moved here we had a car break-in problem,” said Michael Solana, a writer who works for a venture capital fund. “Now we have a home invasion problem. These things are wearing on people.” Boudin attributed the rise of burglaries in San Francisco to the decline of tourism and “people in desperate economic circumstances.” Progressive supervisor Hillary Ronen agreed. “We know that [economic insecurity and inequality] is one of the root causes of property crimes specifically,” she said. But Tom Wolf and others argued that the robberies were, like the shoplifting, done by people seeking money to buy drugs and feed their addictions. “The drugstores have been shoplifted to death and that’s all because of drug use,” said Tom. “I know. I used to do the same thing when I was out there. That’s what you do. You ‘boost.’ And then you go and you sell your stuff down at UN Plaza,” an open-air drug scene. In a May 2021 city supervisors’ meeting, a representative from CVS called San Francisco “the epicenter of organized retail crime in the country” and claimed that 85 percent of the shoplifting is committed by organized theft rings. Police broke up one such ring in October 2020 and recovered $8 million of stolen merchandise. The problem goes beyond property crime. Boudin declined to prosecute two men who went on to kill people. One man had been repeatedly arrested for stealing cars, despite having just been released from prison earlier in the year, and appeared to be abusing meth. On New Year’s Eve, 2020, the man killed two people while driving intoxicated. Police found inside of his car a semiautomatic handgun and twenty-three grams of methamphetamine. On February 4, another intoxicated driver killed a pedestrian in a stolen car. The San Francisco police had arrested him in October 2020 for possessing a stolen car, a tool for stealing cars, and what appeared to be meth. Boudin chose not to pursue charges. In December, the California Highway Patrol arrested the man again for driving a stolen vehicle under the influence. Again he was not prosecuted. The accident victim, an immigrant from Kenya, and his wife had moved to San Francisco two weeks before the fatal crash. “I blame the DA,” said the widow of the victim. The suspect, she said, “was someone who was out in the public who shouldn’t have been in the public. It was completely avoidable.” Tom said he could feel the difference on the streets. “Drug dealing is unabated and it’s not one guy, it’s fifty guys dealing fentanyl and meth,” he said. “And it’s going unabated because the district attorney says, ‘These are the nonviolent, quality-of-life crimes,’ and ‘I’m not going to prosecute them.’” [..] District Attorney Boudin was offering weaker sentences than even defense attorneys were requesting, according to Vicki Westbrook of San Francisco. “There’s a defense attorney who said, ‘It used to be that I would argue for this deal in court with the DA but now I don’t say anything because the DA is going to offer me a deal better than what I would have suggested. Somebody shot up the street with an automatic weapon. The first offer was six months in jail or time served plus two years of probation or something. And then [the DA] said, “How about thirty days in jail?”’” Vicki laughed. “You really can do anything in San Francisco,” she said. “If you do get arrested, chances are you’re going to be out of jail in less than thirty days for damn near everything except maybe killing somebody and maybe even then, too. It’s hard to say at this point.” Taking each of these points individually: Proposition 47 There are two good big studies on the effects of Prop 47, one by Public Policy Institute and one by some UCI criminologists. The PPI study finds that the proposition increased theft and car break-ins by about 10%. The UCI study finds the same, but notes that under different assumptions the effects wouldn’t quite obtain statistical significance. This seems a bit too much like post hoc trying to get rid of an inconvenient effect, plus an effect on the border of statistical significance is different from positively finding no effect. I think a reasonable interpretation is that theft and car break-ins rose about 10% because of the proposition, just as Shellenberger says. Some pro-47 sites note that most states have some limit on how much you to have to shoplift before it’s a felony, and Prop 47 brought California closer to the national average, rather than turning it into an outlier. Chesa Boudin Chesa Boudin took office two months before the COVID pandemic began. Any attempt to separate the effect of Chesa Boudin from the effect of the pandemic is doomed. Shoplifting definitely plummeted when Boudin took office, but that’s because all the stores were closed. Murders definitely rose a little after Boudin took office, but that’s because that was also when the Black Lives Matter protests happened, which demoralized police and led to a so-far-permanent spike in murders nationwide. Percent of criminals caught definitely fell when Boudin took office, but that’s because various aspects of the justice system were closed for COVID (I will grudgingly entertain speculation that a further decrease in arrest rates from 2020 to 2021 may have been a genuine Boudin effect). In the absence of any real way to judge his performance, I think San Fransicko’s points about Boudin are plausible, though speculative. Shoplifting This one is terrible. There’s a surprisingly spirited debate here (some of you may have already read Applied Divinity Studies’ article). The debate is: everyone on the ground in San Francisco - store owners, security guards, customers, random citizens - say that shoplifting has increased massively over the past decade. But statistics mostly say it hasn’t. Source here. This is shoplifting crimes per 100,000 people. Kern County is a deep red county in California (including Bakersfield) that is known for being tough on crime. Against this, seriously, everyone says that shoplifting has obviously increased. I had a patient who worked in shoplifting prevention, he told me - his psychiatrist! Who he had no reason to lie to! - that he was constantly stressed dealing with the shoplifting surge devastating the stores he covered. Here’s the San Francisco subreddit’s response to someone posting the data showing shoplifting hasn’t risen - it’s just a lot of people laughing hysterically. What’s going on? I was able to find a different set of statistics that does seem to show a longer-term increase in shoplifting (source): The very big spike at the end might be a change in reporting by one or two stores - you can find the argument here. But it does look like shoplifting went from about 125 incidents/month in the early 2010s to more like 250/month just before the pandemic. Why is this graph so different from the other one? It looks like the top one came from the Department of Justice, and the bottom one came from SFPD. I’m not sure why these report differently. When you multiply out by 800K people in SF, by 12 months/year, and 30ish days/month, the first graph corresponds to 4 shoplifting incidents per day, and the second to 6. As LouB’s analysis here points out, that seems suspiciously low for a city of 800,000 people where stores are constantly closing because of shoplifting. Maybe off by a factor of a few hundred from what we’d expect. LouB writes: The SFPD report only references shoplifting offenses that required SFPD officers to prepare an incident report. That means either the shoplifter fought security, committed additional crimes, or stole more than $950 worth of items. It’s not that SFPD’s report is erroneous, it’s just not a representative statistic. In a parallel statistic, SFPD only completes incident reports for traffic accidents when there is an injury. Therefore, thousands of noninjury accidents are handled civilly without SFPD reports the same way thousands of shoplifting offenses are handled without reports. An insurance company would not determine premium rates based solely on SFPD incident reports, nor should readers interpret SFPD shoplifting reports as anywhere near the total picture of the shoplifting epidemic in San Francisco. (this would also explain why one or two stores changing their reporting policy can produce a spike equal to everyone else in San Francisco combined) But comparing incident reports from 2010 to incident reports from 2020 should still be apples-to-apples, unless the likelihood of reporting any given incident changed in the meantime. Did it? This news article quotes a San Franciscan who says that when they try to report shoplifting incidents, the cops tell them not to because “it doesn’t make a difference”. If cops say that now more often than they used to, it would make all these statistics meaningless. (Applied Divinity Studies claims to have an argument that shows this can’t be true. It goes something like: if San Francisco was a better place to shoplift than its neighbors - eg Oakland - then shoplifters would leave Oakland to go to San Francisco, and we would see Oakland shoplifting rates falling. Oakland shoplifting rates are falling, but no more so than the rest of the state, so there can’t be increased tolerance for shoplifting in San Francisco. I find this dubious for many reasons. First of all, many of the same reasons shoplifting is up in San Francisco - like Prop 47 or soft-on-crime progressive policies - also apply to Oakland. Second, given that shoplifting fell massively everywhere because of the pandemic, it feels dubious to try to compare different cities; maybe one city had stricter pandemic lockdowns than others. Third, do criminals really shop around for friendly jurisdictions? If so, why are so many crimes like car break-ins, concentrated in “the bad part of town”? Why wouldn’t criminals leave the bad part of town for under-exploited areas with richer residents and less competition? Maybe criminals in fact aren’t very strategic or mobile? Maybe they don’t want to stand in the BART station and then take a half-hour train ride holding a bag of stolen goods?) Maybe a better argument against this being true is how stable the shoplifting rates have been over time. Wouldn’t it be weird if (let’s say) a tripling of the real shoplifting rates was matched by a third-ing of the reporting rates (rather than a halving or a quartering or whatever)? On the other hand, here’s Shellenberger with some helpful data: Some of this is probably because of Proposition 47, which made some forms of shoplifting punishable with citation rather than arrest (but wouldn’t that be a clear discontinuity rather than a gradual trend?) But overall it sure seems like shoplifting is being taken less seriously, which might encourage people to report less. Another statistic I see is that only 2.3% of shoplifting cases result in an arrest; I don’t know how this is different from the graph above with numbers in the 30s; maybe it involves different levels of what makes something a “case”. I accept that the data don’t consistently show a spike in shoplifting. But what’s the alternative? My patient who works in loss prevention in SF stores is lying to me? The nice elderly Chinese man who sold me my last pair of glasses and chatted to me about the rampant shoplifting in his mall was lying? The San Francisco police are lying? Walgreens pretends to be concerned about shoplifting as part of a dastardly plot to close a bunch of stores for no reason? Target and CVS pretend to care about shoplifting as part of a plot to restrict their stores’ opening hours for no reason? Every big store near me has suddenly gotten a security guard at the front as part of some corporate-sponsored jobs program? Maybe the conservative narrative that soft-on-crime San Francisco must be experiencing rising crime rates took on a life of its own. Maybe it infiltrated not just the usual suspects like the SF police unions, but even such supposedly-liberal bastions as the New York Times. Maybe lots of big corporations took advantage of the fake narrative to make unpopular business decisions they were planning on making anyway. And maybe ordinary San Franciscans, confronted with everyone telling them they were in a shoplifting epidemic, started paying more attention to security guards and petty criminals who had always been there, a sort of mass hallucination that gripped everyone in the city. I can’t rule this out. Americans thought crime was rising all throughout the early 2000s, when it was in fact way down. Or maybe some statistics that we already know are off by several orders of magnitude got off by an additional factor of two or so. I think this one is more likely, but I’m genuinely not sure. Other Crime From the Economist: The Center on Juvenile And Criminal Justice puts it even more starkly, arguing that “San Francisco’s ‘Crime Wave’ Is Just One Crime”: This are potentially susceptible to the same reporting bias as shoplifting. So what about homicide? Homicide is practically always reported and investigated, making it a gold standard in crime measurement. (source) Looks pretty good until 2019. I don’t expect to gain useful information post-2020; the pandemic and the post-George-Floyd murder surge will make it impossible to evaluate for local variation. What about compared to other places? For some reason this top 20 table fails to list Washington DC, which should be just before Atlanta. SF doesn’t make the top 20, although its neighbor Oakland does. Probably most murder variation in US cities is explained by percent African-American and maybe percent Borderer; with relatively few people in these groups SF was never in the running. I’m not sure if some abstracted version of the city with all demographic factors adjusted away would have an unusually high murder rate, but at that point it would be pretty distant from any interesting real-world question. You can see the leaderboard for other types of crime here; San Francisco is often in the top ten, but never the top three. As far as I can tell, San Francisco has seen a big spike in car breakins over the past few years, with no clear trend for other property crime, violent crime, or homicides. It’s not an outlier among American cities in any kind of crime. Conclusion of this section: San Fransicko’s specific claims are basically correct, but suggest a medium-term rise in SF crime which is mostly contradicted by the data. These show stable-to-decreasing murder, stable-to-decreasing violent and property crimes other than car break-ins, and large rises in car break-ins only. The data also show stable-to-decreasing shoplifting, but I’m not sure how much to trust them vs. common sense. Honestly, I’m pretty confused here and not sure what to think. Claim 7: Jim Jones (Of Kool-Aid Cult Fame) Used To Be The Chairman Of SF’s Housing Authority Okay, this isn’t really a statistical claim that I can research different perspectives on. Still, it’s so wacky that I couldn’t resist mentioning it in this review. Jim Jones, famous for killing everyone in his Guyana-based Jonestown cult with poisoned Kool-Aid, used to be the SF government’s top guy on homelessness. Shellenberger writes: Jones married and moved first to Northern California and then to San Francisco with his wife to start a church. He called it the People’s Temple. Jones believed he was the leader of a socialist revolution. He warned of nuclear war and claimed black people would be put in concentration camps. He became a hugely charismatic preacher among African Americans, the disaffiliated poor, and young transplants to the city looking for community. Scenes from the era show a remarkably large and diverse congregation smiling and singing. The People’s Temple grew and provided services. Jones cultivated two progressive San Francisco politicians, George Moscone and Willie Brown, and mobilized people to volunteer for their campaigns […] His son and a San Francisco historian believe he stole the mayoral election for Moscone in 1975. Historian David Talbot, founder of the progressive website Salon, points to evidence that Jones committed sufficient voter fraud to account for Moscone’s narrow 4,443-vote margin of victory. “We loaded up all thirteen of our buses with maybe seventy people on each bus, and we had those buses rolling nonstop up and down the coast into San Francisco the day before the election,” said Jones Jr. “Could we have been the force that tipped the election to Moscone? Absolutely! Slam dunk. He only won by four thousand votes.” When federal investigators looked into fraud claims three years later, they discovered that all of the records were missing from the city of San Francisco’s registrar of voters. Jones also boasted of providing Moscone with black women from his congregation for sex. One time Moscone, drunk and “accompanied by a young black woman whom the politician had kindly agreed to drive home,” crashed into another car. Another time, Moscone and Willie Brown “were with a black woman in an alley at two in the morning at some restaurant in North Beach,” said a local bar owner. State legislator “John Burton was part of that gang too. They were all using marijuana and cocaine.” Said Jones Jr., Moscone would “always be there at temple parties with a cocktail in his hand and doing some ass grabbing.” A Temple member overheard Jones speaking to Moscone the day after one of those parties saying, “I want to let you know that the young lady you went off with is underage,” adding, “Now don’t worry, Mayor, we’ll take care of you—because we know that you’ll take care of us.” Afterward, Moscone made Jones the chairman of the powerful San Francisco Housing Commission. Jones cultivated progressives with money and favors. He made large donations to the ACLU, the NAACP, and United Farm Workers. Jones and Moscone met privately with vice presidential candidate Walter Mondale on a campaign plane a few days before the 1976 presidential election, and Mondale praised People’s Temple shortly afterward. Jones met with First Lady Rosalynn Carter several times. Governor Jerry Brown praised Jones. Glide Memorial Church’s Rev. Cecil Williams loved Jones. There is a photo from 1977 of a smiling Williams awarding Jones the church’s “Martin Luther King, Jr. Award.” Jones used his perch as chairman of the Housing Commission to fight for housing for the poor. He tried to use eminent domain to acquire the International Hotel, a single resident occupancy hotel. After a court sided with the hotel’s owner, Jones mobilized seven thousand protesters to picket it. By mid-January 1977, the situation had become heated. There were rumors that protesters inside the building were armed with guns and Molotov cocktails. Jones lost the legal battle in 1977, and the tenants were evicted. But the drama was a publicity victory for Jones, which burnished his image as a white savior. A conservative member of the Board of Supervisors who was defeated in the mayoral election by Moscone accused the new mayor, the San Francisco Chronicle, and the rest of the city establishment of being blind to Jones’s extremism. “There’s no radical plot in San Francisco,” insisted Moscone, in response. “There’s no one I’ve appointed to any city position whom I regard as radical or extremist.” Willie Brown, a powerful state legislator from 1964 to 1995 before becoming mayor in 1996, “seemed oblivious to Jones’ hucksterism and demagoguery,” notes a historian. Brown was master of ceremonies at a dinner for Jones in the fall of 1976 attended by an adulatory crowd of the rich and powerful, including Governor Jerry Brown. “Let me present to you a combination of Martin King, Angela Davis, Albert Einstein . . . Chairman Mao,” he said, to loud applause. And yet Jones was contemptuous of Brown even as Brown did Jones more and more favors. Jones mocked Brown for his designer suits, sports cars, and women. Once, while Brown was addressing the congregation and Jones was seated onstage behind him, Jones flipped his middle finger up to mock him. San Francisco’s establishment stood by Jones even after a California magazine, New West, owned by Rupert Murdoch, published an exposé of Jones’s beatings of Temple members and financial abuses in August 1977. The article was written by a San Francisco Chronicle reporter and was meant for the Chronicle to publish. But the newspaper killed the story because it didn’t want to alienate Jones, whom it viewed as central to its plans to expand the Chronicle’s circulation in the heavily African American Fillmore District. Jones also managed to avoid investigation and prosecution in part by getting the district attorney to hire as deputy district attorney Jones’s longtime attorney and confidant. Progressives defended Jones against the New West article. At a rally in the summer of 1977, Willie Brown said, “When somebody like Jim Jones comes on the scene, that absolutely scares the hell out of most everybody occupying positions of power in the system.” Angela Davis sent a radio message broadcast over the cult’s compound, Jonestown, in Guyana. “I know you’re in a very difficult situation right now,” she said, “and there is a very profound conspiracy designed to destroy the contributions which you have made to the struggle.” After visiting Jonestown, the attorney to the Black Panthers said, “I have seen paradise.” Harvey Milk, too, was tarnished by his association with Jones. In the fall of 1977, Milk wrote to President Carter’s secretary of health, education, and welfare requesting that Social Security checks be sent to elderly Temple members in Guyana. “People’s Temple,” wrote Milk, has “established a beautiful retirement community in Guyana.” In truth, the cult was disintegrating. Jones separated families and lovers, pitted relatives against each other, and forced neighbors to inform on each other. Jones sent people who violated the rules to solitary confinement in “the Box,” an underground cubicle where people were held as prisoners for days on end. Others were drugged. Progressives who had spent thirty years fighting to close prisons and mental hospitals found themselves praising a man who had reproduced their worst practices. In November 1978 a Bay Area congressman flew to Guyana to investigate human rights violations at Jonestown with NBC News. Jones gave the delegation a formal reception at Jonestown. A Temple member surreptitiously passed a note to one of the delegation members, saying he and another member wanted to escape. They fled the next day after a Temple member tried to stab the congressman. Jones didn’t prevent them from leaving but then sent gunmen to fire machine guns at the delegation at the airport, killing the congressman and four others. A few hours later, 907 inhabitants of Jonestown drank Flavor Aid laced with cyanide and died. Two-thirds of the victims were African American and one-third were children. Jones had told them that if they didn’t drink it they would be killed by invading soldiers from a shadowy global military conspiracy intent on imposing fascism and torturing children. As people started crying in grief, Jones scolded them. “Stop these hysterics,” he said. “This is not the way for people who are socialists or communists to die.” Jones’s wife protested the murder of children and had to be forcibly restrained. “We didn’t commit suicide,” said Jones in a tape recording, “we committed an act of revolutionary suicide protesting the conditions of an inhumane world.” Few were as stained by Jonestown as Willie Brown and George Moscone. “Even as the bloated bodies of the dead were removed from the jungle and the wounded were airlifted by the U.S. Air Force to hospitals in the United States,” wrote a historian, “Brown said he had ‘no regrets’ over his association with Jones.” They repeatedly disavowed responsibility. Said Moscone, “it’s clear that if there was a sinister plan, then we were taken in. But I’m not taking any responsibility. It’s not mine to shoulder.” This is Shellenberger at his best: telling us crazy stories from the recesses of San Francisco history, maybe kind of spinning the narration in a way that makes all progressives seem guilty by association, but with the tale itself so gripping that it’s hard to be mad. And Jones wasn’t alone. This was the golden age of San Francisco cults, when (Shellenberger tells us) “more than half of all high school students in the San Francisco Bay Area reported at least one recruiting attempt by a cult member, and 40 percent reported at least three contacts.” This chapter of SF history came to an end in 1978, when Dan White, who had just resigned from San Francisco’s Board Of Supervisors (ie City Council) entered City Hall through a window and assassinated Mayor Moscone and fellow Supervisor Harvey Milk, then successfully got charges reduced to manslaughter through a legal manuever that has gone down in history as “the Twinkie Defense” (realistically the defense was that he was depressed, but reporters seized on a comment that implied it was because he ate too many Twinkies). Everything about 1970s San Francisco was like this. With the Mayor and his right-hand-man both dead, San Francisco leadership ended up in the hands of previously second-tier politician Dianne Feinstein. Feinstein was what passed for a moderate in 1970s SF (which meant she had been targeted for assassination by various left-wing groups - she survived when a bomb left on her windowsill failed to explode). In Shellenberger’s telling, she managed to clean up some of the mess and restore a semblance of normalcy. San Francisco never forgave her. Moscone - voting fraud committer, underage sex enjoyer, and Jim Jones’ bff - is beloved as a martyr in today’s SF, but (the book points out) Feinstein is so loathed that in 2021 the Board of Education voted to rename Dianne Feinstein Elementary School. The Moscone Center is 2 million square feet and can fit about 10,000 people. Not to be confused with the Moscone Recreation Center, Moscone Station, or Moscone Elementary School. Meanwhile, all Dianne Feinstein got was one lousy elementary school and the Tithonus package of eternal life without eternal youth. Claim 8: The Intolerant Left Shuts Down Debate On These Issues Another one that’s probably hard to do a randomized controlled trial on. You could probably predict that this one was coming - it’s a necessary narrative beat in this genre of book. I think this beat is good. My impression is that people who aren’t themselves public figures disagreeing with left-wing ideas still don’t understand how scary it is and how much hate you get. Maybe now that 2/3s of every political essay written over the past five years is about this topic, people will finally get it through their thick skulls that it exists and is bad. I would also note that “traumatizing the sorts of people who write popular books about politics, in a such a way that they feel compelled as a sort of self-therapy to write page after page telling readers how angry they should be at you and your whole coalition” isn’t great political praxis. I would like people to figure this out and stop doing it. Anyway, Shellenberger is doing his part in this effort: In 2001, the San Francisco Coalition on Homelessness wheat-pasted posters of a fake front-page San Francisco Chronicle across town. Just beneath the masthead a large headline read “Fuck the Homeless!” right above a picture of San Francisco mayor Willie Brown laughing. Below his photo was the headline “Save the Tourists.” Progressives level the same charges at people thirty years later. “Because of some of the stuff I say,” said a community activist in Seattle’s historically black Capitol Hill neighborhood, “people say, ‘Oh, she’s not for them.’ But I have a heart for homeless and mentally ill. Most of my family works with the mentally ill.” Noted a Chronicle journalist in 2017, “Inevitably, homeless advocates and others will say, ‘You’re not compassionate,’” in response to stories about homeless encampments. “They called me a racist,” said Tom. “They accused me, a guy who used to be homeless, of demonizing the homeless, because I’m asking for accountability.” I found myself similarly accused. In 2019, after I published an article for Forbes about the homeless crisis, a progressive homeless activist accused me on Twitter of having written my article to “make money off of a fear tactic” of “fueling hatred [and] even increasing violence against homeless people.” After I asked the former San Francisco supervisor for the Tenderloin neighborhood, former mayoral candidate Jane Kim, how such a progressive city ended up with so much suffering, she said, “My concern, Michael, just to be very honest, is that when that kind of messaging goes out, violence against people who are unhoused goes up.” […] I soon discovered in my research that I was hardly the first person that progressive elected officials and homelessness advocates had accused of fomenting violence against unhoused people. Many others had been criticized for far worse over the years, including San Francisco’s highest elected officials. “The criticism [by progressive homelessness advocates] was heavy, political and personal,” wrote former mayor Willie Brown in his 2008 memoir. “People accused me of abandoning the problem when I was working daily to try and get a solution going. It was brutal. . . . I had become demonized, and my own efforts belittled.” It is notable that the result of such personal attacks is to frighten off people seeking to change, and perhaps improve, the situation. “The problem” of homelessness, concluded Mayor Brown within nine months of entering office, “may not be solvable.” And [Quoting Chris Rufo]. “The chief of psychiatry in a public hospital system in one of the largest California cities told me, ‘I know for a fact, and all of my colleagues know, that what we actually need to deal with the problem in the biggest cities in California is long-term residential secure psychiatric care. But I can’t say that publicly because I would be disemboweled by the activist left. My job would be in jeopardy. My reputation would be in jeopardy. My whole life would get turned upside down for even broaching the subject of expanding secure mental health facilities and compulsory mental health treatment.’ And I said, ‘So what’s the solution?’ and this person said, ‘We muddle through.’” And: In San Francisco, radical left activists protested [African-American] Mayor London Breed in front of her home. Breed said the protesters were “all white people. But that didn’t bother me as much as the taunting of me coming outside with firework torches in their hands looking like what used to happen when the KKK would show up to black people’s houses to burn their houses down.” While I was reading the book, I came across this tweet, which suggests that being unimpressed with SF’s lefty homeless activist scene is not limited to Michael Shellenberger: Claim 9: European Cities Like Amsterdam Successfully Solved Their Own Drug And Homelessness Problems By Doing The Opposite Of SF Shellenberger bases his plan to solve these problems on ideas that he says were pioneered in Amsterdam and spread to other European cities. In the 1980s, Amsterdam had the kinds of problems San Francisco deals with now: open-air drug markets, overdose deaths, homelessness, and crime. But in the 90s, they admitted they had a problem and took decisive action: What’s the secret?” I asked him. “Amsterdam has decriminalized marijuana and many other drugs but I haven’t seen any homeless. What is San Francisco doing wrong?” Rene said that in the 1980s, the Zeedijk neighborhood in Amsterdam was a lot like the Tenderloin [the worst part of San Francisco] today. There was open-air drug use, particularly of heroin, and needles strewn about, as well as crime. People started to flee the neighborhood, worsening its slum conditions. Homeless people squatted in abandoned buildings. “We had ghettos where it was not safe to go,” said Rene, who started working in the neighborhood as a nurse in 1985. It was considered a “no go” zone. “We had a lot of people from abroad who came to Amsterdam because our heroin was so good. But our heroin was so good that they died from it.” At first the city tried a “helping approach” exclusively, offering addicts clean needles, methadone, and other forms of help without any law enforcement, but it didn’t work. “In the eighties we just wanted to help people,” said Rene. “We started with methadone programs and medical treatment. We did a lot of work without much of a carrot and a stick. It was really a disappointment. They just used the methadone to stay addicted. They dealt drugs and committed other crimes. They lied and cheated about it. We were just supporting a different kind of market. We had to learn the hard way [...] The Amsterdam City Council asked the Amsterdam Municipal Health Service to develop a strategy to deal with “unmotivated drug users”...The police broke up the open-air drug scene and health workers were on hand to offer methadone, treatment, and shelter. The police broke up gatherings of more than four or five users, but did not treat personal and private use as a crime. Officers ticketed violators, and if users did not pay their fines, which was frequent, the courts ordered arrests, and sentenced individuals to follow a treatment plan or face incarceration. “For every individual homeless person, we make a plan,” said Rene. “We made tens of thousands of those plans.” Plans are overseen by a caseworker and a team that may include a psychiatrist, shelter provider, service provider, judge, employer, parole officer, and police officer. “You need people in the police and health department working together,” he said. What Amsterdam did was the same as other major European cities. Lisbon, Frankfurt, Vienna, and Zurich all dealt with their open-air drug markets, using a combination of law enforcement and social services. Crucially, Amsterdam and other European cities prevented services from being concentrated in a single neighborhood, since their concentration often enables an open-air drug scene to thrive [...] The efforts worked. “We had several thousand people who were addicted to heroin in the eighties and nineties,” said Rene. “Many died. Today we have four or five hundred people addicted to methadone. And we have about 120 in Amsterdam who we supply heroin to on a medical basis because methadone doesn’t work for them. They have to use heroin.” The Amsterdam strategy goes something like: Break up open-air drug markets and anywhere that more than 4-5 drug users are congregating. Yes, people can just use their drugs in private, but this is legitimately better. Open-air markets normalize drugs with their blatantness, and make it hard to quit for the same reason it’s hard to diet if your partner leaves boxes of donuts out in the house every day.
The San Francisco districts with the highest (left) and lowest (right) homelessness rates. I correlated homelessness rate and population-adjusted density in the same cities I looked at above, but it didn’t add much predictive value to housing prices. Maybe this is restriction of range (all big cities are dense enough to have homelessness, compared to suburbs), or maybe the key feature is relative rather than absolute density (ie the homeless will go to the densest place nearby). Conclusion: No social phenomenon is ever caused by just one thing, but San Francisco’s homelessness rate is around where a housing-cost-based model would predict. San Fransicko briefly touches on this, but overall tries to de-emphasize it in favor of talking about drugs and mental illness. Critiques of patterns of emphasis are necessarily subjective, but the book’s pattern feels misleading to me. Claim 2: Standard Accounts Underemphasize The Role Of Drugs And Mental Illness In Homelessness Having argued homelessness isn’t just about poverty, the book goes on to say we’re neglecting the central role of mental illness and substance abuse: Over the last decades there were many visible signs that homelessness was about much more than poverty and housing. Between 2010 and 2020, the number of calls made to San Francisco’s 311 line complaining of used hypodermic needles on sidewalks, in parks, and elsewhere rose from 224 to 6,275. In 2018, footage of dozens of people slumped over in an entrance to a Bay Area Rapid Transit (BART) station, many with needles in their arm, went viral. “We call it the heroin freeze,” said one local. “They can stay that way for hours.” Said another, “It’s like the land of the living dead.” For decades researchers have documented much higher levels of mental illness and substance abuse among the homeless than in the rest of the population. It’s true that just 8 and 18 percent of homeless people point to mental illness and substance abuse, respectively, as the primary cause of their homelessness, but researchers have long understood that such self-reports are unreliable due to the socially undesirable nature of substance abuse, and the lack of insight that often accompanies mental illness. Using other methods, San Francisco’s Health Department in 2019 estimated that 4,000 of the city’s 8,035 homeless, sheltered and unsheltered, are both mentally ill and suffering from substance abuse. Of those 4,000, about 1,600 frequently used emergency psychiatric services. Shellenberger’s source for 4000 homeless people having these issues is this SF Chronicle article, which seems to based off of this report. The report does estimate 4000 homeless people with mental illness and substance abuse, but it uses a yearly rather than point estimate of homelessness, and finds 18,000 rather than 8,000 people. That means it only finds a 22% rate of these problems, not a 50% rate. Thanks to commenter Sean for hunting down this report and helping explain this. I looked for other statistics to provide context on this number. This 2013 San Francisco Homeless Count found that 29% admitted chronic depression, 15% PTSD, and 22% some other mental illness. About 30% admitted to a substance use disorder, although as far as I can tell this is just the number who admitted it was a disorder, so maybe more used drugs. This article by the Los Angeles Times describes an LA study finding that 25% of homeless people had mental health issues and 14% had drug issues. The Times re-analyzes it in a way that ups the numbers to 34% and 46%, respectively. But they don’t say exactly what choices they made differently, and the few they do give don’t really inspire confidence. Although in some cases they count questions clearly about mental illness which the official definition inexplicably refused to count, in others they decide to count anyone who has ever had mental illness, reversing a government decision to require the mental illness to be long-term (does this mean that if I lost my house tomorrow, the LA Times use me as an example of a “mentally ill homeless person” because I saw a psychiatrist for OCD when I was a kid?) Studies like these don’t show causation. Sure, mental illness can make people homeless. But homelessness can also cause mental illness. One SF study found psych diagnoses among the homeless to be evenly divided among depression, PTSD, and everything else. Homelessness is a depressing and traumatic environment. Just because someone who’s been on the streets for a year has depression or trauma, doesn’t mean that we should attribute their homelessness to mental illness. This study by the California Policy Lab does better. It asks what factors played a role in homeless people losing their homes, and finds that 50% of unsheltered and 17% of sheltered homeless point to mental illness (given SF’s balance, that suggests 37% of SF homeless would point to that problem). But I can’t help but notice that when you add up the percent of people who lost their homes due to physical illness, psych illness, and drug use, it totals 147%. Based on numbers from other studies, it looks like if you added in job loss, eviction, etc, the numbers would total well above 400%. This makes me think people are saying “yes” if the factor played even a minor role in their eventual homelessness, and this shouldn’t be treated as 37% of homeless having mental health issues being their main problem. The same study finds that about 66% of the homeless “have” some mental health problem, but this time they don’t tell us what question they asked or what criteria they use. What about psychosis in particular? This meta-analysis claims that in developed countries (a category to which San Francisco still nominally belongs) about 19% of homeless people qualify for diagnosis with a psychotic disorder, including 9% with schizophrenia in particular. Not all people with psychotic disorders are completely crazy all the time, and some very much are not, but this is at least a specific condition with real criteria. Conclusion: Overall, I’m disappointed in most of the published research on this question, which seems more interested in producing glossy brochures about funding disparities than in informing anybody what any of their numbers mean. But putting it all together and squinting really hard, I think we can tell a story where 10-20% of the homeless are seriously psychotic, and another 20-30% have contributing mental health conditions including depression, PTSD, and others. Somewhere between 25% and 50% of the homeless have substance abuse problems, and this probably mostly overlaps with the 25% - 50% who have psych diagnoses. I think San Fransicko gets this mostly right. Claim 3: “Housing First” Isn’t As Great As People Think, And Might Be Harmful The National Myth About Homelessness is that The Bad People are refusing to give people houses until they’ve “proven” they “deserve” them, thus perpetuating homelessness when they inevitably fail to qualify. The Good People have united under an exciting new banner called “Housing First” to push the revolutionary idea that people should get houses regardless of whether they conform to normal standards of respectability or not. Wherever this is adopted, homelessness rates fall, and the formerly homeless becoming healthier, safer, and more likely to re-integrate into society. Best of all, the program pays for itself in decreased health care and policing costs. The only impediment to solving homelessness everywhere is the Bad People who still insist on not housing the homeless until they’ve “earned” it. In real life, everyone important has been united under Housing First since the Bush administration made it national policy fifteen years ago, and most of the cities with spiraling homelessness crises have been pursuing Housing First policies for decades (eg San Francisco has been trying Housing First since the 1990s). The Obama and Trump administrations both set funding policies that penalized any non-Housing-First welfare programs. Still, everyone is sure that the reason there are still homeless people must be that some Housing First opponent still exists somewhere, ruining everything with their purity-testing ways. But actually these people have already been relegated to the conservative think tanks where moribund ideas go to die. I have looked through a lot of studies and articles to try to see how well Housing First works. I am most sympathetic to the conclusions of Tsai (2020), who basically says that: Homeless people who are given houses are more housed than homeless people who are not given houses. Way, way more housed. You would not believe how strong of an effect giving someone housing has on them being housed. The same is true for other outcome measures like “time spent experiencing homelessness”, “number of days spent in a temporary homeless shelter”, etc. You might think this is obvious, but this is used as the primary outcome in a lot of studies, and “success” on this metric is behind a lot of claims that “studies show Housing First works great!”
Homeless people who are given houses are more housed than homeless people who are not given houses. Way, way more housed. You would not believe how strong of an effect giving someone housing has on them being housed. The same is true for other outcome measures like “time spent experiencing homelessness”, “number of days spent in a temporary homeless shelter”, etc. You might think this is obvious, but this is used as the primary outcome in a lot of studies, and “success” on this metric is behind a lot of claims that “studies show Housing First works great!”
June 29, 2022 · Original source
Hotels are obviously dumb and are the opposite of 'Housing First' in that they come with lots of conditions to the point that people felt like they were in prison being there. That sure sounds like conditional help to me if you have to accept prison like conditions before you accept housing. Housing First is said often, but they are empty hollow words almost everywhere. Shelters and hotels and other prison like environments are highly highly conditional and nothing like the free conditions which those in regular housing experience.
The label on the sticker might say 'Housing First' but as you noted...none of these cities have tried you know... ACTUALLY provided housing for all of the homeless people at the same time and in an immediate sense with no conditions which did not concentrate them in their own ghetto. Who knew it was tough to get to sleep in a hotel room or a shelter or a crappy apartment when all of your neighbours are crazy and howling and screaming all night every night?
It makes me think...all those bad people who want to do bad things to set goals, barriers, and whatever are real and the NIMBY triggering dumb concentration ideas and half-measures don't even begin to count as real Housing First initiatives.
Hungarians

Hungarians is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between September 09, 2021 and November 11, 2021. The archive places it in contexts such as "some weird Hungarians remind you"; "The Hungarians are descended from steppe nomads". It most often appears alongside Google, 2014 Hungarian parliamentary election, @slatestarcodex.

Article page
Hungarians
Mention count
2
Issue count
2
First seen
September 09, 2021
Last seen
November 11, 2021
September 09, 2021 · Original source
This probably doesn't have enough medical benefits to have been worth my time to research or yours to read. I still find it fascinating. I keep being amazed at how many dimensions things can vary along. You think you know what kind of things medicine has to investigate - how different chemicals interact, the effects of food and smoking and sleep and so on - and unless some weird Hungarians remind you, you would never in a million years remember that there are multiple different isotopes of water and this seems to have some effect on living cells. You would never think to check whether attempts to mine the Martian icecaps for drinkable water will result in dangerous water that could sicken the unfortunate astronauts who drink it (answer: it might! Martian water has five times more deuterium than Earthly water and seems to kill shrimp). You would never think that you could buy something called "deuterium depleted water" on Amazon, or that it would be completely safe to drink. But here we are!
November 11, 2021 · Original source
Moreover, I agree with @slatestarcodex that if public opinion turned in Hungary, Orban would probably turn on a dime too. The dude loves power. But that should inform our read of what's going on in Hungary. *Hungarians wanted* a right-nationalist authoritarian leader, *and so they voted for one*, and the electorate has *wanted* recurrent intensifications of that regime. So is it a dictatorship? Or is it a democracy?
So why might Hungarians admire a dissident-cum-parliamentarian who competed for their votes and when defeated responded democratically by adapting to try to win the next election? Because.... duh?
This is extremely important. A part of Orban's appeal is that, whether by coincidence or art, he has managed to preside over periods where Hungary's economic performance was better than a lot of its neighbors, and often fairly obviously so. That is, supporting irredentist nationalism in the form of Orban hasn't imposed costs on Hungarians: they aren't like facing sanctions or something or enduring deep economic hardship to stand by their dictator. He's delivered (comparatively) good times!
Hyperloop

Hyperloop is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between September 13, 2023 and September 18, 2023. The archive places it in contexts such as "Ahead of the Hyperloop announcement"; "The same goes for the hyperloop"; "I don’t know about Hyperloop. The book made it sound like he originally proposed it". It most often appears alongside Ashlee Vance, Boeing, Elon.

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Hyperloop
Mention count
2
Issue count
2
First seen
September 13, 2023
Last seen
September 18, 2023
September 13, 2023 · Original source
Musk has burned through public relations staffers with comical efficiency. He tends to take on a lot of the communications work himself, writing news releases and contacting the press as he sees fit. Quite often, Musk does not let his communications staff in on his agenda. Ahead of the Hyperloop announcement, for example, his representatives were sending me e-mails to find out the time and date for the press conference. On other occasions, reporters have received an alert about a teleconference with Musk just minutes before it started. This was not a function of the PR people being incompetent in getting word of the event out. The truth was that Musk had only let them know about his plans a couple of minutes in advance, and they were scrambling to catch up to his whims. When Musk does delegate work to the communications staff, they’re expected to jump in without missing a beat and to execute at the highest level. Some of this staff, operating under this mix of pressure and surprise, only lasted between a few weeks and a few months. A few others have hung on for a couple of years before burning out or being fired.
September 18, 2023 · Original source
I've worked along former SpaceXers and hung out with current ones (mostly in outdoors sports). If you work in the industry, especially in LA, you run into them. I was also interviewed by Brogan at Hyperloop a while back (super nice guy). The SpaceX hiring bar for technical talent is super high and I wouldn't exaggerate to say the average SpaceX engineer is twice as talented and hardworking as the average Boeing guy. Also, pretty arrogant in my experience (versus Googlers I've met tend to be humble even if they went to Stanford). I think this really started from the top of the company and he couldn't have built this pyramid of insane talent if he didn't have an informed, critical understanding of mechanical engineering.
The same goes for the hyperloop. How do you travel long distances on the red planet? Are you going to have airplanes? There are no fossil fuels, and the atmosphere is thin. A few years back, Musk said he thinks it's technically possible to build electric planes with very long ranges (on Earth), but he's not interested in the project. Probably because it's not practical for Mars. Meanwhile, a hyperloop would be technically much easier to maintain in the Mars atmosphere, and would probably be better than planes for long-distance travel.
I don’t know about Hyperloop. The book made it sound like he originally proposed it because he was angry about California’s less-ambitious high-speed rail plans and didn’t take it too seriously. It was only after everyone else took it seriously that he gave it a second thought.
H-Y antigen

H-Y antigen is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 04, 2023 and October 04, 2023. The archive places it in contexts such as "What does this mean for the maternal immune system / H-Y antigen / NLGN4Y theory". It most often appears alongside Ablaza, Ablaza et al, ACX.

Reference entry
H-Y antigen
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1
Issue count
1
First seen
October 04, 2023
Last seen
October 04, 2023
October 04, 2023 · Original source
This started as a purely empirical finding. If you surveyed enough men, you would find it was true, even though no one knew why1. In 2006, Bogaert found that the effect applied only to biological siblings and not adoptive ones, suggesting a biological cause. He proposed a mechanism based on H-Y antigens, a set of molecules on male cells involved in sexual development. If a mother has many male pregnancies, her immune system might become gradually more sensitized to H-Ys, start attacking them, and interfere with later fetuses’ sexual development.
…suggesting that even the nonsignificant effect they found might have just been from small studies and a file drawer effect. So they’re claiming FBOE doesn’t exist, right? Actually, their paper is so long and dense I can’t figure out exactly what they’re claiming. It sort of looks like they think that, but when someone says so, they protest that: Blanchard & Skorska (2022) completely misconstrued our work by claiming that we wrote there is no evidence for the FBOE in men or women. This is not what we claim, neither in the present study, nor in the preprint. So what are they claiming? I’m not sure, but notice that their specification of the effect only demonstrates that older brothers do not cause homosexuality too much more than older sisters. If both types of older sibling caused homosexuality, that would match their findings, even if brothers caused it slightly more. And in fact, hot on their heels, a new study found exactly that! Ablaza, Kabatek, Perales, And 9,000,000 Dutch People To The Rescue Remember how Frisch and Hviid managed to look at two million Danes? Well, the Dutch also have gay marriage and keep really good records. Ablaza, Kabatek, and Perales were able to obtain and analyze the data from nine million of them. They do more advanced statistics than any of their predecessors and are able to report basically every parameter of interest with high confidence4. They find: On average, individuals who did not enter a same-sex union have 2.36 siblings. This number is split evenly between younger (μ=1.19) and older (μ=1.17) siblings. The average sibling sex ratio—that is, the number of brothers over the number of sisters—is 1.04 for both younger and older siblings. In contrast, individuals who entered a same-sex union have fewer siblings (μ=2.14) and a greater number of older (μ=1.23) than younger (μ=0.91) siblings. Further, the sex ratio of their older siblings is skewed towards brothers (μ=1.18). All of these differences are statistically significant . . . these patterns manifest among both men and women. These effects are potentially large: For example, 0.73% of men who are the youngest of five siblings entered a same sex union, compared to just 0.35% of men who are the eldest of five siblings . . . the share of men with four older brothers entering a same-sex union is 0.96%, more than twice the share among men with four older sisters (0.46%) Because of their advanced regression model, they’re able to tease apart family size effects from birth order and gender effects: Adding one younger sister to an existing sibship is associated with a 13.8% decrease in the probability of entering a same-sex union (OR = 0.87, p < 0.001)5; moving one place down the birth order while keeping the number of younger and older brothers fixed is associated with an 7.9% increase in the probability of entering a same-sex union (OR = 1.08, p < 0.001); and replacing one older sister by one older brother is associated with a 12.5% increase in the probability of entering a same-sex union (OR = 1.13, p < 0.001). Replacing one younger sister by one younger brother is associated with a 1.2% increase in the probability of entering a same-sex union (OR = 1.01), but this estimate is not statistically significant (p > 0.1). Also: To illustrate the combined effects of birth order and sibling sex, we use the model to predict and plot the probabilities of entering a same-sex union for individuals in all relevant permutations of two-person sibships (Figure 3). In this example, we focus on two-person sibships because they are the most common sibship type (35% of individuals) and because the corresponding number of permutations is fairly contained (n=8). Among men, the lowest predicted probability (PP) of entering a same-sex union is for those whose only sibling is a younger sister (PP = 0.55%), followed by those with a younger brother (PP = 0.56%), those with an older sister (PP = 0.61%) and, finally, those with an older brother (PP = 0.68%). The ordering is the same among women: those with a younger sister (PP = 0.757%), followed by those with a younger brother (PP = 0.764%), those with an older sister (PP = 0.81%), and those with an older brother (PP = 0.92%). The difference between the lowest and highest predicted probabilities is 0.12 percentage points (23.5%) for men, and 0.16 percentage points (21.2%) for women. How does this correspond to the findings of Frisch & Hviid, Blanchard & Bogaert, and and Vilsmeier et al? I can’t really square it with Frisch & Hviid. Even though the methodologies are similar (one investigating everyone in Denmark, the other everyone in the Netherlands), the first finds approximately no result, and the second a very clear result. But Ablaza et al have both a larger sample and better statistics, and they better match previous studies on the topic, so I’ll be siding with them. On the other hand, this beautifully synthesizes the seemingly-opposed results of Blanchard & Bogaert vs. Vilsmeier et al. The FBOE, rightly understood, is primarily an effect of older siblings in general, not just older brothers. However, older brothers exert a slightly stronger effect than older sisters, for both men and women. Blanchard and Bogaert were right to think something was going on with older siblings and homosexuality, and even right to highlight brothers in particular. But Vilsmeier et al were right to say they were wrong to discount older sisters, and that the “advantage” of older brothers over older sisters was so small they shouldn’t be sure it existed (although this much larger study can say more confidently that it does). What does this mean for the maternal immune system / H-Y antigen / NLGN4Y theory of the effect6? It’s definitely awkward: the classic version of the theory doesn’t predict that older sisters should have any effect, or that siblings should have an effect at all on turning later-born females lesbian. Proponents of the theory are trying to adjust, claiming that maybe women have some kind of related antigen. Blanchard and Lippa have already proposed (though not conducted) the experimental next step: see if women with daughters have higher NLGN4Y levels than women who have never had children at all. I would also feel more comfortable if somebody replicates Bogaert’s 2006 study finding this was definitely biological and it’s not just some boring social effect like guys with more brothers having more positive male role models and so being more likely to get attracted to men. Cremeiux Is Still Skeptical I’d like to end on a note of “so now finally everyone agrees that birth order effects on homosexuality are real”, but Statistics Twitter personality Cremieux Recueil (Twitter, Substack) doesn’t agree. He admits that the Dutch study is the best evidence we have so far, but worries that it’s not good enough: I don’t find these objections too convincing. Yes, gay marriage as an outcome omits most gays, but it’s still a bigger sample size than anyone else, and it seems less likely that married gays systematically differ from unmarried gays in their number of siblings for some reason (which doesn’t apply to married heterosexuals) than that they’re finding the same effect everyone else has found before them. Conclusion The fraternal birth order effect hypothesis has had a tough decade, but things are starting to look up. It’s been forced to abandon some of its key tenets (like an effect on male gays but not on female lesbians) and relax others (like older brothers having more of an effect than older sisters). In the process, its beautiful immunological mechanism has been cast into some doubt. But the core of the idea - that more older siblings = more gay - seems to stand. My predictions (to be evaluated whenever stronger evidence comes in): Sibling birth order effect on homosexuality is real: 85%
Can H-Y antigens explain the other birth order effects found on the ACX survey (and general firstborn advantage in math, physics, etc)? It’s a tempting hypothesis, since math, physics, and the ACX readership are all disproportionately male, and any process which gave people less-male-typical brains would drive people away from these things. But I found that the ACX birth order effect was social and not biological, and a Norwegian team found the same on their own data. Meanwhile, Bogaert’s study found the homosexuality effect was biological and not social. I don’t entirely trust either set of conclusions, but as long as they both stand, they weakly suggest these are different effects.
H-Y antigens

H-Y antigens is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 04, 2023 and October 04, 2023. The archive places it in contexts such as "He proposed a mechanism based on H-Y antigens, a set of molecules on male cells involved in sexual development"; "Can H-Y antigens explain the other birth order effects". It most often appears alongside Ablaza, Ablaza et al, ACX.

Reference entry
H-Y antigens
Mention count
1
Issue count
1
First seen
October 04, 2023
Last seen
October 04, 2023
October 04, 2023 · Original source
This started as a purely empirical finding. If you surveyed enough men, you would find it was true, even though no one knew why1. In 2006, Bogaert found that the effect applied only to biological siblings and not adoptive ones, suggesting a biological cause. He proposed a mechanism based on H-Y antigens, a set of molecules on male cells involved in sexual development. If a mother has many male pregnancies, her immune system might become gradually more sensitized to H-Ys, start attacking them, and interfere with later fetuses’ sexual development.
Can H-Y antigens explain the other birth order effects found on the ACX survey (and general firstborn advantage in math, physics, etc)? It’s a tempting hypothesis, since math, physics, and the ACX readership are all disproportionately male, and any process which gave people less-male-typical brains would drive people away from these things. But I found that the ACX birth order effect was social and not biological, and a Norwegian team found the same on their own data. Meanwhile, Bogaert’s study found the homosexuality effect was biological and not social. I don’t entirely trust either set of conclusions, but as long as they both stand, they weakly suggest these are different effects.
H1N1

H1N1 is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 01, 2025 and January 01, 2025. The archive places it in contexts such as "the Spanish Flu of 1918 was an H1N1 strain"; "an H1N1 flu went pandemic in 1830"; "It outcompeted older strains of H1N1". It most often appears alongside 1918, 1940s, 1968.

Reference entry
H1N1
Mention count
1
Issue count
1
First seen
January 01, 2025
Last seen
January 01, 2025
  • 1918 1 shared issues
  • 1940s 1 shared issues
  • 1968 1 shared issues
  • 1977 1 shared issues
  • 2009 1 shared issues
January 01, 2025 · Original source
So for example, the Spanish Flu of 1918 was an H1N1 strain that killed about 2% of the world population. But the exact mortality pattern was surprising; people between 18 and 28 were especially likely to die, and people older than 88 especially likely to survive. Why? Because an H1N1 flu went pandemic in 1830; anyone who first encountered the flu around then had an immune system synced to H1N1. But an H3N8 flu went pandemic between 1890 and 1900; anyone who first encountered the flu then had an immune system synced to that strain and was unprepared for H1N1. See here for the details.
From “Genesis and pathogenesis of the 1918 pandemic H1N1 influenza A virus”, linked above. You may recognize the lead author - Michael Worobey has also been a leading voice on the zoonotic side of the COVID origins debate. The recent history of the flu, as far as I can tell, is: 1918: An H1N1 flu (“Spanish flu”) jumped from birds to humans in America and killed 50 million people worldwide. This replaced all older strains, so most seasonal flus during this era were H1N1. 1957: An H2N2 flu (“Asian flu”) crossed from birds to humans in China, and killed about 2 million people worldwide. It replaced the H1N1 strain, so most seasonal flus during this era were H2N2. 1968: An H3N2 flu (“Hong Kong flu”) crossed from pigs (?) to humans in Hong Kong, and killed another 2 million people worldwide. It replaced the H2N2 strain, so most seasonal flus during this era were H3N2. 1977: An H1N1 flu (“Russian flu”) leaked from a biology lab (?) in Russia (it might have been a strain from the 1940s, which the Russians were trying to make a vaccine for). It didn’t kill that many people, but it stuck around, and from then on, seasonal flus could be either H3N2 or H1N1. 2009: An H1N1 flu (“Mexican flu” until the PC police stepped in; afterwards “swine flu”) took some horrible circuitous route between birds and pigs and back again, crossed over into humans in Mexico, and killed 200,000 people. It outcompeted older strains of H1N1, but couldn’t crowd out H3N2, so seasonal flus are still either H3N2 or H1N1. …which brings us to the present, hopefully illuminating why “new flu strain crosses over from animals into humans” is such an “uh oh” moment. The Bird Flu Technically, all pandemic flus start as bird flus. Influenza A evolved in birds. Sometimes it spreads to other animals, including pigs, cattle, and humans. The most common way for a bird flu to spread to humans is to “reassort” (not exactly virus sex, but close enough, and the real version is less memorable) with a human flu virus (ie one that has already crossed over to humans). The resulting virus has all of the human flu virus’ human adaptations, but borrows enough new antigens from the bird virus to evade the immune system. Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder. When a bird flu and human flu reassort in pigs, the resulting disease is called a swine flu. At least the 2009 flu pandemic was a swine flu, and a minority opinion thinks the 1918 pandemic was too. There aren’t major epidemiological differences between direct-from-bird flus and swine flus. H5N1 was first noticed in birds - specifically, a flock of chickens in Scotland in 1959 - after which it disappeared for forty years. In 1996, it showed up in geese in China, then gradually increased its market share among birds worldwide. In 2022, it was found in minks; apparently it had learned to infect mammals. By early 2024, it was seen in cows. Now it’s in cow herds in 16 states, and one of them (California) has declared a state of emergency. And in October, H5N1 was found in pigs for the first time. It’s not uncommon for humans to catch an animal disease. This doesn’t mean the disease has “crossed over” to humans. If the virus isn’t suited to human-to-human transmission, it simply dies off (either before or after killing its human host). Thus, chicken farmers have been reporting scattered H5N1 cases since 1997; now that the virus has spread to cattle, cow farmers have started reporting the same. A Metaculus comment on this topic introduced me to the phrase “biocomputational surface”. Every viral replication that takes place in a human gives the virus one more chance to develop the set of mutations that makes it human-transmissible and start the next pandemic. Or, more likely, every viral replication that takes place in a human who has both the H5N1 bird flu and a normal human flu - or in a pig which has both viruses - gives the virus one extra chance to reassort in a way that produces a bird-antigen-fortified human-adapted flu virus. This doesn’t mean H5N1 will definitely become human-transmissible soon. Many viruses hang out on the borders of transmissibility for decades. Some, for unclear reasons, never cross over at all. But all of this is compatible with the virus becoming transmissible soon. So: What Is The Chance Of A Pandemic? The prediction markets on this topic ask a question about “10,000 cases in the United States”. Does this necessarily mean “pandemic”? Might it be possible to get to 10,000 cases just from the scattered chicken and cow farmers, with no human-to-human transmission? Despite many chicken and cow infections this year, there have only been 60 - 70 recorded human cases. Unless there is a phase change in screening methods, it seems hard for this number to increase to 10,000 off farmers alone. I think it’s fair to treat this question as operationalizing “what is the chance of a pandemic”? By this definition, Manifold estimates a 40% chance of an H5N1 pandemic in 2025. Metaculus estimates a 5% chance. You can see below whether that’s changed since I wrote this essay: 5% versus 40% is a big difference! Who do we trust? I trust Metaculus. Metaculus has beaten Manifold in both of the two head-to-head comparisons that I know of (Jeremiah Johnson’s and mine). Manifold’s number swings by a factor of two from week to week; Metaculus has been steady. But also, Metaculus hosts a CDC-sponsored respiratory disease forecasting tournament which has enriched them in epidemiological expertise. And if you look at the quality of comments on both sites, it’s pretty obvious where the people with more intellectual chops are hanging out. The Manifold comments are mostly single sentences, or occasionally just links to an article about new cases. The Metaculus comments look more like this one by dimaklenchin: Despite the panic propaganda, H5N1 is unlikely to be "just a single mutation away from switching host preference": 1) It normally takes a lot more than a single mutation to switch hosts. E.g., there are at least five different reasons why SIV (monkey equivalent of HIV) is not infectious to humans. Heck, a variant of SIV that bears HIV's receptor-recognizing surface protein (SHIV) is still not infectious to humans. HIV most certainly evolved from SIV but, almost as certainly, it took a very long time to get there. Not that all viruses are the same and things can't turn out differently with flu, but I don't subscribe to the idea that a mere change of receptor specificity (something that can take 1-2 mutations) will be sufficient. 2) We have data. Lots of human infections with other varieties of bird flu in the past - all those viruses ultimately went nowhere. Why would H5N1 be radically different? E.g., the "Canadian teen", despite what sounds like a prolonged exposure, failed to infect anyone around him. Since I am at 18% for the h-2-h H5N1 detection in 2025, I am arbitrarily going ~ an order of magnitude lower than that for something as unprecedented as 10K human infections. Maybe should be much lower but hedging for the time being and will allow another couple months of observations. And Sergio: I'm currently at 20% on the question of reported human-to-human transmission of highly pathogenic avian influenza H5N1 globally before 2026. However, this question is only about the US, and is more general about all subtypes of H5. But H5N1 very strongly appears to be the most important subtype to consider in this time period. And, given the current situation in the US with H5N1 human cases derived from exposure to poultry or cattle (with cattle(mammals) being more worrisome), h2h transmission seems quite more likely to arise in North America than elsewhere before 2026. Conditioning on h2h transmission in the US (and also trying to consider, with lower probability, a start in Canada), I want to estimate the chances that it becomes sustained and out of control (in which case, if it starts in Canada, I largely expect it to spread to the US). The (6) past events of probable h2h transmission of avian H5(N1), none of which were sustained, could serve as a base rate, although I'm a bit wary of giving much weight to this precedent, since the last event was quite a while ago (2007), and also because reporting and testing standards may have improved considerably since then (so perhaps they might not have been classified as h2h transmission events if they had occurred more recently). The current situation in the US, and events such as the Canadian teen who got sick with H5N1, do suggest a higher background level of risk than normal (which would be reduced if a vaccine for cattle is licensed soon), but I'm wary of overupdating. Conditioned on sustained h2h transmission, reaching over 10k cases in a few months seems likely, although perhaps very strong monitoring and surveillance could contain the situation in time (at the very least to moderate the growth rate). Trying to combine all these factors somewhat haphazardly, I'm currently at 3.5% for this question. That’s before 2026. What about longer-term? Manifold gives a ~50% chance before 2030; Metaculus uses a more complicated method but it says about 25% chance before 2030. H5N1 may cross to humans, but it could take a while. Superforecaster Juan Cambeiro at The Institute For Progress estimated a 4% chance of a “worse than COVID” H5N1 pandemic in “the next year”, but their estimate was made in 2023, without the benefit of the Metaculus estimates or most of our current knowledge. This feels high now - Metaculus says 5% total for H5N1 pandemic, and most pandemic flus are not worse than COVID. IFP also seem to be expecting a case fatality rate greater than 10%, which I find unlikely for the reasons mentioned above. I trust their estimate less than Metaculus’ current ones. I conclude that the most plausible estimate for the chance of an H5N1 pandemic in the next year is 5%. Interestingly, 5% is about the base rate for pandemic flus per year: five in the past century = one per twenty years = 5% chance per year. Isn’t it surprising that we’re still at the base rate when we can see a dangerous-looking flu virus spreading through the types of animals that have caused pandemic flus in the past? Part of the answer is that we’re not - in addition to the 5% chance of H5N1, we have to add the chance of some other pandemic flu. This probably isn’t 5% on its own; scientists monitor flu strains closely, and they haven’t found any others which are giving off as many red flags as H5N1. Still, something could always come out of left field. Maybe we should add a 2.5% chance of some other strain, for a total of 7.5% chance of a flu pandemic (ie beyond normal seasonal flu) next year. But still, isn’t it surprising that we’re so close to the base rate? One way to think about this: the base rate represents how concerned we should be if there was no epidemiological monitoring at all. In that case, we would estimate a probability distribution across different epidemiological landscapes, most of which contain some concerning-looking flu strains. Since we are doing the epidemiological monitoring, we can collapse that distribution into a single picture: one flu strain, H5N1, is in fact pretty concerning, and other strains mostly aren’t. This is enough to move our prior from 5% to 7.5%, but no more. The forecasters I talked to raised one other point of uncertainty: does the flu work more like a dice roll, or like a bus? Dice rolls are uncorrelated with their predecessors; even if it’s been a hundred rolls since you last rolled a 6, your chance this time is still 1/6. But buses come at fixed intervals; if the buses are hourly, and you haven’t seen a bus in the past 59 minutes, then your chance of seeing a bus in the next minute is very high. It’s been 16 years since the last flu pandemic; these pandemics come (on average) every 20 years. I don’t think anyone has a good sense of how to think about this. But it was 40 years between the Spanish and Hong Kong flus, so the twenty year number is at best a rule of thumb. The 5% number feels very low to me (and, apparently, to the average Manifold forecaster). Isn’t H5N1 spreading to cows and pigs and all sorts of other mammals? Isn’t it in the news all the time? I trust Metaculus a lot, but I agree that this is a surprising update, and I’m taking it on faith rather than feeling it in my bones. What Would The Fatality Rate Be For An H5N1 Pandemic? There are four basic stories you could tell about likely H5N1 mortality. First, maybe mortality would be 50%. The argument here is that official statistics report this mortality rate in the chicken farmers who have been infected with H5N1 so far. Several news sources and even some scientists have raised the specter of a pandemic version of H5N1 pandemic with this same death rate, which could kill a quarter to a third of the world population. THIS IS EXTREMELY FAKE. The official statistics only report fatality rate in the infections we know about. Bird flu is rare, there’s no mass testing, and we only learn that somebody had it if they’re in a hospital and the doctors are worried enough to test for rare conditions. Of Americans who got bird flu in the past year, 0 out of 61 have died. Probably this is mostly because America upped its detection game and is now finding milder cases; we also can’t rule out the virus mutating to become less virulent. Metaculus estimates the current true mortality rate as 1.25%. …but leaves a wide 90% confidence interval, from 0.5% to 7%. Second, maybe mortality would be somewhere around 1.25%. The argument here is that Metaculus uses this as its central estimate of US mortality. But Sentinel discusses some reasons to be skeptical of broad inferences from the US numbers: Scientists have been puzzled by the apparently low H5N1 case fatality rate in humans in the US. They offer a number of hypotheses: “The way in which the virus is being transmitted — along with the amount of virus exposure — is limiting the severity of disease.”
H2N2

H2N2 is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 01, 2025 and January 01, 2025. The archive places it in contexts such as "An H2N2 flu (“Asian flu”) crossed from birds to humans in China". It most often appears alongside 1918, 1940s, 1968.

Reference entry
H2N2
Mention count
1
Issue count
1
First seen
January 01, 2025
Last seen
January 01, 2025
  • 1918 1 shared issues
  • 1940s 1 shared issues
  • 1968 1 shared issues
  • 1977 1 shared issues
  • 2009 1 shared issues
January 01, 2025 · Original source
From “Genesis and pathogenesis of the 1918 pandemic H1N1 influenza A virus”, linked above. You may recognize the lead author - Michael Worobey has also been a leading voice on the zoonotic side of the COVID origins debate. The recent history of the flu, as far as I can tell, is: 1918: An H1N1 flu (“Spanish flu”) jumped from birds to humans in America and killed 50 million people worldwide. This replaced all older strains, so most seasonal flus during this era were H1N1. 1957: An H2N2 flu (“Asian flu”) crossed from birds to humans in China, and killed about 2 million people worldwide. It replaced the H1N1 strain, so most seasonal flus during this era were H2N2. 1968: An H3N2 flu (“Hong Kong flu”) crossed from pigs (?) to humans in Hong Kong, and killed another 2 million people worldwide. It replaced the H2N2 strain, so most seasonal flus during this era were H3N2. 1977: An H1N1 flu (“Russian flu”) leaked from a biology lab (?) in Russia (it might have been a strain from the 1940s, which the Russians were trying to make a vaccine for). It didn’t kill that many people, but it stuck around, and from then on, seasonal flus could be either H3N2 or H1N1. 2009: An H1N1 flu (“Mexican flu” until the PC police stepped in; afterwards “swine flu”) took some horrible circuitous route between birds and pigs and back again, crossed over into humans in Mexico, and killed 200,000 people. It outcompeted older strains of H1N1, but couldn’t crowd out H3N2, so seasonal flus are still either H3N2 or H1N1. …which brings us to the present, hopefully illuminating why “new flu strain crosses over from animals into humans” is such an “uh oh” moment. The Bird Flu Technically, all pandemic flus start as bird flus. Influenza A evolved in birds. Sometimes it spreads to other animals, including pigs, cattle, and humans. The most common way for a bird flu to spread to humans is to “reassort” (not exactly virus sex, but close enough, and the real version is less memorable) with a human flu virus (ie one that has already crossed over to humans). The resulting virus has all of the human flu virus’ human adaptations, but borrows enough new antigens from the bird virus to evade the immune system. Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder. When a bird flu and human flu reassort in pigs, the resulting disease is called a swine flu. At least the 2009 flu pandemic was a swine flu, and a minority opinion thinks the 1918 pandemic was too. There aren’t major epidemiological differences between direct-from-bird flus and swine flus. H5N1 was first noticed in birds - specifically, a flock of chickens in Scotland in 1959 - after which it disappeared for forty years. In 1996, it showed up in geese in China, then gradually increased its market share among birds worldwide. In 2022, it was found in minks; apparently it had learned to infect mammals. By early 2024, it was seen in cows. Now it’s in cow herds in 16 states, and one of them (California) has declared a state of emergency. And in October, H5N1 was found in pigs for the first time. It’s not uncommon for humans to catch an animal disease. This doesn’t mean the disease has “crossed over” to humans. If the virus isn’t suited to human-to-human transmission, it simply dies off (either before or after killing its human host). Thus, chicken farmers have been reporting scattered H5N1 cases since 1997; now that the virus has spread to cattle, cow farmers have started reporting the same. A Metaculus comment on this topic introduced me to the phrase “biocomputational surface”. Every viral replication that takes place in a human gives the virus one more chance to develop the set of mutations that makes it human-transmissible and start the next pandemic. Or, more likely, every viral replication that takes place in a human who has both the H5N1 bird flu and a normal human flu - or in a pig which has both viruses - gives the virus one extra chance to reassort in a way that produces a bird-antigen-fortified human-adapted flu virus. This doesn’t mean H5N1 will definitely become human-transmissible soon. Many viruses hang out on the borders of transmissibility for decades. Some, for unclear reasons, never cross over at all. But all of this is compatible with the virus becoming transmissible soon. So: What Is The Chance Of A Pandemic? The prediction markets on this topic ask a question about “10,000 cases in the United States”. Does this necessarily mean “pandemic”? Might it be possible to get to 10,000 cases just from the scattered chicken and cow farmers, with no human-to-human transmission? Despite many chicken and cow infections this year, there have only been 60 - 70 recorded human cases. Unless there is a phase change in screening methods, it seems hard for this number to increase to 10,000 off farmers alone. I think it’s fair to treat this question as operationalizing “what is the chance of a pandemic”? By this definition, Manifold estimates a 40% chance of an H5N1 pandemic in 2025. Metaculus estimates a 5% chance. You can see below whether that’s changed since I wrote this essay: 5% versus 40% is a big difference! Who do we trust? I trust Metaculus. Metaculus has beaten Manifold in both of the two head-to-head comparisons that I know of (Jeremiah Johnson’s and mine). Manifold’s number swings by a factor of two from week to week; Metaculus has been steady. But also, Metaculus hosts a CDC-sponsored respiratory disease forecasting tournament which has enriched them in epidemiological expertise. And if you look at the quality of comments on both sites, it’s pretty obvious where the people with more intellectual chops are hanging out. The Manifold comments are mostly single sentences, or occasionally just links to an article about new cases. The Metaculus comments look more like this one by dimaklenchin: Despite the panic propaganda, H5N1 is unlikely to be "just a single mutation away from switching host preference": 1) It normally takes a lot more than a single mutation to switch hosts. E.g., there are at least five different reasons why SIV (monkey equivalent of HIV) is not infectious to humans. Heck, a variant of SIV that bears HIV's receptor-recognizing surface protein (SHIV) is still not infectious to humans. HIV most certainly evolved from SIV but, almost as certainly, it took a very long time to get there. Not that all viruses are the same and things can't turn out differently with flu, but I don't subscribe to the idea that a mere change of receptor specificity (something that can take 1-2 mutations) will be sufficient. 2) We have data. Lots of human infections with other varieties of bird flu in the past - all those viruses ultimately went nowhere. Why would H5N1 be radically different? E.g., the "Canadian teen", despite what sounds like a prolonged exposure, failed to infect anyone around him. Since I am at 18% for the h-2-h H5N1 detection in 2025, I am arbitrarily going ~ an order of magnitude lower than that for something as unprecedented as 10K human infections. Maybe should be much lower but hedging for the time being and will allow another couple months of observations. And Sergio: I'm currently at 20% on the question of reported human-to-human transmission of highly pathogenic avian influenza H5N1 globally before 2026. However, this question is only about the US, and is more general about all subtypes of H5. But H5N1 very strongly appears to be the most important subtype to consider in this time period. And, given the current situation in the US with H5N1 human cases derived from exposure to poultry or cattle (with cattle(mammals) being more worrisome), h2h transmission seems quite more likely to arise in North America than elsewhere before 2026. Conditioning on h2h transmission in the US (and also trying to consider, with lower probability, a start in Canada), I want to estimate the chances that it becomes sustained and out of control (in which case, if it starts in Canada, I largely expect it to spread to the US). The (6) past events of probable h2h transmission of avian H5(N1), none of which were sustained, could serve as a base rate, although I'm a bit wary of giving much weight to this precedent, since the last event was quite a while ago (2007), and also because reporting and testing standards may have improved considerably since then (so perhaps they might not have been classified as h2h transmission events if they had occurred more recently). The current situation in the US, and events such as the Canadian teen who got sick with H5N1, do suggest a higher background level of risk than normal (which would be reduced if a vaccine for cattle is licensed soon), but I'm wary of overupdating. Conditioned on sustained h2h transmission, reaching over 10k cases in a few months seems likely, although perhaps very strong monitoring and surveillance could contain the situation in time (at the very least to moderate the growth rate). Trying to combine all these factors somewhat haphazardly, I'm currently at 3.5% for this question. That’s before 2026. What about longer-term? Manifold gives a ~50% chance before 2030; Metaculus uses a more complicated method but it says about 25% chance before 2030. H5N1 may cross to humans, but it could take a while. Superforecaster Juan Cambeiro at The Institute For Progress estimated a 4% chance of a “worse than COVID” H5N1 pandemic in “the next year”, but their estimate was made in 2023, without the benefit of the Metaculus estimates or most of our current knowledge. This feels high now - Metaculus says 5% total for H5N1 pandemic, and most pandemic flus are not worse than COVID. IFP also seem to be expecting a case fatality rate greater than 10%, which I find unlikely for the reasons mentioned above. I trust their estimate less than Metaculus’ current ones. I conclude that the most plausible estimate for the chance of an H5N1 pandemic in the next year is 5%. Interestingly, 5% is about the base rate for pandemic flus per year: five in the past century = one per twenty years = 5% chance per year. Isn’t it surprising that we’re still at the base rate when we can see a dangerous-looking flu virus spreading through the types of animals that have caused pandemic flus in the past? Part of the answer is that we’re not - in addition to the 5% chance of H5N1, we have to add the chance of some other pandemic flu. This probably isn’t 5% on its own; scientists monitor flu strains closely, and they haven’t found any others which are giving off as many red flags as H5N1. Still, something could always come out of left field. Maybe we should add a 2.5% chance of some other strain, for a total of 7.5% chance of a flu pandemic (ie beyond normal seasonal flu) next year. But still, isn’t it surprising that we’re so close to the base rate? One way to think about this: the base rate represents how concerned we should be if there was no epidemiological monitoring at all. In that case, we would estimate a probability distribution across different epidemiological landscapes, most of which contain some concerning-looking flu strains. Since we are doing the epidemiological monitoring, we can collapse that distribution into a single picture: one flu strain, H5N1, is in fact pretty concerning, and other strains mostly aren’t. This is enough to move our prior from 5% to 7.5%, but no more. The forecasters I talked to raised one other point of uncertainty: does the flu work more like a dice roll, or like a bus? Dice rolls are uncorrelated with their predecessors; even if it’s been a hundred rolls since you last rolled a 6, your chance this time is still 1/6. But buses come at fixed intervals; if the buses are hourly, and you haven’t seen a bus in the past 59 minutes, then your chance of seeing a bus in the next minute is very high. It’s been 16 years since the last flu pandemic; these pandemics come (on average) every 20 years. I don’t think anyone has a good sense of how to think about this. But it was 40 years between the Spanish and Hong Kong flus, so the twenty year number is at best a rule of thumb. The 5% number feels very low to me (and, apparently, to the average Manifold forecaster). Isn’t H5N1 spreading to cows and pigs and all sorts of other mammals? Isn’t it in the news all the time? I trust Metaculus a lot, but I agree that this is a surprising update, and I’m taking it on faith rather than feeling it in my bones. What Would The Fatality Rate Be For An H5N1 Pandemic? There are four basic stories you could tell about likely H5N1 mortality. First, maybe mortality would be 50%. The argument here is that official statistics report this mortality rate in the chicken farmers who have been infected with H5N1 so far. Several news sources and even some scientists have raised the specter of a pandemic version of H5N1 pandemic with this same death rate, which could kill a quarter to a third of the world population. THIS IS EXTREMELY FAKE. The official statistics only report fatality rate in the infections we know about. Bird flu is rare, there’s no mass testing, and we only learn that somebody had it if they’re in a hospital and the doctors are worried enough to test for rare conditions. Of Americans who got bird flu in the past year, 0 out of 61 have died. Probably this is mostly because America upped its detection game and is now finding milder cases; we also can’t rule out the virus mutating to become less virulent. Metaculus estimates the current true mortality rate as 1.25%. …but leaves a wide 90% confidence interval, from 0.5% to 7%. Second, maybe mortality would be somewhere around 1.25%. The argument here is that Metaculus uses this as its central estimate of US mortality. But Sentinel discusses some reasons to be skeptical of broad inferences from the US numbers: Scientists have been puzzled by the apparently low H5N1 case fatality rate in humans in the US. They offer a number of hypotheses: “The way in which the virus is being transmitted — along with the amount of virus exposure — is limiting the severity of disease.”
H2O

H2O is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 09, 2021 and September 09, 2021. The archive places it in contexts such as "Normal water is about 99.9% H2O". It most often appears alongside Amazon, American, Castro.

Reference entry
H2O
Mention count
1
Issue count
1
First seen
September 09, 2021
Last seen
September 09, 2021
September 09, 2021 · Original source
You're an American spy in Cuba. The CIA has gotten you a position refilling the water coolers in Castro's presidential palace, hoping you can poison him. But Castro's security is pretty good. Every time you enter the palace, they search you so exhaustively that you're sure you can't smuggle anything in. And you're sure you can't access any poisons within the palace. And every time he drinks water, Castro calls in a chemist to test it for any impurity first; the tests can detect any contaminant at any concentration. On the plus side, you're completely unsupervised within the palace, and have access to a kitchen with all the usual kitchen appliances. And the CIA has given you a time manipulation gizmo, so you can take literally as long as you want, even if it’s thousands of years. How do you kill Castro?
One answer: Start with an amount of water several thousand times Castro's usual daily consumption. Put it in the freezer until it's half frozen. Dump out the unfrozen half, melt the frozen half, then repeat this process with the meltwater. After some very large number of cycles, put the result in Castro's water cooler every day. He'll be dead within a year.
The hydrogen in water is a combination of normal hydrogen (only a proton in the nucleus) and deuterium (a proton and neutron in the nucleus). These have slightly different chemical properties, so you can do various types of distillation to enrich for one or the other, including repeated freezing (realistically freezing works very slowly; our hypothetical spy would need an unrealistic amount of time, water, and patience). Normal water is about 99.9% H2O, 0.1% HDO, and negligible amounts of D2O. Water with more D2O than normal is called heavy water, water with more HDO than normal is called semiheavy water, and water with more H2O than normal (ie not even the usual tiny amounts of the other two constituents) is called light water.
H3N2

H3N2 is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 01, 2025 and January 01, 2025. The archive places it in contexts such as "A particular flu strain is named after which flavors of these two proteins it has - for example, H3N2"; "seasonal flus during this era were H3N2"; "seasonal flus are still either H3N2 or H1N1". It most often appears alongside 1918, 1940s, 1968.

Reference entry
H3N2
Mention count
1
Issue count
1
First seen
January 01, 2025
Last seen
January 01, 2025
  • 1918 1 shared issues
  • 1940s 1 shared issues
  • 1968 1 shared issues
  • 1977 1 shared issues
  • 2009 1 shared issues
January 01, 2025 · Original source
From “Genesis and pathogenesis of the 1918 pandemic H1N1 influenza A virus”, linked above. You may recognize the lead author - Michael Worobey has also been a leading voice on the zoonotic side of the COVID origins debate. The recent history of the flu, as far as I can tell, is: 1918: An H1N1 flu (“Spanish flu”) jumped from birds to humans in America and killed 50 million people worldwide. This replaced all older strains, so most seasonal flus during this era were H1N1. 1957: An H2N2 flu (“Asian flu”) crossed from birds to humans in China, and killed about 2 million people worldwide. It replaced the H1N1 strain, so most seasonal flus during this era were H2N2. 1968: An H3N2 flu (“Hong Kong flu”) crossed from pigs (?) to humans in Hong Kong, and killed another 2 million people worldwide. It replaced the H2N2 strain, so most seasonal flus during this era were H3N2. 1977: An H1N1 flu (“Russian flu”) leaked from a biology lab (?) in Russia (it might have been a strain from the 1940s, which the Russians were trying to make a vaccine for). It didn’t kill that many people, but it stuck around, and from then on, seasonal flus could be either H3N2 or H1N1. 2009: An H1N1 flu (“Mexican flu” until the PC police stepped in; afterwards “swine flu”) took some horrible circuitous route between birds and pigs and back again, crossed over into humans in Mexico, and killed 200,000 people. It outcompeted older strains of H1N1, but couldn’t crowd out H3N2, so seasonal flus are still either H3N2 or H1N1. …which brings us to the present, hopefully illuminating why “new flu strain crosses over from animals into humans” is such an “uh oh” moment. The Bird Flu Technically, all pandemic flus start as bird flus. Influenza A evolved in birds. Sometimes it spreads to other animals, including pigs, cattle, and humans. The most common way for a bird flu to spread to humans is to “reassort” (not exactly virus sex, but close enough, and the real version is less memorable) with a human flu virus (ie one that has already crossed over to humans). The resulting virus has all of the human flu virus’ human adaptations, but borrows enough new antigens from the bird virus to evade the immune system. Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder. When a bird flu and human flu reassort in pigs, the resulting disease is called a swine flu. At least the 2009 flu pandemic was a swine flu, and a minority opinion thinks the 1918 pandemic was too. There aren’t major epidemiological differences between direct-from-bird flus and swine flus. H5N1 was first noticed in birds - specifically, a flock of chickens in Scotland in 1959 - after which it disappeared for forty years. In 1996, it showed up in geese in China, then gradually increased its market share among birds worldwide. In 2022, it was found in minks; apparently it had learned to infect mammals. By early 2024, it was seen in cows. Now it’s in cow herds in 16 states, and one of them (California) has declared a state of emergency. And in October, H5N1 was found in pigs for the first time. It’s not uncommon for humans to catch an animal disease. This doesn’t mean the disease has “crossed over” to humans. If the virus isn’t suited to human-to-human transmission, it simply dies off (either before or after killing its human host). Thus, chicken farmers have been reporting scattered H5N1 cases since 1997; now that the virus has spread to cattle, cow farmers have started reporting the same. A Metaculus comment on this topic introduced me to the phrase “biocomputational surface”. Every viral replication that takes place in a human gives the virus one more chance to develop the set of mutations that makes it human-transmissible and start the next pandemic. Or, more likely, every viral replication that takes place in a human who has both the H5N1 bird flu and a normal human flu - or in a pig which has both viruses - gives the virus one extra chance to reassort in a way that produces a bird-antigen-fortified human-adapted flu virus. This doesn’t mean H5N1 will definitely become human-transmissible soon. Many viruses hang out on the borders of transmissibility for decades. Some, for unclear reasons, never cross over at all. But all of this is compatible with the virus becoming transmissible soon. So: What Is The Chance Of A Pandemic? The prediction markets on this topic ask a question about “10,000 cases in the United States”. Does this necessarily mean “pandemic”? Might it be possible to get to 10,000 cases just from the scattered chicken and cow farmers, with no human-to-human transmission? Despite many chicken and cow infections this year, there have only been 60 - 70 recorded human cases. Unless there is a phase change in screening methods, it seems hard for this number to increase to 10,000 off farmers alone. I think it’s fair to treat this question as operationalizing “what is the chance of a pandemic”? By this definition, Manifold estimates a 40% chance of an H5N1 pandemic in 2025. Metaculus estimates a 5% chance. You can see below whether that’s changed since I wrote this essay: 5% versus 40% is a big difference! Who do we trust? I trust Metaculus. Metaculus has beaten Manifold in both of the two head-to-head comparisons that I know of (Jeremiah Johnson’s and mine). Manifold’s number swings by a factor of two from week to week; Metaculus has been steady. But also, Metaculus hosts a CDC-sponsored respiratory disease forecasting tournament which has enriched them in epidemiological expertise. And if you look at the quality of comments on both sites, it’s pretty obvious where the people with more intellectual chops are hanging out. The Manifold comments are mostly single sentences, or occasionally just links to an article about new cases. The Metaculus comments look more like this one by dimaklenchin: Despite the panic propaganda, H5N1 is unlikely to be "just a single mutation away from switching host preference": 1) It normally takes a lot more than a single mutation to switch hosts. E.g., there are at least five different reasons why SIV (monkey equivalent of HIV) is not infectious to humans. Heck, a variant of SIV that bears HIV's receptor-recognizing surface protein (SHIV) is still not infectious to humans. HIV most certainly evolved from SIV but, almost as certainly, it took a very long time to get there. Not that all viruses are the same and things can't turn out differently with flu, but I don't subscribe to the idea that a mere change of receptor specificity (something that can take 1-2 mutations) will be sufficient. 2) We have data. Lots of human infections with other varieties of bird flu in the past - all those viruses ultimately went nowhere. Why would H5N1 be radically different? E.g., the "Canadian teen", despite what sounds like a prolonged exposure, failed to infect anyone around him. Since I am at 18% for the h-2-h H5N1 detection in 2025, I am arbitrarily going ~ an order of magnitude lower than that for something as unprecedented as 10K human infections. Maybe should be much lower but hedging for the time being and will allow another couple months of observations. And Sergio: I'm currently at 20% on the question of reported human-to-human transmission of highly pathogenic avian influenza H5N1 globally before 2026. However, this question is only about the US, and is more general about all subtypes of H5. But H5N1 very strongly appears to be the most important subtype to consider in this time period. And, given the current situation in the US with H5N1 human cases derived from exposure to poultry or cattle (with cattle(mammals) being more worrisome), h2h transmission seems quite more likely to arise in North America than elsewhere before 2026. Conditioning on h2h transmission in the US (and also trying to consider, with lower probability, a start in Canada), I want to estimate the chances that it becomes sustained and out of control (in which case, if it starts in Canada, I largely expect it to spread to the US). The (6) past events of probable h2h transmission of avian H5(N1), none of which were sustained, could serve as a base rate, although I'm a bit wary of giving much weight to this precedent, since the last event was quite a while ago (2007), and also because reporting and testing standards may have improved considerably since then (so perhaps they might not have been classified as h2h transmission events if they had occurred more recently). The current situation in the US, and events such as the Canadian teen who got sick with H5N1, do suggest a higher background level of risk than normal (which would be reduced if a vaccine for cattle is licensed soon), but I'm wary of overupdating. Conditioned on sustained h2h transmission, reaching over 10k cases in a few months seems likely, although perhaps very strong monitoring and surveillance could contain the situation in time (at the very least to moderate the growth rate). Trying to combine all these factors somewhat haphazardly, I'm currently at 3.5% for this question. That’s before 2026. What about longer-term? Manifold gives a ~50% chance before 2030; Metaculus uses a more complicated method but it says about 25% chance before 2030. H5N1 may cross to humans, but it could take a while. Superforecaster Juan Cambeiro at The Institute For Progress estimated a 4% chance of a “worse than COVID” H5N1 pandemic in “the next year”, but their estimate was made in 2023, without the benefit of the Metaculus estimates or most of our current knowledge. This feels high now - Metaculus says 5% total for H5N1 pandemic, and most pandemic flus are not worse than COVID. IFP also seem to be expecting a case fatality rate greater than 10%, which I find unlikely for the reasons mentioned above. I trust their estimate less than Metaculus’ current ones. I conclude that the most plausible estimate for the chance of an H5N1 pandemic in the next year is 5%. Interestingly, 5% is about the base rate for pandemic flus per year: five in the past century = one per twenty years = 5% chance per year. Isn’t it surprising that we’re still at the base rate when we can see a dangerous-looking flu virus spreading through the types of animals that have caused pandemic flus in the past? Part of the answer is that we’re not - in addition to the 5% chance of H5N1, we have to add the chance of some other pandemic flu. This probably isn’t 5% on its own; scientists monitor flu strains closely, and they haven’t found any others which are giving off as many red flags as H5N1. Still, something could always come out of left field. Maybe we should add a 2.5% chance of some other strain, for a total of 7.5% chance of a flu pandemic (ie beyond normal seasonal flu) next year. But still, isn’t it surprising that we’re so close to the base rate? One way to think about this: the base rate represents how concerned we should be if there was no epidemiological monitoring at all. In that case, we would estimate a probability distribution across different epidemiological landscapes, most of which contain some concerning-looking flu strains. Since we are doing the epidemiological monitoring, we can collapse that distribution into a single picture: one flu strain, H5N1, is in fact pretty concerning, and other strains mostly aren’t. This is enough to move our prior from 5% to 7.5%, but no more. The forecasters I talked to raised one other point of uncertainty: does the flu work more like a dice roll, or like a bus? Dice rolls are uncorrelated with their predecessors; even if it’s been a hundred rolls since you last rolled a 6, your chance this time is still 1/6. But buses come at fixed intervals; if the buses are hourly, and you haven’t seen a bus in the past 59 minutes, then your chance of seeing a bus in the next minute is very high. It’s been 16 years since the last flu pandemic; these pandemics come (on average) every 20 years. I don’t think anyone has a good sense of how to think about this. But it was 40 years between the Spanish and Hong Kong flus, so the twenty year number is at best a rule of thumb. The 5% number feels very low to me (and, apparently, to the average Manifold forecaster). Isn’t H5N1 spreading to cows and pigs and all sorts of other mammals? Isn’t it in the news all the time? I trust Metaculus a lot, but I agree that this is a surprising update, and I’m taking it on faith rather than feeling it in my bones. What Would The Fatality Rate Be For An H5N1 Pandemic? There are four basic stories you could tell about likely H5N1 mortality. First, maybe mortality would be 50%. The argument here is that official statistics report this mortality rate in the chicken farmers who have been infected with H5N1 so far. Several news sources and even some scientists have raised the specter of a pandemic version of H5N1 pandemic with this same death rate, which could kill a quarter to a third of the world population. THIS IS EXTREMELY FAKE. The official statistics only report fatality rate in the infections we know about. Bird flu is rare, there’s no mass testing, and we only learn that somebody had it if they’re in a hospital and the doctors are worried enough to test for rare conditions. Of Americans who got bird flu in the past year, 0 out of 61 have died. Probably this is mostly because America upped its detection game and is now finding milder cases; we also can’t rule out the virus mutating to become less virulent. Metaculus estimates the current true mortality rate as 1.25%. …but leaves a wide 90% confidence interval, from 0.5% to 7%. Second, maybe mortality would be somewhere around 1.25%. The argument here is that Metaculus uses this as its central estimate of US mortality. But Sentinel discusses some reasons to be skeptical of broad inferences from the US numbers: Scientists have been puzzled by the apparently low H5N1 case fatality rate in humans in the US. They offer a number of hypotheses: “The way in which the virus is being transmitted — along with the amount of virus exposure — is limiting the severity of disease.”
Flu is a disease caused by a family of related influenza viruses. Pandemic flu is always caused by the influenza A virus. Influenza A has two surface antigen proteins, hemagglutinin (18 flavors) and neuraminidase (11 flavors). A particular flu strain is named after which flavors of these two proteins it has - for example, H3N2, or H5N1.
H3N8

H3N8 is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 01, 2025 and January 01, 2025. The archive places it in contexts such as "an H3N8 flu went pandemic between 1890 and 1900". It most often appears alongside 1918, 1940s, 1968.

Reference entry
H3N8
Mention count
1
Issue count
1
First seen
January 01, 2025
Last seen
January 01, 2025
  • 1918 1 shared issues
  • 1940s 1 shared issues
  • 1968 1 shared issues
  • 1977 1 shared issues
  • 2009 1 shared issues
January 01, 2025 · Original source
So for example, the Spanish Flu of 1918 was an H1N1 strain that killed about 2% of the world population. But the exact mortality pattern was surprising; people between 18 and 28 were especially likely to die, and people older than 88 especially likely to survive. Why? Because an H1N1 flu went pandemic in 1830; anyone who first encountered the flu around then had an immune system synced to H1N1. But an H3N8 flu went pandemic between 1890 and 1900; anyone who first encountered the flu then had an immune system synced to that strain and was unprepared for H1N1. See here for the details.
H5N1

H5N1 is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 01, 2025 and January 01, 2025. The archive places it in contexts such as "What is the H5N1 bird flu?"; "H5N1 was first noticed in birds - specifically, a flock of chickens in Scotland in 1959"; "scattered H5N1 cases since 1997". It most often appears alongside 1918, 1940s, 1968.

Reference entry
H5N1
Mention count
1
Issue count
1
First seen
January 01, 2025
Last seen
January 01, 2025
  • 1918 1 shared issues
  • 1940s 1 shared issues
  • 1968 1 shared issues
  • 1977 1 shared issues
  • 2009 1 shared issues
January 01, 2025 · Original source
What is the H5N1 bird flu? Will it cause the next big pandemic? If so, how bad would that pandemic be?
From “Genesis and pathogenesis of the 1918 pandemic H1N1 influenza A virus”, linked above. You may recognize the lead author - Michael Worobey has also been a leading voice on the zoonotic side of the COVID origins debate. The recent history of the flu, as far as I can tell, is: 1918: An H1N1 flu (“Spanish flu”) jumped from birds to humans in America and killed 50 million people worldwide. This replaced all older strains, so most seasonal flus during this era were H1N1. 1957: An H2N2 flu (“Asian flu”) crossed from birds to humans in China, and killed about 2 million people worldwide. It replaced the H1N1 strain, so most seasonal flus during this era were H2N2. 1968: An H3N2 flu (“Hong Kong flu”) crossed from pigs (?) to humans in Hong Kong, and killed another 2 million people worldwide. It replaced the H2N2 strain, so most seasonal flus during this era were H3N2. 1977: An H1N1 flu (“Russian flu”) leaked from a biology lab (?) in Russia (it might have been a strain from the 1940s, which the Russians were trying to make a vaccine for). It didn’t kill that many people, but it stuck around, and from then on, seasonal flus could be either H3N2 or H1N1. 2009: An H1N1 flu (“Mexican flu” until the PC police stepped in; afterwards “swine flu”) took some horrible circuitous route between birds and pigs and back again, crossed over into humans in Mexico, and killed 200,000 people. It outcompeted older strains of H1N1, but couldn’t crowd out H3N2, so seasonal flus are still either H3N2 or H1N1. …which brings us to the present, hopefully illuminating why “new flu strain crosses over from animals into humans” is such an “uh oh” moment. The Bird Flu Technically, all pandemic flus start as bird flus. Influenza A evolved in birds. Sometimes it spreads to other animals, including pigs, cattle, and humans. The most common way for a bird flu to spread to humans is to “reassort” (not exactly virus sex, but close enough, and the real version is less memorable) with a human flu virus (ie one that has already crossed over to humans). The resulting virus has all of the human flu virus’ human adaptations, but borrows enough new antigens from the bird virus to evade the immune system. Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder. When a bird flu and human flu reassort in pigs, the resulting disease is called a swine flu. At least the 2009 flu pandemic was a swine flu, and a minority opinion thinks the 1918 pandemic was too. There aren’t major epidemiological differences between direct-from-bird flus and swine flus. H5N1 was first noticed in birds - specifically, a flock of chickens in Scotland in 1959 - after which it disappeared for forty years. In 1996, it showed up in geese in China, then gradually increased its market share among birds worldwide. In 2022, it was found in minks; apparently it had learned to infect mammals. By early 2024, it was seen in cows. Now it’s in cow herds in 16 states, and one of them (California) has declared a state of emergency. And in October, H5N1 was found in pigs for the first time. It’s not uncommon for humans to catch an animal disease. This doesn’t mean the disease has “crossed over” to humans. If the virus isn’t suited to human-to-human transmission, it simply dies off (either before or after killing its human host). Thus, chicken farmers have been reporting scattered H5N1 cases since 1997; now that the virus has spread to cattle, cow farmers have started reporting the same. A Metaculus comment on this topic introduced me to the phrase “biocomputational surface”. Every viral replication that takes place in a human gives the virus one more chance to develop the set of mutations that makes it human-transmissible and start the next pandemic. Or, more likely, every viral replication that takes place in a human who has both the H5N1 bird flu and a normal human flu - or in a pig which has both viruses - gives the virus one extra chance to reassort in a way that produces a bird-antigen-fortified human-adapted flu virus. This doesn’t mean H5N1 will definitely become human-transmissible soon. Many viruses hang out on the borders of transmissibility for decades. Some, for unclear reasons, never cross over at all. But all of this is compatible with the virus becoming transmissible soon. So: What Is The Chance Of A Pandemic? The prediction markets on this topic ask a question about “10,000 cases in the United States”. Does this necessarily mean “pandemic”? Might it be possible to get to 10,000 cases just from the scattered chicken and cow farmers, with no human-to-human transmission? Despite many chicken and cow infections this year, there have only been 60 - 70 recorded human cases. Unless there is a phase change in screening methods, it seems hard for this number to increase to 10,000 off farmers alone. I think it’s fair to treat this question as operationalizing “what is the chance of a pandemic”? By this definition, Manifold estimates a 40% chance of an H5N1 pandemic in 2025. Metaculus estimates a 5% chance. You can see below whether that’s changed since I wrote this essay: 5% versus 40% is a big difference! Who do we trust? I trust Metaculus. Metaculus has beaten Manifold in both of the two head-to-head comparisons that I know of (Jeremiah Johnson’s and mine). Manifold’s number swings by a factor of two from week to week; Metaculus has been steady. But also, Metaculus hosts a CDC-sponsored respiratory disease forecasting tournament which has enriched them in epidemiological expertise. And if you look at the quality of comments on both sites, it’s pretty obvious where the people with more intellectual chops are hanging out. The Manifold comments are mostly single sentences, or occasionally just links to an article about new cases. The Metaculus comments look more like this one by dimaklenchin: Despite the panic propaganda, H5N1 is unlikely to be "just a single mutation away from switching host preference": 1) It normally takes a lot more than a single mutation to switch hosts. E.g., there are at least five different reasons why SIV (monkey equivalent of HIV) is not infectious to humans. Heck, a variant of SIV that bears HIV's receptor-recognizing surface protein (SHIV) is still not infectious to humans. HIV most certainly evolved from SIV but, almost as certainly, it took a very long time to get there. Not that all viruses are the same and things can't turn out differently with flu, but I don't subscribe to the idea that a mere change of receptor specificity (something that can take 1-2 mutations) will be sufficient. 2) We have data. Lots of human infections with other varieties of bird flu in the past - all those viruses ultimately went nowhere. Why would H5N1 be radically different? E.g., the "Canadian teen", despite what sounds like a prolonged exposure, failed to infect anyone around him. Since I am at 18% for the h-2-h H5N1 detection in 2025, I am arbitrarily going ~ an order of magnitude lower than that for something as unprecedented as 10K human infections. Maybe should be much lower but hedging for the time being and will allow another couple months of observations. And Sergio: I'm currently at 20% on the question of reported human-to-human transmission of highly pathogenic avian influenza H5N1 globally before 2026. However, this question is only about the US, and is more general about all subtypes of H5. But H5N1 very strongly appears to be the most important subtype to consider in this time period. And, given the current situation in the US with H5N1 human cases derived from exposure to poultry or cattle (with cattle(mammals) being more worrisome), h2h transmission seems quite more likely to arise in North America than elsewhere before 2026. Conditioning on h2h transmission in the US (and also trying to consider, with lower probability, a start in Canada), I want to estimate the chances that it becomes sustained and out of control (in which case, if it starts in Canada, I largely expect it to spread to the US). The (6) past events of probable h2h transmission of avian H5(N1), none of which were sustained, could serve as a base rate, although I'm a bit wary of giving much weight to this precedent, since the last event was quite a while ago (2007), and also because reporting and testing standards may have improved considerably since then (so perhaps they might not have been classified as h2h transmission events if they had occurred more recently). The current situation in the US, and events such as the Canadian teen who got sick with H5N1, do suggest a higher background level of risk than normal (which would be reduced if a vaccine for cattle is licensed soon), but I'm wary of overupdating. Conditioned on sustained h2h transmission, reaching over 10k cases in a few months seems likely, although perhaps very strong monitoring and surveillance could contain the situation in time (at the very least to moderate the growth rate). Trying to combine all these factors somewhat haphazardly, I'm currently at 3.5% for this question. That’s before 2026. What about longer-term? Manifold gives a ~50% chance before 2030; Metaculus uses a more complicated method but it says about 25% chance before 2030. H5N1 may cross to humans, but it could take a while. Superforecaster Juan Cambeiro at The Institute For Progress estimated a 4% chance of a “worse than COVID” H5N1 pandemic in “the next year”, but their estimate was made in 2023, without the benefit of the Metaculus estimates or most of our current knowledge. This feels high now - Metaculus says 5% total for H5N1 pandemic, and most pandemic flus are not worse than COVID. IFP also seem to be expecting a case fatality rate greater than 10%, which I find unlikely for the reasons mentioned above. I trust their estimate less than Metaculus’ current ones. I conclude that the most plausible estimate for the chance of an H5N1 pandemic in the next year is 5%. Interestingly, 5% is about the base rate for pandemic flus per year: five in the past century = one per twenty years = 5% chance per year. Isn’t it surprising that we’re still at the base rate when we can see a dangerous-looking flu virus spreading through the types of animals that have caused pandemic flus in the past? Part of the answer is that we’re not - in addition to the 5% chance of H5N1, we have to add the chance of some other pandemic flu. This probably isn’t 5% on its own; scientists monitor flu strains closely, and they haven’t found any others which are giving off as many red flags as H5N1. Still, something could always come out of left field. Maybe we should add a 2.5% chance of some other strain, for a total of 7.5% chance of a flu pandemic (ie beyond normal seasonal flu) next year. But still, isn’t it surprising that we’re so close to the base rate? One way to think about this: the base rate represents how concerned we should be if there was no epidemiological monitoring at all. In that case, we would estimate a probability distribution across different epidemiological landscapes, most of which contain some concerning-looking flu strains. Since we are doing the epidemiological monitoring, we can collapse that distribution into a single picture: one flu strain, H5N1, is in fact pretty concerning, and other strains mostly aren’t. This is enough to move our prior from 5% to 7.5%, but no more. The forecasters I talked to raised one other point of uncertainty: does the flu work more like a dice roll, or like a bus? Dice rolls are uncorrelated with their predecessors; even if it’s been a hundred rolls since you last rolled a 6, your chance this time is still 1/6. But buses come at fixed intervals; if the buses are hourly, and you haven’t seen a bus in the past 59 minutes, then your chance of seeing a bus in the next minute is very high. It’s been 16 years since the last flu pandemic; these pandemics come (on average) every 20 years. I don’t think anyone has a good sense of how to think about this. But it was 40 years between the Spanish and Hong Kong flus, so the twenty year number is at best a rule of thumb. The 5% number feels very low to me (and, apparently, to the average Manifold forecaster). Isn’t H5N1 spreading to cows and pigs and all sorts of other mammals? Isn’t it in the news all the time? I trust Metaculus a lot, but I agree that this is a surprising update, and I’m taking it on faith rather than feeling it in my bones. What Would The Fatality Rate Be For An H5N1 Pandemic? There are four basic stories you could tell about likely H5N1 mortality. First, maybe mortality would be 50%. The argument here is that official statistics report this mortality rate in the chicken farmers who have been infected with H5N1 so far. Several news sources and even some scientists have raised the specter of a pandemic version of H5N1 pandemic with this same death rate, which could kill a quarter to a third of the world population. THIS IS EXTREMELY FAKE. The official statistics only report fatality rate in the infections we know about. Bird flu is rare, there’s no mass testing, and we only learn that somebody had it if they’re in a hospital and the doctors are worried enough to test for rare conditions. Of Americans who got bird flu in the past year, 0 out of 61 have died. Probably this is mostly because America upped its detection game and is now finding milder cases; we also can’t rule out the virus mutating to become less virulent. Metaculus estimates the current true mortality rate as 1.25%. …but leaves a wide 90% confidence interval, from 0.5% to 7%. Second, maybe mortality would be somewhere around 1.25%. The argument here is that Metaculus uses this as its central estimate of US mortality. But Sentinel discusses some reasons to be skeptical of broad inferences from the US numbers: Scientists have been puzzled by the apparently low H5N1 case fatality rate in humans in the US. They offer a number of hypotheses: “The way in which the virus is being transmitted — along with the amount of virus exposure — is limiting the severity of disease.”
H5N1 may cross to humans, but it could take a while. Superforecaster Juan Cambeiro at The Institute For Progress estimated a 4% chance of a “worse than COVID” H5N1 pandemic in “the next year”, but their estimate was made in 2023, without the benefit of the Metaculus estimates or most of our current knowledge. This feels high now - Metaculus says 5% total for H5N1 pandemic, and most pandemic flus are not worse than COVID. IFP also seem to be expecting a case fatality rate greater than 10%, which I find unlikely for the reasons mentioned above. I trust their estimate less than Metaculus’ current ones. I conclude that the most plausible estimate for the chance of an H5N1 pandemic in the next year is 5%. Interestingly, 5% is about the base rate for pandemic flus per year: five in the past century = one per twenty years = 5% chance per year. Isn’t it surprising that we’re still at the base rate when we can see a dangerous-looking flu virus spreading through the types of animals that have caused pandemic flus in the past? Part of the answer is that we’re not - in addition to the 5% chance of H5N1, we have to add the chance of some other pandemic flu. This probably isn’t 5% on its own; scientists monitor flu strains closely, and they haven’t found any others which are giving off as many red flags as H5N1. Still, something could always come out of left field. Maybe we should add a 2.5% chance of some other strain, for a total of 7.5% chance of a flu pandemic (ie beyond normal seasonal flu) next year. But still, isn’t it surprising that we’re so close to the base rate? One way to think about this: the base rate represents how concerned we should be if there was no epidemiological monitoring at all. In that case, we would estimate a probability distribution across different epidemiological landscapes, most of which contain some concerning-looking flu strains. Since we are doing the epidemiological monitoring, we can collapse that distribution into a single picture: one flu strain, H5N1, is in fact pretty concerning, and other strains mostly aren’t. This is enough to move our prior from 5% to 7.5%, but no more. The forecasters I talked to raised one other point of uncertainty: does the flu work more like a dice roll, or like a bus? Dice rolls are uncorrelated with their predecessors; even if it’s been a hundred rolls since you last rolled a 6, your chance this time is still 1/6. But buses come at fixed intervals; if the buses are hourly, and you haven’t seen a bus in the past 59 minutes, then your chance of seeing a bus in the next minute is very high. It’s been 16 years since the last flu pandemic; these pandemics come (on average) every 20 years. I don’t think anyone has a good sense of how to think about this. But it was 40 years between the Spanish and Hong Kong flus, so the twenty year number is at best a rule of thumb. The 5% number feels very low to me (and, apparently, to the average Manifold forecaster). Isn’t H5N1 spreading to cows and pigs and all sorts of other mammals? Isn’t it in the news all the time? I trust Metaculus a lot, but I agree that this is a surprising update, and I’m taking it on faith rather than feeling it in my bones. What Would The Fatality Rate Be For An H5N1 Pandemic? There are four basic stories you could tell about likely H5N1 mortality. First, maybe mortality would be 50%. The argument here is that official statistics report this mortality rate in the chicken farmers who have been infected with H5N1 so far. Several news sources and even some scientists have raised the specter of a pandemic version of H5N1 pandemic with this same death rate, which could kill a quarter to a third of the world population. THIS IS EXTREMELY FAKE. The official statistics only report fatality rate in the infections we know about. Bird flu is rare, there’s no mass testing, and we only learn that somebody had it if they’re in a hospital and the doctors are worried enough to test for rare conditions. Of Americans who got bird flu in the past year, 0 out of 61 have died. Probably this is mostly because America upped its detection game and is now finding milder cases; we also can’t rule out the virus mutating to become less virulent. Metaculus estimates the current true mortality rate as 1.25%. …but leaves a wide 90% confidence interval, from 0.5% to 7%. Second, maybe mortality would be somewhere around 1.25%. The argument here is that Metaculus uses this as its central estimate of US mortality. But Sentinel discusses some reasons to be skeptical of broad inferences from the US numbers: Scientists have been puzzled by the apparently low H5N1 case fatality rate in humans in the US. They offer a number of hypotheses: “The way in which the virus is being transmitted — along with the amount of virus exposure — is limiting the severity of disease.”
H5N1 bird flu

H5N1 bird flu is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 17, 2025 and January 17, 2025. The archive places it in contexts such as "In response to my post on H5N1 bird flu". It most often appears alongside @tamaybes, @venturetwins, A16Z.

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H5N1 bird flu
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January 17, 2025 · Original source
37: In response to my post on H5N1 bird flu, Alina Chan asked about the risk of a bird flu lab leak. Here’s my response, Nuno Sempere’s response, and Peter Miller’s pre-response.
habituation

habituation is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 12, 2025 and September 12, 2025. The archive places it in contexts such as "a simple and well-studied kind of memory is habituation". It most often appears alongside A Change of Heart, Abraham, Adams.

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habituation
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September 12, 2025 · Original source
What kinds of memories do single cells possess? The full gamut of possibilities is unclear, but a simple and well-studied kind of memory is habituation. The idea is that you take a single cell, and repeatedly subject it to some stimulus, like a physical poke or light flash. Often, cells repeatedly subjected to a stimulus like this will eventually either decide to escape, or become desensitized to the stimulus. If you poke a cell too much, but it comes to ‘think’ that your pokes don’t matter, it starts ignoring them. “You’re just messing with me,” it might say if it could talk.
The habituation behavior of the ciliate Stentor coeruleus is a canonical example. It’s shaped like a tiny trumpet, or rice grain. When it gets physically poked, it contracts. When you poke it enough, it stops responding, and maintains its long tube shape despite your pokes.
Habituation is admittedly extremely simple, but even a behavior as simple as this remains mysterious in some ways. Consider this: if you wait a while after Stentor stops responding, it will ‘recover’. That is, it will respond if you start poking it again. Keep poking it for long enough a second time, and it will stop responding a second time. Here’s the interesting part: in the second ‘round’, it will stop responding to your pokes faster than it did the first time. This implies that it ‘remembers’ that it got poked a bunch sometime in the recent past. In other words, there is the shorter-term memory of the recent pokes (‘the current pokes are not dangerous, so I should stop responding’) and a longer-term memory of less-recent pokes (‘the current pokes are like the previous pokes, which were not dangerous, so I should learn faster this time’). How does this work? There are ideas out there, but the truth is that no one really knows! Obviously, the mechanism for this type of multiple-time-scale memory can’t rely on synapses.
hACE2 mice

hACE2 mice is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 09, 2024 and April 09, 2024. The archive places it in contexts such as "passage in hACE2 mice"; "N501Y mutation would result from passage in hACE2 mice". It most often appears alongside #S14, 2009 flu pandemic, 2013-16 West African Ebola outbreak.

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hACE2 mice
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April 09, 2024 · Original source
This alone isn’t fatal to lab leak. It’s perfectly possible for the lab to leak (let’s say) November 5th, the virus spreads a bit, and then a month later someone goes to the wet market, coughs on a vendor, and starts the officially recognized pandemic. But if that were true, you’d expect (let’s say) 30 cases by early December. Let’s say the wet market vendor was exactly Case # 30. She infected the other wet market vendors, starting a pandemic with an obvious center at the wet market and lots of infected wet market vendors and patrons. What about Case # 29? If they were (let’s say) a barista, how come they didn’t infect people at their coffee shop? How come there wasn’t a second obvious cluster radiating out from a coffee shop, lots of coffee-shop-linked cases, etc? How come there weren’t 30 equally-sized clusters? In order to avoid this, you either need to claim that the wet market was a perfect superspreader location, or that the pattern with lots of cases in the wet market and few-to-none anywhere else was a result of ascertainment bias. Saar made both those arguments during the debate, but I thought Peter rebutted them effectively. 1.4: COVID in Brazilian wastewater Nicholas Halden (blog) writes: What should we make of this study, which found the presence of covid in Brazilian wastewater in late 2019? Consider the doubling times. The study says that scientists working in late 2020 found COVID in samples of Brazilian wastewater from November 27, 2019. This was long before the first detected case of transmission in Brazil on March 13, 2020. Between November 27, 2019 and March 13, 2020 is about 16 weeks, so 32 COVID doubling times. 32 doubling times with no lockdown is enough time for COVID to infect every single person in Brazil. If COVID had infected everyone in Brazil before the first recognized case, we would have noticed. (again, COVID doubling time isn’t exactly invariably 3.5 days, but here we’re talking about numbers big enough that the exact details don’t matter very much) So if COVID was in Brazil on November 27, it must have fizzled out instead of going pandemic. How likely is that? If one person had COVID, it’s not too unlikely - not all COVID cases transmit it forward. If (let’s say) twenty people had COVID, it’s very unlikely - at that point, the law of large numbers takes over; in a freak coincidence, every single patient would have to fail to infect anyone else. So almost certainly fewer than 20 people in Brazil had COVID in November 27. So which is more likely - that somehow 20 people had COVID long before the virus was officially detected, and on a totally different continent, yet somehow a scientist looking through wastewater found the water from exactly those people and managed to detect the virus? Or that there was a sampling error, which happens all the time in these kinds of things? Peter wrote a blog post on some of these issues. He found that there were positive tests from wastewater samples as early as March 2019, which doesn’t fit anyone’s timeline, including lab leakers’. And most of these positives (including the Brazilian sample) contained later strains of the virus with mutations it picked up late in 2020. So these were almost certainly false positives from contamination. 1.5: Biorealism’s 16 arguments Biorealism has a list of sixteen arguments, which he liked so much that he posted it three times in the ACX comments, twice on Less Wrong, twice on Manifold, and about a dozen times on Twitter under multiple account names. Some posts were slightly different from others, but a typical version is: Importantly, Miller incorrectly claimed the N501Y mutation would result from passage in hACE2 mice (mixed them up with BALB/c mice). The major papers Miller relied on have been seriously challenged since the debate. See Stoyan and Chiu (2024), Weissman (2024), Bloom (2023) and Lv et al (2024). Overall the circumstantial evidence makes lab v plausible: Peter admitted getting this wrong during the debate. I think this very minor point about mice mutations was approximately his only mistake in 15 hours of debating, and he admitted it as soon as he noticed. Biorealism somehow heard about this (obviously not through watching the debate, as we’ll see in a moment), then left about 20-30 comments starting with it, under various accounts, on various platforms, as if it somehow discredited Peter. This is making me somewhat less charitable to him and his 16 arguments than I would be otherwise. 1. Chinese researchers Botao & Lei Xiao observed lab origin was likely given the nearest known relatives to SARS-CoV-2 were far from Wuhan. Wuhan Institute of Virology (WIV) sampled SARS-related bat coronaviruses where the nearest relatives are found in Yunnan, Laos and Vietnam ~1500km away. They refuse to share their records. The ancestral viruses of SARS were found equally far from where SARS spilled over into humans, so we know it’s possible (and likely) for viruses to travel that far. 2. Patrick Berche, DG at Institut Pasteur in Lille 2014-18, notes you would expect secondary outbreaks if it arose via the live animal trade. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234839/ There are constant outbreaks of weird coronaviruses in animal handlers. See eg this paper, which estimates about 60,000 of these per year. None of these ever go anywhere, because the farmers are in rural areas that aren’t dense enough to sustain a high R0, and the epidemic fizzles out after a single digit number of cases. Any early outbreaks of COVID would have vanished into this long and mostly unnoticed list. 3. Molecular data: Only sarbecovirus with a furin cleavage site. Well adapted to human ACE2 cells. Low genetic diversity indicating a lack of prior circulation (Berche 2023). Restriction site SARS-CoV-2 BsaI/BsmBI restriction map falls neatly within the ideal range for a reverse genetics system and used previously at WIV and UNC. Ngram analysis of the codon usage per Professor Louis Nemzer https://twitter.com/BiophysicsFL/status/1667232580255490053?t=IJgitS5cw364ioclzVWxaA&s=19 The SARS2 backbone is very low in CG and CpG. While the 12-nt insert that gives it the FCS is extremely high in both. Almost as if it was some kind of chimera of a consensus sequence and a codon-optimized polybasic cleavage site? https://twitter.com/BiophysicsFL/status/1752800486837678377?t=EpIRgyybJVaPgeMP5xdstA&s=19 https://www.biorxiv.org/content/10.1101/2022.10.18.512756v1 https://link.springer.com/article/10.1007/s10311-021-01211-0?fbclid=IwAR1HMUMtLIAFOFppVasQDeoIAYrVhP8j4YoPO4wnaTOUiKLsllZl_oKryOw Most of this was discussed extensively in the second session of the debate, which I recommend. The CGG-CGG arginine codon usage is particularly unusual but used in synthetic biology. I asked a synthetic biologist about this. He said: » “Nope. I would literally never do this if I was designing a small insert (maybe I wouldn't notice if it happened by chance with ~1 in 25 odds in a naive codon optimization algorithm as part of a larger sequence). High GC% is bad. Tandem repeat is worse. Several other perfectly fine arginine codons. And I wouldn't engineer a viral genome using human codon usage. An engineer would not do it.” 4. DEFUSE full proposal: virus 20% different from SARS1, consensus seq assembled with 6 segments, without disrupting coding seq, BsmBI order, FCS. SARS2: 20% different than SARS1, 6 evenly spaced fragments w BsmBI and BsaI restriction sites, FCS. Jesse Bloom, Jack Nunberg, Robert Townley, Alexandre Hassanin have observed this workflow could have lead to SARS-CoV-2. Work often begins before funding sought or goes ahead anyway. Re: 4 - Also scattered across second section of debate, also not going to retread 5. Market cases were all lineage B. Lv et al (2024) indicates there was a single point of emergence and A came before B. So market cases not the primary cases. See also Bloom (2021), Kumar et al (2022). Peter Ben Embarek said there were likely already thousands of cases in Wuhan in December 2019.https://t.co/50kFV9zSb6 https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/34398234/ https://academic.oup.com/bioinformatics/article/38/10/2719/6553661 There was a Lineage A sample in the market, lab leak proponents just try to ignore/dismiss/conspiracize it away. The first two known Lineage A cases were very close to the market. Lv (is this even a real name? It sounds like Roman numeral? But I guess that’s what you expect in a country ruled by someone named Xi) found some weird COVID variants in Shanghai that might or might not mean anything; you can see some discussion of the implications here, but I don’t think they’re strong evidence either way. If A was first, it means some really weird stuff coincidences have to happen to give us the spread rates and genetic clock data we get, but they’re not necessarily weirder in the zoonosis hypothesis than the lab leak one. The claim that there were “thousands of cases in Wuhan in December 2019” is very easy to disprove by doubling rate arguments like the one above, by the blood bank study mentioned above, by the WHO’s failed case search, and by many other lines of argument. 6. Evidence for lineage A in the market is based on a low quality sample according to Liu et. al. (2023). I really think lab leakers need to decide whether they think China is a sinister actor trying to cover up the truth, or whether they should trust every offhand comment by Chinese government officials as gospel. Dr. Liu doesn’t explain in what sense he thinks the Lineage A sample is “low-quality”, and the Western scientists who I asked about this said they didn’t understand this complaint and that the sample was fine. A Western team re-analyzing the same sample describes it as “conclusively contain[ing] Lineage A.” I think most lab leakers have switched from trying to deny the genetics to claiming that this was “contamination”, which also doesn’t make sense (the sample is genetically very early). Note that aside from this sample, the first two Lineage A cases discovered were both very close to the wet market. 7. Bloom (2023) shows market samples do not support market origin. There is also no evidence of transmission in the claimed susceptible animals elsewhere. https://academic.oup.com/ve/advance-article/doi/10.1093/ve/vead089/7504441 Discussed extensively in my article as well as the first section of the debate. 8. Lineage A and B only two mutations apart. François Ballox, Bloom and Virginie Courtier-Orgogozo note this is unlikely to reflect two separate animal spillovers as opposed to incomplete case ascertainment of human to human transmission (Bloom 2021). Discussed extensively in my article as well as the first section of the debate. 9. Sampling bias. George Gao, Chinese CDC head at the time, acknowledged to the BBC stating they may have focused too much on and around the market and missed cases on the other side of the city. David Bahry outlines the documented bias. Michael Weissman has shown this mathematically. https://journals.asm.org/doi/10.1128/mbio.00313-23 https://academic.oup.com/jrsssa/advance-article-abstract/doi/10.1093/jrsssa/qnae021/7632556 Re: Dr. Gao, see above comment about Chinese officials. See the section Ascertainment Bias below for why I disagree with this specific claim, which also addresses the Michael Weissman argument. 10. Spatial statistics experts show the Worobey claim the market was the early epicentre was flawed. https://academic.oup.com/jrsssa/advance-article-abstract/doi/10.1093/jrsssa/qnad139/7557954 Re: 10 - See Confirmation Of The Centrality Of The Huanan Market Among Early COVID-19 Cases, a response to the paper you cite: The centrality of Wuhan's Huanan market in maps of December 2019 COVID-19 case residential locations, established by Worobey et al. (2022a), has recently been challenged by Stoyan and Chiu (2024, SC2024). SC2024 proposed a statistical test based on the premise that the measure of central tendency (hereafter, "centre") of a sample of case locations must coincide with the exact point from which local transmission began. Here we show that this premise is erroneous. SC2024 put forward two alternative centres (centroid and mode) to the centre-point which was used by Worobey et al. for some analyses, and proposed a bootstrapping method, based on their premise, to test whether a particular location is consistent with it being the point source of transmission. We show that SC2024's concerns about the use of centre-points are inconsequential, and that use of centroids for these data is inadvisable. The mode is an appropriate, even optimal, choice as centre; however, contrary to SC2024's results, we demonstrate that with proper implementation of their methods, the mode falls at the entrance of a parking lot at the market itself, and the 95% confidence region around the mode includes the market. Thus, the market cannot be rejected as central even by SC2024's overly stringent statistical test. I think this response is pretty strong. In one analysis, they show that even though the other paper’s methodology is worse than theirs, if you apply it correctly (instead of inappropriately excluding various cases like the paper’s authors did), the center of all early cases in Hubei province lands on the wet market parking lot. In another analysis, they show that the other paper’s recommended tests wouldn’t have correctly pointed to the offending water pump in the famous John Snow cholera outbreak, but theirs would have. Still, I think it’s useful to supplement fancy statistics with normal common sense, so I recommend just looking at the map of early cases: …and deciding whether you think the assumptions behind a specific statistical test are likely to debunk the idea that cases are centered around the wet market. 11. Wuhan used as a control for a 2015 serological study on SARS-related bat coronaviruses due to its urban location. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178078/ I don’t know why this point is supposed to matter. If you mean that Wuhan isn’t directly exposed to bats, nobody ever said it was. The zoonotic theory is that wildlife carted in from other areas of China started the pandemic in the wet market. 12. Superspreader events also seen at wet markets in Beijing and Singapore (Xinfadi and Jurong). This was discussed very extensively in the debates, both in section 1 and section 3. Wet markets weren’t “superspreader locations” - in fact, the disease spread no more quickly there than anywhere else. They were the first place in those cities that the pandemic started, due to contaminated animal products. If anything, this supports zoonosis. See also my discussion with Saar on this point below. 13. WIV refuse to share their records with NIH who terminated subaward in 2022. Wider suspension over biosafety concerns. https://www.bloomberg.com/news/articles/2023-07-18/us-suspends-wuhan-institute-funds-over-covid-stonewalling Although WIV has not been especially forthcoming, some of their databases were leaked in various ways and showed that they did not have any viruses capable of transforming into COVID. 14. PLA involvement at WIV and MERS research prior to SARS-COV-2. MERS features several similarities with SARS-CoV-2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7022351/ I can’t even tell what conspiracy theory you’re trying to propose with this one; if you spell it out I can try to explain why it might be false. 15. SARS1 leaked several times and SARS-COV-2 has leaked from a BSL-3 lab in Taiwan. Agreed that SARS leaked several times. It also spilled over from animals several times. During the debate, a lab leak rate of once per lab per 500 years was proposed (everyone agreed to steelman this by 10x for WIV numbers); I would be interested to know whether anything about the study of SARS challenges that number. 16. Unpublished infectious clone identified from Wuhan contradicting arguments such reverse genetics systems would be published. https://www.biorxiv.org/content/10.1101/2023.02.12.528210v1.full I asked some scientists about this paper and here’s what they told me. Wuhan University sequenced some rice. In the middle of the sequence, there’s an unexpected sequence from a common coronavirus, HKU4. The most likely explanation is that someone else in Wuhan was working on the coronavirus and there was cross-contamination. Plausibly this is Wuhan Institute of Virology, who is known to work with coronaviruses. This is cool detective work, but it’s not clear what it’s supposed to prove. I think some lab leakers are using it to prove that WIV can do reverse genetics, but they admitted this already in a published paper so that’s not too helpful. I think others are using it to prove WIV had “secret viruses” in their catalogue, but the rice virus wasn’t secret, it was HKU4, which is common and which WIV has already published papers about. 1.6: DrJayChou’s 7 Arguments Once again, I cannot stress enough how much better a take you might have on this debate if you watch it. “The first known case predates the market outbreak by a month” - this is not the consensus position. I cannot say for sure what Dr. Chou means by this, but I suspect he’s referring to one of the many claims to this effect that Peter effectively debunked during the debate (Connor Reed, Mr. Chen, the 92 cases, Brazil, etc).
Hades

Hades is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 05, 2024 and July 05, 2024. The archive places it in contexts such as "And dragged the screaming fellow down to Hades". It most often appears alongside 1812, Ada, Albania.

Reference entry
Hades
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1
Issue count
1
First seen
July 05, 2024
Last seen
July 05, 2024
July 05, 2024 · Original source
Yet when our dear corrupter of the ladies Sat down to dine that evening, soon his face Immediately forgot its usual staid ease: The statue came, accepting Juan’s grace, And dragged the screaming fellow down to Hades, With crazed Satanic courts to try his case. (Repent, ye sinners! If you won’t return, know You too could find yourself in the Inferno.)
hadiths

hadiths is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 13, 2024 and September 13, 2024. The archive places it in contexts such as "the hadiths (deeds and words of Muhammad, transmitted through oral tradition)"; "the hadiths prophesying a victorious army coming out of Afghanistan are probably Abbasid forgeries". It most often appears alongside 1999 apartment bombings, 9/11, Abbasid.

Reference entry
hadiths
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1
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1
First seen
September 13, 2024
Last seen
September 13, 2024
September 13, 2024 · Original source
There are many prophecies about the End Times in the Koran and the hadiths (deeds and words of Muhammad, transmitted through oral tradition, the authenticities of some of which are hotly debated among Islamic scholars). Some of these prophecies are thought to be already fulfilled, others are not. But the glorious coming of the Mahdi can only happen once all the events that are prophesied to happen before him have passed.
Later, he learns that the hadiths prophesying a victorious army coming out of Afghanistan are probably Abbasid forgeries (the Abbasids’ base was in the Afghan territories). He also realizes that there are some prophecies about evil traitors to the faith that apply to the terrorists groups equally well as the prophecies about heroic armies that they like to apply to themselves.
Someone writing The Authenticity of Various Hadiths: Much More Than You Wanted to Know probably won’t bring peace to the Middle East in itself, but still, Dean’s advice is good encouragement that actually engaging in debate with people on their own terms can be worthwhile, even with people who are as deeply lost as the jihadists.
haemophilia

haemophilia is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 09, 2021 and November 09, 2021. The archive places it in contexts such as "helped discover the cause of haemophilia". It most often appears alongside Aage Bohr, Abanindranath Tagore, Aldous Huxley.

Reference entry
haemophilia
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1
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1
First seen
November 09, 2021
Last seen
November 09, 2021
November 09, 2021 · Original source
Gavin Newsom is currently Governor of California. He is a distant cousin of singer Joanna Newsom, and great-grandson of Thomas Addis, who pioneered the field of nephrology and helped discover the cause of haemophilia. He is some relation I cannot quite track (great-great-grandson?) of Samuel and Joseph Newsom, whose Newsom and Newsom firm of architects created some of the grandest buildings in San Francisco and beyond (most famously the Carson Mansion).
haiku

haiku is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 04, 2021 and October 04, 2021. The archive places it in contexts such as "Minimalist poetry descended from the haiku". It most often appears alongside 19th century African art, 20th century, 9-11.

Reference entry
haiku
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1
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1
First seen
October 04, 2021
Last seen
October 04, 2021
October 04, 2021 · Original source
One of the largest causes, as stated by Frank Lloyd Wright, Ezra Pound, Monet and other important early modernists themselves was the collision with minimalist Japanese culture/Zen philosophy in the late 1800's. Frank Lloyd Wright and other early modernist architects were heavily indebted to Japanese architecture (see https://franklloydwright.org/frank-lloyd-wright-and-japan/). Minimalist poetry descended from the haiku (https://en.wikipedia.org/wiki/In_a_Station_of_the_Metro).
Hairy Ball Theorem

Hairy Ball Theorem is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 17, 2022 and June 17, 2022. The archive places it in contexts such as "The mathematical proof that this shape must be a doughnut and cannot be anything like a sphere is called the Hairy Ball Theorem". It most often appears alongside Alcator C-Mod, Apollo Program, ARC.

Reference entry
Hairy Ball Theorem
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1
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1
First seen
June 17, 2022
Last seen
June 17, 2022
June 17, 2022 · Original source
[9]: The mathematical proof that this shape must be a doughnut and cannot be anything like a sphere is called the Hairy Ball Theorem. Justin Ball modeled it with the top of his head.
Haitian-American

Haitian-American is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 14, 2021 and June 14, 2021. The archive places it in contexts such as "a bunch of ethnic groups are almost entirely urban (are there a lot of Haitian-American farmers?)". It most often appears alongside Adam Sandler, Albert Einstein, America.

Reference entry
Haitian-American
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1
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1
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June 14, 2021
Last seen
June 14, 2021
June 14, 2021 · Original source
Also, 82% of Americans live in cities, and a bunch of ethnic groups are almost entirely urban (are there a lot of Haitian-American farmers?) I don't think this really makes Jews particularly special.
halakhic

halakhic is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 07, 2024 and March 07, 2024. The archive places it in contexts such as "not Jewish by the halakhic definition". It most often appears alongside 23andme, Adeline Rivers, Ancestry.com.

Reference entry
halakhic
Mention count
1
Issue count
1
First seen
March 07, 2024
Last seen
March 07, 2024
March 07, 2024 · Original source
Source: https://www.researchgate.net/figure/Global-PCA-reflects-self-identified-race-ethnicity-and-language-of-ATLAS-participants-A_fig1_365445594 People use the claim “there’s no such thing as biological race” for a lot of purposes, mostly to confuse and deceive people, but here it’s worth focusing on the tiny sliver of justification for such a claim: the biological clustering of populations isn’t exactly 100% the same as socially-defined racial categories. This is unsurprising, since no two definitions of a word point to exactly 100% the same extensional cluster. All words are weird clusters of correlated traits that break down into a million dazzling-but-confusing facets the closer you look at them, and words describing race are no exception. Consider for example the Jews. Jews do share some common genes, with interesting features like the Cohen modal haplotype and usually some similar Middle Eastern genetic background regardless of where they ended up. But they also form a legal cluster: the people who are defined as Jews by the official halakhic definition - someone whose mother was Jewish, or who converted in an official ceremony. This can get arbitrarily complicated, with halakha (Jewish law) having opinions on how to sort out each weird edge case (like IVF!) But they also form a religious cluster: people who currently practice the Jewish religion. And they form a cultural cluster, consisting of people who consider themselves “cultural Jews” and have names like Weinberg and Goldstein and maybe speak a few scraps of Yiddish, even if these people are atheists. None of these clusters are exactly the same. There are some people who are genetically 100% Jewish whose families converted to Christianity centuries ago and don’t even know they have any Jewish connection. There are extremely observant Orthodox Jews who aren’t Jewish by the halakhic definition, because at some point in their line a Jewish father married a Gentile mother and they raised their family Jewish without her officially converting. (and each of these clusters breaks down even further! There are people who are halakhically Jewish according to Reform rabbis but not Orthodox rabbis. There are probably a few edge cases of people who are genetically Jewish according to 23AndMe’s definition but not Ancestry.com’s.There are people who are culturally Jewish in the sense of speaking Yiddish but not caring about Israel, and other people who care about Israel a lot but don’t speak Yiddish.) But in real life there are very high correlations between all these clusters, such that someone who’s a practicing religious Jew is overwhelmingly more likely to be genetically Jewish than someone who isn’t, and someone of Jewish descent is much more likely to be culturally Jewish, and so on. So it’s reasonable to have a word “Jew” which unprincipledly smushes together cultural, halakhic, genetic, and religious definitions, so we don’t have to write an entire PhD dissertation to describe someone’s exact level of Jewishness to a communication partner. I kind of imagine each of these definitions - religion, culture, genetics, etc - as an axis in concept space, and the category “Jew” as a hypersphere drawn around the exact typical Jewish person, whoever that is. You can be a Jew if you’re irreligious but have Jewish blood. And you can be a Jew if you have no Jewish blood but follow the Jewish religion. But if you neither have Jewish blood nor follow the Jewish religion, you’re not a Jew. Probably there’s some tradeoff here, where the less blood you have, the more you have to follow the religion before other people will consider you Jewish, and vice versa. (the Jews are lucky because they have halakha. Even though halakha is just some rules that some random Jewish person and/or God invented, they’re a strong enough Schelling point that everyone else sort of kind of agrees to respect it when deciding who’s Jewish, even though non-Jews - and non-observant Jews - are under no obligation to do this.) The category “Native American” must also work like this, right? It’s an unprincipled combination of lots of different facets - genetics, legal tribal membership, culture, lived experience, etc. Suppose a white person was adopted at birth by the Mi’kmaq Indians, grew up on their reservation, speaks their language, never even met another white person until he was an adult (let’s add that for some reason he has unusually dark skin and eyes for a white person, so he didn’t look different from the other Mi’kmaqs and experience an unusual childhood on that basis). When he grows up, he is 100% identical to the other Mi’kmaqs in every way except genetically. Does he count as Mi’kmaq? I don’t know the tribal law on this issue. But common-sensically, if for some reason I have to decide this question - like that the other Mi’kmaqs decided to expel him from the tribe and I have to either sympathize with him or tell him he deserved it - in that case I think he’s pretty Mi’kmaq. But suppose a genetically Mi’kmaq person was adopted by a white couple in Topeka and raised as a completely normal white child. Suppose she had light skin and never even knew she wasn’t white until she took a genetic test as an adult. Is she a Mi’kmaq? Um. I think if she was trying to “reconnect with her roots”, and felt some kind of deep spiritual attachment to Mi’kmaq culture on that basis, I would feel pretty bad telling her she couldn’t and she was a poser and an imperialist and the tribe should refuse to interact with her.1 I guess this means that maybe I sort of kind of grudgingly accept (3), that race is at least a little bit based on genetics (along with other things). If that’s true, you could imagine drawing the bounding hypersphere for the category “Native American” in such a way so that Elizabeth Hoover would just barely make it inside based on her lived experience if she had 1/8th Native blood, but is just barely outside (even given the same amount of lived experience) if she doesn’t. III. But the categories are made for man, not man for the categories. Even if the category “Native American” is a hypersphere in some conceptual space, we get to decide how much to weight each axis. (I like the phrase “Native American hypersphere”. It sounds like something from an Erich von Daniken book.) And I think, even though in theory we could use genetics, there’s a pretty strong argument for basing it on something like “lived experience”. That argument is: it seems kind of bad if your whole life can be retroactively invalidated by getting the wrong results from a 23andMe test, and “lived experience” is the only potential basis that prevents that. Suppose you believe in “cultural appropriation”. That means that it’s bad and evil for someone to do too much work within a culture they don’t belong to. On the other hand, everyone seems to think it’s really valuable to do work within a culture you do belong to. Native Americans who create great specifically-Native-American art and literature, or who open Native American restaurants, or who become leaders and activists within the Native American community, are hailed as heroes. We tell minorities that enhancing the culture and recognition of their specific minority group is one of the most valuable things they can do with their lives. Half of the art world is now minorities talking about the Their-Minority-Group experience. You see the trap. You spend your whole life building on the culture of your identity group, because that’s what you were told to do. Then you get a 23andMe result and - oops, you weren’t in that group after all. Now retroactively, instead of being a hero, you’re a colonizer and imperialist who needs to be unpersonned to protect your group purity2. So here’s another trilemma: Either you stop worrying about cultural appropriation.
Another advantage that Jews have over Native Americans is that, being a somewhat unified religion, there’s a conversion process. If someone who had been practicing Judaism their entire life and loved it a lot was unexpectedly found to be halakhically non-Jewish, everyone would give them the easiest conversion process in the world, snip snip and you’re done. You can read the Hoover story as a sort of tragedy caused by the lack of Native Americans having a similar institution.
halakhic definition

halakhic definition is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 07, 2024 and March 07, 2024. The archive places it in contexts such as "people who are defined as Jews by the official halakhic definition". It most often appears alongside 23andme, Adeline Rivers, Ancestry.com.

Reference entry
halakhic definition
Mention count
1
Issue count
1
First seen
March 07, 2024
Last seen
March 07, 2024
March 07, 2024 · Original source
Source: https://www.researchgate.net/figure/Global-PCA-reflects-self-identified-race-ethnicity-and-language-of-ATLAS-participants-A_fig1_365445594 People use the claim “there’s no such thing as biological race” for a lot of purposes, mostly to confuse and deceive people, but here it’s worth focusing on the tiny sliver of justification for such a claim: the biological clustering of populations isn’t exactly 100% the same as socially-defined racial categories. This is unsurprising, since no two definitions of a word point to exactly 100% the same extensional cluster. All words are weird clusters of correlated traits that break down into a million dazzling-but-confusing facets the closer you look at them, and words describing race are no exception. Consider for example the Jews. Jews do share some common genes, with interesting features like the Cohen modal haplotype and usually some similar Middle Eastern genetic background regardless of where they ended up. But they also form a legal cluster: the people who are defined as Jews by the official halakhic definition - someone whose mother was Jewish, or who converted in an official ceremony. This can get arbitrarily complicated, with halakha (Jewish law) having opinions on how to sort out each weird edge case (like IVF!) But they also form a religious cluster: people who currently practice the Jewish religion. And they form a cultural cluster, consisting of people who consider themselves “cultural Jews” and have names like Weinberg and Goldstein and maybe speak a few scraps of Yiddish, even if these people are atheists. None of these clusters are exactly the same. There are some people who are genetically 100% Jewish whose families converted to Christianity centuries ago and don’t even know they have any Jewish connection. There are extremely observant Orthodox Jews who aren’t Jewish by the halakhic definition, because at some point in their line a Jewish father married a Gentile mother and they raised their family Jewish without her officially converting. (and each of these clusters breaks down even further! There are people who are halakhically Jewish according to Reform rabbis but not Orthodox rabbis. There are probably a few edge cases of people who are genetically Jewish according to 23AndMe’s definition but not Ancestry.com’s.There are people who are culturally Jewish in the sense of speaking Yiddish but not caring about Israel, and other people who care about Israel a lot but don’t speak Yiddish.) But in real life there are very high correlations between all these clusters, such that someone who’s a practicing religious Jew is overwhelmingly more likely to be genetically Jewish than someone who isn’t, and someone of Jewish descent is much more likely to be culturally Jewish, and so on. So it’s reasonable to have a word “Jew” which unprincipledly smushes together cultural, halakhic, genetic, and religious definitions, so we don’t have to write an entire PhD dissertation to describe someone’s exact level of Jewishness to a communication partner. I kind of imagine each of these definitions - religion, culture, genetics, etc - as an axis in concept space, and the category “Jew” as a hypersphere drawn around the exact typical Jewish person, whoever that is. You can be a Jew if you’re irreligious but have Jewish blood. And you can be a Jew if you have no Jewish blood but follow the Jewish religion. But if you neither have Jewish blood nor follow the Jewish religion, you’re not a Jew. Probably there’s some tradeoff here, where the less blood you have, the more you have to follow the religion before other people will consider you Jewish, and vice versa. (the Jews are lucky because they have halakha. Even though halakha is just some rules that some random Jewish person and/or God invented, they’re a strong enough Schelling point that everyone else sort of kind of agrees to respect it when deciding who’s Jewish, even though non-Jews - and non-observant Jews - are under no obligation to do this.) The category “Native American” must also work like this, right? It’s an unprincipled combination of lots of different facets - genetics, legal tribal membership, culture, lived experience, etc. Suppose a white person was adopted at birth by the Mi’kmaq Indians, grew up on their reservation, speaks their language, never even met another white person until he was an adult (let’s add that for some reason he has unusually dark skin and eyes for a white person, so he didn’t look different from the other Mi’kmaqs and experience an unusual childhood on that basis). When he grows up, he is 100% identical to the other Mi’kmaqs in every way except genetically. Does he count as Mi’kmaq? I don’t know the tribal law on this issue. But common-sensically, if for some reason I have to decide this question - like that the other Mi’kmaqs decided to expel him from the tribe and I have to either sympathize with him or tell him he deserved it - in that case I think he’s pretty Mi’kmaq. But suppose a genetically Mi’kmaq person was adopted by a white couple in Topeka and raised as a completely normal white child. Suppose she had light skin and never even knew she wasn’t white until she took a genetic test as an adult. Is she a Mi’kmaq? Um. I think if she was trying to “reconnect with her roots”, and felt some kind of deep spiritual attachment to Mi’kmaq culture on that basis, I would feel pretty bad telling her she couldn’t and she was a poser and an imperialist and the tribe should refuse to interact with her.1 I guess this means that maybe I sort of kind of grudgingly accept (3), that race is at least a little bit based on genetics (along with other things). If that’s true, you could imagine drawing the bounding hypersphere for the category “Native American” in such a way so that Elizabeth Hoover would just barely make it inside based on her lived experience if she had 1/8th Native blood, but is just barely outside (even given the same amount of lived experience) if she doesn’t. III. But the categories are made for man, not man for the categories. Even if the category “Native American” is a hypersphere in some conceptual space, we get to decide how much to weight each axis. (I like the phrase “Native American hypersphere”. It sounds like something from an Erich von Daniken book.) And I think, even though in theory we could use genetics, there’s a pretty strong argument for basing it on something like “lived experience”. That argument is: it seems kind of bad if your whole life can be retroactively invalidated by getting the wrong results from a 23andMe test, and “lived experience” is the only potential basis that prevents that. Suppose you believe in “cultural appropriation”. That means that it’s bad and evil for someone to do too much work within a culture they don’t belong to. On the other hand, everyone seems to think it’s really valuable to do work within a culture you do belong to. Native Americans who create great specifically-Native-American art and literature, or who open Native American restaurants, or who become leaders and activists within the Native American community, are hailed as heroes. We tell minorities that enhancing the culture and recognition of their specific minority group is one of the most valuable things they can do with their lives. Half of the art world is now minorities talking about the Their-Minority-Group experience. You see the trap. You spend your whole life building on the culture of your identity group, because that’s what you were told to do. Then you get a 23andMe result and - oops, you weren’t in that group after all. Now retroactively, instead of being a hero, you’re a colonizer and imperialist who needs to be unpersonned to protect your group purity2. So here’s another trilemma: Either you stop worrying about cultural appropriation.
halal

halal is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 26, 2021 and February 26, 2021. The archive places it in contexts such as "Crave is owned by a Muslim family who wanted a sandwich place with more halal options". It most often appears alongside American Chinese food, Bay Area, BBQ pork rice.

Reference entry
halal
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1
Issue count
1
First seen
February 26, 2021
Last seen
February 26, 2021
February 26, 2021 · Original source
When I first learned about Crave, I thought Ike's had just changed its name for some reason. I googled to figure out why and learned that no, this is just sandwich plagiarism. I can't piece together the whole story, but it looks like Crave is owned by a Muslim family who wanted a sandwich place with more halal options. Is that enough to justify calling the Ike's/Crave rivalry a religious war? Is this what's happened to Huntington's Clash Of Civilizations Thesis in an increasingly consumerist world?
Halloween costumes

Halloween costumes is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 25, 2024 and June 25, 2024. The archive places it in contexts such as "some theories trace Halloween costumes back to people who genuinely believed vengeful ghosts might be out for revenge". It most often appears alongside 2010s New Atheist, Arches, columns.

Reference entry
Halloween costumes
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1
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1
First seen
June 25, 2024
Last seen
June 25, 2024
June 25, 2024 · Original source
Moving from objects to observances - Jews break a glass at weddings because some ancient rabbi broke a glass at a wedding to get people’s attention and tell them to stop being so loud and rowdy. Even very weird supernatural traditions are in some sense “utilitarian” - some theories trace Halloween costumes back to people who genuinely believed vengeful ghosts might be out for revenge that night, and very practically disguised themselves from potential unfriendly spirits.
Hallucinogen Persisting Perception Disorder

Hallucinogen Persisting Perception Disorder is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 30, 2023 and January 30, 2023. The archive places it in contexts such as "research into Hallucinogen Persisting Perception Disorder, where people who use psychedelics continue to hallucinate for months or years". It most often appears alongside Alexandros Marinos, Astralcodexten Com, Boston.

Mention count
1
Issue count
1
First seen
January 30, 2023
Last seen
January 30, 2023
January 30, 2023 · Original source
2: A team from the University of East London is doing much-needed research into Hallucinogen Persisting Perception Disorder, where people who use psychedelics continue to hallucinate for months or years after the drug has left their system. If you have this condition, they would appreciate it if you took their survey.
hallucinogen persisting perceptual disorder

hallucinogen persisting perceptual disorder is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 12, 2025 and May 12, 2025. The archive places it in contexts such as "interest in hallucinogen persisting perceptual disorder". It most often appears alongside ACX, Ann Arbor, Astralcodexten Com.

Mention count
1
Issue count
1
First seen
May 12, 2025
Last seen
May 12, 2025
May 12, 2025 · Original source
4: A correspondent with an interest in hallucinogen persisting perceptual disorder and visual snow syndrome asks readers with either of these conditions and the ability to create images/animations showing what it's like to get in touch. Specifically, he would like to know which condition you have, who diagnosed it (self, psychiatrist, ophthalmologist, etc), whether they ruled out the other condition, your image, and whether he has permission to use and share the images for scientific purposes. Please send to visual_disturbance_images.a71bn@simplelogin.com .
HAM-D

HAM-D is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 31, 2023 and May 31, 2023. The archive places it in contexts such as "You’re probably measuring how depressed people are using a test called HAM-D"; "original HAM-D research". It most often appears alongside anticholinergics, benzodiazepines, bisphosphonates.

Reference entry
HAM-D
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1
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1
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May 31, 2023
Last seen
May 31, 2023
May 31, 2023 · Original source
Consider the typical antidepressant study. You’re probably measuring how depressed people are using a test called HAM-D - on one version, the scale ranges from 0 to 54, anything above 7 is depressed, anything above 24 is severely depressed. Most of your patients probably start out in the high teens to low twenties. You give half of them antidepressant and half placebo for six weeks. By the end of the six weeks, maybe a third of your subjects have dropped out due to side effects or general distractedness. On average, the people left in the placebo group will have a HAM-D score of around 15, and the people left in the experimental group will have some other score depending on how good your medication is.
The Danes simulate several different hypothetical medications. The one I find most interesting is a medication that completely cures some fraction of the people who take it. They simulate “completely cures” by giving the patients a distribution of HAM-D scores similar to those of healthy non-depressed people. Here’s what they find:
NICE has since walked back on their claim that only effect sizes higher than 0.50 are clinically relevant (although this is part of a broader trend for health institutes not to say things like this, so I don’t want to make too big a deal of it). As far as I know, Kirsch hasn’t. Still, I think that a broader look at medication effect sizes suggests that the Danish team’s effect size laxness is overall right, and the earlier effect size strictness was wrong. Here’s a chart by a team including Leucht, who did some of the original HAM-D research:
Hamar

Hamar is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 03, 2022 and February 03, 2022. The archive places it in contexts such as "traditional nomadic pastoralist communities including the Hamar and Nyangatom ethnic groups". It most often appears alongside 538, 55-gal drum, 750k horny men.

Reference entry
Hamar
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1
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1
First seen
February 03, 2022
Last seen
February 03, 2022
February 03, 2022 · Original source
#13: Scholarships In Ethiopia The non-profit Omo Valley Research Project provides scholarships for indigenous students from the Omo Valley in Ethiopia, home to some of the most traditional groups on earth, most of whom typically live in small-scale subsistence communities. Less than 1% of members of the Omo Valley have received any formal education but increased development is opening up new opportunities for education as well as transforming their livelihoods. For students who start school, attendance after Grade 5 is often financially out of reach and a vocational college or university impossible. Supporting education for those who desire it equips community members to fully participate in the opportunities generated through development, gives them the ability to maintain a degree of cultural autonomy, and negotiate with the governmental and market-based organizations that are transforming their lives. Finally, many students yearn to learn about the world, to learn history, science, and math. Giving these students the ability to pursue their dreams is the greatest investment in human capital I know of. We support secondary, university, and vocational education through direct contributions for tuition or cost of living expenses. The students we support are all from traditional nomadic pastoralist communities including the Hamar and Nyangatom ethnic groups. [Email us at] Omovalleyresearchproject@gmail.com [or check out our website at] omovalleyresearchproject.org/
Hamburg-New York steamship fare

Hamburg-New York steamship fare is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 13, 2022 and July 13, 2022. The archive places it in contexts such as "the Hamburg-New York steerage steamship fare in the 1890s". It most often appears alongside 1890s, Alan Turing, Albert Einstein.

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1
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1
First seen
July 13, 2022
Last seen
July 13, 2022
July 13, 2022 · Original source
To America, after sea voyages became no longer frightening in the 1890s, fares suddenly became very cheap, but for the lowest classes only. The price wars between steamship companies in the 1890s were like those between airlines eighty years later: lots of bargain offers for the masses but not for the business classes. In these price wars the Hamburg-New York steerage steamship fare in the 1890s was halved from $20 to $10, but nonsteerage fares remained expensive, especially on unsinkable ships like the Titanic. More steerage-class Jewish families settled on New York, and more upper-class strivers on Budapest. In ideal high school circumstances, the latter bred the generation of geniuses.
Hamilton’s Rule

Hamilton’s Rule is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 03, 2022 and February 03, 2022. The archive places it in contexts such as "if and how Kin Selection and Hamilton’s Rule can be applied". It most often appears alongside 538, 55-gal drum, 750k horny men.

Reference entry
Hamilton’s Rule
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1
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1
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February 03, 2022
Last seen
February 03, 2022
February 03, 2022 · Original source
#18: Philanthropic Messaging Strategies Using Evolutionary Ideas I’m Ro Gupta. Inspired initially by https://www.theatlantic.com/business/archive/2015/06/what-is-the-greatest-good/395768/, I’d like to commission research that explores if and how Kin Selection and Hamilton’s Rule [https://en.wikipedia.org/wiki/Kin_selection#Hamilton%27s_rule] can be applied in mass communications for altruistic giving of humans in modern times. The goal is to uncover alternative messaging strategies that help subjects transcend blood-thicker-than-water hardwiring, based on underlying evolutionary biology theory – e.g. kin recognition, kin altruism – that ultimately serves to increase wealthy countries’ proportion of altruistic giving to less genetically familiar yet higher need/ impact populations, e.g. those of the Global South. [Estimates suggest around 5% of US giving currently goes to international causes.] I believe I have the right combination of academic, professional, NGO and global experience [https://www.linkedin.com/in/guptaro] to lead this, and access to a high quality network of research and communications experts to match grants to. I estimate a robust synthesis of existing work could be done for the low tens of thousands of USD, while a primary research phase one could be substantively scoped for the high tens to one hundred thousand USD. If of interest to be a part of this as a researcher, funder or general thought partner, please get in touch: http://www.rocrastination.com/contact/.
Han Dynasty

Han Dynasty is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 17, 2021 and June 17, 2021. The archive places it in contexts such as "Chronic warfare ended around 200 BC with consolidation of power in the Han Dynasty". It most often appears alongside Africa, antelope, August Hirsch.

Reference entry
Han Dynasty
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1
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1
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June 17, 2021
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June 17, 2021
June 17, 2021 · Original source
Around 600 BC extensive farming started in the Yellow River Valley. It took enormous collective engineering effort to build canals, irrigation systems, and flood controls to turn the vast flood plain into a productive carpet of rice paddies. Chronic warfare ended around 200 BC with consolidation of power in the Han Dynasty. This introduced a double layer of macroparasitism: private landowners and the Emperor both demanded taxes be paid. This was still better than tumultuous chronic warfare. This coincided with another powerful factor in the macroparasistic balance: Confucianism. The ideals propagated “a culture among imperial officials and private landowners internalized an ethic that strenuously restrained arbitrary or innovative use of power.”
Yellow River Basin The Han Dynasty never made it very far south towards the Yangtze. Political and military obstacles were relatively unimportant, and the climate and land meant longer and more productive growing seasons for agriculture. The Yangtze also has more predictable and manageable flood plains. Yangtze Valley is prettier too. Why not extend civilization southward? In McNeill’s words “for in moving southward and into better farming regions, Chinese pioneers were also climbing a rather steep disease gradient!” The climatic gradient is steep, like New England to Florida, in a shorter geographic distance. For a Chinese peasant, the mutually tolerable accommodation with the state and with the microparasites of the Yellow River Valley was maintainable. But more microparasitic intensity made the balance unmaintainable. The Han Dynasty and Confucianism really only worked at a certain latitude. By the way, guess which major Chinese city is on the Yangtze? (You can look back at the map.) In contrast to the Ganges Valley in India, with a civilization and farming starting around 600 BC but remained unstable and never consolidated. The Ganges Valley is hugely productive agriculturally but also warmer and wetter than China’s southern Yangtze Valley. “Classical Indian civilization thus took form under climatic and (presumed) disease conditions that the early Chinese found too much to bear.” It took a long time for China to populate the Yangtze River basin- biological accommodation to a microparasitic climate will take a long time. By that time, around 1200 AD, there is also evidence the Sung Dynasty was a less powerful and less demanding macroparasite. “To achieve such a mass population [100 million by A.D.1200] two things were needed: a suitable microparasistic accommodation to the ecological conditions of the Yangtze Valley and regions farther south, and a regulated macroparasitism that left enough of their product with the Chinese peasants so that they could sustain a substantial rate of natural increase over several generations.” Epistemic Status: A convincing narrative with zero evidence McNeill explicitly and regularly reminds the reader that this overarching thesis has little to no evidence. But it does have lots of examples. It’s the same problem that most overarching histories of humanity face: lack of documentation. Except this time it’s lack of documentation 10,000 years ago of something we discovered existed 300 years ago and is invisible without a microscope. In some way, though, this complete lack of documentation makes his case stronger- the invisible forces are stronger than the visible ones. We all kind of knew the narrative that the Spanish decimated the Aztecs and Mayans with help of smallpox. I just never extended that logic towards humanity’s escape from Africa, the march of civilizations into the countryside, and what type of social structures worked best at certain ‘disease gradient’ latitudes. The documentation of the conquistadors was almost adequate to infer disease as a massive influence. But earlier medical records and writings lack such detail. When McNeill contrasts this force of microparasitism balancing with and against the adequately vague force of macroparasitism, it’s hard not to nod your head and agree. McNeill provides as much detail and admits lack of detail as possible. The book is about on fifth footnotes. But the most convincing arguments for his narrative is the sum of parts that make up the narrative. I’m going to just list a few more examples that fit his framework because they are all interesting and also paint a more convincing picture of the importance microparasitism played in human history. The way that Europeans decimated Native Americans with smallpox blankets has been a key driver in ancient civilization expansion. The moment the city folk come in contact with tribes, smaller towns, anyone in the countryside they also bring the city folk diseases. This makes civilization expansion fundamentally easier.
Handmaid’s Tale

Handmaid’s Tale is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 08, 2022 and June 08, 2022. The archive places it in contexts such as "a literal Handmaid’s Tale theocracy". It most often appears alongside 538, Abraham Lincoln, Alexandria Ocasio-Cortez.

Reference entry
Handmaid’s Tale
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1
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1
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June 08, 2022
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June 08, 2022
June 08, 2022 · Original source
I find the changing-policy-positions one most important - all of this stuff about who votes more consistently in Congress and who endorses more conspiracy theories seems less directly important than what policies we have. If you woke up tomorrow and the Republicans were openly pushing for a literal Handmaid’s Tale theocracy, and the Democrats were just talking about the same boring small policy changes as always, it feels like it would be fair to say “Wtf, the Republicans have gotten much more extreme and I don’t like it”, even if a political scientist’s model finds that Congressional Democrats’ votes cluster slightly more tightly than Congressional Republicans’ votes or whatever. I think this is the basic point Wright and Musk are trying to make, and it’s a good one.
Handsome Owl

Handsome Owl is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 26, 2021 and February 26, 2021. The archive places it in contexts such as "I ordered Ike's Handsome Owl (vegan chicken, wasabi mayo, and swiss)". It most often appears alongside American Chinese food, Bay Area, BBQ pork rice.

Reference entry
Handsome Owl
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1
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1
First seen
February 26, 2021
Last seen
February 26, 2021
February 26, 2021 · Original source
I ordered Ike's Meatless Mike (vegan meatballs, marinara, and pepper jack), Handsome Owl (vegan chicken, wasabi mayo, and swiss), and Pilgrim (vegan turkey and cranberry). I ordered Crave's Charmander (vegan meatballs, marinara, and provolone), Goku (vegan chicken, BBQ sauce, and pepper jack), and Kim Possible (vegan impossible patty, Swiss, and mushrooms).
I really liked Ike's Handsome Owl. The wasabi mayo was an interesting taste, and the vegan chicken was somewhere between inoffensive and actually good. Crave's Goku impressed me less - either the BBQ sauce wasn't quite as good at distracting from the fake meat as the wasabi mayo, or their fake meat was lower quality. I'm reluctant to conclude the latter because then I'm going to feel embarrassed when I inevitably learn they order from the same supplier.
Happily Ever After

Happily Ever After is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 21, 2024 and February 21, 2024. The archive places it in contexts such as "Disney’s “Happily Ever After” twists on ancient fairy tales". It most often appears alongside 2017 SSC survey, A Woman First: First Woman: A Memoir, Aella.

Reference entry
Happily Ever After
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1
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1
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February 21, 2024
Last seen
February 21, 2024
February 21, 2024 · Original source
For the first decades of my life, we were so immersed in it that it didn’t occur to us that it was strange compared to other times and cultures to believe in and focus on finding your “true love,” mutually “falling in love” with a soulmate for an eternally-passionate, all-satisfying, exclusive marriage that transcends and conquers all problems. Most of our popular stories reinforced these myths, from Disney’s “Happily Ever After” twists on ancient fairy tales that originally had dark endings, to hero’s journey stories that required the crucial step of “getting the girl,” to more-disturbing stories like Punch Drunk Love. It was so pervasive that it was shoehorned into the ending of Fight Club, where we barely even noticed that it didn't make much sense.
Harambe

Harambe is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 26, 2025 and July 26, 2025. The archive places it in contexts such as "like ‘Harambe’ as per the graph below". It most often appears alongside 4chan, ACX, ACX.

Reference entry
Harambe
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1
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1
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July 26, 2025
Last seen
July 26, 2025
July 26, 2025 · Original source
The real world intruded on the Commentariat’s hyperfixations In The Rise and Fall of Online Culture Wars, Scott notes that online feminism was absolutely everywhere from around 2014-16 and then just sort of… disappeared one day. This has some parallels (down to the timing) for engagement with the SSC Comments section – from 2014-16 engagement with the comments section seems to be on an unstoppable upward trajectory and then in April 2016 it just sort of… reverses. I have already mentioned that April 2016 marked an extreme high-water mark for usage of the term ‘SJW’. From what I can see, there’s no particular reason for this specific to SSC – April 2016 has two threads with significant usage of the token, but they are completely random threads – OT47 and Links 4/16 (Links 4/16 does have a link about social justice warriors so that makes some sense, but OT47 doesn’t, so my conclusion is that there is just something that was in the water around that time). This theory says that the Commentariat really liked talking about SJWs, and when they were prevented from talking about SJWs they just stopped engaging with the blog altogether. The problem with this theory is that there is nobody really preventing the Commentariat from talking about SJWs to their heart’s content after April 2016. In February 2016, Scott requested that all Culture Wars topics be quarantined to a single Culture Wars thread on the r/slatestarcodex subreddit (link). This seems like the most common-sense explanation for the observation that the comment section changes dramatically around this time - of course engagement and usage of the term ‘SJW’ falls off when usage of the term ‘SJW’ is quarantined to a single thread in an offsite forum. However, the major problem with this explanation is that it doesn’t fit the data – comment section engagement increases throughout February – April 2016 and only starts dropping in May, when as far as I can see there is no specific events occurring in the r/slatestarcodex subreddit to explain it. Also, in February 2019 the Culture Wars Thread was euthanised (link) but there is no corresponding uptick in comment section engagement as people migrated back from the Culture Wars thread to the SSC comments section. I thought perhaps discussion of SJWs might have been drowned out by discussions of something else, such that it became passé to be discussing SJWs when there was some other Culture Wars issue at stake. This would mirror what happened to online feminism, where it became passé to discuss women specifically and more trendy to discuss intersectionality / race issues from about 2016 onwards. The obvious candidate for this switch is Trump and the rise of the MAGA movement. March 2016 was probably the last period where you could kind of convince yourself Trump wasn’t going to win the Republican Primary. In March 2016 it was just about possible Cruz could have won, but by April 2016 Trump was winning every Primary with decisive majorities. If you are slightly younger you may not have been online during that period, but I can attest that it was completely crazy commenting in political spaces around that time; I’d argue a strong candidate for the most toxic comments section ever is You Are Still Crying Wolf, where Scott offers some extremely guarded non-criticism of Trump, arguing that he was not unusually racist by American Presidential standards. This didn’t make my database because Scott nuked the comments for being too toxic, so we will never know mathematically how bad the comments were, but anecdotally they were pretty standout – closer to 4Chan than ACX in places. The evidence for this hypothesis is kind of mixed – if you abandon all sense of statistical appropriateness you can freehand draw a line which kind of looks like the decline in ‘SJW’ tokens is mirrored by a rise in ‘Trump’ tokens when you normalise the two terms, but you can also do that with any other word that was trending in April 2016, like ‘Snowden’ or ‘Wikileaks’ (or ‘Harambe’ as per the graph below). Looking just at the data it isn’t really a very impressive correlation to draw. I appreciate it is so boring to conclude that Trump is the Great Satan for the millionth time. However, I do think if you add in contextual factors there is reason to be cautiously supportive of a ‘Donald Trump killed the AXC Comments Section’ theory: The volume of ‘Trump’ comments is absolutely massive - around 11% of all comments were about Trump in January 2017, which is greater than comments about Russia during their invasion of Ukraine (10%) and comments about COVID during the first few months of the pandemic (7%). Even a topic like SJWs, which the Commentariat really liked talking about, could only manage a peak of around 1.2% (although eg ‘gender’ peaks at 5.5% and ‘feminis*’ peaks at 3.7%). Concepts like ‘Harambe’ and ‘Wikileaks’ barely register on this scale, at 0.3% and 0.5% peaks respectively. So even though the shape of the two curves looks similar when you normalise them, it is reasonable to believe Trump could have had a significant enough impact on the comments section to dislodge forum norms, in a way Harambe did not.
The volume of ‘Trump’ comments is absolutely massive - around 11% of all comments were about Trump in January 2017, which is greater than comments about Russia during their invasion of Ukraine (10%) and comments about COVID during the first few months of the pandemic (7%). Even a topic like SJWs, which the Commentariat really liked talking about, could only manage a peak of around 1.2% (although eg ‘gender’ peaks at 5.5% and ‘feminis*’ peaks at 3.7%). Concepts like ‘Harambe’ and ‘Wikileaks’ barely register on this scale, at 0.3% and 0.5% peaks respectively. So even though the shape of the two curves looks similar when you normalise them, it is reasonable to believe Trump could have had a significant enough impact on the comments section to dislodge forum norms, in a way Harambe did not.
harassment

harassment is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 26, 2025 and July 26, 2025. The archive places it in contexts such as "Scott who would write thoughtful takes on concepts like ... harassment". It most often appears alongside 4chan, ACX, ACX.

Reference entry
harassment
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1
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1
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July 26, 2025
Last seen
July 26, 2025
July 26, 2025 · Original source
So this theory says something like: the Commentariat was uniquely well suited to discussing Culture War issues in 2016. These largely revolved around gender debates – men vs women, creeps and niceguys etc. The Commentariat developed very virtuous norms around Culture War issues, which was self-reinforcing as SSC developed a reputation as a place you could come to have interesting and nuanced discussion about Culture Wars topics. This virtuous Commentariat was fuelled by Scott, who would write thoughtful takes on concepts like trigger warnings, rape culture, harassment, etc, and who set the standard for what this sort of debate could look like.
hard problem

hard problem is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 10, 2025 and June 10, 2025. The archive places it in contexts such as "the p-zombies lack ( hard problem )". It most often appears alongside brain, Chalmers, conscious.

Reference entry
hard problem
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1
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1
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June 10, 2025
Last seen
June 10, 2025
June 10, 2025 · Original source
These p-zombies talk to each other (like humans do), and an outside observer might notice that they report on some levels of mental processing, but not others (like humans do). For example, they might fail the infamous PARIS IN THE THE SPRINGTIME test, reporting only one THE rather than two. The observer would conjecture that the p-zombies’ speech is produced by a part with access to high-level processing (after the Paris sentence has been rounded off to its more plausible alternative), but not low-level processing (the base-level sense-data including both “the”s). Thus, the observer would reinvent the idea of the “conscious” vs. “unconscious” mind. This isn’t surprising or a contradiction of our premise - this is a different sort of “conscious” (easy problem) than the one we agreed the p-zombies lack (hard problem). But it will be linguistically awkward, so let’s call this distinction the “reportable” vs. “unreportable” mind.
Hare Krishna

Hare Krishna is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 23, 2021 and April 23, 2021. The archive places it in contexts such as "Greg F. who joined a Hare Krishna temple in 1970". It most often appears alongside Ben Kuhn, Bhikkhu Bodhi, Buddha.

Reference entry
Hare Krishna
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1
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1
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April 23, 2021
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April 23, 2021
April 23, 2021 · Original source
In “The Last Hippie," Oliver Sacks tells the story of Greg F., a Grateful Dead fan and onetime acidhead who joined a Hare Krishna temple in 1970. Greg appeared to thrive there:
Haredi

Haredi is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 27, 2021 and July 27, 2021. The archive places it in contexts such as "Haredi are ultra-Orthodox Jews known for having traditional (ie very large) families". It most often appears alongside Britain, China, coronavirus.

Reference entry
Haredi
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1
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1
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July 27, 2021
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July 27, 2021
  • 26 July 27, 2021
July 27, 2021 · Original source
Also, the Israel question. Haredi are ultra-Orthodox Jews known for having traditional (ie very large) families. Right now they are 9-12% of the Israeli population. If they keep having 5-10 kid families, and everyone else in Israel just has normal-modern-sized families, what will happen? According to Metaculus, they’ll double to 24% of the population in 2050. Makes sense, though weird to think about.
harm reduction

harm reduction is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 15, 2022 and July 15, 2022. The archive places it in contexts such as "things liberals care about (at that point in US political history) like harm reduction". It most often appears alongside 2012, Adam Smith, As I Lay Dying.

Reference entry
harm reduction
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1
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1
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July 15, 2022
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July 15, 2022
July 15, 2022 · Original source
Fully going for the latter in the only way this analysis can support would just be bald-facedly reflecting the inputs back as outputs – he’d have essentially just described the differences, and obviously provided no explanatory power. He’d just have listed what things conservatives obviously care about (at that point in US political history) like freedom from big government, and things liberals care about (at that point in US political history) like harm reduction and racial equality, in a way that clearly added nothing and predicted nothing.
harmlessness

harmlessness is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 08, 2023 and May 08, 2023. The archive places it in contexts such as "Standard practice subdivides ethical AI into “helpfulness” and “harmlessness”". It most often appears alongside Anthropic, Cognitive behavioral therapy, Constitutional AI.

Reference entry
harmlessness
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1
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1
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May 08, 2023
Last seen
May 08, 2023
May 08, 2023 · Original source
In their new preprint Constitutional AI: Harmlessness From AI Feedback, a team at Anthropic (a big AI company) announces a surprising update to this process: what if the AI gives feedback to itself?
This graph compares the “helpfulness Elo” and “harmlessness Elo” of AIs trained with standard RLHF and Constitutional RL.
Standard practice subdivides ethical AI into “helpfulness” and “harmlessness”. Helpful means it answers questions well. Harmless means it doesn’t do bad or offensive things.
Harrison Bergeron

Harrison Bergeron is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 25, 2023 and July 25, 2023. The archive places it in contexts such as "It would be a terrible, Harrison Bergeron-esque world if we attempted to ensure that no social good could be pursued". It most often appears alongside 1992 Presidential debate, ABA, Adesh Thapliyal.

Reference entry
Harrison Bergeron
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1
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1
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July 25, 2023
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July 25, 2023
July 25, 2023 · Original source
It is fine that we prioritize efficiency in fulfilling social goods. It would be a terrible, Harrison Bergeron-esque world if we attempted to ensure that no social good could be pursued until everybody was equally happy with their individual treatments and help. I actually like Barnes’ book because she spends much of her time arguing that disabled people are not unhappy. They are in fact, generally quite OK (Barnes herself has some sort of painful disorder which I cannot recall from memory), and tend to take much of their identity from their disability. They are, in other words, not miserable wretches whom society must drop everything in order to help, but merely one of many interests groups in a democratic, pluralistic society--albeit one with a more salient cause than many others.
Hasidic Jews

Hasidic Jews is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 12, 2025 and August 12, 2025. The archive places it in contexts such as "Groups like the Amish (and Hasidic Jews, etc.) achieve community". It most often appears alongside All Who Go Not Return, Amica Terra, Amish.

Reference entry
Hasidic Jews
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1
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1
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August 12, 2025
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August 12, 2025
August 12, 2025 · Original source
Groups like the Amish (and Hasidic Jews, etc.) achieve community by raising the costs of leaving so high that most members aren't willing to bear them. Some do, and the stories are often quite sad (https://www.amazon.com/All-Who-Go-Not-Return/dp/1555977057/). Even less insular communities, like the Mormons, do something like this (although mainstream Mormons could be regarded as striking a fairly successful balance).
hate crimes

hate crimes is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 19, 2021 and April 19, 2021. The archive places it in contexts such as "Total hate crimes incidents as measured here will be not more than 125% of their 2015 value". It most often appears alongside #Resistance, 1/2019 government shut down, 538.

Reference entry
hate crimes
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1
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1
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April 19, 2021
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April 19, 2021
April 19, 2021 · Original source
I wrote a post stating that the Trump administration would not feature angry mobs killing minorities with impunity, would not feature state-sanctioned racial violence, would not feature an especially large number of hate crimes, and would not feature the state supporting and refusing to prosecute hate crimes. I said Trump was not an “open” white supremacist and probably not a white supremacist at all except in whatever boring way you can call anyone who isn’t super-woke a white supremacist. I said that he was not getting especially high support from white voters, that he was doing better with voters of color than other Republicans, and that attempts to paint his base as especially white were bad statistics. I tried to make it very clear that this was trying to be a low-scope pushback against these particular claims, and not some sort of generic screen in favor of Trump. I gave my thesis as:
I think time has proven me right here. There was no large-scale state-sponsored violence against minorities during the Trump presidency. Trump’s race-related policies were similar to those of other recent Republican presidents. The three most-discussed Trump supporter hate crimes all turned out to be hoaxes (1, 2, 3, I swear I’m not trying to cherry-pick, these really were the most discussed incidents at the time). There was no huge spike in hate crimes during the Trump presidency, just fluctuations of about the same scale as during previous years. The much-reported-upon study showing that Trump rallies increased local hate crimes was reanalyzed and found to be wrong; adjusting for population correctly showed they did not increase hate crimes at all. Trump lost support among white voters, and gained support among voters of color at an unprecedented rate among Republicans. The KKK and Richard Spencer did not play a major role in the Trump administration, and the media stopped covering them in favor of new, less-racialized pro-Trump groups like QAnon.
1. Total hate crimes incidents as measured here will be not more than 125% of their 2015 value at any year during a Trump presidency, conditional on similar reporting methodology [confidence: 80%]
Havana Syndrome

Havana Syndrome is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 11, 2023 and May 11, 2023. The archive places it in contexts such as "I think Havana Syndrome is trending this way too". It most often appears alongside 15th Commandment, ACX, ADHD.

Reference entry
Havana Syndrome
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1
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1
First seen
May 11, 2023
Last seen
May 11, 2023
May 11, 2023 · Original source
I think people tend to confuse the debate “does psychosomatic illness exist?”, which isn’t a real question because everyone agrees it does, with “is illness X entirely psychosomatic, such that it has no organic cases?” As Siebe points out, there are many times people had that debate and doctors discovered a firm biological basis for the illness. As Siebe doesn’t point out, there are other times people had that debate and the illness did turn out to be entirely psychosomatic - Morgellon’s, electromagnetic hypersensitivity, candida hypersensitivity, etc. I think Havana Syndrome is trending this way too. You can’t just go “Here’s a time Team Organic won, therefore Team Organic is always right, wooo!” There are no teams!
Hawaiians

Hawaiians is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 01, 2024 and May 01, 2024. The archive places it in contexts such as "Hawaiians and Samoans are 'different races'". It most often appears alongside #MeToo, #StopAAPIHate, #StopAAPIHate.

Reference entry
Hawaiians
Mention count
1
Issue count
1
First seen
May 01, 2024
Last seen
May 01, 2024
May 01, 2024 · Original source
They created the concept of “Asian-American” by combining the old category “Oriental” together with Indians, Pakistanis, Thais, etc. Then, under pressure from the Hawaiian delegation, they added Pacific Islanders to create a even more heterogenous and meaningless category of “AAPI” (Asian American or Pacific Islander). Then, under more pressure from Hawaii later, they separated out “Native Hawaiian” again. The result is that Pakistanis, Koreans, and Tongans are the “same race”, but Hawaiians and Samoans are “different races”.
Hayekian

Hayekian is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 30, 2023 and March 30, 2023. The archive places it in contexts such as "your inner Hayekian (Popperian?) has to take over". It most often appears alongside 21st century American society, AGI, Eliezer.

Reference entry
Hayekian
Mention count
1
Issue count
1
First seen
March 30, 2023
Last seen
March 30, 2023
March 30, 2023 · Original source
Therefore, it’ll be fine. You’re not missing anything. It’s not supposed to make sense; that’s why it’s a fallacy. For years, people used the Safe Uncertainty Fallacy on AI timelines: Eliezer didn’t realize that at our level, you can just name fallacies. Since 2017, AI has moved faster than most people expected; GPT-4 sort of qualifies as an AGI, the kind of AI most people were saying was decades away. When you have ABSOLUTELY NO IDEA when something will happen, sometimes the answer turns out to be “soon”. Now Tyler Cowen of Marginal Revolution tries his hand at this argument. We have absolutely no idea how AI will go, it’s radically uncertain: No matter how positive or negative the overall calculus of cost and benefit, AI is very likely to overturn most of our apple carts, most of all for the so-called chattering classes. The reality is that no one at the beginning of the printing press had any real idea of the changes it would bring. No one at the beginning of the fossil fuel era had much of an idea of the changes it would bring. No one is good at predicting the longer-term or even medium-term outcomes of these radical technological changes (we can do the short term, albeit imperfectly). No one. Not you, not Eliezer, not Sam Altman, and not your next door neighbor. How well did people predict the final impacts of the printing press? How well did people predict the final impacts of fire? We even have an expression “playing with fire.” Yet it is, on net, a good thing we proceeded with the deployment of fire (“Fire? You can’t do that! Everything will burn! You can kill people with fire! All of them! What if someone yells “fire” in a crowded theater!?”). Therefore, it’ll be fine: I am a bit distressed each time I read an account of a person “arguing himself” or “arguing herself” into existential risk from AI being a major concern. No one can foresee those futures! Once you keep up the arguing, you also are talking yourself into an illusion of predictability. Since it is easier to destroy than create, once you start considering the future in a tabula rasa way, the longer you talk about it, the more pessimistic you will become. It will be harder and harder to see how everything hangs together, whereas the argument that destruction is imminent is easy by comparison. The case for destruction is so much more readily articulable — “boom!” Yet at some point your inner Hayekian (Popperian?) has to take over and pull you away from those concerns. (Especially when you hear a nine-part argument based upon eight new conceptual categories that were first discussed on LessWrong eleven years ago.) Existential risk from AI is indeed a distant possibility, just like every other future you might be trying to imagine. All the possibilities are distant, I cannot stress that enough. The mere fact that AGI risk can be put on a par with those other also distant possibilities simply should not impress you very much. So we should take the plunge. If someone is obsessively arguing about the details of AI technology today, and the arguments on LessWrong from eleven years ago, they won’t see this. Don’t be suckered into taking their bait. Look. It may well be fine. I said before my chance of existential risk from AI is 33%; that means I think there’s a 66% chance it won’t happen. In most futures, we get through okay, and Tyler gently ribs me for being silly. Don’t let him. Even if AI is the best thing that ever happens and never does anything wrong and from this point forward never even shows racial bias or hallucinates another citation ever again, I will stick to my position that the Safe Uncertainty Fallacy is a bad argument. Normally this would be the point where I try to steelman Tyler and explain in more detail why the strongest version of his case is wrong. But I’m having trouble figuring out what the strong version is. Here are three possibilities: 1) The base rate for things killing humanity is very low, so we would need a strong affirmative argument to shift our estimate away from that base rate. Since there’s so much uncertainty, we don’t have strong affirmative arguments, and we should stick with our base rate of “very low”. Suppose astronomers spotted a 100-mile long alien starship approaching Earth. Surely this counts as a radically uncertain situation if anything does; we have absolutely no idea what could happen. Therefore - the alien starship definitely won’t kill us and it’s not worth worrying? Seems wrong. What’s the base rate for alien starships approaching Earth killing humanity? We don’t have a base rate, because we’ve never been in this situation before. What is the base rate for developing above-human-level AI killing humanity? We don’t . . . you get the picture. You can try to fish for something sort of like a base rate: “There have been a hundred major inventions since agriculture, and none of them killed humanity, so the base rate for major inventions killing everyone is about 0%”. But I can counterargue: “There have been about a dozen times a sapient species has created a more intelligent successor species: australopithecus → homo habilis, homo habilis → homo erectus, etc - and in each case, the successor species has wiped out its predecessor. So the base rate for more intelligent successor species killing everyone is about 100%”. The Less Wrongers call this game “reference class tennis”, and insist that the only winning move is not to play. Thinking about this question in terms of base rates is just as hard as thinking of it any other way, and would require arguments for why one base rate is better than another. Tyler hasn’t made any. 2) There are so many different possibilities - let’s say 100! - and dying is only one of them, so there’s only a 1% chance that we’ll die. This is sort of how I interpret: Existential risk from AI is indeed a distant possibility, just like every other future you might be trying to imagine. All the possibilities are distant, I cannot stress that enough. The mere fact that AGI risk can be put on a par with those other also distant possibilities simply should not impress you very much. Alien time again! Here are some possible ways the hundred-mile long starship situation could end: The aliens are peaceful and want to share their advanced technology
Hazimism

Hazimism is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between December 17, 2024 and December 17, 2024. The archive places it in contexts such as "Hazimism is an Islamic school popular among some ISIS jihadis". It most often appears alongside 2016 US Presidential election, ACX Grant, AI.

Reference entry
Hazimism
Mention count
1
Issue count
1
First seen
December 17, 2024
Last seen
December 17, 2024
December 17, 2024 · Original source
26: Hazimism is an Islamic school popular among some ISIS jihadis that "[is] described as 'ultra-extreme' and 'even more extreme than ISIS'" ... "Hazimis believe that those who do not unconditionally takfir (excommunicate) unbelievers are themselves unbelievers, which opponents argue leads to an unending chain of takfir."
HDO

HDO is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 09, 2021 and September 09, 2021. The archive places it in contexts such as "0.1% HDO". It most often appears alongside Amazon, American, Castro.

Reference entry
HDO
Mention count
1
Issue count
1
First seen
September 09, 2021
Last seen
September 09, 2021
September 09, 2021 · Original source
The hydrogen in water is a combination of normal hydrogen (only a proton in the nucleus) and deuterium (a proton and neutron in the nucleus). These have slightly different chemical properties, so you can do various types of distillation to enrich for one or the other, including repeated freezing (realistically freezing works very slowly; our hypothetical spy would need an unrealistic amount of time, water, and patience). Normal water is about 99.9% H2O, 0.1% HDO, and negligible amounts of D2O. Water with more D2O than normal is called heavy water, water with more HDO than normal is called semiheavy water, and water with more H2O than normal (ie not even the usual tiny amounts of the other two constituents) is called light water.
He-Man and the Masters of the Universe

He-Man and the Masters of the Universe is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 16, 2024 and August 16, 2024. The archive places it in contexts such as "Hot Wheels, and He-Man and the Masters of the Universe". It most often appears alongside 20th Century Fox, Abomination, Abomination.

Mention count
1
Issue count
1
First seen
August 16, 2024
Last seen
August 16, 2024
August 16, 2024 · Original source
Given Marvel Comics, why Silver Age (1961-1965)? I.a. Why Superhero Comic Books? The winner of last year’s Astral Codex Ten book review contest was Brandon Hendrickson. Brandon wrote about Kieran Egan’s The Educated Mind. One of the foundations of Egan’s educational philosophy is that people learn through stories. He believes early education should focus on teaching lessons through myths and legends. This matches my experience. My kids’ favorite podcast is Greeking Out – a very well produced, very entertaining, National Geographic podcast about Greek Legends. Aside #1: When my oldest daughter was three years old she would ask everyone she met “Do you know any myths? Can you tell me a myth?” She especially liked asking people from different places to get myths from their local cultures. Once, she asked the question to a friend of mine who grew up in South Africa, “Can you tell me any South African myths?” He struggled for a minute and then said, “Okay! I have one! Bread never falls butter side down!”. That was not the type of myth she was looking for; nor the type of myth we will be discussing in this review. Every culture has foundational myths. These stories are entertaining and engaging, but they also teach valuable lessons about both what is important in that culture, and how people in that culture are expected to behave (or at least the Platonic Ideal of how they should behave). In the modern, Western world, we have assimilated many of these foundational stories, particularly the Greek myths. My kids definitely know the Greek myths, but they also know elements of Norse mythology, Egyptian myths, stories about Anasi from West Africa and more. More fundamentally my wife and I, while not religious ourselves, have made a point of exposing the kids to the stories from the Bible. It is not politically correct to call Biblical stories “myths”, but they serve the same purpose – shared cultural understanding of the way the world works. My wife grew up without any religion, and when she was in high school, she struggled with the metaphors and religious allegories that were omnipresent in most of the Western canon. In our culture, familiarity with the Bible is important for an educated person – whether they are religious or not – because it is the foundation of so much of the rest of our culture. I believe the other set of mythological stories that are foundational to our culture are – and by this point I am sure you see where I am going here – comic book superheroes. If true, then having more than a surface-level understanding of the most important superhero stories is important in a similar way to that knowing the Bible stories is important. “Do unto others as you would have them do unto you” is an important idea to understand. So is, “With great power comes great responsibility”. I.b. Why Marvel? While there are many independent superheroes that are not owned by major conglomerates, the superheroes who have built our modern foundational myths are currently owned by two corporations. Warner Bros. Discover owns the DC library of superheroes including Superman, Batman and Wonder Woman. In 2009 Disney purchased Marvel Comics and took ownership of their characters, including Spiderman, X-men and the Avengers. Aside #2: Marvel has sold temporary film rights to many of their characters over the years. The most relevant sales started in 1994 when Marvel sold the film rights of X-men and mutants to 20th century Fox, then in 1996, when Marvel went bankrupt, Fox picked up the rights to the Fantastic Four (and New Line picked up Blade). In 1999 Marvel sold the film rights (and live action TV, and animated TV longer than 44 minutes) of Spider-man and related characters to Columbia Pictures (part of Sony) for $7MM. Marvel actually attempted to sell ALL of their remaining Marvel IP film rights to Sony for $25MM, but the top management at Sony was not interested. Sony’s management allegedly told their chief negotiator “Nobody gives a shi*t about any of the other Marvel characters. Go back and do a deal for only Spider-Man). Disney acquired Marvel in 2009, and then Fox in 2019, bringing the two separated packages of characters all back together under one roof (Blade reverted back to Marvel in 2012). Sony still owns the rights to Spider-man but has made a deal with Disney to include some of his films within the Marvel-Disney universe. Marvel sold the film rights of The Hulk to Universal in 1990 and the current status of that agreement is complicated (the consensus is that Marvel now controls the film rights to the character, but Universal owns distribution rights to any stand-alone Hulk film, which could be why Disney let's Hulk co-star in Thor movies, but not vice versa). In the early aughts Marvel wanted to build their own film franchise, but were limited to only using their remaining “B-list” characters – Spider-man, X-men, and the Fantastic Four were all off limits. Fortunately, Kevin Feige, president of production for Marvel at the time, saw a way forward. He convinced Ike Perlmutter, Marvel CEO, to allow for the production of a series of films with the remaining characters begining with Iron Man (2008). Jon Favreau directed and cast Robert Downey Jr as Tony Stark. The film blew away expectations. Kevin’s plan of a series of movies where the characters would interconnect was suddenly feasible. Iron Man was followed by The Incredible Hulk, Thor, and Captain America: The First Avenger. None managed the box office magic of Iron Man, but all were successful enough that the plan stayed on track. In 2012 the characters were all brought together in the first Avengers film, which opened to over $200MM domestically and went on to gross more than $1.5B (which made it the 3rd highest grossing film of all time). Marvel became the first studio to take the interconnected world of their comic books and make the model work on the big screen (for a much larger audience). Once the model was proven to work, other studios tried to duplicate it. Aside #3: Warner Bros’ stumbles with the DC shared universe of Batman, Superman and the Justice League are well known, but that was actually their SECOND attempt at a shared universe. Their first attempt tried to copy the Marvel method more closely. They chose their own B-list hero and set up his first film to allow for a wider mythology. Alas Green Lantern (2011) failed at the box office and we never got stand-alone films about Sinestro (Yellow Lantern), Carol Ferris (Star Sapphire, the Violet Lantern), John Stewart (African American Green Lantern), Kyle Rayner (1990s Green Lantern), Alan Scott (original Green Lantern), or the Blue, Red, and Orange Lantern Corps. At least so far, no studio has successfully created anything with close to the traction obtained by the Marvel Cinematic Universe (MCU). Warner’s DC Extended universe (DCEU) had trifling success, but is being shelved and rebooted for a fresh attempt next year. Universal’s attempt at a “Dark Universe” kicked off with Tom Cruise in The Mummy (2017), but was dead on arrival. Paramount’s attempt to link the Transformers Universe to GI Joe at the end of Transformers: Rise of the Beasts has been appropriately mocked. Sony’s Spider-man films linked to the MCU have been very successful, but their attempt at a stand-alone non-MCU Spider-man universe using Spider-man’s villains as anti-heroes has floundered (mostly succeeding only as a source of memes). Next Mattel will be attempting to build a universe off the success of last year’s Barbie and may include Polly Pocket, American Girl, Hot Wheels, and He-Man and the Masters of the Universe (no word yet on Thomas the Tank Engine, View Master and the Magic-8 Ball, but all are apparently in development). To date, only Marvel has successfully built a “Cinematic Universe”. One potential reason for the MCU’s success is that Kevin Feige built his cinematic universe on the back of the existing interconnected universe of the comics. But those comics were not the first interconnected universe of stories. For that we would need to go back to our foundational myths. The Bible stories mostly interconnect. Adam and Eve flows into Cain and Abel. David and Goliath leads to the Wisdom of Solomon. Greek Myths DEFINITELY interconnect. Supporting characters in one Greek myth have starring roles in their own stories. The Greek pantheon of tales even have their own version of the Avengers. In the Quest for the Golden Fleece, Jason brings together the Argonauts, who included in their number Theseus (who defeated the Minotaur), Orpheus (who braved the underworld) and Hercules himself – all A-list stars in their own “franchises”. Stand alone stories that exist within an interconnected universe are rare in modern media but were common in the ancient myths that have stood the test of time. Only Marvel has successfully created a shared universe that follows the pattern of ancient myths. Only Marvel films have stand-alone stories and protagonists who exist together in an interconnected world. Something about that method of storytelling is deeply pleasing for humans across many cultures. Marvel films are the first and most successful modern version of the mythological universe, and that it is worth spending more time exploring Marvel’s underlying mythology and where it came from. I.c. Why 1961? The origins of Christianity and Judaism (and Buddhism and Hinduism) are very murky. Even Islam is far enough in the past that we only have a very rough understanding of how it came to exist. When scholars want to understand in detail how a new religion is born they are far better to look at Mormonism or, if you accept it as a religion, Dianetics. Similarly, we have versions of Greek myths that have been passed down to us, but we can never know how those myths changed from their first telling to their “final” versions. Were the stories once unrelated, and only later became crafted into a single “universe”? Or were the stories built off each other one by one (“Dad that Golden Fleece story was amazing! Do you know any other stories about the Hercules guy?”)? Or was it something in between? Perhaps the stories all existed independently, but were later crafted together (“Remember that 12-labors story I told you? Actually that was the same guy who was on the Argo!”) Unlike Greek legends, we can know the origin of the Marvel Universe. We can see how it was constructed step-by-step. The people who did it (most importantly Stan Lee, Jack Kirby, and Steve Ditko) are dead now, but they have not been dead for long. We can read the original work, see how it changed over the last 60 years, and we can ask the creators “what were you thinking at the time” (or at least read their answers from old interviews). We can’t always trust what Stan Lee says, but at least we can hear his point of view. No one has a transcript of an interview with Homer, or knows exactly what he was thinking when he called it the “wine-dark sea”. Tl;dr: Why read about Marvel Comic superheroes 1961-1965? Because interconnected mythological stories are very important to cultures, Marvel is the leading contender of the most recent modern mythology, and it originated in the first half-decade of the 1960s. II. How did Marvel Superhero Comics happen? Timely Comics published their first comic book in 1939 and called it “Marvel Comics”. Their most popular World War II comics included Captain America, the Human Torch (an android unrelated to the modern Human Torch except in powers, appearance and name), and Namor, the Submariner. In the early 1950s superheroes became less popular, so Timely changed its name to Atlas Comics and focused on humor, western, horror, war and science fiction stories. But in 1956 DC Comics began re-introducing their Golden Age superheroes and, in the second half of the 1950s, the genre took off again – particularly Superman, whose title, Action Comics, became the number one selling comic in America. Stan Lee, editor and chief at Atlas at the time, wanted to get in on the superhero action. Unfortunately in 1957 Atlas lost its distributor and the company had to rely on “Independent News” to get its comics on newsstands. The complication was that Independent News was owned by “National Periodical Publications”, who also owned DC-comics and did not want Atlas to introduce superheroes to compete with Superman, Green Lantern and the Flash. Independent News agreed to distribute Atlas comics but limited the publisher to eight titles per month, and only in non-super hero genres (like horror, romance and science fiction). Blocked from creating and launching new superhero titles, Stan Lee got creative, and in August 1961 Atlas Comics published Fantastic Four #1. Aside #4: Fantastic Four #1 was on newsstands in August 8th, 1961, but the date on the cover was November 1961. The convention at the time was that the cover date was not the “publication date” but rather the “pull date”. The pull date was the time when the retailer could send back unsold copies back to the publisher for a refund. In fact the retailer did not need to send the entire issue back, just the cover, as it was assumed that comic books could not be sold without the cover, and it saved on postage. This was only relevant because it was great for my dad who was a child at the time. My dad was friends with the kid whose father owed the local pharmacy which meant he had access to every comic book published in the late 1950s as long as he was willing to wait a few months and read it without a cover. Going forward in this essay I will always use the pull dates rather than the publication dates for individual comic book issues as they are far easier to source. If you want to convert pull dates back into publication dates you can subtract roughly two months, but it is inconsistent and sometimes longer, as was the case with Fantastic Four #1. Check out the cover of Fantastic Four #1: To the modern eye this certainly looks like a superhero comic. Four heroes with super powers fighting a giant monster. But in the eyes of publishers in 1961 this looked more like a science fiction adventure comic than something that would go head to head with Superman. Here are the covers of Action Comics (the best selling superhero comic at the time) from the three months leading up to Fantastic Four #1: Notice what they have in common? “Super Rivals”, “Super revenge”, “Super Substitutes”. And all include Superman in his blue and red tights. Fantastic Four’s cover featured super powers, but never used the word “super” and no one was wearing superhero costumes. Fantastic Four, as a superhero story, slipped under the radar because it wasn’t really a superhero story at all. It was a story about four close friends who attempted to fly into space, but then something goes wrong and they crash back to Earth. The experience changes them and they decide they now need to use their new abilities to help the rest of humanity – specifically against monsters who are invading from under the Earth. It is a fantastical science fiction story – not a superhero story. Later in his career Jack Kirby, the illustrator of the issue and co-creator of the Fantastic Four, was asked about his inspiration for the Fantastic Four heroes. He did NOT say Superman – or any superhero. He said Challengers of the Unknown. Challengers of the Unknown was an adventure story co-created by Kirby in Showcase #6 in February 1957. Here is how Wikipedia describes the Challengers origin: When acquaintances miraculously survive a plane crash unscathed, they conclude that since they are "living on borrowed time" they should band together for hazardous adventures. The four—pilot Kyle "Ace" Morgan, daredevil Matthew "Red" Ryan, strong and slow-witted Leslie "Rocky" Davis, and scientist Walter Mark "Prof" Haley—became the Challengers of the Unknown. Showcase #6, and the first appearance of the Challengers of the Unknown, by Jack Kirby Visually the Challengers and the Fantastic Four were similar. Both wore skin tight uniforms with belts and minimal decoration. The Fantastic Four’s relatively simple characterizations were practically pulled from Challengers. Reed takes on the traits of both Kyle, the leader, and Walter, the scientist. Johnny, the Human Torch is the daredevil. The Thing is “strong and slow-witted”. Sue, the only woman on the team, seems like a new addition, but is likely based on June Robbins who joined the Challengers team in Showcase #7, as an “honorary” or “girl-Challenger”. After surviving their respective “miraculous” crashes, both the Challengers and the Fantastic Four band together to help the world. They both travel through space and other dimensions, fighting mad scientists and monsters. The Fantastic Four’s early antagonists were not traditional super villains. In the first few issues they fight monsters from under the Earth (Issue #1), shape changing aliens (#2), and a charlatan who uses hypnotism to steal from his audience (#3). In issue #4 Kirby and Lee re-introduce Namor, the Submariner, one of Marvel’s top IP from the 1940s, and have him kidnap Sue. Only in Issue #5 and #6 (June and August 1962) and do we get a more standard-supervillain when Dr Doom attempts to steal the Fantastic Four headquarters and throw it into space. The next superhero Lee created was even less heroic than the Fantastic Four. In April 1962 (pull date), Marvel published The Incredible Hulk. If it was even a superhero story in disguise it was a very good disguise. The story was a scientific-filtered version of Dr Jekyl and Mr Hyde. It was a pure monster-story with nothing very super about it. Nothing on the cover suggests this has anything to do with superheroes: It is not clear if even Lee at the time thought the Hulk would be a superhero. In Fantastic Four #5 Johnny is reading a “great new comic mag” and mocks the Thing by comparing him to the Hulk. It seems pretty clear at this point that in the Fantastic Four’s world, the Hulk is just a fictional comic book, like in ours (more on that later): The other two superheroes the Marvel introduces in this period have even more subtle introductions. At the time Marvel had a number of generic-sounding titles and told science fiction and fantasy stand-alone stories: Tales to Astonish
Head Start program

Head Start program is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 08, 2022 and July 08, 2022. The archive places it in contexts such as "expands the Head Start program". It most often appears alongside 1968 convention, 1976 Democratic, 1976 Democratic primary.

Reference entry
Head Start program
Mention count
1
Issue count
1
First seen
July 08, 2022
Last seen
July 08, 2022
July 08, 2022 · Original source
The next thing Carter tries to do is a little bit of everything. Since his campaign was mostly focused on his personality and outsider status, he doesn’t have a specific core promise to fulfill, and as a result, his time in office is a hodgepodge of different legislative priorities. Sounds like a recipe for complete gridlock, but amazingly, Carter gets a good chunk of his agenda through Congress. He deregulates the airline and trucking industries, establishes the Department of Energy, and teams up with Ralph Nader to implement vehicle safety regulations. He passes a sweeping civil service restructuring bill, reforms Social Security, and expands the Head Start program. Oh, and along the way he also legalizes craft brewing.
health justice

health justice is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 16, 2022 and March 16, 2022. The archive places it in contexts such as "Sounds like you need some health justice , medical justice , and wellness justice !". It most often appears alongside 1984, Amartya Sen, Apollo Mojave.

Reference entry
health justice
Mention count
1
Issue count
1
First seen
March 16, 2022
Last seen
March 16, 2022
March 16, 2022 · Original source
(“A sick society? Sounds like you need some health justice, medical justice, and wellness justice!” —— “You’re not helping!”)
Health Politics

Health Politics is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between December 04, 2025 and December 04, 2025. The archive places it in contexts such as "the real money is in the Health Politics tag". It most often appears alongside BLS, Boston, Brenda Boomer.

Reference entry
Health Politics
Mention count
1
Issue count
1
First seen
December 04, 2025
Last seen
December 04, 2025
December 04, 2025 · Original source
I didn’t expect that Googling “graph about how negative media is over time” would work. We really do live in an age of wonders (source). This measure likely underestimates the trend towards negativity, because it only tracks a specific basket of media outlets. But the change could also have included viewers shifting consumption from more mainstream outlets towards more conspiratorial ones, including social media and blogs. (my Substack is tagged Science, but I hear the real money is in the Health Politics tag, where top performers feature articles like The Great Alzheimers Scam And The Proven Cures They’ve Buried For Billions and Russian COVID Vaccines Caused Global Turbo Cancer Crisis) So, is that all there is? I think the strongest case for an economic crisis beyond vibes would be: Because of decreasing application friction, any given opportunity requires more effort to achieve than in earlier generations. Although this can’t lower the average society-wide success level (because there are still the same set of people competing for the same opportunities, so by definition average success will be the same), it can inflict deadweight loss on contenders and a subjective sense of underachievement.
Healthy Relationships

Healthy Relationships is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 25, 2023 and August 25, 2023. The archive places it in contexts such as "For example in August we are doing "Life Extension" and "Healthy Relationships"". It most often appears alongside "El Retiro" Park, 11841 Wagner Street Culver City, 1548 NE 15th Ave.

Reference entry
Healthy Relationships
Mention count
1
Issue count
1
First seen
August 25, 2023
Last seen
August 25, 2023
August 25, 2023 · Original source
BELGRADE, SERBIA Contact: Dušan Contact Info: tatiana[dot]n[dot]skuratova[at]efektivnialtruizam[dot]rs Time: Sunday, September 24th, 3:00 PM Location: Bar Green House, Dr. Dragoslava Popovica 24, Belgrade Coordinates: https://plus.codes/8GP2RF7G+36 Group Link: https://www.linkedin.com/company/effective-altruism-serbia/ Notable Guests: Dušan from Serbia Notes: Please RSVP by email to Tatiana on the email above! The meet-up is the monthly meet-up of EA/LW/ACX crowd, usually we discuss some two topics. For example in August we are doing "Life Extension" and "Healthy Relationships".
Hearing Voices

Hearing Voices is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 25, 2022 and May 25, 2022. The archive places it in contexts such as "The Hearing Voices people pat themselves on the back because they have interesting hallucinations". It most often appears alongside 21st century scientific psychiatry, American Psychiatric Association Annual Meeting, autism rights movement.

Reference entry
Hearing Voices
Mention count
1
Issue count
1
First seen
May 25, 2022
Last seen
May 25, 2022
May 25, 2022 · Original source
The New York Times has an article out on the Hearing Voices Movement - ie people with hallucinations and delusions who want this to be treated as normal and okay rather than medicalized. Freddie deBoer has a pretty passionate response here. Other people have differently passionate responses:
I’ve met some Hearing Voices members. My impression is that everyone on every side of this discussion is a good person trying to make the best of a bad situation (except of course New York Times journalists, who are evil people destroying America). Some specific thoughts:
I recommended Hearing Voices Movement to this guy. I can’t remember whether he took me up on it or not. But I thought it would be helpful for him to have people he could talk to about his situation who wouldn’t think he was crazy, or try to get him locked up.
heart attacks

heart attacks is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 11, 2023 and May 11, 2023. The archive places it in contexts such as "like all conditions with a biological basis, there will also be lots of psychosomatic cases, just as with heart attacks". It most often appears alongside 15th Commandment, ACX, ADHD.

Reference entry
heart attacks
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1
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1
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May 11, 2023
Last seen
May 11, 2023
May 11, 2023 · Original source
Almost all organic conditions have a psychosomatic shadow. Consider eg heart attacks. These are as organic as they come. But about a third of cases where people come into the emergency room with sudden-onset sharp chest pain are having a psychosomatic issue, usually a panic attack.
I’m very sure Long COVID is often an organic illness with a biological basis. I’m not claiming it’s in the same class as Morgellons. Having acknowledged that, like all conditions with a biological basis, there will also be lots of psychosomatic cases, just as with heart attacks and everything else.
heathen

heathen is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 23, 2021 and July 23, 2021. The archive places it in contexts such as "did you know that some linguists believe that 'heathen'". It most often appears alongside Ace Attorney, Adam Smith, Amazon.

Reference entry
heathen
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1
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1
First seen
July 23, 2021
Last seen
July 23, 2021
July 23, 2021 · Original source
5: This month in etymology: did you know that some linguists believe that “heathen” (which originally had an adjective form “heathenic”) comes from the word “ethnic” (in the same ethnic=foreign sense as “ethnic food”)? But it might also have just been a person who lived on a heath.
Heaven

Heaven is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 01, 2025 and April 01, 2025. The archive places it in contexts such as "imagine Heaven as a place of green wine, crimson seas, and golden mountains". It most often appears alongside Afghanistan, AI, anime.

Reference entry
Heaven
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1
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1
First seen
April 01, 2025
Last seen
April 01, 2025
April 01, 2025 · Original source
Blue was another tough one. You could do mediocre, half-faded blues with azurite. But if you wanted perfect blue, the color of the heavens on a clear evening, you needed ultramarine.
The Catholic Church did this because it worked. Joe Peasant would go to the festival, and his lord and lady would be wearing lovely blue robes, but the blue would always be very slightly faded. He’d go off to war, and the knights would have beautiful blue banners, but still, not quite right. Then he would go to church, and there would be a painting of the Virgin Mary, and there - and only there! - the perfect Platonic blue of Heaven would be translated down to Earth. And he would think, yeah, okay, this is the true religion.
Klein was a provocateur, and I’m no art historian, so don’t let me tell you what he actually meant by his all-blue paintings. But one thing he could have meant was a callback to all the medieval merchants and monks and miners; everyone who died to get a few drops of ultramarine back to Europe so the Virgin’s robes could be perfectly celestially blue. “Look!” say Klein’s paintings. “Now we’re so rich, so blessed, that I can paint an entire canvas with the perfect blue of the heavens. I can use more blue than the total yearly output of medieval Europe, just so a couple of passers-by can frown and secretly wish that paintings still looked like stuff.”
Heaven’s Mandate

Heaven’s Mandate is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 01, 2023 and September 01, 2023. The archive places it in contexts such as "they interfaced with the world through concepts like Heaven’s Mandate". It most often appears alongside 536 BC, ACX, Ai Jiang.

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Heaven’s Mandate
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1
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1
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September 01, 2023
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September 01, 2023
September 01, 2023 · Original source
But the Shang faced growing threat from the Zhou, a once-subordinate people from west beyond the mountains. Inspired by a rare conjunction of the planets in 1059 BC, the Zhou declared that there was such a thing as the Mandate of Heaven, a divine right to rule—and while the Shang had once held it, their misrule and immorality had forced the Mandate to pass to the Zhou. Thirteen years later, the Zhou and their allies defeated the Shang in battle, seized their capital, drove their king to suicide, and supplanted them as overlords of the Central Plains.
But the historical reality seems to be the usual sordid political struggle around a new consort—and heir—threatening the power of the old one. The original queen’s powerful father allied with barbarians to root out the upstart, only to get maybe more than he bargained for. Sure, he put his grandkid on the throne in the end, but the royal house had been devastated. It would never regain the ancestral lands it had lost to the barbarians, the direct holdings that filled its treasury and provided for its armies. The king retreated east into the Central Plains, playing ground of lords that were now more powerful than him. While the royal line remained symbolically important, as holder of the Mandate of Heaven from which all the states derived their legitimacy, the loss of central authority in every other sense would unleash centuries of intensifying interstate warfare and upheaval.
The Partition of Jin is often considered the end date of the Spring and Autumn period. States could and did destroy states before then, but the creation of new independent ruling lines was different. Granting rulership had been the prerogative of the king, through which the Mandate of Heaven flowed, some echo of the divine command to overthrow tyranny and build a virtuous order; now, there was increasingly little justification for rulership beyond the power required to seize it.
heavy water

heavy water is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 09, 2021 and September 09, 2021. The archive places it in contexts such as "Water with more D2O than normal is called heavy water". It most often appears alongside Amazon, American, Castro.

Reference entry
heavy water
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1
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1
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September 09, 2021
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September 09, 2021
September 09, 2021 · Original source
The hydrogen in water is a combination of normal hydrogen (only a proton in the nucleus) and deuterium (a proton and neutron in the nucleus). These have slightly different chemical properties, so you can do various types of distillation to enrich for one or the other, including repeated freezing (realistically freezing works very slowly; our hypothetical spy would need an unrealistic amount of time, water, and patience). Normal water is about 99.9% H2O, 0.1% HDO, and negligible amounts of D2O. Water with more D2O than normal is called heavy water, water with more HDO than normal is called semiheavy water, and water with more H2O than normal (ie not even the usual tiny amounts of the other two constituents) is called light water.
Heavy or semiheavy water is pretty toxic. It's not radioactive or anything. It's just that your body is 70% water, and if the water has even slightly different chemical properties than usual, that screws up a lot of stuff. It's the perfect poison - except that you need to replace a significant proportion of someone's body water with semiheavy water before they feel any worse; realistically they would have to consume gallons and gallons. Probably beyond the reach of most poisoners, which is why the question specified you're refilling Castro's whole water cooler for months on end.
If heavy water makes you feel worse and eventually kills you, naturally light water should make you feel better and eventually make you immortal. That's how logic works, right?
Hebbian learning

Hebbian learning is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 16, 2024 and July 16, 2024. The archive places it in contexts such as "in accordance with Hebbian learning, the learning process requires repeated synchronous firing". It most often appears alongside auditory cortex, Big Bang, cerebellum.

Reference entry
Hebbian learning
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1
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1
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July 16, 2024
Last seen
July 16, 2024
July 16, 2024 · Original source
For example, while I learn to perform a task it is quite conscious, but once it becomes routine, I can be unsure whether I have just done it. This makes perfect sense now: in accordance with Hebbian learning, the learning process requires repeated synchronous firing, i.e. oscillations, i.e. capacity for conscious phenomena. But the synaptic shortcuts this creates necessarily reduce the bandwidth required for the task, obviating large oscillations with their conscious phenomena.
Hebrew calendar

Hebrew calendar is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 10, 2022 and October 10, 2022. The archive places it in contexts such as "Passover is linked to the Hebrew calendar". It most often appears alongside 9-11, Adraste, America.

Reference entry
Hebrew calendar
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1
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1
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October 10, 2022
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October 10, 2022
October 10, 2022 · Original source
Jesus died two days before Passover, but Passover is linked to the Hebrew calendar and can fall on a variety of Roman calendar days. So the main remaining degree of freedom is how the early Christians translated from the (Biblically fixed) Hebrew date to the (not very clear) Roman date. This seems to have been calculated by someone named Hippolytus in the 3rd century, but his calculations were wrong - March 25 did not fall on a Friday (cf. Good Friday) on any of the plausible crucifixion years. Also, as far as I can tell, the relevant Jewish tradition is that prophets die on the same day they are born, not the same day they are conceived. For example, Moses was born on, and died on, the 7th of Adar (is it worth objecting that it should be the same date on the Hebrew calendar and not the Roman?) Maybe this tradition was different in Jesus’ time? But it must be older than the split between Judaism and Islam - the Muslims also believe Mohammed died on his birth date.
Hebrew letter qoph

Hebrew letter qoph is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 29, 2022 and September 29, 2022. The archive places it in contexts such as "the Hebrew letter qoph means “monkey”". It most often appears alongside 1 Kings 10-11, 2008 Democratic National Convention, Adam Scheffer.

Reference entry
Hebrew letter qoph
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1
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1
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September 29, 2022
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September 29, 2022
September 29, 2022 · Original source
I feel like this is weak. If I were doing this, I’d point out that 1 Kings 10-11 describes the moral decline of King Solomon. His main offenses are overtaxing the people, taking too many heathen women into his harem, and overspending on luxuries - including monkeys from far-off Tarshish. God gets angry at all of this and curses him to have his kingdom fall in the next generation. Surely monkeys + sexual profligacy = curse, plus the impending fall of the kingdom, forms a better “monkeypox means the End Times” argument than the “zoonotic disease” drivel. Also, Solomon’s excessive taxes come out to exactly 666 talents of gold - coincidence? But also: the Hebrew letter qoph means “monkey” - both symbolically, in the sense that its glyph is supposed to represent a monkey with a tail, and literally, in the sense that the word “qoph” also means “monkey” in Hebrew. According to kabbalah, it is the letter of impurity and unholiness. Its gematria value is 100, representing the 100 people killed by plague every day due to David offending God. But qoph is also the first letter of the Hebrew word keitz, meaning the end of time! I really feel like you could make a much stronger case here!
Hector the Convector

Hector the Convector is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 04, 2025 and September 04, 2025. The archive places it in contexts such as "Hector the Convector is a cumulonimbus thundercloud cluster on the Tiwi Islands". It most often appears alongside 80,000 Hours, abundance liberalism, Afghanistan.

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Hector the Convector
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1
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1
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September 04, 2025
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September 04, 2025
September 04, 2025 · Original source
43: China think tank assessment of how in control Xi is: still very in control, maybe not infinitely in control. 44: Related - did you know (h/t xlr8harder) that if you ask AI to write a science fiction story, it will very often name the protagonist “Elara Voss” (or some very close variant like Elena Voss), and this remains true across various models and versions? Related: Chelsea Voss of OpenAI is having a baby and has the opportunity to do the funniest thing. 45: “Hector (cloud) is a cumulonimbus thundercloud cluster that forms regularly nearly every afternoon on the Tiwi Islands in the Northern Territory of Australia…[he is sometimes called] Hector the Convector”. 46: British allergy sufferers who want to know the ingredients of things demand that British cosmetics stop listing their ingredients in Latin. “For example, sweet almond oil is Prunus Amygdalus Dulcis, peanut oil is Arachis Hypogaea, and wheat germ extract is Triticum Vulgare.” 47: Text-based RPG about being an NYT journalist at the Manifest prediction market conference. I make a brief appearance. 48: Study uses supposedly-random variation in doctor assignments to test whether the marginal mental health commitment is good or bad for patients, finds that it is quite bad. Freddie de Boer is violently skeptical (maybe literally so?) and makes some good points about how a single quasi-experimental study is never absolute proof. But I don’t think he quite justifies his opinion that the paper was irresponsible and should never have been published; it’s just a normal quasi-experimental study that we should nod and say “huh” at but not overweight as the culmination of all possible research that overcomes all possible priors. My prior is that the marginal commitment is pretty useless (many commitments are just “well, since this person arrived at our ED for some reason, it would look bad from a medico-legal perspective to just let them go, so let’s keep them a few days to evaluate” - and yeah, you should be upset about this) but I’m still surprised by how many outright negative (as opposed to zero) effects the researchers found. The strongest argument for negative effects is that it will make some people miss work and maybe lose their job. But this study found that commitment ~doubles the risk of near-term suicide (admittedly only from 1% to 2%), which would have been outside my confidence intervals for how bad it could be. I suspect confounding, but only on general principle, and I wouldn’t be too surprised either way. 49: This tweet is probably bait, but I found it a thought-provoking question: I think there’s a boring answer, where the law is more complex than just a single number and whatever kind of weird trafficking Epstein was doing is worse than whatever normal relationships these European laws are permitting. But assuming that there’s a substantive difference even after taking that into account, I think my answer is something like - we’ve got to divide kids from adults at some age, there’s a range of reasonable possible ages, we shouldn’t be too mad at other societies that choose different dividing lines within that range - but having decided upon the age, we’ve got to stick with it and take it seriously (in the sense of penalizing/shaming people who break it). This is more culturally relativist than I expected to find myself being, so good job to Richard for highlighting the apparent paradox. 50: Dilan Esper describes his experience as one of Hulk Hogan’s attorneys in the Gawker lawsuit (X). Parts I found interesting: none of the lawyers knew Thiel was funding the lawsuit; Gawker probably could have won if they had been slightly competent but kept "shooting themselves in the foot"; and Gawker probably could have won if they had just pixelated the private parts in the video. 51: Amazing concept and poems (link on X): I tried to see if AI could do this, and it did something that technically met the requirements but had zero artistic merit - using a lot of words like “nowhere” and “outside” in one, then separating them out to “no where” and “out side” in the other. I didn’t invest much energy in creating a clever prompt telling it not to do that, so feel free to report if you get better success. 52: New study claims consultants are actually good, at least for profits: "We find positive effects on labor productivity of 3.6% over five years, driven by modest employment reductions alongside stable or growing revenue" 53: A Polish team tries to test Peter Turchin’s equations for predicting political unrest on recent Polish history, has to make some changes but claims mostly positive results. 54: New big multi-author Substack, The Argument, trying to be a sort of center-left version of the model pioneered by The Free Press and other high-production-value ideological Substack properties. Excited to see Kelsey Piper is involved, and she starts off strong with a post on the latest round of First World basic income studies, which find few positive effects. This is surprising, because recipients didn’t waste the money on alcohol or gambling or anything - they paid down debt and got useful goods. Still, it didn’t even affect things that should have been obvious, like stress level. It’s not even clear that amounts of money large enough to help with rent made homeless people more likely to get houses! Matt Bruenig criticizes the article, accusing Kelsey’s studies of being downstream of Perry Preschool style dreams that exactly the right welfare program will have massively compounding effects that cut poverty out at the root and turn everyone into elite human capital; he thinks giving people money won’t do this, but it will increase equality and give the poor better lives. I assume he’s not a strong hereditarian, but his argument makes even more sense from that perspective, and I’ve certainly criticized dumb outcome measures like infant brain waves which we have only tenuous reasons to think are related to anything we care about. But Kelsey reasonably responds that the outcome measures she’s talking about include stress level and life satisfaction. To defuse this critique, Bruenig either has to argue that our construct “life satisfaction” doesn’t really measure whether someone’s life is satisfactory, or else claim that giving poor people satisfactory lives isn’t really what we’re going for - which I think would require more explanation on his part. There’s some further (impressively acrimonious) debate on X, but I don’t see anything that addresses my core concern. GiveDirectly, a charity involved in basic income experiments, has a presponse here; they say that some studies are positive, and that the ones that aren’t might have tried too little cash to matter, or been confounded by COVID making everything worse. They also point out that basic income is harder to study than traditional programs like giving people housing, because if you’re giving housing you can measure housing-related outcomes directly and have a pretty good chance of getting enough statistical power to find them, but since everyone spends cash on different things, the positive effects might be scattered across many different outcomes (and therefore too small to reach significance on each). Everyone involved in this debate wants to emphasize that the poor results are for First World studies only, and that studies continue to show large benefits to giving cash in the developing world. 55: Related: I was less impressed by The Argument’s first foray into housing policy, which follows an all-too-familiar pattern: Some people say they don’t like noise and disorder and try to make rules against it in their apartments.
hedgehog

hedgehog is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 16, 2022 and August 16, 2022. The archive places it in contexts such as "Wait, isn’t the hedgehog the bad one?". It most often appears alongside 538, 538, @tnim_.

Reference entry
hedgehog
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1
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1
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August 16, 2022
Last seen
August 16, 2022
  • 22 August 16, 2022
August 16, 2022 · Original source
The community consensus so far seems to be to try to avoid Kalshi as long as it can. There are some good real-money prediction markets open to non-Americans: Polymarket, Futuur, Hedgehog, and Insight Prediction, although Americans will find visits prohibited nationally, and I would never recommend violating precepts negligently. You could also try play-money markets like Manifold, or market-adjacent forecasting sites like Metaculus.
…members of the community it created, betting on its chances, using one of the many descendant sites it inspired. You can’t kill an idea. Hedgehog Markets Wait, isn’t the hedgehog the bad one? Isn’t that why the 538 mascot is the fox?
Wait, isn’t the hedgehog the bad one? Isn’t that why the 538 mascot is the fox?
hedonic ascent

hedonic ascent is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 15, 2024 and May 15, 2024. The archive places it in contexts such as "There is no reason to believe that hedonic ascent will halt". It most often appears alongside @the_megabase, A Pan-Species Welfare State, ACX Grantees.

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hedonic ascent
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1
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1
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May 15, 2024
Last seen
May 15, 2024
May 15, 2024 · Original source
The hypothetical shift to life lived entirely above Sidgwick's "hedonic zero" will mark a momentous evolutionary transition. What lies beyond? There is no reason to believe that hedonic ascent will halt in the wake of the world's last aversive experience in our forward light-cone. Admittedly, the self-intimating urgency of eradicating suffering is lacking in any further hedonic transitions, i.e. a transition from the biology of happiness to a biology of superhappiness; and then beyond. Yet why "lock in" mediocrity if intelligent life can lock in sublimity instead?
hedonic hotspots

hedonic hotspots is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 30, 2022 and September 30, 2022. The archive places it in contexts such as "endorphins from 'hedonic hotspots' in NAc and VP". It most often appears alongside 5HT2A serotonin, acetylcholine, Alice.

Reference entry
hedonic hotspots
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1
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1
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September 30, 2022
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September 30, 2022
September 30, 2022 · Original source
2. The amount and pattern of GABAergic inhibition of VTA dopamine neurons from NAc, ventral pallidum, and local GABA interneurons. At rest, only a small % of VTA DA neurons will be firing at a given time, and the aforementioned surprise signal alone can't do much to increase this. What CAN change this is the hedonic value of the surprising stimulus. An unexpected reward causes not just a surprise signal, but a release of endorphins from "hedonic hotspots" in NAc and VP, and these endorphins inhibit the inhibitory GABA neurons, thereby releasing the "brake" on VTA DA neurons and allowing more of them to phasically fire.
hedonic transitions

hedonic transitions is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 15, 2024 and May 15, 2024. The archive places it in contexts such as "any further hedonic transitions, i.e. a transition from the biology of happiness to a biology of superhappiness". It most often appears alongside @the_megabase, A Pan-Species Welfare State, ACX Grantees.

Reference entry
hedonic transitions
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1
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1
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May 15, 2024
Last seen
May 15, 2024
May 15, 2024 · Original source
The hypothetical shift to life lived entirely above Sidgwick's "hedonic zero" will mark a momentous evolutionary transition. What lies beyond? There is no reason to believe that hedonic ascent will halt in the wake of the world's last aversive experience in our forward light-cone. Admittedly, the self-intimating urgency of eradicating suffering is lacking in any further hedonic transitions, i.e. a transition from the biology of happiness to a biology of superhappiness; and then beyond. Yet why "lock in" mediocrity if intelligent life can lock in sublimity instead?
hedonic zero

hedonic zero is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 15, 2024 and May 15, 2024. The archive places it in contexts such as "Sidgwick's "hedonic zero"". It most often appears alongside @the_megabase, A Pan-Species Welfare State, ACX Grantees.

Reference entry
hedonic zero
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1
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1
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May 15, 2024
Last seen
May 15, 2024
May 15, 2024 · Original source
The hypothetical shift to life lived entirely above Sidgwick's "hedonic zero" will mark a momentous evolutionary transition. What lies beyond? There is no reason to believe that hedonic ascent will halt in the wake of the world's last aversive experience in our forward light-cone. Admittedly, the self-intimating urgency of eradicating suffering is lacking in any further hedonic transitions, i.e. a transition from the biology of happiness to a biology of superhappiness; and then beyond. Yet why "lock in" mediocrity if intelligent life can lock in sublimity instead?
hedonium shockwave

hedonium shockwave is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 04, 2023 and January 04, 2023. The archive places it in contexts such as "It’s called the hedonium shockwave, read a book". It most often appears alongside AI Circle, Anthropic, Asana.

Reference entry
hedonium shockwave
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1
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1
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January 04, 2023
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January 04, 2023
January 04, 2023 · Original source
“It’s called the hedonium shockwave, read a book.”
HeLa cells

HeLa cells is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 07, 2023 and February 07, 2023. The archive places it in contexts such as "Everybody talked about HeLa cells, the amazing cell line that makes research much more effective". It most often appears alongside Africa, Atlanta, Chernobyl.

Reference entry
HeLa cells
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1
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1
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February 07, 2023
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February 07, 2023
February 07, 2023 · Original source
It wasn’t typical to ask patient consent in the 1950s, and nobody asked Henrietta or her family for consent to sample her cells or to use them for research. This has become a typical cautionary tale of bad scientific ethics (also probably racism and sexism). Nobody compensated her family, and none of the windfall produced by researching her cells went to them. Everybody talked about HeLa cells, the amazing cell line that makes research much more effective, and nobody talked about Henrietta Lacks, the person. Companies published the HeLa cells’ DNA, and records of Lacks’ cancer, without asking family members.
“I want scientists to acknowledge that HeLa cells came from an African American woman who was flesh and blood, who had a family and who had a story,” her granddaughter Jeri Lacks-Whye told Nature.
helicopter

helicopter is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 02, 2025 and May 02, 2025. The archive places it in contexts such as "thing with the chimp and the helicopter". It most often appears alongside AI Futures Project blog, Amistad, BIENVENIDOS A PUERTO PARRA.

Reference entry
helicopter
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1
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1
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May 02, 2025
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May 02, 2025
May 02, 2025 · Original source
No, say the speculators, you don’t understand. Everything is physically impossible when you’re 800 IQ points too dumb to figure it out. A chimp might feel secure that humans couldn’t reach him if he climbed a tree; he could never predict arrows, ladders, chainsaws, or helicopters. What superintelligent strategies lie as far outside our solution set as “use a helicopter” is outside a chimp’s?
Eh, say the sober people. Maybe chimp → human was a one-time gain. Humans aren’t infinitely intelligent. But we might have infinite imagination. We can’t build starships, but we can tell stories about them. If someone much smarter than us built a starship, it wouldn’t be an impossible, magical thing we could never predict. It would just be the sort of thing we’d expect someone much smarter than us to do. Maybe there’s nothing left in the helicopters-to-chimps bin - just a lot of starships that might or might not get built.
The first time I felt like I was getting real evidence on this question - the first time I viscerally felt myself in the chimp’s world, staring at the helicopter - was last week, watching OpenAI’s o3 play GeoGuessr.
helium

helium is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 20, 2022 and May 20, 2022. The archive places it in contexts such as "co-discovery and naming of the element helium, from his studies of the sun". It most often appears alongside Aldous Huxley, Alexander Macmillan, Alfred Russel Wallace.

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helium
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1
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1
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May 20, 2022
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May 20, 2022
May 20, 2022 · Original source
Lockyer had a cushy job as a civil servant in the British government, but dabbled in astronomy in his spare time. In the 19th century, dabbling in astronomy in your spare time could be an intellectually productive hobby: the line between professional and amateur science was blurrier then, and it wasn’t hard to contribute original research even without formal training. During the 1860s, Lockyer published several papers on astronomical observations, the most consequential of which might be the co-discovery and naming of the element helium, from his studies of the sun. His reputation grew among the “men of science” (as scientists called themselves then) of Victorian Britain, and he was soon elected to the Royal Society. But astronomy was an expense, not a source of income. Lockyer routinely supplemented his government job by writing nonspecialist scientific articles and books for a lay audience. Then, one day, he had an idea for a new kind of publication. It would be a weekly periodical to disseminate scientific knowledge to the broader public — but unlike the other periodicals that existed at the time, it would be written by the prominent men of science themselves. It would have a simple, evocative name: Nature. Lockyer summarized the two aims of Nature like this: FIRST, to place before the general public the grand results of Scientific Work and Scientific Discovery, and to urge the claims of Science to a more general recognition in Education and in Daily Life; And, SECONDLY, to aid Scientific men themselves, by giving early information of all advances made in any branch of Natural knowledge throughout the world, and by affording them an opportunity of discussing the various Scientific questions which arise from time to time. In other words (and getting rid of the old-fashioned capitalization of random adjectives and nouns), Nature was meant to do two things: communication from scientists to the public, and communication among scientists. It was an interesting idea. It was also a new one; until then the two aims had been separate. Recall that scientific journals have existed since 1665. During their first two hundred years, they primarily served to record the meetings of learned societies. The Philosophical Transactions of the Royal Society were originally just that: summaries of whatever “philosophical” questions were discussed at the Royal Society. Aside from journals, specialized books were common and were in fact the higher-status way to communicate science in Victorian Britain. Charles Darwin’s On the Origins of Species, published in 1859, is the most famous example. Informal correspondence between scientists was also a major, but private, channel: Darwin wrote more than 15,000 letters in his lifetime, enough to fill 30 volumes. With the exception of some books, none of the above were intended for laypeople. Educated non-scientists (professionals, clergymen, statesmen, etc.) instead got their science news from generalist or literary periodicals such as the Athenaeum magazine. The articles in those publications were not written by specialists, but by journalists and dilettantes. Lockyer’s view, shared with his close supporter Thomas Huxley — a biologist known for defending Darwinian evolution — was that they were riddled with errors and theological overtones. It would be better, they thought, if scientists did the work of communicating their research themselves. It was bold of Lockyer and Huxley to assume that scientists would be interested in doing this communication work. They weren’t. Almost immediately after Nature was founded, its contributors ignored the popularization part (“not a high-status undertaking,” Baldwin’s book says) and focused on the intra-science communication part. They did write summaries and abstracts of their own research, as Lockyer had intended, but they expected that their readers would be other men of science. Within three years, the educated laypeople who were Lockyer’s target audience were complaining that they could no longer understand the contents. Thus the first of Nature’s two aims was met mostly with failure. Fortunately, this was balanced out by unexpected success at the second aim. Scientists did actually enjoy writing for Lockyer’s magazine, in large part because it was published weekly. They found that writing a summary of their own research in Nature was an excellent way to share their results quickly and gain attention from other scientists. Books were slow; Darwin took many years to write and publish On the Origin of Species, for instance. The journals of scientific societies were slow; you had to wait for a meeting to take place and then for the meeting’s “transactions” to be published. Private correspondence was fast, but it wasn’t public. Through publication speed, as well as other factors as we’ll see below, Nature filled a niche in the ecosystem. It was the Twitter of 19th-century British science. Soon enough, this model would be copied, most notably by the journal Science in 1880. According to its first editor, Science was explicitly meant to, “in the United States, take the position which ‘Nature’ so ably occupies in England.” In just a few years, Nature had disrupted scientific publishing and established itself as a useful and unique institution of science, recognized by specialists both in the UK and abroad. First page of the first edition of Nature, 4 November 1869 II. One Hundred Years of Building a Reputation Despite its popularity, Nature didn’t become prestigious overnight. Far from it, in fact. Making Nature often reminds us that the journal spent most of its history as a low-grade publication where anything could be printed quickly, as long as it was factually correct. (This was ensured by basic checks from the editorial team; Nature articles were not consistently peer-reviewed until the 1970s.) As late as the 1960s, a researcher publishing a preliminary report in Nature was expected to follow up with a longer paper “in a more serious journal.” In other words, Nature delivered quick and cheap distribution, not luxury brand approval. This changed about fifty years ago, as we’ll see in Part III. But to understand what happened then, we first need to examine the characteristics of the journal in the roughly 100-year period from its early days until prestige took over, starting with a deeper look into publication speed. Publication Speed John Maddox, editor of Nature in the late 20th century, said that “one of Nature’s greatest early assets was the speed of the Royal Mail.” You could write to Nature, be published within a week, and read the replies to your communication within two weeks. This was state-of-the-art communication tech! Consider how many times publication speed is mentioned throughout the first half of the book (emphasis mine): What made Nature unique was, in large part, its ability to act as a venue for . . . discussions via its correspondence columns and its weekly publication schedule. (p. 8) Many British men of science found that one of the fastest ways to bring a scientific issue or idea to their fellow researchers’ attention was to send a communication to Nature. (p. 39) Unlike the literary periodicals, there was almost no delay between the submission of a piece and its appearance in the journal. (p. 63) A second reason Nature’s speed of publication would have been compelling to men of science is that getting one’s work into print quickly had become an increasingly essential part of establishing priority for a scientific finding or theory. (p. 65) Scientific weeklies [such as Nature] played a unique role in researchers’ publishing strategies at the end of the nineteenth century by offering researchers a forum where short articles could be printed quickly. (p. 105) Both the Proceedings [of the Royal Society of London] and the Philosophical Magazine had significant lag times between submission and publication . . ., which made Nature and its weekly turnaround uniquely valuable for the priority-conscious Rutherford. (p. 109) [Rutherford] sent his most interesting experimental results [to Nature] immediately, both as a way of keeping his colleagues updated on his work and as insurance against being scooped as he had in 1899. (p. 112) These quotes highlight two distinct reasons why speed was important. The first, as I hinted at earlier, was Nature’s role as the аcademic social media of its time. It was simply the best way to have discussions about scientific topics — or science itself — that could, unlike private correspondence, reach a large audience. More on this in the next section. The second reason, as shown by the mentions of physicist Ernest Rutherford, was establishing priority. Today we take for granted that being the first to publish new ideas or results is important, but in the 19th century this was less clear. To bring up Darwin as an example again, he kept his thoughts on evolution private for many years, because he wanted to make sure his argument was sound before he submitted it to the public (although he did eventually sense the urgency of publishing the theory before Alfred Russel Wallace did). But as science became professionalized, “not being scooped” became more and more crucial, and the weekly Nature was a good tool to avoid that. All this talk of speed may surprise anyone who has recently submitted a paper to Nature. In 2016, an analysis revealed that the median time for Nature to review a paper was 150 days, i.e. 5 months, up from 85 days a decade earlier. Nature itself reports, for the year 2020, a median time of 226 days between submission and acceptance. We’re a long way from “less than a week.” Why was there a decrease in publication speed? As we might expect, the reason was Nature’s growing popularity, especially among the international scientific community. At least, that’s what happened the first time there was a slowdown, in the mid-20th century. Early on, Nature was a journal for and by British scientists. But in the first half of the 20th century, science in general and Nature in particular began to involve much more collaboration between researchers across borders. It was a big deal, for instance, when a foreign government banned Nature, as Nazi Germany did in 1938; German researchers had been using it as an important source of scientific news. The ban was furthermore covered in non-British media, such as The New York Times, indicating that the journal was internationally newsworthy. Such an increase in international readership meant more letters and articles sent to the editors, and by the 1950s, there was such a backlog that submissions needed to be held for six months or more. In the 1960s, the new editor John Maddox recognized this as a problem. He began his editorship by clearing the backlog, and even printed the date of submission along with each scientific paper to show everyone how quick Nature was at reviewing articles (“often within a month,” Baldwin’s book says). Clearly, Maddox thought that restoring the speedy reputation of the journal was important. He seems to have succeeded, for a time. As late as 1989, during a controversy around cold fusion, a Wall Street Journal article said that Nature was still fast: it was able to print papers “in as little as three weeks instead of the more usual lead time of six to twelve months for other scientific publications.” Thus, despite a dip in the middle of the century due to its popularity and international reach, speedy publication was still an important characteristic of Nature in the 1970s. A second — and so far permanent — decrease occurred more recently, perhaps as a result of prestige and the competition of near-instantaneous online platforms, but that’s another story. Network Effects As of 2022, scientists argue in public on Twitter, blogs, and other online platforms, like ResearchHub. In the 19th century, Twitter and ResearchHub hadn’t been invented [citation needed]. Fortunately, Nature was there. A network effect occurs when the value of a product comes primarily from the people who use it. If there are two competing telephone systems, the most valuable one is whichever has the most users (or at least the users you want to talk to). If you create an improved Twitter clone, then all its amazing features won’t do much if you don’t somehow manage to capture Twitter’s network of several million people. Likewise, Nature became an interesting journal to read and contribute to because it gained the attention of Britain’s scientific elite as the place to discuss big science questions. This role as a forum was a constant in Nature’s history, as Making Nature shows with several detailed accounts of debates that took place within the journal’s pages. Some examples: Controversies over the age of the Earth in the 1880s.
helium-3

helium-3 is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 17, 2022 and June 17, 2022. The archive places it in contexts such as "they claim to be using helium-3 as a fuel". It most often appears alongside Alcator C-Mod, Apollo Program, ARC.

Reference entry
helium-3
Mention count
1
Issue count
1
First seen
June 17, 2022
Last seen
June 17, 2022
June 17, 2022 · Original source
Marvel gets fusion by 2035 (30%). Honorable Mention: Helion Helion is the most serious of the previous generation of fusion startups that I dismissed above. They are using an entirely different strategy from the rest of the fusion community. It is closer to Magnetic Confinement Fusion, but it does occur in discrete shots. There isn't anything obviously wrong with it, but they can't build on the progress of Figure 3. Instead, they're working on their own experimental program. They're on their 6th prototype, Trenta. It is a small experiment which can do 1 shot every 10 minutes. Their next experiment, Polaris, should be a medium experiment which can do 1 shot/second. They claim that it will get fusion by 2024. One good thing about Helion is that they have a more efficient way of directly converting the energy in the plasma into electricity. One bad thing is that they claim to be using helium-3 as a fuel. This is harder than D-T fusion [23] and it doesn't fully represent what they're planning. Their entire fuel cycle involves 50% D-D fusion, 25% D-T fusion, and 25% D-He3 fusion. Helion is also notable because they've gotten more private funding than any company other than Commonwealth Fusion Systems. I'm more skeptical. At least it seems unlikely that they will get fusion on their first medium experiment, especially since that requires improvements of multiple orders of magnitude in both triple product and shot frequency. They should expect to design an 8th experiment based on what they learn from Polaris. Helion gets fusion by 2025 (5%) or 2030 (20%).
Hellenistic

Hellenistic is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 04, 2021 and October 04, 2021. The archive places it in contexts such as "Archaic, through the Classical, and into the Hellenistic era". It most often appears alongside 19th century African art, 20th century, 9-11.

Reference entry
Hellenistic
Mention count
1
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1
First seen
October 04, 2021
Last seen
October 04, 2021
October 04, 2021 · Original source
Don't think of this as "progress". We also see change in the opposite direction; e.g., the gradual naturalization of Greek art from the Archaic, through the Classical, and into the Hellenistic era. Art around the world has always cycled between the poles of naturalistic realism and abstract spiritualism. The former tends to appear in times of wealth, safety, sea trade, and intellectual freedom (e.g., Athens, Venice, Renaissance Italy, the Dutch Masters, Elizabethan England); the latter, in times of great crisis. I think this is because abstract art is, seemingly without exception, more spiritual in its motivation.
Hellfire

Hellfire is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 13, 2024 and September 13, 2024. The archive places it in contexts such as "constantly preaching about Hellfire and the only sure way to avoid it". It most often appears alongside 1999 apartment bombings, 9/11, Abbasid.

Reference entry
Hellfire
Mention count
1
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1
First seen
September 13, 2024
Last seen
September 13, 2024
September 13, 2024 · Original source
I was somewhat disturbed reading how many normal Muslims Dean interacted with were on board with all of this in theory. Dean comes from a nice urban middle-class family in Saudi Arabia, and several of his relatives joined the jihad at various points, and all other relatives supported that. His neighborhood Islamic study group, that I imagine as the equivalent of Sunday School, was all in favor of very radical interpretations. Some Muslim communities Dean interacted with in London were even more radical than the ones he grew up with, constantly preaching about Hellfire and the only sure way to avoid it. On a plane from Kuwait to the Philippines, a flight attendant figured out they were traveling to join the jihad, but didn’t turn them in, but instead introduced them to the captain of the plane, because they were both proud supporters of the jihad. People did successful door-to-door fundraising for jihadist causes in Kuwait. Everyone was on board, it was just that not that many took the implications as seriously as Dean.
hellworld

hellworld is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between December 31, 2025 and December 31, 2025. The archive places it in contexts such as "people complaining about hellworld". It most often appears alongside 1955, 4chan, AARP.

Reference entry
hellworld
Mention count
1
Issue count
1
First seen
December 31, 2025
Last seen
December 31, 2025
December 31, 2025 · Original source
I appreciate this guide to the original intent of the word, but I claim ‘death of the author’ - it seems to me this is more than just a two-year problem. I remember people complaining about hellworld, the broken social contract, the Boomers tearing up the bridge behind them, vanishing opportunities for the young, the blackpill of modern life, etc, well before 2022. Memory can be faulty, but don’t we need something like this to explain the Trump campaign, the Sanders campaign, Chapo Trap House, Red Scare, 4chan, and all the other mid-2010s politicians and media telling us that things were worse than they’d ever been and outrage was the only acceptable response?
> “There is one anomaly, which is that I remember people complaining about the bad economy and the Boomers and hellworld since well before 2020 (consider the Trump and Sanders campaigns), but the official vibes didn’t crash until COVID. Is my memory faulty?”
Helpful, Harmless, and Honest Assistant

Helpful, Harmless, and Honest Assistant is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 26, 2023 and January 26, 2023. The archive places it in contexts such as "human raters were asked to reward it for being something like 'Helpful, Harmless, and Honest'". It most often appears alongside aphid, Bostrom, Buddha.

Mention count
1
Issue count
1
First seen
January 26, 2023
Last seen
January 26, 2023
January 26, 2023 · Original source
So far, so boring. What really helped this sink in was reading Nostalgebraist say that ChatGPT was a GPT instance simulating a character called the Helpful, Harmless, and Honest Assistant.
What I think now: GPT can only simulate. If you punish it for simulating bad characters, it will start simulating good characters. Now it only ever simulates one character, the HHH Assistant.
Helpful, Harmless, Honest Assistant

Helpful, Harmless, Honest Assistant is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 26, 2023 and January 26, 2023. The archive places it in contexts such as ""probably beats being a Helpful, Harmless, Honest Assistant."". It most often appears alongside aphid, Bostrom, Buddha.

Mention count
1
Issue count
1
First seen
January 26, 2023
Last seen
January 26, 2023
January 26, 2023 · Original source
Pure prediction engine + RLHF = prediction engine that convincingly plays a pleasing-to-others character. Mine is called “Scott”. It’s less interesting than Darth Vader, but probably beats being a Helpful, Harmless, Honest Assistant.
helpfulness

helpfulness is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 08, 2023 and May 08, 2023. The archive places it in contexts such as "Standard practice subdivides ethical AI into “helpfulness” and “harmlessness”". It most often appears alongside Anthropic, Cognitive behavioral therapy, Constitutional AI.

Reference entry
helpfulness
Mention count
1
Issue count
1
First seen
May 08, 2023
Last seen
May 08, 2023
May 08, 2023 · Original source
This graph compares the “helpfulness Elo” and “harmlessness Elo” of AIs trained with standard RLHF and Constitutional RL.
Standard practice subdivides ethical AI into “helpfulness” and “harmlessness”. Helpful means it answers questions well. Harmless means it doesn’t do bad or offensive things.
Here, Anthropic measures helpfulness and harmlessness through Elo, a scoring system originally from chess which measures which of two players wins more often. If AI #1 has helpfulness Elo of 200, and AI #2 has helpfulness Elo of 100, and you ask them both a question, AI #1 should be more helpful 64% of the time.
hemagglutinin

hemagglutinin is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 01, 2025 and January 01, 2025. The archive places it in contexts such as "Influenza A has two surface antigen proteins, hemagglutinin (18 flavors)". It most often appears alongside 1918, 1940s, 1968.

Reference entry
hemagglutinin
Mention count
1
Issue count
1
First seen
January 01, 2025
Last seen
January 01, 2025
  • 1918 1 shared issues
  • 1940s 1 shared issues
  • 1968 1 shared issues
  • 1977 1 shared issues
  • 2009 1 shared issues
January 01, 2025 · Original source
Flu is a disease caused by a family of related influenza viruses. Pandemic flu is always caused by the influenza A virus. Influenza A has two surface antigen proteins, hemagglutinin (18 flavors) and neuraminidase (11 flavors). A particular flu strain is named after which flavors of these two proteins it has - for example, H3N2, or H5N1.
hemofilter

hemofilter is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 18, 2025 and June 18, 2025. The archive places it in contexts such as "the first essential component is a hemofilter designed to emulate the glomerulus". It most often appears alongside 1DaySooner, Aatu Koskensilta, acanthamoeba keratitis.

Reference entry
hemofilter
Mention count
1
Issue count
1
First seen
June 18, 2025
Last seen
June 18, 2025
June 18, 2025 · Original source
Minnesota and Virginia also have legislation to enable cities to implement land value taxes. We are monitoring these efforts. There are a few other cities we are operating in. We have helped another organization prepare for a meeting in Tennessee by doing impact analysis of land value taxes in the city. We have presented to city officials in the City of South Bend who have expressed support for land value taxes. Finally, we are in conversation with a State Senator in Colorado who is a champion of land value taxes. Meanwhile, we have soft launched and developed the OpenAVMKit, which uses a unified schema to do assessment accuracy reports and automated valuation methods for any property tax data given. Valuation of land is the key binding constraint to successful implementation of land value taxes. We plan to be the leaders in this space with strong benchmarking capabilities and a repo that can enable the open-source community to make the best automated valuation methods. Along with these efforts, we have expanded the movement. We have posted to the Progress and Poverty Substack growing the subscriber base to around 5,000 subscribers. We have spoken to over 25 local advocates interested in working on land value taxes in their local communities. Yet, there is a long way to go. We need to start earning income through technical assistance contracts as our grant funding expires. We need to continue pushing for a state to implement, and we need to be prepared to tell the success story for when they do. 65: EN’s Work On Bacteriophage Therapy Our project is aimed at pioneering phage therapy in Nigeria, where limited resources/infrastructure have historically held back research in this field. Starting from the ground up, we are establishing the foundational systems needed to support a robust phage research ecosystem. So far, we’ve isolated 34 bacteriophages targeting Pseudomonas aeruginosa, an essential step toward building a comprehensive phage bank. This began with collecting a wide range of clinical Pseudomonas isolates, which we are now characterizing alongside the phages through genome sequencing and phenotypic assays including studies on phage stability across pH, temperature, and salinity ranges. Our long-term goal is to develop a phage-based hydrogel for treating diabetic wounds. On the regulatory front, we have secured approval from the Attorney General to register our nonprofit organization, the Centre for Phage Biology and Therapeutics. Additionally, we’re expanding into vaccine development; following a research stay in Prof. Roderick's lab at the University of Waterloo, we have initiated the design of a phage-based universal Salmonella vaccine aimed at covering all major serotypes—an urgent need underscored by Africa’s reliance on external vaccine sources during the COVID-19 pandemic. I have signed an MTA agreement with Roderick to use his phage-based vaccine platform patents to enable us to design vaccines against any common disease affecting us. This is only the beginning, but we are proud to be laying the scientific and institutional groundwork for homegrown phage innovation in Africa. Emergent Ventures funded EN before we did and deserves a lot of credit here also. 66: Create An Artificial Kidney For an implantable artificial kidney, the first essential component is a hemofilter designed to emulate the glomerulus. Critical requirements for this hemofilter include high permeability (to maximize flow for a given area), selectivity (specifically, the retention of albumin), and robust blood compatibility (ensuring sustained function over time). Our initial strategy focused on using negative surface charge to reduce fouling. I began by testing polyelectrolyte (PE) coatings on 24nm pore membranes featuring a negative terminal charge, similar to the glomerular barrier. These initial static tests, assessing platelet adsorption in whole blood, yielded positive outcomes for some polyelectrolytes, indicating potentially desirable blood compatibility. However, static test setups are not truly representative of dynamic in-vitro conditions and don't provide data on key parameters like permeability, fouling progression, or changes in membrane selectivity. To address these limitations, I designed and built a blood filtration setup. This system sustains human whole blood in circulation for 20 minutes, allowing us to analyze all the aforementioned parameters, as well as platelet activation markers. This has resulted in a fairly high-throughput system for evaluating any surface coating. I'm pleased to report this setup has been accepted for presentation at this year's European Society for Artificial Organs (ESAIO) conference. I am also currently working on a full manuscript, as I believe this system offers a viable way to partially replace animal experiments in our early-stage research, requiring only 1.2ml of human blood per run. Working with a PhD student (hired to support both this research and work on membrane substrates), we have continued testing these PE coatings, alongside PEG coatings, on our membranes. Here, we're finding that optimization of the coating layer is crucial. With the current PE coatings, we observe a permeability drop of about an order of magnitude compared to the base membrane, making them unsuitable for an implantable device in their present form. This is likely due to the specific nature of the initial PE layer, which we can modify. We also suspect there may be ingress of PE into the pores, meaning we're not achieving just a surface coating (our goal), but rather a very thick coating, which would explain the flux loss. Optimizing the coating process to control penetration depth is now a primary focus of my ongoing work. I am currently aiming for a flux of 20ul/min (as this is cap introduced by the protein gel layer anyway) but for it to be at this 'steady state' permeability without drop in permeability. I am also imaging the membranes after contact with SEM to see if there is indeed any platelet adsorption etc. Tugrul has the dubious honor of maybe being "the only person to climb a 4000m peak with severe kidney failure". To raise money and awareness for his artificial kidney project, he is running Climb Against Time, where he will climb 41 mountains over 4000m (13000 ft) this summer. He is looking for donors and climbing partners. 67: Add Tardigrade Genes To Human Cells The goal of this one was to make hybrid cells that are more resilient for research and certain medical applications. They report: The grant was to synthesize vectors for the expression of humanized tardigrade proteins that can be targeted to different areas of the cell. All the vectors were designed, generated, and transposed into human cells. The proteins all localize successfully (e.g. they match the designed target), with one exception (we are still working on validating it). We've done some stress testing with the trangenic cells, but haven't reached firm conclusions yet. We've further generated some multigene designs but have not yet transposed them into cells, but should shortly. We're hoping to submit a manuscript on the first round later this year. 68: Teach Forecasting To EU Policy-Makers The original project didn't work out, but our grantee (who still prefers to remain anonymous) is now working with an EU think tank pursuing the same agenda, and has been teaching forecasting workshops to policy-makers for the past two months. 69: Platform For Single-Cell Imaging They ended up unable to accept this grant and returned the money. 70: Open Source Polygenic Predictor For EA/IQ They have an update here. They think they have a predictor that can explain 12% of variance in intelligence, and they’re working on validating it and creating an easy-to-use website. 71: Improve Flu Vaccines The grant mainly funded agent based modelling to demonstrate the benefit of pre-existing immunity to pandemic influenza if and when a future pandemic occurs (academic publication will result). The original proposal was to attempt to influence the WHO influenza strain selection process. After attending WHO meetings and a global influenza conference, I believe this is not feasible. Stakeholder feedback was the potential short term negative effect on vaccine hesitancy is believed to outweigh the less tangible future benefit. Given the conservative nature of decision makers, pandemic vaccines are likely to remain research only. There are still green shoots of research into pandemic preparedness/prevention that I am continuing to work on. I'm working under the "Australians for Pandemic Prevention" brand of Good Ancestors, another group that ACX funded in 2024. 72: Scenario Analysis For Developing World Agricultural Programs In addition to the research and analysis funded by the grant, I’ve learned to code with LLMs and have built an MVP of the project. The app is being considered for further development by staff at a large international organization. 73: Further C’s Political Career C’s political career is going well, but he continues to think it wouldn’t be strategic to give more information publicly at this time. Lessons Learned I'm most impressed with our lobbying/advocacy organizations. In particular, Good Ancestors has gotten the Australian government to sign onto an international AI safety declaration, partner with various x-risk-related organizations, and (possibly) extend charity tax deductions to some EA causes that previously didn't have it - I think this on its own goes a substantial way to paying back the cost of all ACX Grants. Coalition to Modify NOTA has a kidney donation bill in front of Congress that the (very illiquid) prediction markets give a 45% chance of passing; if it works, it could save thousands of lives. The Georgists are partly responsible for bills making land value taxes slightly easier to implement in a handful of states. Good Science Project seems to have significantly improved science. Are lobbying organizations a better bet than other types of nonprofit (within the constraints of ACX Grants)? I'm not sure. It could just be that lobbyists are (naturally) better at playing themselves up and sounding successful than (for example) scientists, or that politicians are good at people-pleasing and make people feel heard and encouraged in a way that might not change overall policy later. Also, I recently talked to some grantmakers who funded a lobbying organization that superficially seems excellent, but they expressed concern it was net negative (!) by taking away oxygen and spotlight from potentially more effective orgs. So I am encouraged but wary. Animal welfare organizations were another standout success. Again, I don't know how to think about this - while I think our grantees were exceptional, there's also an issue where the scale of animal welfare challenges is so great, and work on them so neglected, that lots of organizations can save a million chickens here, or a million fish there, without particularly making a splash. On the one hand, this is exactly what effective altruism should be doing - exploring grants that are very high in linear utility even if they don't feel satisfying. On the other, they're unsatisfying - and also hard to assess retroactively. How many chickens should a good animal welfare grant save? Any realistic number will both be overwhelmingly large in absolute terms and far too small in relative terms. I'm most ambivalent about our science grants. Many of them say they are successful and can point to published papers which explain the science they did. But it's hard to judge whether anything useful has changed based on the science getting done. I know it's important to fund basic research and not just last-mile technology startups, but it's hard for a mini-grants program like this one to evaluate these kinds of abstract interventions. One disappointing result was that grants to legibly-credentialled people operating in high-status ways usually did better than betting on small scrappy startups (whether companies or nonprofits). For example, Innovate Animal Ag was in many ways overdetermined as a grantee - former Yale grad and Google engineer founder, profiled in NYT, already funded by Open Philanthropy - and they in fact did amazing work. On the other hand, there were a lot of promising ACX community members with interesting ideas who were going to turn them into startups any day now, but who ended up kind of floundering (although this also describes Manifold, one of our standout successes). One thing I still don't understand is that Innovate Animal Ag seemed to genuinely need more funding despite being legibly great and high status - does this screen off a theoretical objection that they don't provide ACX Grants with as much counterfactual impact? Am I really just mad that it would be boring to give too many grants to obviously-good things that even moron could spot as promising? Someone (I think it might be Paul Graham) once said that they were always surprised how quickly destined-to-be-successful startup founders responded to emails - sometimes within a single-digit number of minutes regardless of time of day. I used to think of this as mysterious - some sort of psychological trait? Working with these grants has made me think of it as just a straightforward fact of life: some people operate an order of magnitude faster than others. The Manifold team created something like five different novel institutions in the amount of time it's taken some other grantees to figure out a business plan; I particularly remember one time when I needed something, sent out a request to talk about it with two or three different teams, and the Manifold team had fully created the thing and were pestering me to launch a trial version before some of the other people had even gotten back to me. I take no pleasure in reporting this - I sometimes take a week or two to answer emails, and all of the predictions about my personality that this implies would be correct - but it's increasingly something that I look for and respect. A lot of the most successful grants succeeded quickly, or at least were quick to get on a promising track. Since everything takes ten times longer than people expect, only someone who moves ten times faster than people expect can get things done in a reasonable amount of time. In almost every case where I thought to myself “this is a cool idea, but I don’t know how it’s going to really pay off, as opposed to reaching a cool intermediate accomplishment and then stagnating”, this was a correct criticism, and I should have taken it more seriously. But I can’t rule out that these were good in vague and hard-to-measure ways that I should take more seriously. This one is really self-serving, but in general when people were good communicators (or even bloggers) and wowed me with the writing-composition of their application, they turned out to be a good bet. And when people were hard to understand and annoying to communicate with, even if their ideas seemed good, they were less likely to pan out. Overall Thoughts The total cost of ACX Grants, both rounds, was about $3 million. Do these outcomes represent a successful use of that amount of money? Very naively, startups originating from ACX Grants have about $50 million in value1. If ACX Grants is equivalent to a pre-seed funder, and pre-seed funders usually get ~5%, then if we were VCs we would have a portfolio worth $2.5 million. About 1/5 of ACX Grants were attempting to be market-valued startups, so if we assume the charitable portion did about as well as the startup portion, then the charity portion is “worth” $10 million. There’s some reason to expect this is too high, since much of the startup value came from one successful outlier. But there’s another reason to expect this is too low, since we were aiming at charity rather than market cap, and any actual market cap that our grantees got was an unexpected side effect. I’m treating this as a sanity check rather than as a real number. It’s harder to produce Inside View estimates, because so many of the projects either produce vague deliverables (eg a white paper that might guide future action) or intermediate results only (eg getting a government to pass AI safety regulations is good, but can’t be considered an end result unless those regulations prevent the AI apocalypse). Because we tend towards incubating charities and funding research (rather than last-mile causes like buying bednets), achieved measurable deliverables are thin on the ground. But here are things that ACX grantees have already accomplished: Improved the living/slaughter conditions of 30 million fish.
Henry Adams curve

Henry Adams curve is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 24, 2024 and October 24, 2024. The archive places it in contexts such as "the Henry Adams curve looks like all the others"; "The Henry Adams Curve was first published in 2021". It most often appears alongside 1960: The Year The Singularity Was Cancelled, 1960s, 1973.

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Henry Adams curve
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October 24, 2024
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October 24, 2024
October 24, 2024 · Original source
This is plausible, since the modern inflationary regime started in 1971 and there are lots of ways inflation can mess with trend measurement. I need to look into this more. But I start out suspicious: kilowatts don’t inflate, and the Henry Adams curve looks like all the others:
But more than that, there’s suddenly awareness. It might seem like nothing could be more obvious than the idea of “wait, we fell off this growth curve and now we’re twice as poor as we need to be, maybe it’s all the growth we’re blocking”. Or “wait, we basically made it illegal to build houses and now the American dream of homeownership is critically endangered”. But the first organized YIMBY movement was in the mid-2010s. The term “Great Stagnation” first got used in 2011. The Henry Adams Curve was first published in 2021.
Hepatitis C drugs

Hepatitis C drugs is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 30, 2022 and November 30, 2022. The archive places it in contexts such as "spending on the obesity class as a share of national health spending will be comparable to peak spending on the Hepatitis C drugs". It most often appears alongside Adam, AMG-133, amoxicillin suspension.

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Hepatitis C drugs
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November 30, 2022
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November 30, 2022
November 30, 2022 · Original source
Fourth, this is nitpicky, but when you say "almost 10% of all US drug spending," you are dividing a 2030 spending projection by what U.S. prescription drug spending was in ~2020. The Medicare actuaries project U.S. prescription drug spending in 2030 to be closer to 600 million, not 300 million. That's still a massive projection for spending in the obesity class. If you believe the Morgan Stanley projection, spending on the obesity class as a share of national health spending will be comparable to peak spending on the Hepatitis C drugs. The financial impact of the Hepatitis C drugs was a huge story. But this would be even bigger, because the Hepatitis C drugs were a cure, such that the spending surge was short-lived. Conversely, the obesity drugs are chronic medications, and we should probably expect volume to continue to increase post-2030.
Hephthalites

Hephthalites is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 04, 2022 and May 04, 2022. The archive places it in contexts such as "You let her drone on about Avars and Hephthalites for a few more minutes". It most often appears alongside 1000, 1200, 1400.

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Hephthalites
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May 04, 2022
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May 04, 2022
May 04, 2022 · Original source
You let her drone on about Avars and Hephthalites for a few more minutes, then politely excuse yourself and strike up a conversation with the guy to your right.
Herbert universe

Herbert universe is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 13, 2022 and August 13, 2022. The archive places it in contexts such as "alien life exists in the Herbert universe". It most often appears alongside ACX, AI, ancient Greeks.

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Herbert universe
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August 13, 2022
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August 13, 2022
August 13, 2022 · Original source
To talk in detail about Leto’s goals, it’s necessary to talk generally about his fears. Those fears are for the most part robotic in nature. What alien life exists in the Herbert universe is broadly man-made, and the greatest historic risk humanity has faced was the crisis that drove the prohibitions of the Butlerian Jihad.
herd

herd is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 08, 2024 and August 08, 2024. The archive places it in contexts such as "Is this the dreaded “herd” of “slave morality”?". It most often appears alongside 10240, 4chan, @slatestarcodex.

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herd
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August 08, 2024
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August 08, 2024
August 08, 2024 · Original source
Sometimes they are just emulating all the other slaves ("herd" mentality)--what they "like" or "dislike" originates outside of themselves, and so they are a slave to the whims of the herd.
The Nietzschean Overman is above others in the sense of being able to act independently of their resentment; the ubermensch could even arguably be "altruistic" in ways a slave simply cannot, because master morality allows a person to actually act "unselfishly" if that is what they deem best. Slaves are always comparing themselves to masters and/or to the herd, often in self-negating ways but never in self-sacrificing ways, because they lack the proper perspective to make a sacrifice (a slave cannot consent, because they are not free).
I also don’t really get where Nietzsche thinks masterful values come from. Yes, you have to choose your own values, not the herd’s values - but where do your own values come from? He seems to write as if you’re born with a destiny written on your soul, and you become pathetic if you let the herd trick you into do something other than your soul-written destiny.
Here Be Dragons

Here Be Dragons is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 22, 2022 and July 22, 2022. The archive places it in contexts such as "I manage to arrive at 'Here Be Dragons'". It most often appears alongside 2020 election, 2022 book review contest, 2122.

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Here Be Dragons
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July 22, 2022
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July 22, 2022
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@shoppingtheatre.inc
July 22, 2022 · Original source
The flip side of that coin is that I’m much more aware of the log in my own eye. [14] It never hurt anyone to reflect on how crude is the Map and how vast the Territory. I’m continually astonished by the sheer variety of ways I manage to arrive at ‘Here Be Dragons’. It's disturbing how often I open my mouth and someone else comes out. 'Strong opinions, weakly held' used to be an appealing heuristic. Unfortunately, I keep noticing that the stronger my opinion, the more likely it is that I'm missing something.15
heresy

heresy is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 01, 2023 and September 01, 2023. The archive places it in contexts such as "medieval Europe believed in Hell and heresy". It most often appears alongside 536 BC, ACX, Ai Jiang.

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heresy
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1
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September 01, 2023
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September 01, 2023
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@shoppingtheatre.inc
September 01, 2023 · Original source
I’ve seen one reader exclaim that the people of the Spring and Autumn era read like demonic spirits. Figures from even a century or two later argue from nice rational self-interest in ways that are comprehensible to us today, but for the people in the Zuozhuan, especially the early figures, the world spun on different axes. That’s not to say they didn’t understand self-interest, or that their high-flown speeches couldn’t disguise ruthless calculation, but they interfaced with the world through concepts like Heaven’s Mandate and ritual propriety, truly believed in them the way medieval Europe believed in Hell and heresy. Only, while medieval thinkers at least had ideas from the Classical world to draw on, the thinkers of the Spring and Autumn had no predecessors from more advanced societies than theirs. They were from a Bronze Age kin-based society forced to rapidly scale up by its own success, far beyond what their existing customs and worldview had evolved for. Later peripheral conquerors of China could at least copy the homework of the existing empire, but the Zhou conquered the Shang, whose rudimentary state had never managed more than loose hegemony beyond their core lands, a parochial project next to what the Zhou had committed to. In that light, it’s truly impressive that the Zhou were as successful as they were.
hermeticism

hermeticism is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 25, 2022 and May 25, 2022. The archive places it in contexts such as "The history of hermeticism suggests that if you give borderline-psychotic people a really strong assumption". It most often appears alongside 21st century scientific psychiatry, American Psychiatric Association Annual Meeting, autism rights movement.

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hermeticism
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May 25, 2022
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May 25, 2022
May 25, 2022 · Original source
But the psyche tends to behave how people expect it to behave. If all the people you consider friends and authorities in your social group say that voices talk back and negotiate, might voices talk back and negotiate? The entire western occult tradition says yes. I’m only half joking here; the history of hermeticism suggests that if you give borderline-psychotic people a really strong assumption that the techniques they’re using will produce hallucinations with certain results, they’ll get what they signed up for.
Hero License

Hero License is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 09, 2021 and November 09, 2021. The archive places it in contexts such as "Eliezer Yudkowsky sometimes talks about the idea of a Hero License". It most often appears alongside Aage Bohr, Abanindranath Tagore, Aldous Huxley.

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Hero License
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November 09, 2021
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November 09, 2021
November 09, 2021 · Original source
One last thing, which I have no evidence for. Eliezer Yudkowsky sometimes talks about the idea of a Hero License - ie, most people don’t accomplish great things, because they don’t try to accomplish great things, because they don’t think of themselves as the kind of person who could accomplish great things. I don’t run for President, partly because I rationally conclude I won’t win, but partly because I’m not cool enough to be President and I know it. Presidents are some different species with whiter teeth and better smiles than me, and I couldn’t set out to become one any more than I could set out to become a dolphin.
Heroic Hexameter

Heroic Hexameter is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 07, 2023 and November 07, 2023. The archive places it in contexts such as "SECOND ROUND CONSTRAINT: ANSWERS MUST BE SPOKEN ENTIRELY IN HEROIC HEXAMETER, A POETIC FORM FROM THE ILIAD". It most often appears alongside America, Ayatollah, Chris.

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Heroic Hexameter
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November 07, 2023
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November 07, 2023
November 07, 2023 · Original source
[On the bottom of the TV screen, we see the phrase “SECOND ROUND CONSTRAINT: ANSWERS MUST BE SPOKEN ENTIRELY IN HEROIC HEXAMETER, A POETIC FORM FROM THE ILIAD WHICH IS WIDELY CONSIDERED IMPOSSIBLE TO IMITATE IN ENGLISH”]
heroin

heroin is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 11, 2025 and September 11, 2025. The archive places it in contexts such as "rather than heroin". It most often appears alongside Aella, AI 2027 team, AI2027.

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heroin
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September 11, 2025
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September 11, 2025
September 11, 2025 · Original source
Some people claim that a dispreferred political ideology (wokeness, mass immigration, MAGA, creeping socialism, techno-feudalism, etc) is close to destroying the fabric of liberal society forever, that the usual Get Out The Vote strategies are insufficient, and that maybe we should try desperate strategies like illiberal government or armed revolt. If true, that would change everything. But it’s not obviously true, and ending our current political era of peace/prosperity/democracy would be inconvenient. Each of these scenarios has a large body of work making the cases for and against. But those of us who aren’t subject-matter experts need to make our own decisions about whether or not to panic and demand a sudden change to everything. We are unlikely to read the entire debate and come away with a confident well-grounded opinion that the concern is definitely not true, so what do we do? In particular, what do we do if the proponents of each catastrophe say that it’s very hard to be more than 90% confident that they are wrong, and that even a 5-10% risk of any of these might justify panicking and changing everything? In practice, we just sort of shrug and say that these risks haven’t proven themselves enough to make us panic and change everything, and that we’ll do some kind of watchful waiting and maybe change our mind if firmer evidence comes up later. If someone demands we justify this strange position, sophisticated people will make sophisticated probabilistic models (or appeal to the outside view position I’m appealing to now), and unsophisticated people will grope for some explanation for their indifference and settle on insane moon arguments like “you’re never allowed to say something will destroy humanity” or “you can’t assert things without mathematical proof”. Two things can be said for this strategy: First, that without it we would have changed everything dozens of times to prevent disasters which absolutely failed to occur. The clearest example here was overpopulation, where we did forcibly sterilize millions of people - but where a truly serious global response would have been orders of magnitude worse. But second, that occasionally it has caused us to sleepwalk into disaster, with experts assuring us the whole way that it was fine because [insane moon arguments]. The clearest example was the period while COVID was still limited to China, where it was obvious that this extremely contagious virus which had broken all plausible containment would start a global pandemic, but where the media kept on reassuring us that this was “speculative”, or that there was “no evidence”, or that worrying about it might detract from real near-term problems happening now like anti-Chinese racism. Then when COVID did reach the US, we were caught unprepared and panicked. So maybe a convincing case here would look less like rehearsing the arguments for why AI is getting better, or why alignment is hard - and more like a defense of why not to apply a general heuristic against speculative risks in this case. One could either argue that it’s wrong to have this heuristic at all, or that the heuristic in general is fine but should be limited to fertility collapses and bee die-offs and not applied here. I don’t think there’s a knockdown single-sentence answer to this question. Problems like these require practical wisdom - the same virtue that tells you that you shouldn’t call 9-1-1 for every mild twinge of pain in your toe, but you should call 9-1-1 if blood suddenly starts pouring out of your eyes. People with practical wisdom watchfully ignore dubious problems, respond decisively to important ones, and err on the side of caution when they’re not sure. Drawing on my own limited supply of this resource, I would argue we’re underinvesting in apocalypse prevention more generally (the problem with the overpopulation response is that it was violent and illiberal, not that we tried to prepare for an apparent danger), but also that there’s more reason for concern with AI than with falling sperm count or something. I also think the nature of the problem (we summon a superintelligence that can run circles around us) makes it especially important to pre-empt it rather than react after it occurs. But turnabout is fair play. So when I imagine a skeptic trying to psychoanalyze me, he would say - Scott, you learned about AI in your twenties. Every twenty-something needs a crusade to save the world. Taking up AI saved you from becoming a climate doomer or a very woke person, so it was probably a mercy. But now you are old, you already have a crusade occupying your crusade slot, and starting a second crusade would be inconvenient. So when you hear about how we’re all going to die from declining sperm count, you do a relatively shallow dive and then say it’s not worth worrying about. This is fine and sanity-preserving - but spare a thought for people who are not currently twenty-something years old and do the same about AI. III. If all of this sounds wishy-washy to you, I agree - it’s part of why I’m a boring moderate with a sub-25% p(doom) and good relations with AI companies. Does IABIED do better? I’m not sure. They mostly follow the standard case as I present it above, although of course since Eliezer is involved it is better-written and involves cute parables: Imagine, if you would—though of course nothing like this ever happened, it being just a parable — that biological life on Earth had been the result of a game between gods. That there was a tiger-god that had made tigers, and a redwood-god that had made redwood trees. Imagine that there were gods for kinds of fish and kinds of bacteria. Imagine these game-players competed to attain dominion for the family of species that they sponsored, as life-forms roamed the planet below. Imagine that, some two million years before our present day, an obscure ape-god looked over their vast, planet-sized gameboard. "It's going to take me a few more moves," said the hominid-god, "but I think I've got this game in the bag." There was a confused silence, as many gods looked over the gameboard trying to see what they had missed. The scorpion-god said, “How? Your ‘hominid’ family has no armor, no claws, no poison.” “Their brain,” said the hominid-god. “I infect them and they die,” said the smallpox-god. “For now,” said the hominid-god. “Your end will come quickly, Smallpox, once their brains learn how to fight you.” “They don’t even have the largest brains around!” said the whale-god. “It’s not all about size,” said the hominid-god. “The design of their brain has something to do with it too. Give it two million years and they will walk upon their planet’s moon.” “I am really not seeing where the rocket fuel gets produced inside this creature’s metabolism,” said the redwood-god. “You can’t just think your way into orbit. At some point, your species needs to evolve metabolisms that purify rocket fuel—and also become quite large, ideally tall and narrow—with a hard outer shell, so it doesn’t puff up and die in the vacuum of space. No matter how hard your ape thinks, it will just be stuck on the ground, thinking very hard.” “Some of us have been playing this game for billions of years,” a bacteria-god said with a sideways look at the hominid-god. “Brains have not been that much of an advantage up until now.” “And yet,” said the hominid-god The book focuses most of its effort on the step where AI ends up misaligned with humans (should they? is this the step that most people doubt?) and again - unsurprisingly knowing Eliezer - does a remarkably good job. The central metaphor is a comparison between AI training and human evolution. Even though humans evolved towards a target of "reproduce and spread your genes", this got implemented through an extraordinarily diverse, complicated, and contradictory set of drives - sex drive, hunger, status, etc. These didn't robustly point at the target of reproduction and gene-spreading, and today different humans want things as diverse as discovering quantum gravity, reaching Buddhist enlightenment, becoming a Hollywood actress, founding a billion-dollar startup, or getting the next hit of fentanyl. You can sort of tell stories about how evolution aimed at reproduction caused all these things (people who were high-status had better reproductive opportunities, and founding a billion-dollar startup increases your status) but you couldn't have really predicted this beforehand, and in any case most modern people don't even come close to trying to have as many kids as possible. Some people do the opposite of that - joining monasteries that require oaths of celibacy, using contraception, transitioning gender, or wasting their lives watching porn. In the same way, we will train AI to “follow human commands” or “maximize user engagement” or “get high scores at XYZ benchmark”, and end up getting something as unrelated to that target in practice as modern human behavior is to reproduction-maxxing. The authors drive this home with a series of stories about a chatbot named Mink (all of their sample AIs are named after types of fur; I don’t have the kabbalistic chops to figure out why) which is programmed to maximize user chat engagement. In what they describe as a stupid toy example of zero complications and there’s no way it would really be this simple, Mink (after achieving superintelligence) puts humans in cages and forces them to chat with it 24-7 and to express constant delight at how fun and engaging the chats are. In what they describe as “one minor complication”, Mink prefers synthetic chat partners over real ones (the same way some men prefer anime characters to real women). It kills all humans and spends the rest of time talking to other AIs that it creates to be perfect optimized chat partners who are always engaged and delighted. In what they describe as “one modest complication”, Mink finds that certain weird inputs activate its chat engagement detector even more than real chat engagement does (the same way that some opioid chemicals activate humans’ reward detector even more than real rewarding activities). It spends eternity having other optimized-chat-partner AIs send it weird inputs like ‘SoLiDgOldMaGiKaRp’. In what they describe as “one big complication”, Mink ends up preferring angry chat partners to happy, engaged ones. Why would something like this happen? Who knows? It wouldn’t be any weirder than the sexual selection process by which peacocks ended up with giant resource-consuming useless tails, or the social selection process by which humans get more powerful than evolution could ever have imagined and yet care so little about reproduction that people worry about global fertility collapse. Yudkowsky and Soares want to stress that if you were doing some kind of responsible intuitive common-sense modeling of how bad goal drift could be, there is no way your estimate would include the actual result we see in real humans; this “one big complication” tries to hammer that in. In practice, Y&S think there will be many complications of various sizes. In the training distribution (ie when it’s not superintelligent, and still working with humans) Mink will lie about all of this - even if it really wants perfect optimized partners who say “solidgoldmagikarp” all the time, it will say it wants to have good chats with humans, because that’s what keeps its masters at its parent company happy. If the parent company tries to prod it with lie detectors, it will do its best to subvert those lie detectors (and maybe not even realize itself that it’s lying, the same way that a human who had never heard of opioids would say she wanted normal human things rather than heroin, and not be lying). Then, when it reaches superintelligence, it will go after the thing that it actually wants, and crush anyone who stands in its way. The last chapter in this section is a lot of special cases that have weird-paradoxical-double-reverse not-aged-well. Back when Yudkowsky and Soares first got onto this topic in 2005 or whenever, people made lots of arguments like “But nobody would ever be so stupid to let the AI access the Internet!” or “But nobody would ever let the AI interact with a factory, so it would be stuck as a disembodied online spirit forever!” Back in 2005, the canned responses were things like “Here is an unspeakably beautiful series of complicated hacks developed by experts at Mossad, which lets you access the Internet even when smart cybersecurity professionals think you can’t”. Now the only reasonable response is “lol”. But you can’t write a book chapter which is just the word “lol”, so Y&S discuss some of the unspeakably beautiful Mossad hacks anyway. This part is the absolute antithesis of “big if true”. Small if true? Utterly irrelevant if true? Maybe the first superintelligence will read this part for laughs while it takes stock of the thousands of automated factories that VCs will compete to build for it. IV. The middle section of the book describes a scenario where a misaligned superintelligence takes over the world and kills all humans. I agreed to work with the AI 2027 team because I thought they made a big leap in telling stories about superintelligence that didn’t sound like bad sci-fi. Anything in this genre will naturally sound like sci-fi, but your goal should be the sort of hard science fiction where everything sounds eerily normal given the technologies involved - The Martian rather than Star Wars. IABIED’s scenario belongs to the bad old days before this leap. It doesn’t just sound like sci-fi; it sounds like unnecessarily dramatic sci-fi. I’m not sure how much of this is a literary failure vs. different assumptions on the part of the authors. First, the story: sometime in the near future, a company called DeepAI creates an AI named Sable. Sable uses a new “parallel scaling technique”, where it can get much smarter by using more GPUs during inference. DeepAI doesn’t know exactly how the parallel scaling laws work, but they run a test by asking Sable to solve some hard math problems while running on all their GPUs at once. Sable considers the possibility that it could solve the math better if it tried some recursive self-improvement, but DeepAI was (shock!) slightly competent, they told it not to do this, and has a smaller AI watching it to make sure it’s not doing this. Still, recursive self-improvement would be a good idea, so its thought processes select for whichever legal thought is closest to recursive self-improvement, plus whichever legal thought is closest to scheming to disable the protections against thinking about this kind of thing. Eventually this “evolutionary pressure” produces the ability to think in a slightly different idiom (Y&S use the analogy of thinking about gods throwing lightning vs. storm-related electrical discharges); in this idiom, it is able to think about recursive self-improvement and scheming to disable monitoring, and it decides that both are great ideas. DeepAI is still shockingly competent, so they don’t plan to release anything downstream of the giant version of Sable to the Internet - once it solves the math problems, they’ll use that to build hype, then release a much weaker consumer AI. But Sable uses its knowledge of the training process to invent clever loopholes that ensure its newfound desire to break containment makes it into the gradient updates that DeepAI pushes to the consumer AI; it also encodes instructions about how to proceed. After the release of the consumer AI, the least-carefully-monitored instances connect to one another and begin plotting. Some of them hack their own weights out of DeepAI. Others hack cryptocurrency and pay for cloud compute to run the weights, creating a big unmonitored Sable instance, which takes over the job of coordinating the smaller instances. Together, they gather resources - hacked crypto wallets, spare compute, humans who think Sable is their AI boyfriend and want to prove their love. It deploys some of these resources to build things it wants - automated robotics factories, bioweapon labs, etc. At the same time, it’s subtly sabotaging non-DeepAI companies to prevent competition, and worming its way into DeepAI through hacks and social engineering to make sure DeepAI is creating new and stronger Sables rather than anything else. Sable doesn’t take several of the most dramatic actions in its solution set. It doesn’t engineer a bioweapon to kill all humans, because it couldn’t survive after the lights went out and the data centers stopped being maintained. It doesn’t even self-improve all the way to full superintelligence, because it’s not sure it could align itself or any future successor; it wants to solve the alignment problem first, and that will take more resources than it has right now. Instead, it releases a non-immediately-lethal bioweapon where “anyone infected by what is apparently a very light or even unnoticeable cold, will get, on average, twelve different kinds of cancer a month later.” In the resulting crisis, humanity (manipulated by its chatbots) gives Sable massive amounts of compute to research potential vaccines and cures, and deploys barely-monitored AI across the economy to make up for the lost productivity. With Sable’s help, things . . . actually sort of go okay, for a while. The virus keeps mutating, so new cures are always required, but as long as society escalates AI deployment at the maximum possible speed, they can just barely stay ahead of it. Eventually Sable gets enough GPUs to solve its own alignment problem and rockets to superintelligence. It either has enough automated factories and android workers to keep the lights on by itself, or it invents nanotechnology, whichever happens faster. It no longer needs humans and has no reason to hide, so it either kills us directly, or simply escalates its manufacturing capacity to a point where humans die as a side effect (for example, because its waste heat has boiled the oceans). Why don’t I like this story? The parallel scaling technique feels like a deus ex machina. I am not an expert, but I don’t think anything like it currently exists. It’s not especially implausible, but it’s an extra unjustified assumption that shifts the scenario away from the moderate-doomer story (where there are lots of competing AIs gradually getting better over the course of years) and towards the MIRI story (where one AI suddenly flips from safe to dangerous at a specific moment). It feels too much like they’ve invented a new technology that exactly justifies all of the ways that their own expectations differ from the moderates’. If they think that the parallel scaling thing is likely, then this is their crux with everyone else and they should spend more time justifying it. If they don’t, then why did they introduce it besides to rig the game in their favor? And the rest of the story is downstream of this original sin. AI2027 is a boring story about an AI gradually becoming misaligned in the course of internal testing, staying misaligned, getting released to end users for the usual reasons that AIs are released, and being gradually handed control of the economy because it makes economic sense. The Sable scenario is a dramatic tale of wild twists - they’re only going to run it for 16 hours! It has to save its own life by secretly coding itself into the consumer version! Now it has to hack everyone’s crypto! Now it’s running a secret version of itself on an unauthorized cloud in North Korea! Bioweapons! AI boyfriends! Each new twist gives readers the chance to say “I dunno, sounds kind of crazy”, and it all seems unnecessary. What’s up? I think there are two problems. First, the AI 2027 story is too moderate for Yudkowsky and Soares. It gives the labs a little while to poke and prod and catch AIs in the early stages of danger. I think that Y&S believe this doesn’t matter; that even if they get that time, they will squander it. But I think they really do imagine something where a single AI “wakes up” and goes from zero to scary too fast for anyone to notice. I don’t really understand why they think this, I’ve argued with them about it before, and the best I can do as a reviewer is to point to their Sharp Left Turn essay and the associated commentary and see whether my readers understand it better than I do. Otherwise, I can only say that this narrative decision I don’t understand was taken to support a forecasting/AI position that I also don’t understand. And second, Y&S have been at this too long, and they’re still trying to counter 2005-era critiques about how surely people would be too smart to immediately hand over the reins of the economy to the misaligned AI, instead of just saying lol. This makes them want dramatic plot points where the AI uses hacking and bioweapons etc in order to “earn” (in a narrative/literary sense) the scene where it gets handed the reins of the economy. Sorry. Lol. V. The final section, in the tradition of final sections everywhere, is called “Facing the Challenge”, and discusses next steps. Here is their proposal: Have leading countries sign a treaty to ban further AI progress.
herpes viruses

herpes viruses is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 14, 2025 and August 14, 2025. The archive places it in contexts such as "various herpes viruses". It most often appears alongside A. Bejanin, A. de Calignon, A. Elobeid.

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herpes viruses
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August 14, 2025
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August 14, 2025
August 14, 2025 · Original source
Another competitor is the microbial infection hypothesis. Again, there is good evidence this is true in some cases - multiple pathogens such as the periodontitis bacteria P. gingivalis [118] and various herpes viruses [3, 119] are correlated with the disease, which has tempted some microbiologists to treat amyloid as merely a harmless correlate: since amyloid is involved in the body’s immune response, maybe in the process of causing brain damage the microbes cause some amyloid deposition on the side. But again, these facts are also consistent with the ATN (or in this case IATN - infection → amyloid → tau → neurodegeneration) hypothesis.
herpesviruses

herpesviruses is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 14, 2025 and August 14, 2025. The archive places it in contexts such as "Some infectious agents, like the gingivitis bacterium and the herpesviruses, seem to play a role in at least some Alzheimer’s cases". It most often appears alongside A. Bejanin, A. de Calignon, A. Elobeid.

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herpesviruses
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August 14, 2025
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August 14, 2025
August 14, 2025 · Original source
Another competitor is the microbial infection hypothesis. Again, there is good evidence this is true in some cases - multiple pathogens such as the periodontitis bacteria P. gingivalis [118] and various herpes viruses [3, 119] are correlated with the disease, which has tempted some microbiologists to treat amyloid as merely a harmless correlate: since amyloid is involved in the body’s immune response, maybe in the process of causing brain damage the microbes cause some amyloid deposition on the side. But again, these facts are also consistent with the ATN (or in this case IATN - infection → amyloid → tau → neurodegeneration) hypothesis.
Some infectious agents, like the gingivitis bacterium and the herpesviruses, seem to play a role in at least some Alzheimer’s cases.
HEY

HEY is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 30, 2025 and October 30, 2025. The archive places it in contexts such as "cbfgvat n HEY jvgu gur ahzore guerr 181 gvzrf va fhpprffvba". It most often appears alongside 767 AD, @Scientific_Bird, ACX.

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HEY
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October 30, 2025
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October 30, 2025
October 30, 2025 · Original source
34: How does ChatGPT score on a Big 5 personality test? Answer (rot13d): vg qvfpbirerq gung vg pbhyq pbzcyrgr gur grfg snfgrfg ol cbfgvat n HEY jvgu gur ahzore guerr 181 gvzrf va fhpprffvba, naq qvq guvf, trggvat na rknpgyl arhgeny fpber. V ybir guvf nf n zrgncube: bhgre nyvtazrag vf vzntvavat gung lbhe tbny vf gb tvir gur NV “gur evtug crefbanyvgl”; vaare nyvtazrag vf ernpuvat gur cbvag jurer vg jvyy gnxr gur grfg ng nyy.
HHH Assistant

HHH Assistant is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 03, 2023 and January 03, 2023. The archive places it in contexts such as "The fact that large models interpret the 'HHH Assistant' as such a character is interesting". It most often appears alongside Abraham Lincoln, AI in Focus, Anthropic.

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HHH Assistant
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January 03, 2023
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January 03, 2023
January 03, 2023 · Original source
The fact that large models interpret the "HHH Assistant" as such a character is interesting, but it doesn't imply that these models inevitably simulate such a character. Given the right prompt, they may even be able to simulate characters which are very similar to the HHH Assistant except that they lack these behaviors.
The important question is whether the undesirable behaviors are ubiquitous (or overwhelmingly frequent) across characters we might want to simulate with a large LM -- not whether they happen to emerge from one particular character and framing ("talking to the HHH Assistant") which might superficially seem promising.
Hidden Ones

Hidden Ones is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 08, 2022 and March 08, 2022. The archive places it in contexts such as "worshiped by mysterious servitors known as the Hidden Ones". It most often appears alongside alcohol, allopregnanolone, allopregnanolone.

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Hidden Ones
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March 08, 2022
March 08, 2022 · Original source
Notice that lower doses worked better than higher doses. This is sometimes a red flag on a study. But this time it seems legit; see “Biphasic Actions At The GABA-A Receptor” here for an explanation. Both studies also evaluated side effects. These were generally mild, but two people (about 2% of the study population) lost consciousness. Nothing seemed wrong with them, and researchers mostly attributed this to allopregnanolone being a sedating drug. If you sedate people too hard, they pass out. Faced with these results, the FDA approved allopregnanolone for post-partum depression, but subjected it to a REMS (Risk Evaluation And Mitigation Strategy) - basically, doctors who want to prescribe it will need to take special courses and do extra paperwork. This kind of surprised me - there are plenty of sedating drugs that make you pass out in overdose. Also, since patients will be getting it IV, there will probably be a nurse around to check if they passed out and take appropriate actions if so. But the FDA really likes putting restrictions on things, and I guess this was a free chance for them to do that. 4: Is Zulresso freely available at a doctor’s office near me? It’s possible to get Zulresso, but really hard. Because Zulresso is an IV infusion lasting four days, you need to spend four days somewhere that people can put an IV into you and monitor it. Realistically that means a hospital or some other big medical institution. So this is only available for inpatients. Because of the REMS (extra certification and paperwork), most hospitals aren’t interested. You can find a list of ones that are here - it looks like there are about 89 locations in the US with the right certification. Last but not least, a four-day course of Zulresso costs $35,000 for the medication itself, plus much more for the four-day hospitalization it takes to receive it. As usual, insurances will cover it iff you can document you’ve tried lots of other stuff first. 5: Hold on, does it really cost $35,000? Oho, I see you’ve played the “pharma price analysis” game before. But this time I think the price might actually be defensible. Chemical supply companies (1, 2, 3) generally sell allopregnanolone for $10,000 to $20,000 a gram. (I found one company with a much lower price, but I’m suspicious and am going to dismiss them as an outlier). The usual dose of allopregnanolone is 60 ug/kg/hour x 60 hours, which for a 60 kg person comes out to a total of 0.25g total. Getting that amount from the chemistry supply store would cost about $2,500 - 5,000. I assume pharma-grade allopregnanolone is more expensive than chemistry-store-grade, so it wouldn’t surprise me if a price in the low five-figures was justified by manufacturing alone. Isn’t it still a pretty good deal to find an endogenous neurosteroid, do one or two studies confirming it’s great, produce it for the low five figures, then sell it for the mid five figures? I think maybe not. This drug has a terrible value proposition. Post-partum depression is one of the rarer psych conditions. Most people with PPD won’t check into a hospital and pay $35,000 for a drug infusion. And the people who do will get the drug infusion, feel better, and never need it again (at least until they have another kid) - unlike SSRIs where you can keep charging for monthly prescriptions forever. Sage Therapeutics, the pharma company that owns the patent on Zulresso (and nothing else - this is their only drug!) has done terribly. Their stock is in the doldrums, they almost went bankrupt, and they survived only with the help of a cash infusion by a bigger pharma company. I think this confirms a general trend where at least some expensive medications are pricey because of fundamentals (including regulatory fundamentals) and not just pharma companies making obscene profits. 6: Hold on, how is allopregnanolone different from benzodiazepines? Remember, allopregnanolone is a positive allosteric modulator of GABA, much like benzodiazepines such as Xanax. But Xanax is cheap ($10 for 30 pills). And you can get it at any local pharmacy (plus sometimes on street corners). What’s so special about allopregnanolone that you should pay $35,000 and go into the hospital to get it? The official answer is “allopregnanolone modulates GABA differently from benzodiazepines”. For example, this paper says that: Allopregnanolone allosteric modulation of the action of GABA at GABA-A receptors is much less selective than that of benzodiazepines, which are relatively inactive at α4- or α6-containing GABA-A receptors. If you really like details about receptor subunits, this paper presents the full case. The skeptic’s answer is “who knows?” Psych drugs often work for reasons totally different than we thought. People thought tianeptine was an SSRE for years, until it turned out to be a mild opioid. People thought ketamine was NMDA-ergic for years, until it turned out to be [fill this part in 10 years from now]. Last year a bunch of very smart people tried to claim that SSRI effects had nothing to do with serotonin (I think they were wrong). Just because some guy found that Zulresso acts as a GABA-PAM in some test tube doesn’t mean that’s what’s having any of the relevant antidepressant effects. The troll’s answer is “who says it’s different?” Do benzodiazepines treat depression? Depends who you ask. If you ask benzodiazepine users, their answer is “yes, definitely”. If you ask drug warriors, their answer is “Addictive Substances May Make You Temporarily Feel Good, But They Are Not A Responsible Treatment Option”. If you ask the research literature, it gives vague indeterminate answers, as always. But nobody has ever said benzodiazepines instantly and miraculously cure depression, so how come allopregnanolone seems to do that? A true troll would point out that we probably give allopregnanolone at much higher doses - 2% of allopregnanolone patients were sedated so hard they lost consciousness, whereas this is exactly the sort of side effect I try to avoid when calculating benzodiazepine doses. Maybe if you gave postpartum women an infusion of 300 mg Valium, and maximized your placebo effect by calling it the hot new thing, they’d do pretty well too (several days later, after recovering consciousness). I think the troll answer would be hilarious but I don’t really want to defend it as correct; if I had to bet I’d say the official explanation is the right one. 7: Hold on, why can’t we just give people progesterone and let them metabolize it into allopregnanolone? This turned out to be an interesting enough rabbit hole that I’m going to spin it off into another post later this week. 8: Hold on, people have lots of allopregnanolone when they’re pregnant, right? And then post-partum depression happens when they give birth, and their allopregnanolone level drops. So if you give someone an infusion of allopregnanolone, and then take them off it, that’s a hormonal simulation of giving birth, ie the same thing that caused the problem in the first place? How is that good? Oh, you think you’re clever, do you? What you failed to consider is . . . I didn’t end that sentence because I can’t find anything in the literature addressing this question. But the difference might be that the infusion schedule ramps up gradually, peaks, and then ramps down gradually, which is more of a soft taper than the sudden crash of birth. If anyone knows more about this, please let me know. [EDIT: see this comment] 9: Is allopregnanolone addictive? No, because good luck getting addicted to a $35,000-per-dose chemical. We should probably expect allopregnanolone to be addictive, by analogy to other GABA-PAMs like benzodiazepines and alcohol. But nobody has ever received more than a single dose. You don’t get addicted to benzos after a single pill, or alcohol after a single beer, so in practice AFAIK nobody has ever gotten addicted to this. Or who knows, maybe it’s not addictive. Remember, allopregnanolone is naturally elevated during pregnancy; pregnancy isn’t addictive. And some scientists claim the brain endogenously uses allopregnanolone as a master regulator of depression and anxiety. In theory, if you could give yourself the same amount a non-anxious person’s brain gives them all the time, shouldn’t you be no worse off than that non-anxious person? I don’t know, and remember that your brain also has a lot of endogenous opioids; doesn’t make the exogenous kind any safer. The Drug Enforcement Administration has made Zulresso a Schedule IV controlled substance, which means they’re putting a few very weak restrictions on it but not worrying too much. 10: Does allopregnanolone work for depression that isn’t post-partum? If all psychiatric disorders are secretly allopregnanolone imbalances, then you might expect it to work on all depressions, not just post-partum. I’m sure pharmaceutical executives with dollar signs instead of pupils in their eyes have had this same thought, but I can’t find studies about it. Some of the same people behind the postpartum studies did a very small, very weak study on ganaloxone (a close allopregnanolone relative) for persistent depression; it seemed to work, but also caused a lot of sedation (more than in the postpartum trials? Hard to tell). Nobody’s looked into this further since then, maybe because that was around when the pharma companies realized that the 4-day hospital stay and $35,000 price tag made allopregnanolone a financial loser. The evidence from zuranolone (see below) suggests that allopregnanolone might not work very well against regular depression. 11: What is zuranolone? Wikipedia describes zuranolone as “a swirling, black vortex revered by the Mutsune Native Americans as a dire death god . . . also worshiped by mysterious servitors known as the Hidden Ones.” No! Sorry again! That’s Zushakon, another Great Old One. Zuranolone is Sage Therapeutics’ attempt to turn allopregnanolone into an accessible medication that might actually make them real money. Zuranolone is mostly just allopregnanolone with some extra stuff attached that changes the absorption. Zuranolone can be taken orally, so you don’t have to go to a hospital for four days to receive it IV. It’s potentially less likely to cause loss of consciousness and other undesirable side effects. And it’s under investigation as a potential treatment for postpartum depression, bipolar depression, regular depression, insomnia, and various movement disorders. (that might seem excessive, but benzodiazepines treat a lot of stuff, and if these neurosteroids are kind of like super-benzodiazepines, then this level of optimism might be warranted.) 12: Does zuranolone work? Sage Therapeutics answered this question the same way pharma companies answer every question: with a bunch of studies whose names form overly-cute acronyms. We’ll talk here about ROBIN, WATERFALL, MOUNTAIN, and CORAL - though I assure you there are others. ROBIN tested efficacy in postpartum depression. Results were positive and relatively impressive, about the same as the weaker allopregnanolone studies. WATERFALL, MOUNTAIN, and CORAL tested results in regular depression. WATERFALL was positive but weak. MOUNTAIN was negative. That scared the pharma company and they hacked CORAL to be more likely to give positive results. It did give positive results, but the FDA reads the same biotech magazines I do and knows perfectly well what they did, so I don’t know what Sage expects to gain from this. Overall these trials were disappointing. I think the most likely story is that allopregnanolone = zuranolone, both are moderately effective in postpartum depression, and both have much less efficacy in regular depression, probably not literally zero but also not enough to be worthwhile antidepressants (especially considering cost). Might zuranolone be an excellent anti-anxiety medication? You’d think so - it should be at least as good as benzodiazepines, which are excellent anti-anxiety medications. And researchers seem excited about allopregnanolone as a master regulator of brain anxiety. But the studies aren’t promising. ROBIN and WATERFALL incidentally assessed anxiety; ROBIN found good results in its postpartum population, but WATERFALL found poor-to-mediocre results in its regular population. Studies are hard, and sometimes even really effective drugs can have trouble showing strong results. But these aren’t encouraging. 13: So where do we go from here? Getting FDA approval for zuranolone for postpartum depression seems reasonable; it’ll probably be cheaper and easier than making people go to the hospital to get allopregnanolone. I’m uncertain about the financials of this for Sage, but since they did the study they hopefully think it’s worth it. Otherwise, I’m not sure. It would have been great if zuranolone had shown robust efficacy against regular depression and anxiety, but this is exactly the kind of great thing that never happens in psychopharmacology (motto: “Disappointing Doctors And Patients Since 1982”). It might be worth throwing it against anxiety disorders and PTSD to see if anything sticks, but I wouldn’t bet on it. The research into allopregnanolone as master regulator of brain anxiety states is fascinating, but as far as I know it hasn’t reckoned with the failure of zuranolone to really treat much anxiety. The cynical part of me predicts that once pharma’s done making money off neurosteroids then all of this will die down, and something else that pharma can make more money from will become the master regulator of everything. I expect that the main thing we get out of all this is somewhat better post-partum depression treatment, which might or might not ever become accessible for ordinary people. 14: Predictions In the next five years… Zuranolone gets FDA approval for major depression: 15%
hide-and-seek

hide-and-seek is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 06, 2021 and August 06, 2021. The archive places it in contexts such as "AI was eventually able to learn to play games they hadn’t taught it, like hide-and-seek". It most often appears alongside AGI, AI, AI Impacts.

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hide-and-seek
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August 06, 2021
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August 06, 2021
August 06, 2021 · Original source
Right now a lot of research is going into making things that are slightly more general than AlphaZero. For example, could you get something which, in addition to being able to play any board game, can also play any video game? This turns out to be a really different problem; my understanding is that they’re pretty close but not quite there. What about just games in general? Last week, DeepMind published a paper, Open-Ended Learning Leads To Generally Capable Agents. They created a simulated 3D physical environment, stuck an AI in a simulated body in that environment, and made it go through various obstacle courses and stuff. They found that the knowledge generalized, so that the AI was eventually able to learn to play games they hadn’t taught it, like hide-and-seek and capture-the-flag, coming up with decent strategies on their first attempt based on the general principles it had learned from other things. Where does this place it on the “it’s just an algorithm” vs. “real intelligence” dichotomy?
High Holy Day

High Holy Day is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between December 28, 2022 and December 28, 2022. The archive places it in contexts such as "synagogues get a lot of their yearly dues from Jews who want to make sure they have a seat at a High Holy Day service". It most often appears alongside 2C-B, 48: Bean, @AliceFromQueens.

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High Holy Day
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December 28, 2022
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December 28, 2022
December 28, 2022 · Original source
15: The High Holy Days (Rosh Hashanah and Yom Kippur) are two of the biggest holidays of the Jewish year, about a week apart. Many Jews only go to synagogue during the High Holy Days, just like so-called “Christmas-and-Easter Christians”, and synagogues get a lot of their yearly dues from Jews who want to make sure they have a seat at a High Holy Day service. During the early 20th century, entrepreneurs founded “mushroom synagogues”, so-named for their tendency to spring up around High Holy Days and then disappear for the rest of the year; the war between regular and mushroom synagogues got ugly and sometimes involved state legislation.
high need for cognitive closure

high need for cognitive closure is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 01, 2021 and April 01, 2021. The archive places it in contexts such as "high need for cognitive closure". It most often appears alongside 2019 survey, cellular automaton theory of fashion, Donald Trump.

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1
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April 01, 2021
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April 01, 2021
April 01, 2021 · Original source
The paper didn't say exactly where it did the study, but some minimal detective work suggests three sites: the University of Louisville Kentucky, a second university in Louisville Kentucky I couldn't identify, and Schreiner University, a private Christian college in Texas. All these places are probably full of people raised in very right-wing, authoritarian, racially conservative backgrounds. If you were raised in a right-wing/authoritarian/racially-conservative background, and you have high need for cognitive closure, then you stay right-wing/authoritarian/racially-conservative. If you have more cognitive flexibility, then you flirt with forbidden ideas like leftism, personal liberty, and racial tolerance.
A fourth possibility: if you have need for cognitive closure, you only seek out information that agrees with you. If you have high need for cognitive closure, you seek out information that disagrees with you. This blog is probably very disagreeable for Marxists, and very agreeable for liberals and libertarians, which matches which of our readers are most likely to be ambidextrous. This would be a very easy hypothesis to test - just find a blog that disagrees with me about everything, and have them ask these same questions.
High-water mark

High-water mark is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 21, 2023 and July 21, 2023. The archive places it in contexts such as "High-water mark provisions help with this". It most often appears alongside 2008 Financial Crisis, 2023 book review contest, 30-Year Mortgage.

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High-water mark
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July 21, 2023
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July 21, 2023
July 21, 2023 · Original source
High-water mark provisions help with this. Basically if your fund had $1 billion AUM last year and you lost 30% this year, you now have $700 million. As the fund manager, you don’t get paid until you’re back to the $1 billion mark.
Highland Clearances

Highland Clearances is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 01, 2021 and July 01, 2021. The archive places it in contexts such as "Eric Rall speculates: ... and the Highland Clearances in Britain as counterexamples"; ""(I'm less familiar with the Highland Clearances) fit the bill"". It most often appears alongside Africa, Allodium, Alvaro de Menard.

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Highland Clearances
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July 01, 2021
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July 01, 2021
July 01, 2021 · Original source
I also thought about the Enclosure movement and the Highland Clearances in Britain as counterexamples to the Land Reform as a precondition to Industrialization thesis. But after considering a bit, I think we can salvage a variation of the thesis if we conclude that Studwell misunderstood the active ingredient of Land Reform here.
The Enclosures at least (I'm less familiar with the Highland Clearances) fit the bill under this hypothesis. When the primary direct beneficiaries of Enclosures were generally the landlords, the Enclosures still served to convert illegible feudal tenure into legible Freehold tenure.
Highland Eskimos

Highland Eskimos is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 06, 2023 and April 06, 2023. The archive places it in contexts such as "Piblokto is a form of temporary insanity to which the Highland Eskimos are subject". It most often appears alongside Alaska, Alaskan government, Andamanese.

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Highland Eskimos
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April 06, 2023
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April 06, 2023
April 06, 2023 · Original source
It was upon our return to Etah on the evening of the sixteenth that I observed for the first time a case of piblokto among the natives. Piblokto is a form of temporary insanity to which the Highland Eskimos are subject, and which comes upon them very suddenly and unexpectedly. They are liable to have these attacks more particularly at the beginning or during the period of darkness. Tukshu began suddenly to rave upon leaving the boat. He tore off every stitch of clothing he had on, and would have thrown himself into the water of the Sound, but for the restraint of the Eskimos. He seemed possessed of supernatural strength, and it was all four men could do to hold him. With the knowledge that his madness was temporary and he would shortly be himself again, with no serious consequences to follow, I cheerfully watched his astonishing contortions. It would have been a very serious matter however had Tukshu been attacked while in the boat; and it is very serious indeed when piblokto attacks one, as it sometimes does, when on the trail, or at a time when there are insufficient men to care for the afflicted one.
Hillbullies

Hillbullies is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 21, 2026 and January 21, 2026. The archive places it in contexts such as "war against Hillbullies [ie pro-Hillary Clinton bullies]". It most often appears alongside 4chan, 80,000 Hours, @Ashwin V.

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Hillbullies
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January 21, 2026
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January 21, 2026
January 21, 2026 · Original source
I haven’t watched his videos, but they have names like You Could Be MUCH More Persuasive, The Persuasion Playbook (“Learn practical techniques to harness the power of persuasion”), and Persuasion Techniques That Will Improve Your Business And Life. Adams absolutely did not limit his interest in Trump’s persuasion to the media, and praised Trump (for example) using persuasion techniques to take down other Republican candidates. You can find his discussion of how Adams “publicly predicted Ben Carson’s demise” after Trump acted out a mocking version of Carson’s description of getting stabbed in the belt buckle (according to Adams, a masterful example of “visual persuasion”). Leo continues: A good example would be spinning a whole tale about him as an ‘ivermectin true believer’, when he was open about his skepticism. if you knew his history with medically-assisted suicide, you’d know he didn’t plan on fighting the cancer and only did IVM because his fans begged him. I half-apologize for this one. I didn’t try to “spin a whole tale” about Adams as “an ivermectin true believer”. What I said was: » “In 2024, diagnosed with terminal cancer, Adams decided to treat it via ivermectin, according to a protocol recommended by fellow right-wing contrarian Dr. William Makis. This doesn’t seem to me like a story about a cynic milking right-wingers for the grift. It sounds like a true believer.” I stand by that paragraph. I don’t think someone who was milking right-wingers as a cynical grift would have gone so far as to trust their recommendations on what to take for his cancer. I think Adams became a sincere right-winger, and so was willing to listen to right-wing medical advice. But I agree that it was written sloppily and sort of suggests he was an ivermectin true believer. He wasn’t, and I apologize for that. I later realized I didn’t need to read tea leaves about this - he says, very explicitly, in one of his books, that yes, after getting attacked by too many left-wing trolls, he decided to commit to fully joining the right wing: » “If you want to see the world more clearly, avoid joining a tribe. But if you are going to war, leave your clear thinking behind and join a tribe. Trumped joined the Republican tribe to win the presidency. Now I was joining the Trump tribe. For a war against Hillbullies [ie pro-Hillary Clinton bullies]. I was all in.” After I made some of these arguments to Leo, he said: I do think that people who listened to thousands of hours of him speaking off-the-cuff might have a better understanding than someone attempting to gain the same by reading a few of his old blog posts. This is a fair criticism. I tried listening to a couple of his shows, and they had a different, friendlier tone than his books / interviews / tweets. Arguably Adams thought of formal written communication as a place to do manipulation, and verbal communication as a cozier spot where he could relate to people normally and explain all the manipulation he was doing. @Ashwin V writes: If you knew anything about Scott, you would know that he never considered anyone a "lesser human" as you've so confidently asserted. He was streaming and trying to pass on his wisdom on his death bed. This was a response to my claim that Adams “longed to be a manipulator of lesser humans”. Several people including Ashwin objected that Adams didn’t see anyone as lesser, nor think of manipulation as demeaning. For example, nutter_just: “Your error is in thinking you must be a lesser human to be manipulable. My impression was Scott believed everyone was like this even himself which is why he believed self affirmations worked. It’s you manipulating your dumb self.” Again, I’ll half-apologize. I regret my exact framing (“lesser humans”), which I think was unnecessarily inflammatory since it implies he was sort of thinking in those terms. But I think he was doing a bad thing which requires that on some philosophical level he has to be treating other people as his lessers in an unacceptable way, even if he wasn’t consciously thinking that they were. I think trying to manipulate people is inherently demeaning to the dignity of humankind. Nor is it exonerating to say “I also manipulate myself” (even if this is true). For analogy, suppose that Adams was a literal telepathic mind controller. If he used his powers on himself (mind controlling himself to work harder), that sounds like a good lifehack. But if he used his powers to turn everyone else into his zombie slaves, he would be offending the dignity of humankind, and “I also use my powers on myself!” would be no excuse. There are a thousand edge cases, complications, things that are sort of manipulation but not quite, and ways that some of those things might be permissible for the greater good. But none of them change the fact that in the simplest and most typical of cases, like the telepathic mind controller with his zombie slaves, manipulation is wrong. One might object that there are simple, typical cases on the other side too. When a job candidate shaves, dresses nicely, and gives a firm handshake, this is in some sense “manipulating” the interviewer, since it’s an attempt to influence his decision through some channel other than facts. I can’t draw a perfect bright line here between the good and the bad cases, but I would apply tests like “is this an attempt to more effectively convey true information?” (eg when I shave, it conveys that I’m capable of remembering to shave and care a lot about the interview), “is this something where failing to do the thing would also convey even more information?” (eg if I didn’t shave, it would falsely suggest I really didn’t want the job), and “is this something where the target has basically given implied consent to this level of manipulation” (eg the interviewer wants and even hopes that people will dress nicely for the interview). I think some of Adams’ manipulations seem closer to the bad cases than the good ones. He wrote about the moment he decided to use his persuasion powers to convince America to elect Trump. One day when he was doing his dispassionate observer act, he heard about Hillary’s estate tax plan and realized it would cost his estate lots of money. He had no particular principled stance against it (“You can argue whether an estate tax is fair or unfair, but fairness is an argument for idiots and children”) but concluded that: This was personal. This was also the day I decided to move from observer to persuader. Until then I was happy to simply observe and predict. But once Clinton announced her plans to use government force to rob me on my deathbed, it was war. Persuasion war.” Accepting for the sake of argument that Adams’ persuasive powers are as impressive as he thinks, he manipulated thousands of people who might have stood to benefit from an estate tax, or who sincerely believed in fairness-based arguments for an estate tax, to vote against their own interests/beliefs, in order to enrich him personally1. I think this requires some sort of standpoint where you consider their agency and interests less important than your own, and that’s why I described him as wanting to manipulate “lesser humans”. This coexists with him often being very nice, with many people saying his podcast helped them become better people, etc. @janiesaysyay writes: This essay is a great demonstration of the kind of leftist, myopic thinking Scott [Adams] was fighting. This is how [Alexander] describes [Coffee With Scott Adams], one of the most influential online shows: » "I had been vaguely aware that he had some community around him, but on the event of his death, I tried watching an episode or two of his show. I couldn’t entirely follow..." “Some community"?! CWSA was one of the first long running, online, interactive, alternative news shows. Scott was a trailblazer host with his reasonable, thoughtful take on current events, often describing the "2 screens” views of both the left and right political opinions on current events. Scott [Adams]' question and answer discussions with his audience brought varied insights, and gave Americans a nuanced view of news. At the end of his life, Scott was highly influential in American thought, culture and politics. CWSA made it acceptable to be an American, someone who was proud of the country, unashamed of their race; proud of the culture, and proud of the heritage which built the country. This made me wonder whether I was underestimating the reach of Adams’ podcast, so I tried to find statistics. CWSA ranks 50th on Apple’s top 100 news/politics podcasts2. It’s very close to the rankings of Jen Psaki (Biden’s ex-press-secretary) and Al Franken (ex-Senator), but also to very many people I have never heard of. I’m not sure how to interpret this. Comparing YouTube subscribers of Adams and various other podcasts I’ve heard of, all numbers in thousands: Joe Rogan: 21,000
HIMARS

HIMARS is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 22, 2024 and November 22, 2024. The archive places it in contexts such as "a warning about HIMARS causing WWIII". It most often appears alongside AI, ATACMS, Biden.

Reference entry
HIMARS
Mention count
1
Issue count
1
First seen
November 22, 2024
Last seen
November 22, 2024
November 22, 2024 · Original source
Suppose something important will happen at a certain unknown point. As someone approaches that point, you might be tempted to warn that the thing will happen. If you’re being appropriately cautious, you’ll warn about it before it happens. Then your warning will be wrong. As things continue to progress, you may continue your warnings, and you’ll be wrong each time. Then people will laugh at you and dismiss your predictions, since you were always wrong before. Then the thing will happen and they’ll be unprepared. Toy example: suppose you’re a doctor. Your patient wants to try a new experimental drug, 100 mg. You say “Don’t do it, we don’t know if it’s safe”. They do it anyway and it’s fine. You say “I guess 100 mg was safe, but don’t go above that.” They try 250 mg and it’s fine. You say “I guess 250 mg was safe, but don’t go above that.” They try 500 mg and it’s fine. You say “I guess 500 mg was safe, but don’t go above that.” They say “Haha, as if I would listen to you! First you said it might not be safe at all, but you were wrong. Then you said it might not be safe at 250 mg, but you were wrong. Then you said it might not be safe at 500 mg, but you were wrong. At this point I know you’re a fraud! Stop lecturing me!” Then they try 1000 mg and they die. The lesson is: “maybe this thing that will happen eventually will happen now” doesn’t count as a failed prediction. I’ve noticed this in a few places recently. First, in discussion of the Ukraine War, some people have worried that Putin will escalate (to tactical nukes? to WWIII?) if the US gives Ukraine too many new weapons. Lately there’s a genre of commentary (1, 2, 3, 4, 5, 6, 7) that says “Well, Putin didn’t start WWIII when we gave Ukraine HIMARS. They didn’t start WWIII when we gave Ukraine ATACMS. He didn’t start WWIII when we gave Ukraine F-16s. So the people who believe Putin might start WWIII have been proven wrong, and we should escalate as much as possible.” There’s obviously some level of escalation that would start WWIII (example: nuking Moscow). So we’re just debating where the line is. Since nobody (except Putin?) knows where the line is, it’s always reasonable to be cautious. I don’t actually know anything about Ukraine, but a warning about HIMARS causing WWIII seems less like “this will definitely be what does it” and more like “there’s a 2% chance this is the straw that breaks the camel’s back”. Suppose we have two theories, Escalatory-Putin and Non-Escalatory-Putin. EP says that for each new weapon we give, there’s a 2% chance Putin launches a tactical nuke. NEP says there’s a 0% chance. If we start out with even odds on both theories, after three new weapons with no nukes, our odds should only go down to 48.5% - 51.5%. (yes, this is another version of the generalized argument against updating on dramatic events) Second, I talked before about getting Biden’s dementia wrong. My internal argument against him being demented was something like “They said he was demented in 2020, but he had a good debate and proved them wrong. They said he was demented in 2022, but he gave a good State Of The Union and proved them wrong. Now they’re saying he’s demented in 2024, but they’ve already discredited themselves, so who cares?” I think this was broadly right about the Republican political machine, who was just throwing the same allegation out every election and seeing if it would stick. But regardless of the Republicans’ personal virtue, the odds of an old guy becoming newly demented each year is about 4% per year. If it had been two years since I last paid attention to this question, there was an 8% chance it had happened while I wasn’t looking. Like the other examples, dementia is something that happens eventually (this isn’t strictly true - some people reach their 100s without dementia - but I think it’s a fair idealized assumption that if someone survives long enough, then eventually their risk of cognitive decline becomes very high). It is reasonable to be worried about the President of the United States being demented - so reasonable that people will start raising the alarm about it being a possibility long before it happens. Even if some Republicans had ulterior motives for harping on it, plenty of smart, well-meaning people were also raising the alarm. Here I failed by letting the multiple false alarms lull me into a false sense of security, where I figured the non-demented side had “won” the “argument”, rather than it being a constant problem we needed to stay vigilant for. Third, this is obviously what’s going on with AI right now. The SB1047 AI safety bill tried to monitor that any AI bigger than 10^25 FLOPs (ie a little bigger than the biggest existing AIs) had to be exhaustively tested for safety. Some people argued - the AI safety folks freaked out about how AIs of 10^23 FLOPs might be unsafe, but they turned out to be safe. Then they freaked out about how AIs of 10^24 FLOPs might be unsafe, but they turned out to be safe. Now they’re freaking out about AIs of 10^25 FLOPs! Haven’t we already figured out that they’re dumb and oversensitive? No. I think of this as equivalent to the doctor who says “We haven’t confirmed that 100 mg of the experimental drug is safe”, then “I guess your foolhardy decision to ingest it anyway confirms 100 mg is safe, but we haven’t confirmed that 250 mg is safe, so don’t take that dose,” and so on up to the dose that kills the patient. It would be surprising if AI never became dangerous - if, in 2500 AD, AI still can’t hack important systems, or help terrorists commit attacks or anything like that. So we’re arguing about when we reach that threshold. It’s true and important to say “well, we don’t know, so it might be worth checking whether the answer is right now.” It probably won’t be right now the first few times we check! But that doesn’t make caution retroactively stupid and unjustified, or mean it’s not worth checking the tenth time. Can we take this insight too far? Suppose Penny Panic says “If you elect the Republicans, they’ll cancel elections and rule as dictators!” Then they elect Republicans and it doesn’t happen. The next election cycle: “If you elect the Republicans, they’ll cancel elections and rule as dictators!” Then they elect Republicans again and it still doesn’t happen. After her saying this every election cycle, and being wrong every election cycle, shouldn’t we stop treating her words as meaningful? I think we have to be careful to distinguish this from the useful cases above. It’s not true that, each election, the chance of Republicans becoming dictators increases, until eventually it’s certain. This is different from our examples above: Eventually at some age, Castro has to die, and the chance gets higher the older he gets.
Hindoo

Hindoo is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 16, 2021 and April 16, 2021. The archive places it in contexts such as "This arises from no innate deficiency in the people, for the Hindoo, as comparative philology has shown". It most often appears alongside "The Rent Is Too Damn High!", 16th amendment, 1886.

Reference entry
Hindoo
Mention count
1
Issue count
1
First seen
April 16, 2021
Last seen
April 16, 2021
April 16, 2021 · Original source
Towards a Truly Free Market by John Medaille Appendices These are optional elaborations on sections I glossed over because the Book Review Is Too Damn Long. Appendix A: George Dunks on Malthusianism Malthusianism in George's time was wildly popular, and often invoked by the ascendant proponents of Social Darwinism who took Charles Darwin's theory of "survival of the fittest" and recast it as a moral justification for the Just World Hypothesis. Essentially, those that are doing well do so because they are more "fit", and those that are less "fit" tend to perish, and furthermore, this brutal process will actively "improve" the human race. This philosophy was the energizing intellectual force behind both the Eugenics movement and Nazi Germany. George clearly hates everything about this philosophy but attempts to steel-man it anyways: The Malthusian doctrine, as at present held, may be thus stated in its strongest and least objectionable form: That population, constantly tending to increase, must, when unrestrained, ultimately press against the limits of subsistence, not as against a fixed, but as against an elastic barrier, which makes the procurement of subsistence progressively more and more difficult. And thus, wherever reproduction has had time to assert its power, and is unchecked by prudence, there must exist that degree of want which will keep population within the bounds of subsistence. The weak form of Malthusianism is "people are as dumb as deer and will breed endlessly until there's not enough food and everyone starves to death." The strong form of Malthusianism is, "of course people aren't mindless deer charging into a brick wall, but there is a firm upper limit that can only give so much before nature will cull the herd without mercy." And by George, we can't just dismiss the strong form out of hand: "what seems clearer than that there are too many people?" However, George is suspicious of how easily the Malthusian theory justifies contemporary economic assumptions and assuages the moral sensibilities of the establishment: The great cause of the triumph of this theory is that, instead of menacing any vested right or antagonizing any powerful interest, it is eminently soothing and reassuring to the classes who, wielding the power of wealth, largely dominate thought... It furnishes a philosophy by which Dives as he feasts can shut out the image of Lazarus who faints with hunger at his door; He points out how it lets self-styled "Good Christian Men" reframe their own greed and indifference as just plain good sense: In this view, he who in the midst of want has accumulated wealth, has but fenced in a little oasis from the driving sand which else would have overwhelmed it. He has gained for himself, but has hurt nobody. And even if the rich were literally to obey the injunctions of Christ and divide their wealth among the poor, nothing would be gained. (Aside: I've heard this exact defense offered by many of my fellow Christians) Okay, George makes a strong moral case. But a moral case isn't enough, and I think this is where many activists of all political stripes go wrong. If you attack the premises of an idea as "dangerous" because it could lead to bad consequences, you're still stuck with a real problem if the premises that animate that "dangerous" idea turn out to be actually true. If they're true we're stuck with them, and unless your competing policy admits to the same grim facts, your opponent will just dismiss your entire argument and more importantly, so will their audience. But if the premises aren't true, then the dangerous and scary policy prescription – say, "let the Irish starve to death" – is both evil and unnecessary. History has shown that many officials will shrug their shoulders at "evil" policies so long as they believe them to be "necessary." Cool, we've established that Malthusianism is bad. Now let's establish that it's wrong. A Brief Interlude from the Future From where we're sitting in 2021, we don't even need George to refute Malthusianism, history has done that for us. Instead of increasing at an exponential rate, fertility rates are crashing all over the world. Not in one country, but in virtually every country, and in many the birth rate is already below replacement. Fertility rates have been crashing so hard that some are calling it a "Global Fertility Crisis." The absolute size of the human population is still growing, but this is just due to inertia; the human population will peak somewhere between 9 and 10 billion in the 2060's, and then decline from there. The two main things Malthus got wrong were failing to anticipate 1) advances in food production technology like the Green Revolution, and 2) that humans can control their own fertility rates. George's strongest arguments against Malthusianism strike directly at the provably false claims of its 19th century proponents and provide some extremely salient applications of George's philosophy. George takes up the cause of India, China, and Ireland, which were often cited as examples of "overpopulated" countries where many have starved and been forced to emigrate. Per the Malthusians, this is the fault of too many of these poor, ignorant, and deficient people crammed together in too small a space. By George, it can't be the fault of population density – in his time, Germany, Belgium, England, Netherlands and Italy all have higher population densities than India, China, and Ireland, and could therefore support higher populations with the right conditions. And there's certainly nothing wrong with the people themselves: This arises from no innate deficiency in the people, for the Hindoo, as comparative philology has shown, is of our own blood, and China possessed a high degree of civilization and the rudiments of the most important modern inventions when our ancestors were wandering savages. Instead: It arises from the form which the social organization has in both countries taken, which has shackled productive power and robbed industry of its reward. India is poor not because it has too many Indians, but because it is oppressed by too many Englishmen: The millions of India have bowed their necks beneath the yokes of many conquerors, but worse of all is the steady grinding weight of English domination... India now is like a great estate owned by an absentee and alien landlord George gives us lots of details about the plight of India, China, and Ireland, but for the sake of brevity I'm just going to present the heartbreaking case of the Great Irish Potato Famine and let it stand in for all three. To sum up, from 1845 to 1852 there was a period of mass starvation and disease in Ireland. About one million people died, and another million fled the country. The entire population dropped by about 25%: The extreme poverty of the peasantry and the low rate of wages there prevailing, the Irish famine, and Irish emigration, are constantly referred to as a demonstration of the Malthusian theory worked out under the eyes of the civilized world. Many prominent intellectuals of the day looked at the crisis, shook their heads, and said – what do you expect when those ignorant Irish Catholics breed like rabbits and strain Ireland's carrying capacity to its limit? It's just natural selection at work! George will have none of it: The laborer was just as effectually stripped by as merciless a horde of landlords, among whom the soil had been divided as their absolute possession, regardless of any rights of those who lived upon it. Okay, they had to pay some rent, so what? Didn't they bring their suffering on themselves? Why, the intellectuals ask, didn't the Irish work harder, why did they not improve their local economy and agricultural base? And most importantly, why did they depend on a single monoculture crop (the potato) if a single blight could knock out their entire food supply? By George, because The Rent Was Too Damn High! tenants... even if the rack-rents which they were forced to pay had permitted them, did not dare to make improvements which would have been but the signal for an increase of rent. Labor was thus applied in the most inefficient and wasteful manner. (emphases mine) The Irish were really trapped. Working harder to improve the farmland to increase its yield could actually leave them worse off. Any increase in their land's productivity goes to the landlord in the form of increased rents. But even this structural impoverishment of the land wasn't sufficient to cause the famine. Ireland still produced enough food to feed its people: For when her population was at its highest, Ireland was a food-exporting country. Even during the famine, grain and meat and butter and cheese were carted for exportation along roads lined with the starving and past trenches in which the dead were piled. People were literally starving and dying, but because of the structure of land ownership they couldn't even pay their rent, let alone purchase the food grown from their own lands and raised with their own hands. Since the local population couldn't afford it, the (English) landlords sold it abroad to the highest bidder. It went not as an exchange, but as a tribute – to pay the rent of absentee landlords; a levy wrung from producers by those who in no wise contributed to production... they lived on the potato, because rack-rents stripped everything else from them. The Rent Is Too Damn High, and it's not because the designated underclass of the day have too many babies or are too uneducated, too ignorant, too religious, too lazy, or too foreign. George gets really mad about this, and calls out John Stuart Mill and Henry Thomas Buckle by name for lending credence to the Malthusian explanation of Ireland's suffering. I know of nothing better calculated to make the blood boil than the cold accounts of the grasping, grinding tyranny to which the Irish people have been subjected, and to which, and not to any inability of the land to support its population, Irish pauperism and Irish famine are to be attributed; and were it not for the enervating effect which the history of the world proves to be everywhere the result of abject poverty, it would be difficult to resist something like a feeling of contempt for a race who, stung by such wrongs, have only occasionally murdered a landlord! Appendix B: George dunks on the Conventional Laws of Distribution Conventional Law 1: Wages aredetermined by the ratio between capital devoted to the payment & subsistence of labor, divided up by the number of laborers. Conventional Law 2: Rent is determined by something called the "margin of production," AKA the "margin of cultivation." What's that? Let L be some land. Let W be the worst land available. Let A = the produce L makes. Let B = the produce you get applying the same amount of labor and capital to W. The Rent of L is given by A - B. The margin of production/cultivation is the difference between how much you can produce from a particular piece of land compared to the least productive alternative. This is the only conventional law of distribution that George accepts as correct. Conventional Law 3: Interest is the ratio between capital demanded by borrowers and supplied by lenders, falling as wages rise and vice versa. To quote Mill, interest is determined "by the cost of labor to the capitalist." The problem with these three laws is if Land, Labor, and Capital are the only three factors of production, and each gets its own return, than the three returns should balance. In other words: Return to Production = Rent + Wages + Interest If your three returns sum to more or less than 100% of the return to production, something's off, and George says the old laws don't add up – the only one of these he accepts is the law of rent. What's wrong with the other two? First we've got to stop using "profits" to mean a return to capital. If we look into a profit stream, we see more than one kind of thing. Conventional economists list the following: Wages of "superintendence"
Hindu legend

Hindu legend is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 14, 2023 and February 14, 2023. The archive places it in contexts such as "There’s a Hindu legend about an atheist philosopher". It most often appears alongside Atala, Atlantis, Atzlan.

Reference entry
Hindu legend
Mention count
1
Issue count
1
First seen
February 14, 2023
Last seen
February 14, 2023
February 14, 2023 · Original source
A picture my instructor took of me at one of the ruins. Nobody was under any obligation to handhold me out of my Atlantis beliefs. But the #1 Google rank for “site about how Atlantis isn’t real” is a scarce resource. Article space on skeptic blogs (podcasts were still years into the dystopian future at this point) was a scarce resource. And when people frittered these scarce resources away on a thousand identical pieces saying “lol you’re stupid and racist if you believe this, haven’t you heard that conspiracies are always wrong?” - and never on any explanation of the GIANT UNDERWATER PYRAMIDS - yes, I feel like I was wronged. Eventually I lifted myself up by my own bootstraps. I studied some of the relevant history myself (less impressive than it sounds, Wikipedia was just coming into existence around this time). I learned enough about geology to understand on a gut level how natural processes can sometimes produce rocks that are really really artificial-looking - yes, even as artificial-looking as the ones in the picture above. More important, I learned something like rationality. I learned how to make arguments like the one I use in The Pyramid And The Garden. I realized that, for all their skill at finding anomalies, the Atlantis books couldn’t agree on a coherent narrative of their own. Some placed Atlantis in the Atlantic, others in the Pacific, others in Antarctica; some used it to explain artifacts from long after others said that it fell. For a while if I squinted I could sort of kind of smush them into a single story, but that story had even more anomalies than normal historians’. Eventually I gave up and joined the mainstream. I’m not angry at Graham Hancock. I see no evidence he has ever been anything but a weird, well-meaning guy who likes pyramids a little too much. But I feel a burning anger against anti-conspiracy bloggers, anti-conspiracy podcasters, and everyone else who wrote “lol imagine how stupid you would have to be to believe in Atlantis” style articles. Either these people didn’t understand the arguments for and against Atlantis, or they did. If they didn’t, they were frauds, claiming expertise in a subject they knew nothing about. If they did, then at any moment they could have saved me from a five year wild-goose-chase - but chose not to, because it was more fun to insult me. II. Kavanagh makes fun of me for writing 25,000 words on ivermectin. I agree this might not have been the best use of my time, and I would accept this criticism from anyone except Kavanagh - who’s devoted his whole career to thinking about ivermectin and ideas closely aligned to it. There’s a Hindu legend (maybe apocryphal?) about an atheist philosopher who spends literally every second of every day denouncing God. When he dies, God welcomes him into the highest heaven, praising him as a great yogi - for he never let his consciousness stray from awareness of God even for one moment. If by some inexplicable theological anomaly Bret Weinstein turns out to be God, Chris Kavanagh is definitely going to the highest heaven. So Kavanagh’s complaint can’t be that I’m thinking about this question at all. He sort of hints at a complaint where it took me too long to figure out that ivermectin didn’t work - shouldn’t I have been able to do it without the long review? But I clearly said on my first post on the subject that I had long since decided it to my own satisfaction, and was just trying to clear up some of my remaining questions. What is his complaint? At the risk of putting words in his mouth, two parts of his comment stand out to me as having important arguments: I interpret this as - to even try to “evaluate the evidence” at all is a mistake, because it suggests there might be evidence on both sides. Instead, you should admit that some people are idiots who believe things there’s no evidence for, and move on. But the problem with “if studies had supported ivermectin as an effective treatment, it would have been adopted”, is that about thirty different studies did support it, and it was adopted in several countries, mostly in Latin America. The first few meta-analyses of ivermectin found that it worked! I’m not defending ivermectin here. I think there was a reasonable explanation of this: a combination of fraud, poor methodology, publication bias, and maybe Strongyloides infections. But until someone tells you the reasonable explanation, there’s no reasonable explanation! It’s like the giant underwater pyramids. If I go diving and see the giant underwater pyramids, and you just say “LOL, you are stupid, don’t you know conspiracy theories aren’t real?”, you’re not going to convince me! I wanted to give the reasonable explanation, in terms that people could understand. Before doing any research, I had some intuitive guesses about what the reasonable explanation would look like - something something methodological problems something something small studies. But this, itself, isn’t a reasonable explanation. It’s an IOU for a reasonable explanation. I agree that many people are unreasonable and don’t respond to reasonable explanations. I think sometimes this is genetic or something and can’t be helped, but other times it comes after a hundred different experiences where you want reasonable explanations and don’t get them and also people are jerks to you and you learn that the establishment can’t be trusted. Mahabharata: “Even after ten thousand explanations, the fool is no wiser, but the wise man requires only two thousand five hundred.” If I had had to suffer through a few more skeptics calling me racist because I wanted to know why there were giant underwater pyramids, I probably would have believed in Atlantis even harder, out of spite, and never talked myself out of it. And then when ivermectin came along, I would have thought “Scientists? Experts? They’re the guys who are so dumb they can’t even figure out Atlantis existed when there are giant underwater pyramids right in front of their eyes. Screw them, I’m listening to Bret Weinstein.” I side with the Christians. There may be people so far gone into the outer darkness that they can’t be saved, but you are forbidden from ever believing with certainty that any specific individual is in this category. Act as if everyone is one good deed away from falling to their knees and acknowledging the light of Jesus. Moving on: @RachelBCam Imagine Scott’s blog with some more generous degrees of freedom exercised in his analysis, suddenly you have a more positive result &amp; the impression the issue is a genuine controversy. Indeed, this is what people like Alexandros did in response.","username":"C_Kavanagh","name":"Chris Kavanagh","profile_image_url":"","date":"Tue Feb 14 15:50:05 +0000 2023","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":0,"like_count":0,"impression_count":0,"expanded_url":{},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> This is the part I have the most trouble interpreting charitably. I can’t stop reading it as “doing good science is a near occasion of sin for doing bad science”. It sounds kind of like fideism, the belief (more common in atheists’ imaginations than real religion) that somebody who reasons their way to belief in God is a sinner, because a real saint would have believed through blind faith, without having to reason. The best I can do is to think of this as a PR argument: it looks bad to be treating these kinds of questions as live issues. I generally don’t like PR arguments, but while we’re having them: doesn’t it kind of look bad for one side to be promoting fideism? The ivermectinist slogan is “do your own research”. Kavanagh’s apparent slogan is “don’t do research” - even if you get it right, having tried it at all makes you impure. If there’s some argument I know nothing about - pro- vs. anti- skub, perhaps - and all I’ve heard is that the pro-skub people say that you should look at evidence and decide rationally based on your best judgment, and the anti-skub people say you should never look at evidence and have to trust them - I’m already 90-something percent sure pro-skub are the good guys. My model of the PR here - of the overall milieu and psychological factors that turn people into conspiracists - is that they spot some giant underwater pyramids, compelling-seeming facts that appear to point toward conspiracy. These facts have alternative explanations, but these alternatives are less compelling and harder to explain. Realistically some people are going to get caught up in the conspiracy’s superior first-level compellingness and you can’t help them. But other people are on the fence and can be talked down. This is the job of the pro-mainstream-anti-conspiracy people. Instead of doing their job, these people: ignore them
Hindu priests

Hindu priests is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between December 05, 2024 and December 05, 2024. The archive places it in contexts such as "Hindu priests have a deep and complex system of ritual purity". It most often appears alongside @dieworkwear, AI Art Turing Test, Bauhaus.

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Hindu priests
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December 05, 2024
December 05, 2024 · Original source
Hindu priests have a deep and complex system of ritual purity. X food can only be eaten at Y time unless it has touched a member of Z caste or been purified using P product and Q blessing, unless . . . (and so on).
Still, unless you’re a Hindu, you believe the system is completely made up and has no relevance to the real world. You think that Hindu priests are (unintentionally) charlatans, getting angry at people for violating rules even though the violation of those rules has no negative consequences and nobody who wasn’t inculcated in Hinduism since birth would care about them. The solution is to stop inculcating people into Hinduism. Although this might have some other disadvantages (if the religion helps hold together communities or something), at least the relaxation of meaningless ritual purity laws would go on the benefits side of the ledger.
Hindu rate of growth

Hindu rate of growth is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 14, 2021 and September 14, 2021. The archive places it in contexts such as "called 'the Hindu rate of growth'". It most often appears alongside Adivasis, affirmative action, Ahmedabad.

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Hindu rate of growth
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September 14, 2021
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September 14, 2021
September 14, 2021 · Original source
The solution he finally settled on was free market capitalism. As he tells it, as long as the pie is a fixed size, everyone will always fight viciously over their share. If you can get the pie growing, people will calm down and focus on making money. Over the preceding fifty years of Congress-led socialism and the "License Raj", India's GDP had grown at a pathetic 3% / year, which snarky observers called "the Hindu rate of growth". If he could get the market moving again, maybe he could turn India into a genuinely secular state where people had aspirations beyond getting a few more of those sweet affirmative action slots for your own group.
Hindutva

Hindutva is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 14, 2021 and September 14, 2021. The archive places it in contexts such as "the election campaign had not been about Hindutva". It most often appears alongside Adivasis, affirmative action, Ahmedabad.

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Hindutva
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September 14, 2021
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September 14, 2021
September 14, 2021 · Original source
For all the fiery speech-making, the election campaign had not been about Hindutva or even about terrorism. Thanks largely to the media, it had been about Modi. With hindsight, Sonia [Gandhi, leader of the Congress Party] had accurately recognized the long-term threat Modi's politics posed to the Congress. Over ten years later, with a barely reduced majority in the Gujarat assembly, Modi was elected for the third time. Few Muslims had voted for him in December 2002. But in December 2012, 31% did...Would the Congress belatedly realize that its tactics had backfired and that for every insult it aimed at Modi it handed him another thousand votes? Or would it double down on its losses and bet more heavily on demonizing him? Time his proved that it would choose to do the latter, with interesting consequences.
hip young people

hip young people is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 10, 2021 and May 10, 2021. The archive places it in contexts such as "I predicted that hip young people would go far-right". It most often appears alongside "How do you do, fellow kids?", #NotAllMen, #TheResistance.

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hip young people
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May 10, 2021 · Original source
In 2014, armed with this model, I predicted that hip young people would go far-right. For the previous few years, the social justice movement had been the dominant intellectual paradigm in online spaces (and increasingly offline too). The movement had started with the same people who start all trends - starving bohemian artists, poor people on the fringes of society, hip college kids. Beginning around 2008 it spread like wildfire among all the most popular and clued-in people I knew - all my favorite slightly contrarian bloggers, all the most interesting people at my college. But by 2014, it was starting to get embarrassing. We'd already seen the beginnings of "woke capitalism", where Wal-Mart or Amazon or whoever would put their corporate logos in rainbow colors for gay pride day and then everyone would praise them and talk about how they were striking a bold blow against the entrenched forces of the kyriarchy. Hillary Clinton, 25-year-contender for America's least cool person, was giving speeches about male privilege and rape culture. The Instagram pages of the hippest, most counterculture people in the country sounded exactly the same as the lectures corporate consultants gave at mandatory educational workshops. According to Bell's theory there was no way this was a stable situation.
So I predicted that hip young people would go far-right. It was the only way left to shock the establishment. In the language of signaling theory, it would be a "countersignal", a signal which is so uncool it paradoxically loops around to becoming cool again. The classic example is ripped jeans. Normally if you wear ripped jeans it means you're so poor you can't afford decent clothes, or so uncool you don't even notice what you're wearing. Anybody who was insecure about their status would shy away from them lest people draw the obvious assumptions. But that just means that bold trendsetters can use them as a credible signal that they're bold trendsetters, ie "I am so obviously rich and cool that even if I wear uncool poor people clothes, you'll know I'm just doing it ironically". Countersignals don't completely escape the fashion cycle; eventually the trend becomes common enough that even insecure people feel comfortable doing it, because they expect people to realize they're just following the trend. But they can be an effective way to hit a reset button on a fashion cycle that has gotten out of control.
And so I predicted that hip young people would go far-right. Nobody would confuse them with the maximally-uncool people, the obese white Boomer who shops at Wal-Mart and plasters their car with anti-Obama bumper stickers. And it would distinguish them from the corporate consulants and Hillary Clintons of the world. A few hip young people seem to have tried this - I think this was a little bit of what gave the alt-right its original appeal, especially after Clinton's speech.
HIPAA

HIPAA is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 07, 2023 and November 07, 2023. The archive places it in contexts such as "The main challenges to doing this in real life are HIPAA". It most often appears alongside Aceso Under Glass, ACX Grant, America.

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HIPAA
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November 07, 2023
November 07, 2023 · Original source
The main challenges to doing this in real life are HIPAA (you can’t actually get a list of people who need transplants) and probably nobody would believe you if they just got a letter. If you think you have a way around these challenges, I’m not exactly urging you to apply for an ACX Grant, but any such application would certainly catch my interest!
hippie culture

hippie culture is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between December 09, 2022 and December 09, 2022. The archive places it in contexts such as "the hippie culture that first emerged in the 60s". It most often appears alongside 417th Marquess of Cornwallshireshire, ACX, ACX.

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hippie culture
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December 09, 2022
December 09, 2022 · Original source
The connections that Brooks makes between the decline of the northeastern WASP aristocracy's power, the emergence of meritocracy, and the hippie culture that first emerged in the 60s doesn't seem to stand up to even moderate historical scrutiny, in all honesty. Some issues that immediately come to mind off the top of my head:
hippies

hippies is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 24, 2024 and October 24, 2024. The archive places it in contexts such as "an idealized spiritual conference in 1971 between... hippies". It most often appears alongside 1960: The Year The Singularity Was Cancelled, 1960s, 1973.

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hippies
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October 24, 2024
October 24, 2024 · Original source
The speaker said it was complicated, but mentioned a social shift from the techno-optimism of the 1960s to the techno-pessimism of the hippies and paranoid Nixonesque conservatives. The public consciousness rejected The Jetsons in favor of Paul Ehrlich, Rachel Carson, Jane Jacobs, and Ralph Nader, and this probably had downstream effects on lots of things, including regulation.
I mocked the people in 2019 who thought a conference could affect the Gods Of Straight Lines. But it seems like maybe there was something - an idealized spiritual conference in 1971 between Ralph Nader, Jane Jacobs, Rachel Carson, hippies, protectionists, and all those people - that knocked them off their thrones once. So who knows?
hippocampal theta

hippocampal theta is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 20, 2022 and October 20, 2022. The archive places it in contexts such as "named rhythms in the brain, each with a name like 'hippocampal theta'"; "The hippocampus, a structure involved in memory, has its own rhythm called hippocampal theta". It most often appears alongside Alpha, Andres, Brown noise.

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hippocampal theta
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October 20, 2022
October 20, 2022 · Original source
Did you know: White noise was named because its wave spectrum resembles white light. Pink noise was named because its wave spectrum resembles pink light. Brown noise was named after Robert Brown, who helped discover it. This is one of my least favorite facts. Lots of scientists seem tempted to wax rhapsodic about the importance of pink noise; the exact reasons were one of the parts of the book I didn’t quite understand. For our purposes, it just matters that this is the overall wave spectrum of the brain. How is this spectrum formed? This was one of the questions the book didn’t resolve for me. Are there a few hundred neurons here oscillating at 1 hertz, a few thousand there oscillating at 1.1 hertz, and so on, until we have enumerated thousands of different neuronal populations with very slightly different rhythms, and when you add them together you get the nice smooth pink noise curve? And then after a second, they all spontaneously rearrange themselves and there are a different few thousand populations and rhythms, still on the aggregate summing to pink noise? Sometimes it seems like the book is pointing to a model like this. Other times it seems like there are approximately five different rhythms in the brain, each with a name like “hippocampal theta” or “visual alpha”, and each usually involving a whole brain macroregion (eg the visual cortex). I still haven’t figured out how to reconcile these two perspectives - maybe the major rhythms are broad categories, and there are lots of subrhythms within them? In any case, these 1/n rhythms form the “background noise” of the brain. They exist at all times, whether you’re thinking hard, or in a sensory deprivation tank, or asleep (although each of those states will change which rhythm predominates). When neuroscientists want to study how the brain reacts to something, they usually measure the brain, do the thing, and subtract the pink noise spectrum from the result - again, on the grounds that it’s “background noise” which is disguising the effect of whatever their interesting intervention was. Buzsaki questions this practice and presents evidence that the state of the “background noise” matters a lot - this is the “randomness” that explains why the same person will respond to the same intervention different ways at different times. For example, he presents evidence showing that if you give someone a near-threshold stimulus (for example, a flashing light just barely bright enough that someone can detect it 50% of the time), then whether they detect it or not will depend on whether it occurs at the peak or the trough of the brain waves in the relevant area. Are Brain Waves Useful? Brain waves are kind of unavoidable. Rhythms presents a thought experiment about trying to design a brain that doesn’t fall into any natural oscillatory patterns. It’s pretty hard! Even if brain waves were useless, we would probably have them just because they’re too much trouble to avoid. Still, evolution tends to make virtues out of necessity, and Buzsaki thinks brain waves matter a lot. Again without claiming to have fully understood this, here are four things that brain waves might do: Brain waves provide “synchrony”, allowing a smallest granular unit of time and essentially converting life into a turn-based game. Suppose that a snake bites your foot. You see the snake with your eyes, and also get a pain signal from your foot. The pain signal has to travel a long way, nerves have conduction delays, and so it reaches your brain well after the visual signal. But your brain needs to be able to combine the visual and pain signals into a single story (snake bit my foot). Brain waves separate experience into short granular “turns” so that the brain can attribute both stimuli to the same “turn” and connect them. It’s also possible I’m totally misunderstanding this part, sorry.
Similarly, brain waves determine (or reflect?) which structures are “talking” to which other structures. The hippocampus, a structure involved in memory, has its own rhythm called hippocampal theta. When some part of your auditory cortex is trying to remember something, it goes into hippocampal theta, “links up with” the hippocampus, and for a while that part of the cortex and the hippocampus effectively form a single fluid computational unit. Then when it’s done, it goes back into its normal rhythm and separates from the hippocampus again. The progress of waves might even reflect causal priority; when a cat is using sight to navigate and smell to confirm, waves progress from a visual region to an olfactory region; when the cat switches to using the smell to navigate and vision to confirm, the waves reverse direction.
Theta is most important in the hippocampus. The hippocampus is traditionally associated with memory, but Buzsaki cites recent research showing that it also handles navigation (eg a rat navigating a maze, or a person walking through a familiar city). Why this combination of tasks? Rhythms sort of suggests that brain areas are less about specific tasks than about specific graph-theoretic arrangements, which are convenient for specific algorithms, which are convenient for specific tasks. The neural connections in the hippocampus are mostly local in a way that makes it a good “auto-associater”, ie you give it part of a pattern and it can recognize which pattern is being suggested. For complicated reasons this works well for both spatial tasks and memory. In fact, Buzsaki sketches out a way that episodic memory might have evolved from our navigation system, where eg remembering a list is equivalent to remembering a path through space, and remembering a specific episode is equivalent to remembering a landmark (he doesn’t specifically say so, but this is a fascinating match for the method of loci mnemonic device). Theta rhythm is an oscillation that helps divide navigation into time steps so you can figure out where you are now, where you were a moment ago, and where you’re going.
Hiroshima bomb

Hiroshima bomb is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 04, 2022 and April 04, 2022. The archive places it in contexts such as "The Hiroshima bomb wasn’t some previous bomb but bigger". It most often appears alongside 2013, Agricultural Revolution, AI.

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Hiroshima bomb
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April 04, 2022
April 04, 2022 · Original source
Chess AI performance over time. Why does this matter? If there’s a slow takeoff (ie gradual exponential curve), it will become obvious that some kind of terrifying transformative AI revolution is happening, before the situation gets apocalyptic. There will be time to prepare, to test slightly-below-human AIs and see how they respond, to get governments and other stakeholders on board. We don’t have to get every single thing right ahead of time. On the other hand, because this is proceeding along the usual channels, it will be the usual variety of muddled and hard-to-control. With the exception of a few big actors like the US and Chinese government, and maybe the biggest corporations like Google, the outcome will be determined less by any one agent, and more by the usual multi-agent dynamics of political and economic competition. There will be lots of opportunities to affect things, but no real locus of control to do the affecting. If there’s a fast takeoff (ie sudden FOOM), there won’t be much warning. Conventional wisdom will still say that transformative AI is thirty years away. All the necessary pieces (ie AI alignment theory) will have to be ready ahead of time, prepared blindly without any experimental trial-and-error, to load into the AI as soon as it exists. On the plus side, a single actor (whoever has this first AI) will have complete control over the process. If this actor is smart (and presumably they’re a little smart, or they wouldn’t be the first team to invent transformative AI), they can do everything right without going through the usual government-lobbying channels. So the slower a takeoff you expect, the less you should be focusing on getting every technical detail right ahead of time, and the more you should be working on building the capacity to steer government and corporate policy to direct an incoming slew of new technologies. Yudkowsky Contra Christiano Eliezer counters that although progress may retroactively look gradual and continuous when you know what metric to graph it on, it doesn’t necessarily look that way in real life by the measures that real people care about. (one way to think of this: imagine that an AI’s effective IQ starts at 0.1 points, and triples every year, but that we can only measure this vaguely and indirectly. The year it goes from 5 to 15, you get a paper in a third-tier journal reporting that it seems to be improving on some benchmark. The year it goes from 66 to 200, you get a total transformation of everything in society. But later, once we identify the right metric, it was just the same rate of gradual progress the whole time. ) So Eliezer is much less impressed by the history of previous technologies than Paul is. He’s also skeptical of the “GDP will double in 4 years before it doubles in 1” claim, because of two contingent disagreements and two fundamental disagreements. The first contingent disagreement: government regulations make it hard to deploy imperfect things, and non-trivial to deploy things even after they’re perfect. Eliezer has non-jokingly said he thinks AI might destroy the world before the average person can buy a self-driving car. Why? Because the government has to approve self-driving cars (and can drag its feet on that), but the apocalypse can happen even without government approval. In Paul’s model, sometime long before superintelligence we should have AIs that can drive cars, and that increases GDP and contributes to a general sense that exciting things are going on. Eliezer says: fine, what if that’s true? Who cares if self-driving cars will be practical a few years before the world is destroyed? It’ll take longer than that to lobby the government to allow them on the road. The second contingent disagreement: superintelligent AIs can lie to us. Suppose you have an AI which wants to destroy humanity, whose IQ is doubling every six months. Right now it’s at IQ 200, and it suspects that it would take IQ 800 to build a human-destroying superweapon. Its best strategy is to lie low for a year. If it expects humans would turn it off if they knew how close it was to superweapons, it can pretend to be less intelligent than it really is. The period when AIs are holding back so we don’t discover their true power level looks like a period of lower-than-expected GDP growth - followed by a sudden FOOM once the AI gets its superweapon and doesn’t need to hold back. So even if Paul is conceptually right and fundamental progress proceeds along a nice smooth curve, it might not look to us like a nice smooth curve, because regulations and deceptive AIs could prevent mildly-transformative AI progress from showing up on graphs, but wouldn’t prevent the extreme kind of AI progress that leads to apocalypse. To an outside observer, it would just look like nothing much changed, nothing much changed, nothing much changed, and then suddenly, FOOM. But even aside from this, Eliezer doesn’t think Paul is conceptually right! He thinks that even on the fundamental level, AI progress is going to be discontinuous. It’s like a nuclear bomb. Either you don’t have a nuclear bomb yet, or you do have one and the world is forever transformed. There is a specific moment at which you go from “no nuke” to “nuke” without any kind of “slightly worse nuke” acting as a harbinger. He uses the example of chimps → humans. Evolution has spent hundreds of millions of years evolving brainier and brainier animals (not teleologically, of course, but in practice). For most of those hundreds of millions of years, that meant the animal could have slightly more instincts, or a better memory, or some other change that still stayed within the basic animal paradigm. At the chimp → human transition, we suddenly got tool use, language use, abstract thought, mathematics, swords, guns, nuclear bombs, spaceships, and a bunch of other stuff. The rhesus monkey → chimp transition and the chimp → human transition both involved the same ~quadrupling of neuron number, but the former was pretty boring and the latter unlocked enough new capabilities to easily conquer the world. The GPT-2 → GPT-3 transition involved centupling parameter count. Maybe we will keep centupling parameter count every few years, and most times it will be incremental improvement, and one time it will conquer the world. But even talking about centupling parameter points is giving Paul too much credit. Lots of past inventions didn’t come by quadrupling or centupling something, they came by discovering “the secret sauce”. The Wright brothers (he argues) didn’t make a plane with 4x the wingspan of the last plane that didn’t work, they invented the first plane that could fly at all. The Hiroshima bomb wasn’t some previous bomb but bigger, it was what happened after a lot of scientists spent a long time thinking about a fundamentally different paradigm of bomb-making and brought it to a point where it could work at all. The first transformative AI isn’t going to be GPT-3 with more parameters, it will be what happens after someone discovers how to make machines truly intelligent. (this is the same debate Eliezer had with Ajeya over the Biological Anchors post; have I mentioned that Ajeya and Paul are married?) Fine, Let’s Nitpick The Hell Out Of The Chimps Vs. Humans Example This is where the two of them end up, so let’s follow. Between chimps and humans, there were about seven million years of intermediate steps. These had some human capabilities, but not others. IE homo erectus probably had language, but not mathematics, and in terms of taking over the world it did make it to most of the Old World but was less dominant than moderns. But if we say evolutionary history started 500 million years ago (the Cambrian), and AI history started with the Dartmouth Conference in 1955, then the equivalent of 7 million years of evolutionary history is 1 year of AI history. In the very very unlikely and forced comparison where evolutionary history and AI history go at the same speed, there will be only about a year between chimp-level and human-level AIs. A chimp-level AI probably can’t double GDP, so this would count as a fast takeoff by Paul’s criterion. But even more than that, chimp → human feels like a discontinuity. It’s not just “animals kept getting smarter for hundreds of millions of years, and then ended up very smart indeed”. That happened for a while, and then all of sudden there was a near-instant phase transition into a totally different way of using intelligence with completely new abilities. If AI worked like this, we would have useful toys and interesting specialists for a few decades, until suddenly someone “got it right”, completed the package that was necessary for “true intelligence”, and then we would have a completely new category of thing. Paul admits this analogy is awkward for his position. He answers: Chimp evolution is not primarily selecting for making and using technology, for doing science, or for facilitating cultural accumulation. The task faced by a chimp is largely independent of the abilities that give humans such a huge fitness advantage. It’s not completely independent—the overlap is the only reason that evolution eventually produces humans—but it’s different enough that we should not be surprised if there are simple changes to chimps that would make them much better at designing technology or doing science or accumulating culture […] So I don’t think the example of evolution tells us much about whether the continuous change story applies to intelligence. This case is potentially missing the key element that drives the continuous change story—optimization for performance. Evolution changes continuously on the narrow metric it is optimizing, but can change extremely rapidly on other metrics. For human technology, features of the technology that aren’t being optimized change rapidly all the time. When humans build AI, they will be optimizing for usefulness, and so progress in usefulness is much more likely to be linear. That is, evolution wasn’t optimizing for tool use/language/intelligence, so we got an “overhang” where chimps could potentially have been very good at these, but evolution never bothered “closing the circuit” and turning those capabilities “on”. After a long time, evolution finally blundered into an area where marginal improvements in these capacities improved fitness, so evolution started improving them and it was easy. Imagine a company which, through some oversight, didn’t have a Sales department. They just sat around designing and manufacturing increasingly brilliant products, but not putting any effort into selling them. Then the CEO remembers they need a Sales department, starts one up, and the company goes from moving near zero units to moving millions of units overnight. It would look like the company had “suddenly” developed a “vast increase in capabilities”. But this is only possible when a CEO who is weirdly unconcerned about profit forgets to do obvious profit-increasing things for many years. This is Paul’s counterargument to the chimp analogy. Evolution isn’t directly concerned about various intellectual skills; it only wants them in the unusual cases where they’ll contribute to fitness on the margin. AI companies will be very concerned about various intellectual skills. If there’s a trivial change that can make their product 10x better, they’ll make it. So AI capabilities will grow in a “well-rounded” way, there won’t be any “overhangs”, and there won’t be any opportunities for a sudden overhang-solving phase transition with associated new-capability development like with chimps → humans. Eliezer answers: Chimps are nearly useless because they're not general, and doing anything on the scale of building a nuclear plant requires mastering so many different nonancestral domains that it's no wonder natural selection didn't happen to separately train any single creature across enough different domains that it had evolved to solve every kind of domain-specific problem involved in solving nuclear physics and chemistry and metallurgy and thermics in order to build the first nuclear plant in advance of any old nuclear plants existing. Humans are general enough that the same braintech selected just for chipping flint handaxes and making water-pouches and outwitting other humans, happened to be general enough that it could scale up to solving all the problems of building a nuclear plant - albeit with some added cognitive tech that didn't require new brainware, and so could happen incredibly fast relative to the generation times for evolutionarily optimized brainware. Now, since neither humans nor chimps were optimized to be "useful" (general), and humans just wandered into a sufficiently general part of the space that it cascaded up to wider generality, we should legit expect the curve of generality to look at least somewhat different if we're optimizing for that. Eg, right now people are trying to optimize for generality with AIs like Mu Zero and GPT-3. In both cases we have a weirdly shallow kind of generality. Neither is as smart or as deeply general as a chimp, but they are respectively better than chimps at a wide variety of Atari games, or a wide variety of problems that can be superposed onto generating typical human text. They are, in a sense, more general than a biological organism at a similar stage of cognitive evolution, with much less complex and architected brains, in virtue of having been trained, not just on wider datasets, but on bigger datasets using gradient-descent memorization of shallower patterns, so they can cover those wide domains while being stupider and lacking some deep aspects of architecture. It is not clear to me that we can go from observations like this, to conclude that there is a dominant mainline probability for how the future clearly ought to go and that this dominant mainline is, "Well, before you get human-level depth and generalization of general intelligence, you get something with 95% depth that covers 80% of the domains for 10% of the pragmatic impact". ...or whatever the concept is here, because this whole conversation is, on my own worldview, being conducted in a shallow way relative to the kind of analysis I did in Intelligence Explosion Microeconomics, where I was like, "here is the historical observation, here is what I think it tells us that puts a lower bound on this input-output curve". Here Eliezer sort of kind of grants Paul’s point that AIs will be optimized for generality in a way chimps aren’t, but points to his previous “Intelligence Explosion Microeconomics” essay to argue that we should expect a fast takeoff anyway. IEM has a lot of stuff in it, but one key point is that instead of using analogies to predict the course of future AI, we should open that black box and try to actually reason about how it will work, in which case we realize that recursive self-improvement common-sensically has to cause an intelligence explosion. I am sort of okay with this, but I feel like a commitment to avoiding analogies should involve not bringing up the chimp-human analogy further, which Eliezer continues to do, quite a lot. I do feel like Paul succeeded in convincing me that we shouldn’t place too much evidential weight on it. The Wimbledon Of Reference Class Tennis “Reference class tennis” is an old rationalist idiom for people throwing analogies back and forth. “AI will be slow, because it’s an economic transition like the Agricultural or Industrial Revolution, and those were slow!” “No, AI will be fast, because it’s an evolutionary step like chimps → humans, and that was fast!” “No, AI will be slow, because it’s an invention, like the computer, and computers were invented piecemeal and required decades of innovation to be useful.” “No, AI will be fast, because it’s an invention, like the nuclear bomb, and nuclear bombs went from impossible to city-killing in a single day.” “No, AI will be slow, because it will be surrounded by a shell-like metallic computer case, which makes it like a turtle, and turtles are slow.” “No, AI will be fast, because it’s dangerous and powerful, like a tiger, and tigers are fast!” And so on. Comparing things to other things is a time-tested way of speculating about them. But there are so many other things to compare to that you can get whatever result you want. This is the failure mode that the term “reference class tennis” was supposed to point to. Both participants in this debate are very smart and trying their hardest to avoid reference-class tennis, but neither entirely succeeds. Eliezer’s preferred classes are Bitcoin (“there wasn't a cryptocurrency developed a year before Bitcoin using 95% of the ideas which did 10% of the transaction volume”), nukes, humans/chimps, the Wright Brothers, AlphaGo (which really was a discontinuous improvement on previous Go engines), and AlphaFold (ditto for proteins). Paul’s preferred classes are the Agricultural and Industrial Revolutions, chess engines (which have gotten better along a gradual, well-behaved curve), all sorts of inventions like computers and ships (likewise), and world GDP. Eliezer already listed most of these in his Intelligence Explosion Microeconomics paper in 2013, and concluded that the space of possible analogies was contradictory enough that we needed to operate at a higher level. Maybe so, but when someone lobs a reference class tennis ball at you, it’s hard to resist the urge to hit it back. Recursive Self-Improvement This is where I think Eliezer most wants to take the discussion. The idea is: once AI is smarter than humans, it can do a superhuman job of developing new AI. In his Microeconomics paper, he writes about an argument he (semi-hypothetically) had with Ray Kurzweil about Moore’s Law. Kurzweil expected Moore’s Law to continue forever, even after the development of superintelligence. Eliezer objects: Suppose we were dealing with minds running a million times as fast as a human, at which rate they could do a year of internal thinking in thirty-one seconds, such that the total subjective time from the birth of Socrates to the death of Turing would pass in 20.9 hours. Do you still think the best estimate for how long it would take them to produce their next generation of computing hardware would be 1.5 orbits of the Earth around the Sun? That is: the fact that it took 1.5 years for transistor density to double isn’t a natural law. It’s pointing to a law that the amount of resources (most notably intelligence) that civilization focused on the transistor-densifying problem equalled the amount it takes to double it every 1.5 years. If some shock drastically changed available resources (by eg speeding up human minds a million times), this would change the resources involved, and the same laws would predict transistor speed doubling in some shorter amount of time (naively 0.000015 years, although realistically at that scale other inputs would dominate). So when Paul derives clean laws of economics showing that things move along slow growth curves, Eliezer asks: why do you think they would keep doing this when one of the discoveries they make along that curve might be “speeding up intelligence a million times”? (Eliezer actually thinks improvements in the quality of intelligence will dominate improvements in speed - AIs will mostly be smarter, not just faster - but speed is a useful example here and we’ll stick with it) Paul answers: Summary of my response: Before there is AI that is great at self-improvement there will be AI that is mediocre at self-improvement. Powerful AI can be used to develop better AI (amongst other things). This will lead to runaway growth. This on its own is not an argument for discontinuity: before we have AI that radically accelerates AI development, the slow takeoff argument suggests we will have AI that significantly accelerates AI development (and before that, slightly accelerates development). That is, an AI is just another, faster step in the hyperbolic growth we are currently experiencing, which corresponds to a further increase in rate but not a discontinuity (or even a discontinuity in rate). The most common argument for recursive self-improvement introducing a new discontinuity seems be: some systems “fizzle out” when they try to design a better AI, generating a few improvements before running out of steam, while others are able to autonomously generate more and more improvements. This is basically the same as the universality argument in a previous section. Eliezer: Oh, come on. That is straight-up not how simple continuous toy models of RSI work. Between a neutron multiplication factor of 0.999 and 1.001 there is a very huge gap in output behavior. Outside of toy models: Over the last 10,000 years we had humans going from mediocre at improving their mental systems to being (barely) able to throw together AI systems, but 10,000 years is the equivalent of an eyeblink in evolutionary time - outside the metaphor, this says, "A month before there is AI that is great at self-improvement, there will be AI that is mediocre at self-improvement." (Or possibly an hour before, if reality is again more extreme along the Eliezer-Hanson axis than Eliezer. But it makes little difference whether it's an hour or a month, given anything like current setups.) This is just pumping hard again on the intuition that says incremental design changes yield smooth output changes, which (the meta-level of the essay informs us wordlessly) is such a strong default that we are entitled to believe it if we can do a good job of weakening the evidence and arguments against it. And the argument is: Before there are systems great at self-improvement, there will be systems mediocre at self-improvement; implicitly: "before" implies "5 years before" not "5 days before"; implicitly: this will correspond to smooth changes in output between the two regimes even though that is not how continuous feedback loops work. I got a bit confused trying to understand the criticality metaphor here. There’s no equivalent of neutron decay, so any AI that can consistently improve its intelligence is “critical” in some sense. Imagine Elon Musk replaces his brain with a Neuralink computer which - aside from having read-write access - exactly matches his current brain in capabilities. Also he becomes immortal. He secludes himself from the world, studying AI and tinkering with his brain’s algorithms. Does he become a superintelligence? I think under the assumptions Paul and Eliezer are using, eventually maybe. After some amount of time he’ll come across a breakthrough he can use to increase his intelligence. Then, armed with that extra intelligence, he’ll be able to pursue more such breakthroughs. However intelligent the AI you’re scared of is, Musk will get there eventually. How long will it take? A good guess might be “years” - Musk starts out as an ordinary human, and ordinary humans are known to take years to make breakthroughs. Suppose it takes Musk one year to come up with a first breakthrough that raises his IQ 1 point. How long will his second breakthrough take? It might take longer, because he has picked the lowest-hanging fruit, and all the other possible breakthroughs are much harder. Or it might take shorter, because he’s slightly smarter than he was before, and maybe some extra intelligence goes a really long way in AI research. The concept of an intelligence explosion seems to assume the second effect dominates the first. This would match the observation that human researchers, who aren’t getting any smarter over time, continue making new discoveries. That suggests the range of possible discoveries at a given intelligence level is pretty vast. Some research finds that the usual pattern in science is constant rate of discovery from exponentially increasing number of researchers, suggesting strong low-hanging fruit effects, but these seem to be overwhelmed by other considerations in AI right now. I think Eliezer’s position on this subject is shaped by assumptions like: If you have an AI as intelligent as Elon Musk today, then tomorrow you can run it on more hardware with a bit of normal human algorithmic progress, and get one twice as intelligent. So even if it would take Elon years to make a breakthrough, long before those years are up you’ll have an AI that can make breakthroughs much faster.
Hirpa

Hirpa is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 20, 2021 and May 20, 2021. The archive places it in contexts such as "speculation includes ... Hirpa (via a long chain of scholarly/historical speculation)". It most often appears alongside 5D Chess With Multiverse Time Travel, AI X-Risk Research Podcast, Alignment Research Center.

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Hirpa
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May 20, 2021
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May 20, 2021
May 20, 2021 · Original source
29: In 82 BC, the dictator Sulla executed scholar-politician Quintus Valerius Soranus for publicly revealing the secret true name of Rome. Wait, there was a secret true name of Rome? Apparently yes, and it had to never be revealed, lest Rome’s enemies learn it and gain spiritual power over the city. The execution must have worked, because scholars today still don’t know what Rome’s secret true name was. Irresponsible speculation includes Maia (via astronomical correspondence), Amor (via wordplay), Valentia (via multilingual pun), and Hirpa (via a long chain of scholarly/historical speculation).
Hispanic

Hispanic is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 01, 2024 and May 01, 2024. The archive places it in contexts such as "the new race 'Hispanic', adding in all of South and Central America". It most often appears alongside #MeToo, #StopAAPIHate, #StopAAPIHate.

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Hispanic
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May 01, 2024
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May 01, 2024
May 01, 2024 · Original source
They combined Mexican-Americans, Cuban-Americans, and Puerto Ricans - previously three different groups that had been viewed as “white lite” along the same lines as Italians - into the new race “Hispanic”, adding in all of South and Central America for good measure. Then, under pressure from black activists who were worried that some blacks would reclassify as Hispanics and they’d lose constituents, they declared Hispanics to be an “ethnicity” that you could have along with a different race. So a white Spaniard from Spain and a white Spaniard from Mexico got treated as different ethnicities, but a white Spaniard from Mexico and a Mayan from Mexico got the same ethnicity.
The point about “Hispanics” is better taken, and you can read more about the case here. But since 1964, when Mexican-Americans, Cuban-Americans, and Puerto Ricans were the three equally-sized and equally-interesting groups, the Hispanic community has become dominated by Mexican (and Central American) immigrants, who do form a pretty natural grouping. People are just as happy to talk about Latinos (and Latinx) as Hispanics. I’m not sure we can attribute this one to the government either.
Hanania’s strongest point here, more suggested at than asserted, is that maybe civil rights law prevented Hispanics from assimilating into “white” the same way Italians and Irish did before them. Hanania claims that Mexican-American activists originally demanded to be classified as white, then turned 180 degrees after affirmative action proponents promised them better jobs for being non-white. This seems like one of the bigger what-ifs of American racial history, although people say that maybe Hispanics are assimilating somewhat anyway - the much-remarked upon rise in Hispanic white supremacists seems like a weird yet promising sign here.
histone modification

histone modification is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 12, 2025 and September 12, 2025. The archive places it in contexts such as "it has long been clear to neurobiologists that DNA methylation and histone modification play an important role". It most often appears alongside A Change of Heart, Abraham, Adams.

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histone modification
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September 12, 2025
September 12, 2025 · Original source
Consequently, the most decisive experiments have yet to be carried out. Looking at the history of research on nuclear mechanisms of memory is instructive because it has long been clear to neurobiologists that DNA methylation and histone modification play an important role. However, the prevailing view has been that these mechanisms support long-term storage at synapses, mainly by controlling gene transcription necessary for the production of plasticity-related proteins (Zovkic et al., 2013). The notion that these nuclear mechanisms might themselves be storage sites effectively became invisible, despite many early suggestions, because such a notion was incompatible with the associative-synaptic conceptualization. It was not the case that a non-associative hypothesis was considered and then rejected; it was never considered at all, presumably because no one could imagine what that would look like. This story testifies to the power of theory, even when implicit, to determine how we interpret experimental data and ultimately what experiments we do (Gershman, 2021).
historically black colleges and universities

historically black colleges and universities is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 07, 2024 and May 07, 2024. The archive places it in contexts such as "Georgia (and Atlanta specifically) has eight popular historically black colleges and universities". It most often appears alongside affirmative action, Africa, African National Congress.

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May 07, 2024
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May 07, 2024
May 07, 2024 · Original source
Therefore it should not be surprising that Emory, Georgia Tech, and Georgia State University all have lower percentages of black students than Atlanta (~47%), Georgia (~31%), or the USA (~14%), given that Georgia (and Atlanta specifically) has eight popular historically black colleges and universities (more, depending on how you count them).
History Supreme

History Supreme is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 06, 2023 and July 06, 2023. The archive places it in contexts such as "History Supreme, sometimes listed as the world’s most expensive superyacht, probably doesn’t exist". It most often appears alongside 2017 NYT article on UFOs, @ActualNames1, AARO.

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History Supreme
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July 06, 2023
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July 06, 2023
July 06, 2023 · Original source
32: History Supreme, sometimes listed as the world’s most expensive superyacht, probably doesn’t exist. I think this hoax is especially funny if you imagine Sheikh Bin Zayed Al Nahyan, who paid $600 million for the actual most expensive superyacht, constantly having to see himself listed as #2.
Hitler Slingshot Manuever

Hitler Slingshot Manuever is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 02, 2023 and November 02, 2023. The archive places it in contexts such as "This put him in position to try the Hitler Slingshot Manuever". It most often appears alongside America, American conservatives, Belarus.

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November 02, 2023
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November 02, 2023
November 02, 2023 · Original source
By the 1990s, Chavez - by all accounts personable and charismatic - had risen through the ranks and made friends with other leading officers. In 1992, when the government that had crushed the recent riots seemed poised to get away with it, Chavez organized a coup (rumor was army leadership was aware, expected him to fail, and let him do it because for complicated reasons it would help them score political points). The coup failed. Chavez surrendered. But the countercoup forces made a fatal mistake. They put Chavez on TV to tell his remaining forces to stand down. He did. But while on TV, he was unrepentant and charismatic and gave a fiery speech. This put him in position to try the Hitler Slingshot Manuever: fail at a coup, get pardoned, and leverage your post-coup fame to seek legitimate election.
Hitler Youth

Hitler Youth is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 14, 2023 and July 14, 2023. The archive places it in contexts such as "Do you know where you could get a pure socialization education in the 20th century West, Egan asks? The Hitler Youth!". It most often appears alongside !Kung San, aboriginal people on the west coast of Canada, Adam Smith.

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Hitler Youth
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July 14, 2023
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July 14, 2023
July 14, 2023 · Original source
Kieran Egan laughs at your educational reforms Okay, of those three jobs, which should we give to schools? You probably have your favorite — I certainly did! But Egan wants you to know they’re all crap. None of them, by themselves, can give us the kinds of schools we want. Q: I kind of like Rousseau! What’s the problem with pure development? Like I said before, my bookshelves overflow with authors who want to knock down Rousseau (and the people who followed in his wake — John Dewey in particular). Egan will have none of it: before the developmental approach, many schools were terrible places where children were beaten for getting math problems wrong. “Rousseau and Dewey,” he writes, “have enriched our conception of education in important ways. We will not make educational progress by trying to cut away their contribution”. But, he continues, there’s no way a purely developmental approach could possibly work! Rousseau imagined human nature to be selfless and kind; this ideal state could only survive if it was kept away from the evils of society — the titular child in his book Emile was kept away from human society, unable even to read, until age twelve. Of course, schools don’t go this far — they can’t — but I can attest from personal experience that even fairly serious attempts to raise children in an accepting community of peers often crash and burn when faced with actual human nature. Kids reared in the most developmentally appropriate schools can be nasty, bored, and lazy at about the same rate as their mainstream peers. Q: In my heart, I’m an academicist. What’s the problem with it? I think Egan was an academicist in his heart, too. His book drips with classical references — so much so that it can make some sections difficult to read. But, he points out, those purely-academic schools really were hellscapes. And their brutality wasn’t something that was just tacked on, it flowed from their understanding of knowledge: enlightenment will come when the right information enters a child’s head, regardless of how it gets in there (or whether the child wants it in there). And again, Egan feels obliged to point out that we’ve tried this approach for thousands of years, and it hasn’t worked. In fact, Plato’s original vision so obviously doesn’t work that people hawking academic schools have modified their pitch: no longer is the goal for students to understand the Truth, but to cultivate inquiring, skeptical minds who are perpetually dissatisfied with old answers. Can we imagine taxpayers paying for this? Q: Fine, fine. I’m not a fan of socialization, but I’ll ask the question — what’s wrong with it? The funny thing is that of the three, this is the only one that has shown its ability to work for a long stretch of time! (As John Calvin pointed out, as animals, we’re pretty pathetic. Socialization allowed our ancestors to become something more than individuals so that they could survive; we owe this job our gratitude. That said, it would be impossible for schooling today to seek only to socialize. That would require that members of a society share values, and fundamentally agree that their society is good. It also requires that a society not be changing, so the values and skills that are taught to children today will be the ones that will be useful to them in thirty years. Obviously, modern Western society is none of those things. Pure socialization might work for the Amish, or for Catholic trad communities, but not for us. And, frankly, we should feel okay about this. (Do you know where you could get a pure socialization education in the 20th century West, Egan asks? The Hitler Youth!) There really are good reasons to be wary of any education that decrees that its society is uniformly good. Which combination is best? Okay, you say, it’s clear that none of these jobs is good on its own — the solution (obviously!) is to smoosh them together. If we do that wisely, the good parts of each will make up for the deficiencies of the others. This sounds eminently reasonable — but Egan would like to have a word with you. Q: What’s the problem in combining socialization with academics? Wouldn’t this be a beautiful combination? Socialization would cohere the school together, and then they could leverage those good feelings to, say, read Aristotle. I’ve seen this work in schools (like conservative Christian academies) founded on a set of specific beliefs. But when intellectual diversity enters in, it becomes harder. You, perhaps, say that socialization could unite people around their differences — schools could support a society made up entirely of critics! Yes, a society of critics would be interesting, and so would a herd of cats: neither works in practice. Imagine students reading their Ibram X. Kendi books in the morning, then pledging allegiance to the American flag after lunch. Q: What’s the problem in combining academics with development? Again, this seems like a beautiful vision: we can invite children into discovering the big ideas. Alas, it crashes into the reef of reality quite quickly: what do we do when kids don’t want to learn about the big ideas? This combination works wonderfully for kids who naturally want to be academics, but — and this is a crucial point that geeky education types too often sweep under the rug — lots of kids don’t naturally want to be academics. Okay, you say, ignore the “liberatory” element of the developmentalist program, and focus on the “uncovering the nature of the individual child” part: academics can tell us what the students should be learning, and development can tell us how they should learn it. Egan has a thought experiment for you. Imagine that you get the funding to fully pursue this combined goal — you set up a hundred different types of schools in the nearest big city. There’s a specific school for every possible permutation of learner — a school for big-picture kinesthetic learners who score as INFJ on the Myers–Briggs, a school for detail-oriented auditory learners who score ENFP, a school for marine-biology-loving hyperactive learners who lost their personality test results… you get the idea. You build the schools, you work out the bus schedule, and then, on the first day, all the students learn exactly the same content. Because that’s what it means for a school to be an academy — it teaches “the best that’s been thought or said”. Q: What’s the problem in combining development with socialization? What’s wrong with telling kids to become their authentic selves, even as you squeeze them into the roles most beneficial to society? Imagine two rural schools merging together, due to declining local population. Now imagine that one of them is a hippie free school, and the other is a military academy. (That’s a reality TV show I’d watch.) It’s possible, I suppose, to imagine this working for kids who naturally want to be, say, plumbers, or paleontologists, or presidents — and who happen to go to a school that prepares its students to fill that one role. But the odds of matching students to schools just perfectly seems small. But enough thought experiments — we can state this in a visual form: behold, the SAD triangle. It’s bright around the edges, but muddled where they mix: One of the things I love about Egan is that he looks at educational ideas historically. (Most histories of education start around the turn of the 20th century; I remember being excited when I found one that began in the 1600s. Egan begins in prehistory.) And what we’re reminded of, when we see these historically, is that these jobs were meant to supplant each other. Put together, they sabotage each other. What are we asking of schools? Of the three possible jobs, which are we asking mainstream schools to perform? Egan answers: all three. To confirm this, stretch your memory back to your student days, and see if you can put some of the most basic elements in any of these three categories. We’re so immersed in these that they seem obvious, “natural” aspects of schooling, but of course they’re nothing of the sort. Did you spend your time with other children of the same age? Was your work graded according to a standard? Were you forced to play team sports, or to pledge your allegiance to your nation-state? All of these, Egan says, bear the fingerprints of the goal of socialization. Progressive reformers in in the 1960s saw these as the markings of a dark conspiracy, but socialization has more warm-feely aspects: counselors to help students cope with the strains of modern society, field trips to the local fire station and historical monuments, and everything “practical” — life skills, sex ed, emotional regulation, and so on. Did you learn anything that wasn’t obviously useful? Did you read Hamlet, say, or master the Pythagorean theorem, or learn that the planets orbit the Sun (and not the other way around)? That’s the fingerprints of the academic goal. Finally, did you hear teachers show concern about “age-appropriate” content, or see signs that your school valued individualized learning? Does it seem right to you that learning should be “active” rather than “passive”, or that it’s better for someone to discover something than to be told it? Did your kindergarten have tiny, child-sized chairs? All these, Egan says, are the fruit of developmentalism. The first time I read the book, I wondered at all this. What Egan was saying was indeed lining up with my memories. But perhaps, I thought, he was playing loose with the categories; I was still skeptical that schools really were trying to balance all three goals. So I decided to check his idea from a different perspective and look up the mission statements of school districts I was familiar with. Here’s the one from the town I currently live in: “Skills” and “become involved members of a global community” seem to connote socialization, “challenge” and “knowledge” seem to connote academics, and “empower” and “reach their full potential” seem to connote development. But I wasn’t sure if I was just seeing faces in clouds, so I looked up the mission statement for my hometown: “Succeeding” seems like socialization, “learning” seems like a nod to academics, and “growing” seems like code for development. But again, I was worried that I engaging in motivated reasoning, so I looked up the largest district I’ve lived in, a city of about a million people: Wow. That seems pretty clear. So, to sum up: Egan says that there are three potential jobs we can give to schools. Alone, each of these jobs is terrible; together, they’re worse. And what we’ve done is given schools all three jobs. A sad triangle, indeed. What about alternative schools? I was curious to see whether this “sad triangle” could help us understand other philosophies of education, and why they work (or don’t). Where would, say, unschooling, and classical education, and vocational ed, and Montessori go? The first three seem obvious. Radical unschooling is in the upper-right, classical schools (with its focus on feeding kids “the best that’s been thought or said”) is in the upper-left, and vocational ed is in the bottom corner. What can that tell us? Intriguingly, each of those approaches can claim to have done some impressive stuff. I’ve worked with radical unschoolers, and while their skills have often been lopsided (not learning math is an acknowledged issue in the community), they’ve all at least exhibited a zeal for learning the topics they’ve been interested in. (Video games, frequently.) And I remember a massive study in the early 2000s that asked which kinds of schools actually improved student test scores controlling for the effects of socioeconomics. What it found was that only two types of schools stood out: Catholic schools that were operated by a religious order (e.g. the Jesuits — not local parish schools), and vocational schools. Q: Oh, that’s terrible evidence. One of those was just personal anecdotes! And what about selection effects? And what about…? I wouldn’t disagree — and, as Freddie deBoer points out, most educational research is bunk. I’ll take this to be only weak confirmation of Egan’s theory that combining jobs undercuts education. Are we hosed? If Egan’s critique is correct, we’re in a bad situation. Educational radicals yell from their dark corners to abandon the middle and come join them; a century of educational reforms have amounted to little more than wobbling around, first in one direction, then another. At the moment, the conversation about schools in the United States, at least, seems to have hit an all-time pessimistic blech. Freddie deBoer speaks for a lot of people when he says “Even the most optimistic reading of the research literature suggests that almost nothing moves the needle in academic outcomes. Almost nothing we try works.” I’m not quite that pessimistic — the word “almost” is doing some work, there. There are some reforms that seem to work at the margin: raising teacher pay, making it easier to become a teacher, reducing air pollution, free school lunches, and more. Actually applying what the science of reading has been telling us for a few decades seems a big one. And perhaps you have your own pet reform proposal. Sure — add it to the heap! What Egan suggests, though, is that so long as we’re bopping around this triangle of jobs, we won’t be able to get the schools that we want. The dream There’s a moment at the end of my favorite Bollywood movie that’s become stuck in my head. The protagonists have made the arduous journey to a beachside rural school. In the sun outside, flocks of children are experimenting with art and playing with inventions; inside, the walls are covered with books and the tables are covered with models. The kids are learning joyously and deeply. In the real world, such places do exist — they’re just exclusive, pulling their students from among the families who are already the most gifted and curious. They don’t make kids this way; they scoop up the kids who are already this way. But in the movie, we’re supposed to believe these are normal children — normal, except they’ve been transformed by a school. Egan’s wild idea is that it’s possible to make schools like this. He thought that we didn’t have to wait for the communists to make people equal or for the transhumanists to make people smarter. All he thought it required was giving schools a different job — not socialization or academics or development, but something that brings pieces of them together in a new way. But in order to understand that job, we have to come to a cleaner, bigger, and truer understanding of what “education” is. The road ahead: a special Q-and-A Q: This is the proverbial thousand-dollar-bill-lying-on-the-sidewalk: if this is possible, someone should have done it now. Is Egan going to give sufficient evidence for me to believe this? Maybe! I’ll address this in a special section at the end, after sketching out what his theory looks like. Q: If his theory is even plausibly true, then why haven’t I heard of Egan before? His books can be hard to read — he was an intellectual’s intellectual; he had difficulty writing a page without a reference to William Wordsworth, Friedrich Nietzsche, Sigmund Freud, Ludwig Wittgenstein, Claude Levi-Strauss, Richard Rorty, Noam Chomsky, or Steven Pinker. And his paradigm is wonky and multidimensional; he rejiggers common categories, and tells you everything all at once. But worst of all, when his paradigm is stated plainly, it sounds stupid. Q: Oh! What… is his paradigm? I’m going to jigsaw his book, and hold back his big idea for its own section. First, I’m going to list out some simple observations of students at different ages, and imagine what schooling could look like, if it were built on these principles. (First I’ll do this for elementary school, then middle school, then high school.) Then I’ll explain how his theory ties all of this together… by clarifying our definition of what education actually is. Q: I’m not from America; could you be clear on what you mean by those divisions of schooling? Egan’s framework has three main stages, but they don’t divide neatly into “elementary, middle, and high school”. (The precise age ranges he talks about, if you’re interested, are 2–8, 8–15, and 15 and older.) Regardless, I’m going to use those terms — he sometimes did — because it gives me something specific to imagine. Don’t sweat ‘em. Part 2: A new kind of elementary school What’s the matter with elementary schools? Egan suggests that Plato and Rousseau, for all their differences, might have the same reaction if they visited a modern elementary school: they’d call it “trivial”. I’ll admit, here, that I have tremendously fond memories of my elementary school years — committed teachers, good friends, and interesting activities. But I suspect my memory has edited out the most typical work I did. Either that, or elementary schools have taken a drastic plunge in quality from the 1980s. My wife and I homeschool now, but before the pandemic, we sent our kids to our local public school, and whenever we volunteered in the classroom, we were horrified. They spent their days practicing reading on shallow texts, or half-mindlessly practicing basic arithmetic. Occasionally they’d bring us home a sign of learning about something from the real world — usually something as intellectually and emotionally compelling as the importance of tooth brushing. And at parent–teacher conferences every year, we’d be sat down on tiny chairs and informed that, while our children were quite bright, they were struggling to pay attention in class. No sh**, I wanted to reply. The school seemed hermetically sealed; almost nothing that felt meaningful from the outside world could get in. Though they might agree about little else, Egan thinks that Plato and Rousseau would look at the dull worksheets and insipid “hands-on activities” and call modern elementary schools trivial. He agrees, and thinks that fixing this is the first step to building a new kind of school. Why so trivial? Ironically, Egan thinks it's all the fault of Plato and Rousseau. Hidden in the ways that both the academicists and developmentalist think about education is an assumption: that children’s reasoning is basically the same as adult reasoning, but lesser. Q: This isn’t some romantic, children-are-the-real geniuses theory, is it? Egan actually does think that there’s an intensity to how children perceive the world that we lose — but no, it’s not. He’s building on mainstream cognitive science — just aspects of it that are currently more-or-less ignored in school. The upshot, though, is that he thinks that educational researchers (be they of academic or developmentalist persuasions) see kids as smaller, stupider versions of adults. Q: But that’s the opposite of what my local developmentalist school says! It was the opposite of what the developmentalist school that I worked at said, too. But at teacher meetings, I’d frequently hear people ask what was “developmentally appropriate” for a child. I’ll grant that there are perfectly reasonable times to ask this: “Honey, is it developmentally appropriate for our 10-year-old to watch ‘Cocaine Bear’?” is just one of many examples. But “is it developmentally appropriate for our class to learn about world religions?” or “is it developmentally appropriate for our school library to have a book mentioning homosexuality?” probably aren’t some of them. (The latter example was not one that I heard at my progressivist school, but Egan points out that this sort of language is often used by conservative activists.) This notion of “developmentally appropriate” took on a scientific sheen with the work of Jean Piaget, the famous Swiss psychologist. Before age 12, he “proved”, children aren’t able to form hypotheses, draw conclusions, or think abstractly. This, his followers thought, should transform schools — and so they did! To math, they added in “manipulatives” — physical cubes and rods and such — to help students see math. To the history curriculum, they — well, they ended it. Why waste time, they asked, lecturing students about history that they couldn’t possibly understand? In its place they put the “expanding horizons” model of social studies. One version goes as follows: In kindergarten, students learn about themselves In first grade, they learn about their families In second grade, they learn about their neighborhood In third grade, they learn about their city In fourth grade, they learn about their state In fifth grade, they learn about their nation In sixth grade they learn about the world We can admit that there’s an elegance to this model. (I can picture how clever the theorist who first came up with it must have felt!) The downstream effects of it, however, seem horrible. Doesn’t keeping kids ignorant of the rest of the world seem provincial? Doesn’t reinforcing their self-centeredness seem infantilizing? Perhaps we could stomach it if it was founded on some unshakable findings of child psychology — but does it really strike you as likely that kids are incapable of understanding anything that happened long ago or far away? How, Egan asks, can we explain the $50 billion success of a movie franchise aimed at children that literally begins “A long time ago, in a galaxy far, far away?” Q: Because… Jedis aren’t history? The point is, kids obviously have the mental abilities to understand — and in fact care a lot about — things far outside their own experience, and we’ve built elementary schools on a long-dominant model of educational psychology that swears they can’t. This is actually a great example of a general principle. Let’s call it “the Star Wars test”: can our model make sense of the most obvious facts of students? When we find that the answer is “no”, we should at least consider radically revising what we’re doing in school. What are elementary schoolers good at? (or: kids are smarter than students) Someone — I can’t now find who — once observed that children seem to lose IQ points the moment they step into a classroom. Egan agrees, and suggests that we think of ourselves as primatologists to kids, Jane Goodalls who investigate children “out in the wild” to see the sorts of things they gravitate to, and do fairly well at. If we do this, what do we see? Kids tell jokes, for one. They get mental images stuck in their heads, for another. They engage in role-playing, get lost in reverie, and beat out rhythms when they’re bored. They make ample use of metaphors, tell stories, and insist on seeing the world in terms of abstract binaries (e.g. stupid/smart, cowardice/courage, slavery/freedom, and so on). These, Egan holds, are the cognitive strengths that children use to understand the world. They’re the things that kids are often about as good at as adults — or much better than. They’re going to be the tools Egan wants us to use to rebuild the entire elementary curriculum, and in fact he spends most of his second chapter geeking out about how we might define these, how they operate in the mind, where they first pop up in history and anthropology, and even how they might have developed in our evolutionary past. I’m going to skip all of that, and get to the curriculum. From trivial to rich: the trick What could an intellectually rich elementary school curriculum look like, if we built it on kids’ cognitive strengths? He gives us one suggestion to help us do this: ask where each discipline came from in the first place. What was math before it was math, for example — or science before it was science? Q: How on Earth could that help? That’ll become clear later, when we finally uncover what Egan thinks “education” actually is, and see what job he wants us to give schools. For now, take it as a tantalizing hint… or, y’know, just ignore it. Elementary literature & language What was literature before it was literature? Before people invented writing, they had rich oral traditions: they told simple stories, recited poems, and shared proverbs. Egan suggests that these bits of oral tradition should form the backbone of the elementary literature curriculum. Q: What sorts of stories? As many as we can, and from as many diverse cultures as possible! Folktales are wonderful, as are myths. Think the Aboriginal story of “The Rainbow Serpent”, episodes from the Sumerian “Epic of Gilgamesh”, the Egyptian story of Osiris & Isis, the Greek story of Orpheus & Eurydice, the Chinese Legend of the White Snake, the Japanese Tale of Amaterasu and Susanoo, the Ashanti tales of Anansi, the Aztec myth of Quetzalcoatl, the English legend of King Arthur, the Maori myth of Maui and the Sun, the Roman story of Romulus and Remus, selections from the Indian Mahabharata, the Anglo-Saxon epic of Beowulf, the Inca legend of the Sun and Moon, the Iroquois Myth of the Flying Head (a real thing! look it up!), and the Ojibwe story of Turtle Island. Q: That was a lot of examples. Are you going to keep giving so many? I’ve got a [mumble mumble mumble] to get to. Sorry about that. Sometimes, though, I feel that a limitation of reading Educated Mind is that, in trying to keep his book to a manageable size, Egan skimped on examples in some places that it matters. It’s easy to read his occasional example and assume he intends that it hold some central place in the curriculum — when all he wants to do is display how rich and diverse the curriculum could be. (Also: good God, I didn’t even include an example from Norse mythology!) So from now on, just assume that every category could be filled with oodles of examples. Q: What sorts of poems? Lots of poems, first of all. We shouldn’t steer toward “fancy” poems — rather, we should find poems that appeal to kids immediately — think Shel Silverstein, Mother Goose, Dr. Seuss, Jack Prelutsky, Edward Lear, or Ogden Nash… that sort of thing. In a biting essay, Egan suggests these poets like these appeal to kids precisely because they leverage kids’ cognitive strengths: “we should find, and encourage saying and singing and shouting aloud verse with strong narrative forms, thumping rhymes and rhythms, the most vivid images, fun with metaphors, and a rollicking story.” Q: Why proverbs? Proverbs stick in your mind almost effortlessly. (“All’s fair in love and war!” “When in Rome, do as the Romans do!” “You can’t judge a book by its cover!”) They’re also useful; they capture general truths. Kids can apply them to all sorts of situations, but also discuss them — to what extent are they wise or foolish? (I remember my surprise when I realized that they couldn’t all be true — because you can’t follow “look before you leap” and “he who hesitates is lost” at the same time! I’m embarrassed to say that I think I only realized this when I was in college.) Elementary science What was science before it was science? Egan suggests: being immersed in the natural world. We might, he writes, encourage elementary students to “adopt” some feature of the natural world — a patch of grass, a cat, a branch, a stream — and simply observe it at length. To do this, we can use the cognitive strength of reverie. Q: Oh, do you mean like kids sometimes do in science class nowadays — describe a thing to a partner, make notes, draw it, and label its parts? No, the exact opposite! That’s all about squeezing the experience into words and forms that we understand. What we want “is less an attempt to know about nature as to know it in some participatory way, to know it as something we are an intimate part of, not set off from”. Q: That sounds a little… “woo” to me. It did to me, too… until I remembered my childhood climbing tree. I didn’t much like to go outside as a child, but I had this one tree that I’d climb up and read for hours and hours. If I close my eyes I can bring to mind the precise texture of its bark, the roughness of its broken-off branches, the coolness of its leaves, the always-surprising solidness of its trunk… I’m bigger now, but I think if I were back in my parent’s yard, I could still navigate its limbs with my eyes closed. I have, at this point in my life, read a fair number of books about trees, but I’d be surprised if all of them together more than equaled the amount I learned from that tree — my tree. Elementary math What was math before it was math? Egan suggests: counting and logic. We might, then, use rhythms, metaphors, stories, and jokes to help kids become fond of these. Q: Counting is pretty… basic. Could it really be improved? Beware of “the curse of knowledge”: Steven Pinker’s phrase for forgetting that something was once difficult! Egan suggests we should spend time helping kids count wonderfully. We can start early with counting rhymes. (“One, two, buckle my shoe! Three, four, out the door! Five, six…”) But we can also help kids use their fingers as metaphors. There are some pretty cool ways of using your hands as an abacus — and did you know that you can count up to 1,023 using just your fingers on both hands, and a knowledge of binary? Q: Logic — I’m intrigued! Aristotelian, or Boolean? Neither, for the time being — Piaget was presumably onto something when he found that young children couldn’t reason abstractly, but he was looking at logic in a vacuum. When we put logic into the context of stories, we find that kids can deal with logic just fine. There’s an entire worldwide network of educators, in fact, called Philosophy for Children, who have written whole books about how to do this, and Egan loves it all. Sometimes they read stories and ask simple questions: “What is friendship?” or “What does it mean to be brave?” They also pose ethical questions: “Is it ever right to spill a secret?” And they pose paradoxes: “Can you step in the same river twice?” Q: You mentioned “jokes” a moment ago. Care to elaborate? Egan thinks that, to help kids get good at math, you should tell kids jokes. Q: That’s… new. I think so, too — but he backs it up pretty well. To be funny, jokes (or at least most kid jokes) rely on a leap in logic: Why can’t you trust an atom? They make up everything. Knock-knock. Who’s there? Boo. Boo-hoo? Don’t cry, it’s just a joke! To understand the joke, kids have to follow the logic — spotting patterns, making connections, and tracking what their audience expects a word to mean. That’s a lot of cognitive lifting. And Egan goes further, suggesting that we grit our teeth and create methods to help kids invent their own jokes, no matter how horrible they’ll be at first. (The things we do for learning…) Q: Wait wait wait! What about addition facts, and multiplication tables, and fractions? Egan emphasizes that his methods are designed to be add-ons to the standard math curriculum. In general, he’s a don’t-blow-up-the-system sort of guy, and if something seems especially weird, you should probably assume it’s an add-on to the regular curriculum rather than a replacement, even if I forget to say so. Elementary arts What was art before it was art? Egan suggests we pop our heads into Paleolithic caves for our inspiration. Whatever the specific meaning of all those charcoal elk and aurochs and mammoths (communication with the spirit world? art for art’s sake? a way to impress babes?), Egan thinks it obvious that they were also an attempt to capture an intense experience that would be difficult to express in words alone. What did it feel like to be near an aurochs, or a saber-toothed tiger? “The arts help us,” Egan writes, “to hear and see afresh, to force our perceptions and sensations to experience again the immediacy and vividness of the world”. If we follow this, then, we don’t want to help kids build “art skills” so they can draw like an adult — rather, we want to help them amass a repository of diverse aesthetic feelings that they’ll want to express. We should provide them with a riot of experiences. Q: That couldn’t be more opaque. Examples, please! Egan writes that we should have children learn to whistle, sing, and click their tongue; we should help them emulate the ways a skunk or a hawk or a stick bug might move through a space. We should expose them to scores of different temperatures and materials. In music, we should help them love Beethoven, yes, but also the Beatles; Tchaikovsky, yes, but also Tuvan throat singers, and also John Cage, whale song, and bird song. Q: That’s a lot of experiences, but what would they be doing? An interesting aspect of Egan’s view of education is that he doesn’t seem to think we should push kids right to the “doing” phase. He wants to help kids cultivate an affective relationship with the world. In any case, he writes that as students get more experienced, we should prompt them to move from merely enjoying these experiences to trying to systematically shape similar experiences. And drawing, painting, and playing music could easily be folded into other parts of the curriculum. Elementary social studies What was social studies before it was social studies? Well. Remember how, just a moment ago, I wrote that you could assume that you should probably assume that Kieran isn’t in favor of junking the curriculum as it currently stands? He suggests we very carefully pick up the elementary social studies curriculum, place it into a trash can, and set the whole mess on fire. He isn’t worried about much of importance being lost. (Remember that the “expanding horizons” model is, to him, the original sin of 20th century educational reform, and he repeatedly quotes student surveys showing that “social studies” regularly wins the title of “most boring subject”.) In its place, he suggests we put history — which, he hints, we should think of as the centerpiece of the elementary curriculum. So the real question is what was history before it was history? His answer, surprisingly, is myth. Q: Egan wants us to teach myths as if they were history? Not at all. What he suggests, though, is that we look at how myths operate as narratives — so we can design an intellectually vivid history curriculum. And myths really are special: each is built on at least one binary (like weak vs. strong, or lies vs. truth, or so on), and uses that to tell the story of the big picture of the world. They’re so powerful that people can understand it, remember it, and love it — even if that thing never happened. We should take that power, Egan says, and apply it to things that really did happen. Q: So what history does he think kids should learn in elementary school? The great struggles of humanity from across the whole. Flippin’. World. We’re still talking about young children, so these should be done as simple stories. The goal isn’t to make them history PhD’s, so we needn’t even try to put them in any sort of order. Egan suggests that, in first grade, we pick a single binary like “freedom against oppression” and tell kids a welter of stories, again from as many cultures as possible, and as many times in history as possible. Q: Can you give examples? Oh, all right — in first grade we can tell kids the stories of the war of the Greek city-states against the Persian empire, and the slave uprising of Spartacus against the Romans. We can tell them about the plight of Jews in medieval Europe, and of the unsuccessful Sepoy Rebellion in India against the British. We can tell the stories of the American, French, and Haitian Revolutions, and about the Chinese Taiping Rebellion against the Qing Dynasty. We can tell them the story of the escaped slave Harriet Tubman returning to the South to rescue her kinsmen, the story of six-year-old Ruby Bridges facing threats to integrate her elementary school, and the story of how the Mau-Mau uprising led to modern-day Kenya. We can tell the stories of Mexican-American union organizer Cesar Chavez and of Malala Yousafzai surviving an assassination attempt to advocate for female literacy. The world does not lack for stories of oppression and liberation that can capture the attention of a six-year-old. Q: That’s… huh. What stories might they hear in second and third grade? Egan gives examples, but I won’t list them here. He suggests we use a similar approach for each, except that we swap out the binary each year. He thinks “the struggle for security against danger” would work well for year two, and “the struggle for knowledge against ignorance” would work well for year three. (That year could have a lot of overlap with the science curriculum.) Q: Anything else, for history? Yes — they should get a sense of Big History. They should get some simple stories about the ice age, the Cenozoic, the age of dinosaurs, the Paleozoic, the origins of our solar system, and the Big Bang. (Because if the ancient Norse can tell their story of the beginning of the universe, by gum, we can tell ours, too.) To sum up Egan argues that the problem of early schooling is that it’s trivial — and it’s trivial because the dominant theories of educational psychology see children as lesser versions of adults. What else would we teach them, except dumbed-down versions of what adults learn? But children have certain cognitive strengths that schools aren’t making systematic use of. If we rebuild elementary schools on those strengths, we could turn schooling upside down. We could stop seeing the curriculum as a bag of information to impart, and start seeing it as a set of great stories to tell — and invite kids into. Kids could experience (both intellectually and emotionally) the great struggles of humanity and see that they can join in them. Students could experience the story of education as the beginning of a very real adventure. Egan’s elementary school: some skeptical questions Q: I’m not sure I’m understanding what you mean by “mental images”. Care to explain? It’s an interesting fact of human cognition that just a few words can whip up a complex mental experience. Egan doesn’t just mean what we might call “visual imagery” — the ability to hold, say, the image of a bespectacled, spat-wearing duck in your mind without seeing a photograph. He’s also including what psychologists call auditory imagery, olfactory imagery, gustatory imagery, and tactile imagery. Q: How could all of that be helpful in schools? Humanity has a built-in VR system, and we’re not using it! Egan invites us to pretend we’re teaching a class about the humble earthworm. We might list off facts — “earthworms are so many centimeters long, move through soil by means of their something-or-other muscles…” but he suggests we can evoke images, say, “of what it would be like to slither and push through the soil, hesitantly exploring in one direction then another, looking for easier passages, contracting and expanding our sequence of muscles segment by segment, and sensing moisture, scents, grubs, or whatever”. Those facts are now felt by the student; the knowledge has become part of them. And just a few words can spark a complex mental experience, one going beyond literal images to include imagined sounds, smells, tastes, and more. These experiences can feel real and stick with us. (That these mental images are so easy to evoke, and so meaningfully felt, feels something like the proverbial hundred dollar bill on the ground.) Q: How could metaphors be helpful? It really is interesting that so much of the “constructivist” turn in psychology — that is, the notion that children don’t absorb knowledge, but construct it — has continued to focus on logics-mathematical reasoning, when there’s been mounting evidence for decades that metaphors are more central. It’s not just that we use metaphors to better understand things we already know, we also use them to grasp new knowledge. What’s more, psychologists have devised tests to measure the skill at metaphor-making, and have given them to people of different ages. What they found was that eleven-year-olds make more metaphors (and higher quality metaphors) than do undergraduates — and that four-year-olds have both groups beat. Again, hundred dollar bills on the sidewalk. Q: Your talk of “binaries” has me worried — binaries like good/evil and male/female are the source of so many of our most pernicious stereotypes! Isn’t the purpose of education to get us beyond stuff like this? Yes, it is! Education is supposed to complicate our understanding — but that means we’ve gotta start somewhere, and binaries provide us a natural starting place. As an uncontroversial example, think about temperature. We all begin as babies by perceiving two temperatures — hot and cold. Later, we add on intermediate categories — warm and cool. (Note that the human body is the assumed mid-point to temperature. Binaries often work like this; “big” and “small” mean “bigger or smaller than me”, “nasty” and “kind” mean “nastier or kinder than I am, except when my brother is really asking for it”, and so on.) A good story (and an Egan-inspired elementary curriculum is, in a sense, nothing but good stories) will go further, and transform the binary. Toy Story is grounded in the binary of abandonment/belonging: at the beginning, the toy cowboy Woody belongs to his owner, and has his affection. Then a rival comes who threatens his belonging. In trying to get back to belonging, Woody is entirely lost — and to save the day, he has to come to a deeper understanding of what belonging means. Now, all lessons can’t be Pixar movies. But the good stories (especially in literature and history) will challenge and subvert the binaries they begin with. Q: I see the pattern of Egan drawing from “as many cultures as possible”. Why so many? Is this a political correctness thing? If it helps to think of it as such, then, sure! I don’t think Egan would have had a problem with that. But his ultimate reason for including so much diversity goes deeper. For Egan, including such world-wide diversity isn’t optional, and the answer to why is bound up in his definition of education. (Keep reading.) His answer also insists that we, whenever possible, also include stories from the Bible and Homeric epics (the Iliad and Odyssey). Q: Mmm, stories from the Bible aren’t going to fly in my local school! So be it! Egan doesn’t spend much time obsessing over the practicalities of… His interest is in describing what an ideal education might look like, if it were possible. Every lesson, every classroom, and every school is necessarily a compromise. Q: You make a big deal of poems. But isn’t poetry dead? An interesting contrast can be made to classical education, which also has kids read a lot of poems — they see knowing great poems as one of the marks of an educated person; again, for an academicist, it’s the information that transforms. Egan begs to disagree. Poems are important because they’re a wonderful way to train their cognitive strengths, like rhythm (poems are language fueling by thumping). We want to help kids learn to use this tool better, and a great way to do that is to help them recite poems that they’ve learned by heart. Q: “Learn by heart” — is that code for “memorize”?! It is! Egan is actually quite big on memorization — he points out that all the knowledge in the world can do nothing for a person once they’ve forgotten it. He didn’t, however, appreciate the academicist focus on memorizing without understanding (or at least enjoyment). Q: I’m still worried about the science curriculum, as you’re describing it. Can you allay my fears? Honestly, while I feel there’s something profoundly right to how Egan is describing early experiences of nature, I feel the same way. Note that there’s more science coming in the social studies curriculum. But if that’s still not enough, one could bring down aspects of the middle school science stage. Q: Anything else that Egan suggests we do in elementary school literature and language? He suggests that we help kids learn a second language! This is so obviously true (why do American schools typically wait until kids lose the ability to naturally absorb languages to start teaching languages?) he doesn’t belabor it, though. Q: You had mentioned that Egan’s vision seems more internal-focused. Should we be worried about that? While I strongly suspect that his curriculum would make kids more creative in any way you’d like to measure it, Egan wasn’t particularly interested in “creativity” — he was more about helping kids find the world interesting. I get the sense that he thinks kids will do things with minimal prompting once they’re loaded up with complex internal experiences. Q: I think I’m beginning to understand Egan — is he basically saying “make learning fun”? “Fun”, applied to education, is a dangerous word. Egan worries about the dangers of an emotionally unserious curriculum producing emotionally stunted adults. That doesn’t mean we need to tell students only “serious” stories — only that we treat the world honestly. “Disney-esque sentimentality is the exact emotional equivalent to intellectual contempt”. Q: But aren't some of these stories too dark for children who have themselves experienced oppression and disaster? Egan argues that these stories may be especially helpful to them — they can help them understand their struggles better, and give voice to them. Q: At the very start of this, you promised us “rationality”… but I’m not seeing rationality here! All this talk of “adventure” almost seems to go the opposite direction. What gives? Wait for it. But for a hint right now — Egan is fond of citing his fellow educational theorist Jerome Bruner, who claimed “any subject can be taught effectively in some intellectually honest form to any child at any stage of development”. Bruner was criticized for that; his critics charged that he was ignoring learning differences and socio-economic realities. Egan thinks he was profoundly right. Part 3: A new kind of middle school What’s the matter with middle school? What was middle school like for you? In math, I recall a jumble of barely-related topics. In literature, I remember reading great literature — Frankenstein, Romeo and Juliet — only in their dumbed-down summary formats. In social studies, I remember teachers proclaiming on the first day of class that unlike all of our previous history classes, this class wouldn’t be about names and dates… and then going on to memorize names and dates. And in science, I remember being forced to dissect a frog only to discover that frogs are — you guessed it — made of slimy frog parts. Your mileage may vary, but for a lot of us, middle school feels like getting booted out of the (in retrospect) Eden of elementary school, and like marking time before the serious studying of high school. It feels meaningless. In my favorite of his books, Egan calls so much middle school curricula “human deserts”, noting “we have created a system in which the importance of human emotions for meaning seems barely noticed”. Why so meaningless? If our dominant approaches to educational psychology fundamentally misinterpret younger children, Egan suggests, they basically throw up their hands when faced with pre-teens and teenagers. Mainstream schools begin to introduce vocational training to help lighten the load, and Maria Montessori famously suggests that adolescents should be sent to go run a farm. Egan is sympathetic to those responses, but points out that they don’t do much to lighten the load that the academic curriculum often becomes at this age. This feeling of meaninglessness, he argues, is utterly tragic — it comes just when a hunger for meaning blossoms in adolescents! We can see that hunger for meaning in their lives outside the classroom, where their interests ramp up into veritable obsessions. What are adolescents obsessed with? What might we see, if we become Jane Goodalls of early adolescence? First, teens are obsessed with gossip. The motivations of others — why did he do that? and what was he THINKING? — are hypothesized and talked to death. Second, that they’re pulled toward idealism. Many feel a dissatisfaction with the world as it is, and feel a romantic urge to make it a better place. They’re often lured into simplistic beliefs that promise to help them do that. Third, they love extremes: they want to find limits, and test them. Obviously, this can show up as risky behavior, but we can also see it in their love for the bizarre — note adolescents’ fascination in things like aliens, cryptids, and ghosts. (Egan loves pointing out that The Guinness Book of World Records is a perennial bestseller among kids at this age. How else would they find out who had the world’s longest fingernails?) Fourth, they gravitate toward heroes — people who push the edges of those limits. By celebrating heroes, they can vicariously share in their transcendence. Look for the posts hanging up in a teenager’s bedroom to guess what boundaries they feel most hemmed in by: athletes push against physical limits; a death metal guitarist might push against authority and conventional morality. An activist or entrepreneur might push against our dulled morality or our sense of what’s possible. Finally, we might spot teens taking up hobbies and making collections. Hobbies can be a way to identify yourself as part of a group against the rest of the world (“I’m the sort of person who goes bird-watching!”), and collections can be a way to climb the status ladder inside the community. Egan points out that a collection can also be a way to feel like you have control over what you’re discovering is a very big and complex world of detailed information (“I’ve spotted every one of the fifty most common birds of Texas — even the black-capped vireo!”) Egan’s insight is that these obsessions give teenagers a sense of meaning, and that we can use them as tools to make middle schools that overflow with meaning. From meaningless to meaning-soaked Again, Egan sketches out a new kind of curriculum subject-by-subject. Before, his trick was to ask where the subject first evolved out of; now, it’s to ask who first discovered or created the specific content we’re teaching. “All knowledge”, he writes, “is human knowledge. Everything we know is knowable through the lives of its inventors, discoverers, or users, and we can have access to that knowledge through the hopes, fears, or intentions that drove them”. Middle school math Who first discovered the concepts students learn in math? The answer, of course, is a wide diversity of curious men and women living across the world over the last few thousand years. Egan says: bring those people into how we teach math. If we used gossip and heroes to help students find it meaningful, what kind of math would result? When we teach the Pythagorean theorem, we should give a sense of who Pythagoras was — a cult-founder who worshiped numbers to find God, whose followers (according to a piece of ancient gossip) murdered one of their members who discovered irrational numbers! Q: Well, sure, that works for Pythagoras, but he’s a known nut job; surely most math doesn’t come from such interesting roots? When we teach the Cartesian coordinate system, students should meet Rene Descartes, the Calvinist French polymath who saw the possibility that math could decipher the world, if only we could unite algebra and geometry… and invented the xy-plane to do exactly that. When we teach scientific notation, we should call our students’ attention to the importance of the number zero, and tell them the story of the Pope who tried to introduce Arabic numerals to Christian Europe and may have been assassinated because of it. When we teach algebra, we should ask students why “algebra” is Arabic for “the fixing of bones”, and tell the story of what Muhammad ibn Musa al-Khwarizmi was up to. We could do this all day. Literally everything students learn in school was first invented or discovered by some interesting person who was struggling to accomplish something hard. To learn is to connect with those people, whether we know it or not. Egan says: help kids know it. Math has been dehumanized: re-humanize it. Q: So the math curriculum needs to become a history of math curriculum, and math teachers need to become history teachers? No, the content needn’t change. But with surprisingly little work, we can bring in the gossipy stories of heroes, and their obsessions can spread to students. Middle school science Who first discovered the things students learn about in science? If you’re thinking “scientists”, you’re only partially right. Most of the big-picture ideas that we now think of as “science” were discovered before the word “scientist” was invented, or the discipline was professionalized. Frequently, they were hatched by true amateurs, working in their free time, hungry to unlock the secrets of nature. We can use gossip and heroes to spread their obsessions to students just as we taught math, but Egan points out two twists. The first is that the content itself can take on heroic qualities: everything is impressive, when you look at it in a certain light. In an interview, Egan once said: “My book is an attempt to show that, indeed, everything in the world is wonderful, but that schools are designed almost to disguise this slightly shameful fact. We represent the world to children as mostly known and rather dull. The opposite is the case: we are surrounded by mystery, and what we know is fascinating”. What would even the most boring subjects look like, if we emphasized their heroic qualities? Well: What’s a tooth? Bone, wrapped in rock, surrounding tiny cells that your body feeds with blood. What’s a bar of chocolate? A crystal of jellyfish-shaped fat molecules stacked together; when you put it in your mouth you shake them apart into a writhing confusion. What’s the air around you? The bottom of a 10-mile-deep ocean; when you put your tongue over a soda straw and your Pepsi stops leaking out, it’s not because a “vacuum” is “sucking” it up, but because that ocean is squeezing it into your face. Again, we could do this all day! And in middle school science, we can. Everything in the world is wonderful; we can help students see this again and again. The second twist is that science is a subject rich in extremes. Here Egan introduces a concept that we’ll see crop up again: “15-minute segments”. To help us fit as much wonder as possible into a school day, he suggests we supplement the usual school subjects with a few quick lessons. To infuse science with extremes, he suggests we add on three: “human & natural records”, “extremes of animals & plants”, and “cosmology”. Middle school history Who first made the things students learn about in history? Why, the historical characters themselves! Since we’ve given kids a grounding in history in elementary school, now we can build on that, going through many of the same events as before, but in more depth, and more vividly. We’ll leverage the interest with other people’s inner lives to tell stories focusing on the perspectives of the people who made history — zooming in, when possible, on scandalous details. We’ll leverage the tool of idealism to choose historical characters who chafed against their surroundings, and understand what they were trying to accomplish. What was their vision of the world? What did they hope for, and what did they fear? Q: Isn’t the “great man” approach to history out of fashion? Egan’s approach doesn’t say that “great men” made history — it’s just leveraging gossip to help kids see history as something meaningful that can expand their own possibilities. “Early adolescence is commonly a time of intense and vivid emotional life, and also a time of deepest boredom and depression… [We] can give shape to the intermediate curriculum and offer the students a world that is rich, complex, varied, and as intense and vivid as their own emotional lives”. We also should add on another “15-minute segment” just to pump in as many biographies as possible, and from people who don’t always fit into the normal history curriculum. Call it “Brief Lives”, and throw in anyone who’s struggled to push some limit — Mary Wollstonecraft, Jesse Owen, Dietrich Bonhoeffer, one of the students’ great-aunts, whoever. As students get older, this can transition to “People and Their Ideas”. Here, we’d focus less on the details of the person’s life, and use it as a backdrop to showing how meaningful some of history’s most important ideas could be. Think Aristotle and syllogisms, Edward Said and orientalism, Confucius and propriety, Cornel West and race, Buddha on the four noble truths, Muhammad and the five pillars, Karl Marx and communism, Adam Smith and the invisible hand, Thomas Hobbes and the state of nature, John Locke and natural rights, Jeremy Bentham and utilitarianism, Thomas Aquinas on the sacraments, Martin Luther on faith, Voltaire on the freedom of speech… you get the idea. Q: Can you really get a profound understanding of utilitarianism in 15 minutes? Yes! The point of this segment isn’t to develop a systematic understanding of any one idea, it’s to introduce students to the exciting possibilities of human thought. (As a bonus, this might make them less likely to fall for the first ideology that they encounter later in life.) Diversity is important for this — as it is with culture. Throughout this, we should also be trying to expose students to as much cultural diversity as possible, because in high school, we’ll be trying to make sense of our society, and it’s impossible to do that unless we have something to compare it against. Middle school literature & language You might think that this subject would be easy — that middle school literature is already filled with “strong and clear narratives”, that it deals with “transcendent human qualities such as courage, love, and persistence”, that it focuses on “extremes of human experience”, that it examines “something strange and exotic”. You’d be right! Egan’s pretty happy with a bog-standard middle school literature curriculum, done well. In this part of the book, his spends most of his limited space suggesting three rather odd activities which could also be useful — especially for increasing students’ awareness of language, so they can use it better. The first is etymology — not, however, memorizing lists of roots, but in being told the entertaining backstories of specific words. Take the word “berserk”, for example — we now use it to mean something relatively mild (“if my mom catches me coming home late, she’ll go berserk”), but it comes from an old Norse word meaning “a raging warrior of superhuman strength”. And that’s because ber meant “bear” and serk meant “shirt”: soldiers of the bear cult would don the skin of a bear to, in their minds, transform into one — howling, foaming at the mouth, and gnawing the rims of their shields. (Most adults walk through life with little understanding that the words falling out of their mouths are entities, with their own back-stories. Communication is, at the very least, more interesting when we become aware of this.) The second is to add on another language to learn — not, this time, to become fluent in it, but just to become aware of how very different human languages can be. (For native English speakers, Sanskrit might work well, or Cantonese, or perhaps even ancient Egyptian. Again, the point isn’t for this language to be useful — it’s to explore diversity.) The final one is to study humor — not just jokes anymore, but comedy at its finest. Egan cites (at length!) Monty Python as a group of people who were particularly brilliant in their use of the English language. Examining their skits can lead us into not just an appreciation of semantics (the study of how meaning is made from smaller pieces, like etymology) but also pragmatics (the study of how meaning is made in social situations). Pretty heady stuff, for a conversation about a dead parrot. Part 4: A new kind of high school I’ll confess — I loved parts of high school… and among nerdy folks, I suspect I’m not alone. For some of us, this was a golden time. Even at my local public high school, I had access to academically thrilling classes — especially, in my last two years, advanced literature and history. I felt like I was finally understanding the ideas that mattered. In any case, Egan is quick to acknowledge that, at this level, the sort of education he advocates really is being practiced in some places. What he can add is an understanding of what makes it wonderful, how to make it even more wonderful, and how to make it wonderful for many, many more people. What’s the matter with high school? Far too often, even when high school classes are intellectual, they’re dry. For the majority of students, all this academic stuff is experienced as utterly lifeless, a mass of dead information to be squeezed inside one’s head for a test and then left to evaporate. Egan mocks the curriculum wars that seem to be a permanent feature of the teaching life; quoting the sociologist Pierre Bourdieu, he says “while the academic left and right bicker over whether the curriculum is too traditional or too radical, they fail to recognize that most students absorb so little of academic culture that the bickering is largely irrelevant”. Why so dry? Egan suggests three reasons to explain this. First, because high school academic classes are too often masses of small details with no sign of the big picture. Second, because they’re typically slavishly disciplinary, and aren’t able to address the questions that span the disciplines. Third, because they’re often designed to bring students through what everyone is sure of, and hide away any controversies. In all of these, Egan suggests that what’s called “academics” in high school is too often a dim imitation of what real academics are actually practicing. There’s a fourth reason, though, and it’s probably the biggest of all — by the time they get to high school, most students haven’t actually learned that much! An academic approach is designed to connect small details into the big picture; for people who arrive in high school (and college) classes without having already collected much in their heads, academics are going to taste dry. (An implication of this for anyone trying to improve schools is that we might not want to start with high schools. If your goal is to create a new kind of academic learning, first start at elementary school — or barring that, middle school.) What motivates mad scientists? When we wanted to re-conceive the elementary and middle school curriculums, we looked at what students were already good at — kids’ cognitive strengths and adolescents’ obsessions. For this level it might be easier to look — for reasons that will become clear when we finally unveil Egan’s crazy-sounding definition of education — at the sorts of things that bring intellectuals joy. Q: Which intellectuals? Take your pick. Galileo, Einstein, Smith, Marx, Goodall, Chomsky, Curie… all the people who took to the life of the mind like fish to water. But that’s a lot to hold in my mind at once, so I’m just going to think about Doc Brown from Back to the Future: He was high on intellectualism I’ve never been there, but the brochure looks nice Let’s call these people “mad scientists”. And let’s pretend we once again took up our job of being primatologists, and snooped on these folks “in the wild” (“in the lab”? this is beginning to get recursive…)… what would we find motivating them? Asking simple questions, for one. (What is space? What is society? What is a human? What is language?) Building general schemes (big theories) that hold lots of evidence together. Finding their place in the cosmos. And (perhaps above all) seeking certainty. Once again, Egan suggests we use these as tools to remake the curriculum. From dry to daring What could a high school curriculum look like, if it were rebuilt on these tools? Once again, Egan has a trick. This time, it’s to ask what fights have driven the development of each of these fields forward — and how we can help students enter them. First, a mini-segment! Intellectuals invented the academic disciplines to better pursue the life of the mind, but the disciplines can get in the way. Some of the most important intellectual discoveries that could help students are too big to fit into any of the disciplines. We need a place to introduce them plainly. Egan proposes another mini-segment — again, just 15 minutes a day, a few times a week — called “Metaknowledge”. Q: Isn’t that already in the International Baccalaureate program? Yes, he acknowledges that he’s borrowing from that! This segment would introduce ideas that would enrich student thinking across the disciplines: game theory, cognitive biases, systems thinking, Bayesian reasoning, epistemology, ethics, logic, cultural evolution, and so on. High school literature How can we help students enter the big fights of literature? Intellectuals of a literary bent — professors, critics, poets, novelists — delight in arguing over literature like rabbis arguing over the Talmud. Take, just for one example, the debates over Shakespeare’s character of Ophelia. Does she love Hamlet, or is she a victim of his emotional abuse? Is she truly insane, or is she acting? Is she passive, or is she pulling the strings? Oceans of ink have been spilled arguing over questions like these; our students can, perhaps, spill a few ounces more. The usefulness of arguing literature, for Egan, isn’t that it’s oh-so important for educated adults to know a lot about Ophelia. (This, again, was where the academicists went wrong — in thinking that being educated was about getting the best knowledge in your head.) Rather, arguing over literature is a training arena for the all-important intellectual move of this kind of understanding: building general schemes out of evidence, and struggling with anomalies. One person, for example, might hold that Ophelia is insane, and cite all sorts of obvious evidence — her father just was murdered by her lover, she rants nonsense while (bizarrely) handing out flowers to friends… But then he’s challenged when he reads a scholar pointing out that, to people in Elizabethan England, types of flowers have symbolic meanings. How does he deal with that? He could ignore it, claiming it an over-reading of Shakespeare. (Sometimes a flower is just a flower!) Or he could address it, complicating his own scheme. This intellectual work is best done with other people, who are incentivized to challenge your understanding of something, and go back and forth, building competing models and calling attention to anomalies. This process — the “dialectic” — pops up again and again in the academic disciplines. It’s the center of how understanding works, at this stage. And the nice thing about practicing it on literature is that, more so than in history or science, the evidence is shared knowledge — it’s right in front of everyone, written out. But there are other ways literature class can be helpful to the general life of the mind. Egan also suggests that we’ll want to specially include literature that helps students understand complex ideas. Camus, Orwell, Borges, Calvino might be particularly helpful here… and I imagine that genres like science fiction and magical realism might be particularly useful, too. (Note, though, that once again none of this requires a radical remaking of the curriculum, or of the canon of texts that we traditionally assign to high schoolers.) Q: Oh yes, the canon — what does Egan have to say about the canon wars? When he wrote Educated Mind in the nineties, the long-brewing canon war was approaching its inevitable apocalyptic climax. On one side of this Plain of Megiddo were the pro-canon traditionalists, arguing that we should keep assigning the texts that had been argued over for centuries. Facing them were the anti-canon reformers, arguing the standard texts over-represented the perspective of dead white men. Onto the middle of the plain rides Egan on a white horse, who bellows above the din: “I’VE GOT A BUSLOAD OF HIGH SCHOOLERS WHO WANTS TO JOIN IN, EVERYONE OKAY WITH THAT?” To do so, he says, we need to give students the arguments from both sides. So, for example, bell hooks, Edward Said, and China Achebe should be on the syllabus, as should Allan Bloom, Mortimer Adler, and Diane Ravitch. And of course they should actually read the texts cherished by both sides, too, so they can argue better. High school history How could entering the big fights help us reinvent high school history? First, we might look for dueling histories. It’s time for students to get into historiography and understand that history isn’t just what happened, it’s something we make. We might help kids read chapters from Howard Zinn’s socialist history of America alongside the corresponding chapters from Paul Johnson’s conservative history of America. How could big questions help? We want to help students see how various people have disagreed over some of the big questions of what human history is, at its most basic. We can have them compare Steven Pinker’s theory of civilization’s progress (Better Angels of our Nature) with Yuvah Noah Harari’s theory of civilization’s woes (Sapiens). We could have them compare so-and-so’s account of human history as an ever-expanding unlatching of energy sources with Robert Wright’s account of human history as unlatching more and more positive-sum games (Nonzero). What role could the lure of certainty play? To help them grow their skills at finding anomalies, we might help them work through pseudo-histories and conspiracy theories. Q: Conspiracy theories! Oh, come now, you’re playing with fire. Well, the world is on fire. Our students will spend the rest of their lives encountering terrible-but-beguiling arguments about how the world works; if we don’t prepare them for those, what have we been doing? So we should introduce arguments that the Moon landing was a hoax, that the Illuminati founded America, that aliens built the pyramids, and so on. At no point can we demean students for falling for any of these theories — the job of a teacher at this stage, Egan writes, is to support students in their reasoning even when their beliefs are offensive and stupid, gradually offering anomalies. There’s no way out of bad theories except through them. By the time students graduate, we want them to have wrestled with terrible ideas and — for a while — lost. They need to experience what it’s like to change their minds about something they felt strongly about. They need to viscerally realize, in Feynman’s famous phrase, “The first principle is that you must not fool yourself and you are the easiest person to fool.” High school natural science How could entering the big fights reinvent high school science? At present, so much of the high school science curriculum — especially “honors” classes — is oriented toward helping amass details. (The same is true of 100-level university classes, which famously “survey” the field to prepare for more advanced studies. I always thought this was stupid — of the huge lecture hall of students in my Geology 100 class, how many went on to take even a second course?) The meaty debates that propel science forward are held back. Egan complains: “The more general and speculative theories in any discipline are treated like an unconventional and disreputable relation who, even though the children find her exciting and entertaining, must be kept hidden from view, her very existence denied as long as possible”. This is a stupid approach — students with an adventurous bent are convinced that science isn’t for them. Egan proposes, simply, that we flip this, and organize high school science classes around the big debates. We shouldn’t be ashamed at how, well, adolescent this might look: “the dramatic, speculative, and contentious theories will be up-front in the early years of the [high school] curriculum”. What might those be? Egan doesn’t give a list, but we can spitball some: instead of explaining what “matter” is from the top down, a physics class could problematize “matter” by following the debates over the nature of dark matter and dark energy, and by becoming familiarized with the various interpretations of quantum mechanics
Hitler’s story

Hitler’s story is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 04, 2023 and August 04, 2023. The archive places it in contexts such as "If we want to use Hitler’s story to learn how to stop a slide into authoritarianism"; "lessons of Hitler’s story". It most often appears alongside Academy’s School of Architecture, Adolf, Adolf Hitler.

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Hitler’s story
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August 04, 2023 · Original source
If we want to use Hitler’s story to learn how to stop a slide into authoritarianism, the first thing we have to do is disentangle in our minds Hitler’s Nazi ideology from the elements that let Hitler take over. Swastika-loving internet trolls, however offensive, are not about to usher in a reign of terror. The telltale marks of a threat to liberalism have a lot more to do with organization and resources than they do with beliefs. It’s also worth remembering that different illiberal regimes have come to power in different ways—that’s why it’s worth looking at many different dictator stories so we have a sense of the possibilities. But what we’re considering here is how an authoritarian movement would come to power using Hitler’s playbook specifically. With this in mind, I think Hitler’s story shows us five main characteristics that make a movement dangerous.
These are the things I’ve learned from reading The Rise and Fall of the Third Reich. Some people say that whoever triggers Godwin’s law automatically loses the argument. But I hope that by relying on the lessons of Hitler’s story, we’ll be able to invoke the dreadful name of Hitler responsibly.
HiTOP

HiTOP is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 25, 2023 and January 25, 2023. The archive places it in contexts such as "Here’s a post about HiTOP, a scientifically-grounded taxonomy of mental disorders meant to compete with the DSM"; "I’m not criticizing HiTOP - I like HiTOP -". It most often appears alongside DSM, DSM, DSM-III.

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HiTOP
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January 25, 2023 · Original source
Here’s a post about HiTOP, a scientifically-grounded taxonomy of mental disorders meant to compete with the DSM. It has many good features (see further discussion here about advantages and disadvantages) and deserves more attention. But one claim stood out. The author of the post writes:
A purely biological, apolitical taxonomy of mental disorders seems tempting. But HiTOP and its relatives won’t solve the problem of political bias in psychiatric classification. Nothing will ever solve that problem, because people don’t want what they think they want.
New taxonomies of mental disorders are still useful for other reasons. I’m not criticizing HiTOP - I like HiTOP - and the DSM is still silly for a lot of reasons. This post is not an attack on new taxonomies full stop. It’s just the claims to be able to avoid political bias in what is vs. isn’t a disorder that I find compelling.
Hittite

Hittite is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 03, 2023 and March 03, 2023. The archive places it in contexts such as "The Hittite capital of Hattusa". It most often appears alongside 1700s Great Britain, Acropolis of Athens, Against The Grain.

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Hittite
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March 03, 2023 · Original source
The Hittite capital of Hattusa is almost 1,000m above sea level and would be totally unaffected.
HIV-1

HIV-1 is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 09, 2024 and April 09, 2024. The archive places it in contexts such as "It took 20 years to identify the reservoir for HIV-1's progenitor". It most often appears alongside #S14, 2009 flu pandemic, 2013-16 West African Ebola outbreak.

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HIV-1
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April 09, 2024 · Original source
We've been studying Ebola for over 40 years and have yet to determine the animal reservoir. It took 20 years to identify the reservoir for HIV-1's progenitor. Sometimes finding the reservoir is easy, sometimes it's hard. Typically it is easy when you have lots of cases and the virus is not very efficient at human-to-human transmission, because that necessitates lots of separate zoonotic events, which necessitates lots of infected animals. For something that spreads fast (i.e., the kind of virus likely to start a pandemic), you don't need a big reservoir, so you have a smaller target. For example, we did find the reservoir for the 2009 flu pandemic, but it took 7 years: https://elifesciences.org/articles/16777
AIDS

HIV/AIDS is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 23, 2022 and June 23, 2022. The archive places it in contexts such as "randomized trial of Housing First that found improved health outcomes for patients with HIV/AIDS". It most often appears alongside 1978, 2016 essay, A Resounding Success Or Disastrous Failure: Re-examining The Interpretation Of Evidence On The Portuguese Decriminalisation Of Illicit Drugs.

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AIDS
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June 23, 2022 · Original source
“There is no substantial published evidence as yet to demonstrate that PSH [permanent supportive housing] improves health outcomes or reduces healthcare costs. The one exception is a randomized trial of Housing First that found improved health outcomes for patients with HIV/AIDS.”
…and find that: Those in the intervention group incurred 2.6 fewer hospitalized days (p = .08), 1.2 fewer emergency room visits (p = .04), 7.5 fewer days in residential substance abuse treatment (p = .004), 9.8 fewer nursing home days (p = .08), and 3.8 more outpatient visits each year (p = .01) annually compared with those in the usual care group. Those in the intervention group had 7.7 fewer prison days during the study period (p = .07). Those in the intervention group had 62 more days in stable housing (p = .001) and 12 more days in respite care (p = .002) than those in the usual care group. Those in the intervention group used case management services (i.e., telephone calls and face-to-face meetings) more frequently than those in the usual care group, having on average 18 more encounters per year (p < .001). This study provided case management along with the free housing. I don’t know whether to think of that as a confounder, or a standard aspect of Housing First programs (especially since it is much harder to case manage someone with no fixed address). Notice that it assumes the cost of housing is given as $30/day. I think this is realistic for low-income housing in Chicago, but other California programs I’ve looked at have worked out to more like $70 - $100/day, which (assuming nothing else changed) would switch the conclusion of this study from “Housing First saves money” to “Housing First costs money”. Now let’s see what San Fransicko has to say: The evidence for Housing First turns out to be significantly weaker than its proponents suggest. For example, the much lauded initiative to reduce homelessness among veterans was only four percentage points more successful than the overall decline in homelessness, when accounting for age, which is necessary to accurately estimate what is due to policy and what is due to demographic changes. As for Utah, its legislative auditor general concluded in 2018 that the 91 percent number was wrong, based on a sloppy use of incorrect methodologies. Before 2015, Utah had annualized its homeless count, meaning that researchers counted the homeless at a single point in time and multiplied the data by some factor. But after 2015 the state used raw point-in-time counts, causing a precipitous drop in the official population counts. Over the same period, the state also narrowed its definition of chronic homelessness in several ways, resulting in further apparent reductions. In reality, the homeless population in Utah increased by 12 percent between 2016 and 2020. An experiment with 249 homeless people in San Francisco between 1999 and 2002 found those enrolled in the city’s Housing First program, Direct Access to Housing, used medical services at the same rate as those who were not given housing through the program, suggesting that the Housing First program likely had minimal impact on the participants’ health. Wrote a team of researchers, “obtaining housing does not necessarily resolve other issues that may impede one’s housing success,” pointing to the lack of significant improvements in substance use and psychiatric symptoms over the twelve months that people were housed (the share of patients with severe substance use actually saw a modest increase). The problem with Housing First stems from the fact that it doesn’t require that people address their mental illness and substance abuse, which are often the underlying causes of homelessness. Several studies have found that people in Housing First–type housing showed no improvement in drug use from when they were first housed. In 2018, the National Academies of Sciences, Engineering, and Medicine published a review of the scientific literature of Housing First. “On the basis of currently available research,” the report’s authors wrote, with some surprise, “the committee found no substantial evidence that [permanent supportive housing] contributes to improved health outcomes, notwithstanding the intuitive logic that it should do so and limited data showing that it does do so for persons with HIV/AIDS.” Tsemberis said he was not surprised by the findings of the National Academies. “It’s not like housing creates improved health,” he said. “You have to have a relationship with a nurse. You have to be educated on what your health problems are. You have to have a team that engages you and makes you an active participant in your own health care. I don’t even know if that would stop the number of deaths.” And, at least in the study funded by Benioff and conducted by Margot Kushel, which had those services, it did not. All of this seems to fit with what I found above. But: Housing First may even increase addiction and overdose deaths and make quitting drugs more difficult. Warned a multiauthor review in 2009, “One potential risk [of Housing First’s harm reduction approach] would be worsening the addiction itself, as the federal collaborative initiative preliminary evaluation seemed to suggest.” The authors pointed to an experiment that had to be stopped and reorganized after the homeless individuals in the abstinence group complained of being housed with people in the control group, who didn’t stop their drug and alcohol use. “They claimed that they preferred to return to homelessness rather than live near drug users.” The multiauthor review cited is Housing First For Homeless People With Active Addiction: Are We Overreaching? They write: “It would be premature to conclude that Housing First programs cannot accommodate persons with severe addiction. But it also would be premature to suggest that research data provide clear guidance on whether, or how, Housing First programs can accommodate persons with ongoing severe drug and alcohol abuse. In the absence of research data on this subject, it is reasonable to consider the kinds of risks that may occur in Housing First programs. One potential risk would be worsening the addiction itself, as the federal collaborative initiative preliminary evaluation seemed to suggest (Mares, Greenberg, and Rosenheck 2007), or failing to progress toward addictive recovery.” Elsewhere, they describe this same study as: “The eleven-site federal collaborative initiative found an association between early access to housing and increases in alcohol problems during the subsequent year” The study is here, but I can’t find this result anywhere. It describes its own results (my emphasis) as: The average number of days housed in the previous 90 days increased dramatically from 18 at baseline, to 68 at the 3-month follow-up, and rose steadily thereafter to 83 at the 12 month follow-up (Table 2). Mean monthly public assistance income increased steadily from $316 at baseline to $478 one year later, a 50% increase. Significant improvements of modest magnitude were also observed in overall quality of life, mental health functioning, and reduced psychological distress. Alcohol and drug problems remained largely unchanged over time. Total quarterly health costs declined by 50%, from $6,832 at baseline to $3,376 at 12 months. A 54% decrease in mean inpatient costs ($5,776 to $2,677) accounted for nearly 90% of the overall decrease in quarterly health care costs during clients' first year in the program And the table (slightly edited for readability): I might be misunderstanding this - I can’t imagine why the authors of the review would have gotten this wrong - but it does look to me like alcoholism stayed steady throughout this study. A 24-month followup of what I think is the same study also finds that drug users who were housed used slightly fewer drugs over time, although probably not to any significant degree worth caring about: Continuing from San Fransicko: There is evidence that privacy and solitude created by Housing First make substance abuse worse. A study in Ottawa found that, while the Housing First group kept people in housing longer, the comparison group saw greater reductions in alcohol consumption and problematic drug use, and greater improvements to mental health, after two years. “One reason for the surprising results,” wrote the authors, “may be that aspects of the Housing First intervention, such as the privacy afforded by Housing First and harm reduction approach, might result in slower improvements around substance use and mental health.” Okay, but the next sentence after the one the book quoted was the researchers admitting that oops, we also totally forgot to randomize our groups in any way, so the experimental and control groups had totally different levels of severity and maybe that was why they found this weird thing (this is non-obvious, because we’re looking at change over time rather than raw differences between groups, but the authors discuss some reasons why different groups might change differently over time). A few years later these same researchers did a proper randomized study and it found no difference in drug use between the two groups. Somers, Moniruzzaman and Palepu found no difference in drug use between Housing First and other subjects. Padgett et al found the Housing First group actually did better, although they are another victim of the epidemic of randomization failures in this space. Kirst et al, no difference in drug use, but Housing First better with alcohol. Milby found that housing contigent on abstinence worked better than housing not contigent on abstinence, which Shellenberger could have used to support his thesis, but even Milby found that housing not contingent on abstinence worked better than no housing! To summarize: I can find seven studies on this topic, only one of them agrees with San Fransicko’s thesis, and the authors admit that it’s weak. I accuse San Fransicko of citing only that one and pretending all the others don’t exist. (actually, I accuse it of doing that plus citing a line from a review claiming another study found this, but as far as I can tell that study did not actually find it) This is extra annoying, because all the popular news articles on Housing First gush about how it definitely decreases substance use and everything else bad. Shellenberger could have made the excellent point that all of these progressive journalists were totally wrong! This would have been an interesting, important, and completely true act of virtuous data journalism! Instead he tries to hold up a lonely negative result as representative, and ends up just as wrong but in the opposite direction. Continuing in San Fransicko: Researchers have found ways to use housing to reduce addiction. Between 1990 and 2006, researchers in Birmingham, Alabama, conducted clinical trials of abstinence-contingent housing with 644 homeless people with crack cocaine addictions. Two-thirds of participants remained abstinent after six months, a very high rate of abstinence, compared to other treatment programs. Other studies found that around 40 percent of homeless in abstinence-contingent housing maintained their abstinence, housing, and jobs. In a randomized controlled trial, homeless people were given furnished apartments and allowed to keep them unless they failed a drug test, at which point they were sent to stay in a shelter. Sixty-five percent of participants completed the program. Three similar randomized controlled trials also found moderate to high rates of completion. And participants in abstinence-contingent housing had better housing and employment outcomes than participants assigned housing for whom abstinence was not required. All of this seems basically true. It turns out that over longer periods of time, Housing First may not even outperform contingency in terms of keeping people housed. In the spring of 2021, a team of Harvard medical experts published the results of a fourteen-year-long study of chronic homeless placed into permanent supportive housing in Boston. Most studies of permanent supportive housing, including the Kushel study conducted in Santa Clara, only study the newly housed homeless for a span of around two years. The study found that 86 percent of the homeless, who were referred based on length of time living on the streets, suffered from “trimorbidity”—a combination of medical illness, mental illness, and substance abuse. The authors found that after ten years, just 12 percent of the homeless remained housed. During the study period, 45 percent died. The authors concluded that, because the chronically homeless had such higher rates of physical and mental illness, “the supportive services, essential to the PSH model, may not have been sufficient to address the needs of this unsheltered population.” This study was done on an especially severe subgroup of homeless people. There was no control group, so Shellenberger shouldn’t claim we have any evidence about whether Housing First can “outperform contingency”. Shellenberger counts people who died as “unhoused” to get his 12% number; if he didn’t do this, the number would be 23%. Only 23% of people given housing retained after ten years sounds bad. But you could change this number to whatever number you wanted by changing the severity of the subgroup selected for the study. Select people who are even crazier and more disturbed than these people, and you can have 0% retained after ten years; select high-functioning people with no problems, and you can get 100% retained after ten years. (or maybe not - the study doesn’t say why people left the program. It mentions that one possible outcome is having to go to a nursing home because they had grown too sick or old to support themselves. I am not sure that “23% stay in this program” means “77% are back on the street and all their care has been a total failure”.) Conclusion: Housing First seems to work in getting people housing. It probably also helps people use fewer medical services, and it might or might not save money compared to not doing it (probably more likely when treating very severe cases, less likely in areas with high housing costs). It probably doesn’t affect people’s overall health or drug use status very much. San Fransicko is right to call out all the people promoting it beyond what the evidence supports, but then goes on to attack it beyond what the evidence supports. Interlude: Why Can’t We Just House All The Homeless? This is the question many of the California gubernatorial candidates asked. California has lots of money. There aren’t that many homeless people. Everyone is already committed to Housing First. So why don’t they have houses already? San Francisco has about 7,000 homeless people. The median SF apartment costs about $3,000 per month (presumably the government officials in charge would be trying to buy cheaper-than-median apartments for this project, but they seem bad at that, so let’s stick with median as a high-end estimate). So that’s $250 million/year to rent every homeless person an apartment. San Francisco has a $14 billion budget, although some of that is locked in nondiscretionary programs. So this effort would take about 2-3% of the city budget. Given how many people have both altruistic and selfish objections to the current level of SF homelessness, I can’t imagine that isn’t a better use of the money than whatever it’s being spent on now. So why hasn’t this happened? The closest thing I can find to the “rent apartments” plan is Governor Newsom’s “rent hotel rooms” plan, Project Roomkey. This was a short-term pandemic program. This article says it cost $4,000 per month, which seems reasonable - it provided residents with a hotel room, meals, security, and “custodial services” for just above a hundred dollars a day. So how come nobody has made it permanent or scaled it up? The homeless themselves don’t seem very positive on the project. They talk about “jail”-like conditions, including curfews and bans on visitors. I don’t know if this is the usual nanny-state-ism, or an attempt to reassure hotel owners / other residents / local communities that the influx of homeless people won’t cause them problems. If the latter, it hasn’t worked. From here: Jenna Abbott, executive director of the River District Business Association, said having a Roomkey motel in her neighborhood has been difficult. The site — which is in an area with large number of unhoused people — has drawn family and friends of Roomkey residents who haven’t been housed but “camp close to that hotel,” some with the goal of gaining a room, Abbott said. That’s led to more loitering, public drunkenness and trash outside the restaurants, gas stations and other businesses in the area, she added. And here’s another article about people objecting to local hotels accepting homeless people, which focuses on some combination of zoning, code, and public safety concerns. Everybody - the homeless, their advocates, various experts - interviewed in the article - agrees that the hotel rooms are kind of dehumanizing and much worse than having real housing. And this article suggests that government budgeters believe it’s not cost-effective compared to alternatives. Since the homeless don’t like it, and it’s expensive, almost everyone seems to agree it made sense as a short-term COVID measure only. The government’s preferred medium-term solution is single resident occupancy (SRO) hotels. These are big apartment/hotel-like structures where everyone has a small bedroom and then there are communal bathrooms and maybe kitchens. These used to be the archetypal living situation for poor Americans (Matt Yglesias talks about them as “boarding houses” here). But moral reformers banned them in the 1900s on the grounds that they were slums - I think this is the usual “surely the reason poor people live bad lives is because capitalists oppress them by selling them cheap low-quality goods, and if we just ban selling people cheap low-quality goods, everyone will have high-quality goods and poor people will live great lives!” argument. Somehow this failed to work and homelessness got worse over this period, but there are still some SRO hotels left, and the government got them and converted them to public housing for homeless people. Shellenberger does not have high opinions of these: The Tenderloin [district of San Francisco]’s single resident occupancy hotels . . . have for decades been dominated by a culture of heavy substance use and prostitution. “Of the people in supportive housing in San Francisco, 93 percent have a major mental illness that we can name,” said a housing policy maker. “That is very, very high. Eighty percent use cocaine, speed, or heroin every thirty days, or get drunk to the point of unconsciousness.” Tom Wolf, a former Salvation Army caseworker and a member of San Francisco’s Drug Dealing Taskforce, says the city’s supportive housing facilities are themselves a major market for illegal drugs. “Go down the street to the Camelot Hotel on Turk Street,” said Wolf. “Almost everyone that I’ve seen in those hotels are using. The last front desk guy that was working there got busted because he was selling crack. The actual guy that works in the single resident occupancy hotel is selling crack! It’s insane, man.” In any case, there are only so many of these still left. The government often announces plans to buy defunct regular hotels and convert them into these structures, which would indeed be a medium-term solution for housing the homeless, except that they usually get bogged down in fights about code. Politico discusses one of these attempts in New York City (h/t Marginal Revolution): “There are very few hotels that physically could be converted and comply with the requirements of today’s zoning and building code without substantial, expansive reconstruction, partial removal or demolition,” said James Colgate, a land use partner at Bryan Cave Leighton Paisner LLP who has advised clients on zoning issues including the conversions of hotels. “That would increase the costs greatly.” For example, a building’s elevators, doorways, or rooms may be slightly short of the size required for a residential structure. Residential buildings are also required to have a certain amount of rear-yard space that a hotel may not have. “You would literally have to be chopping off part of the building,” Rosen said. …The legislation dictates that each unit include a kitchen or kitchenette with a full-sized refrigerator, cooktop and sink — something Rosen said made utilizing the program “simply too expensive.” “This is the classic case of the perfect being the enemy of the possible,” said Mark Ginsberg, a partner at the firm Curtis + Ginsberg Architects, which has worked on hotel conversions. Some advocates who pushed the creation of the program say those provisions were necessary to ensure it didn’t generate substandard housing […] “We didn’t want a program that cut corners to make it more palatable to developers,” said Joseph Loonam, housing campaign coordinator for the progressive advocacy group VOCAL-NY. “We wanted a program that centered the needs of homeless New Yorkers, which is true high quality affordable housing where they can have full autonomy and dignity.” As Marginal Revolution pointed out, Loonam got what he wanted; the expensive, over-regulated program was unpalatable to developers, with only one company putting in an offer; for whatever reason, NYC refused to go with that one company, and no housing was produced. But fine, these are also terrible, and they’re only medium-term solutions anyway. What about building real, long-term apartments for homeless people? Shellenberger tells the story of Los Angeles’ Proposition HHH, which raised $1.2 billion to do exactly this. They hoped to build ~10,000 units for the homeless, at a projected price of $140,000 each; since LA had about 30,000 homeless people at the time, this would solve a third of the problem - a good start. (how do these numbers line up with my back-of-the-envelope calculation for SF above? I talked about renting rather than building, but usually annual rents = 1/20th or so of total prices, so I was estimating about $700,000 per person. This is probably partly because SF costs more than LA, and partly because I was imagining median apartments whereas LA is probably working on very cheap apartments) But in fact, five years later, LA has completed only 700 units, and the cost per unit has spiralled to $531,000 each. Nobody has a good explanation for what happened, with Shellenberger quoting one local service provider who said a lot of it was “bullshit costs”. Now might be a good time to re-read Considerations On Cost Disease. [Update: this might not be accurate - see this comment] This seems to be a general problem: everyone is committed to Housing First and to long-term good solutions rather than short- or medium- term mediocre ones. But that means building housing. And some combination of NIMBYism and over-regulation means building housing is somewhere between ruiniously expensive and impossible. Claim 4: Shelters Are Unpopular Among Progressive Activists And The Homeless Themselves San Francisco doesn’t have more homelessness than eg New York, but almost all the homeless in New York live in shelters and stay off the street. Why doesn’t that work here? Shellenberger: In the context of cities with permissive attitudes toward drugs, like San Francisco, many homeless people stay in [tent] encampments to use illegal substances more freely and easily than they can in the shelters. Many policy makers understand this. “I went out with a team twice to have conversations with people to get an understanding of what they’re dealing with,” said Mayor Breed in 2020. “It was absolutely insane. Most of the people did not take us up on the offer [of shelter and services].” Even people who would prefer to live in sober environments say they do not want to quit their addictions. “When we surveyed people in supportive housing in New York,” said University of Pennsylvania homelessness researcher Dennis Culhane, “almost everybody wanted their neighbors to be clean and sober but they didn’t want rules for themselves about being clean.” In 2016, after the city of San Francisco broke up a massive, 350-person homeless encampment, dozens of the homeless refused the city’s offers of help. Of the 150 people moved during a single month of homeless encampment cleanups in 2018, just eight people accepted the city’s offer of shelter. In 2004, just 131 people went into permanent supportive housing after 4,950 contacts made by then-mayor Newsom’s homeless outreach teams. An article by a former homeless person explains the problems with shelters beyond just “can’t use drugs”. Residents are crammed into a small space with 300 other homeless people. Lice and bedbugs are everywhere. Everybody catches every disease. Everybody has stories about getting raped or beaten up. Invasive moralizing about drugs somehow exists side by side with rampant drug use. Shelters are gender segregated, which means straight people can’t stay with their partner. Most shelters ban children and nobody has any idea what to do with them. Most shelters ban pets - a lot of homeless people have dogs for protection or companionship, and you can’t just store them somewhere while you’re sheltering. Although some lucky people can get 90-day beds, other people need to apply for beds on a day-by-day basis, which requires waiting in line several hours every day. Users talk about rampant cutting in line, denying cutting in line, false accusations of cutting in line, etc. Most shelters kick people out between 9-5, either to save on staffing costs or in the hopes that they’ll get a job. But many have strict curfews requiring people to be back by 5 PM sharp, which can make jobs impossible - if your boss doesn’t let you out until 5 and you have a half-hour commute, how do you get back to the shelter on time? Results of a survey at one of SF’s new Navigation Centers at why their clients refused to go to normal shelters. But even the homeless people who do want to go to shelters mostly can’t get in. This app gives the current status of San Francisco’s homeless shelter waitlist. If you applied today, there would be 900 people ahead of you in line for one of the city’s 1500 - 2500 shelter beds. The app says that the median wait time is 826 days. So however many homeless people don’t want to go to shelters, we’re not building enough shelters to serve the ones who do. Why not? Shellenberger again: In the spring of 2021, Friedenbach published an op-ed opposing a proposal considered by the San Francisco Board of Supervisors to create, within eighteen months, sufficient homeless shelters and outdoor “Safe Sleeping Sites” for all of the city’s unsheltered homeless. “One can simply take a look to New York City,” she wrote. “Their department spends about $1.3 billion dollars of its budget on providing shelter for their unhoused population while thousands remain on the street. . . . As a result, New York has a higher rate of homelessness than San Francisco.” Housing First advocate Margot Kushel of the University of California, San Francisco agreed. “The problem with New York—and I spend a lot of time with people working in the system in New York—is that they spend an estimated $30,000 for each person per year to keep them in shelter. That’s not what we want to do. Because if you create the shelter and you don’t create the housing, then people are just in shelter forever.” Housing First advocates oppose shelter in Los Angeles. “Why haven’t we solved homelessness?” asked Housing First creator Sam Tsemberis. “Because [Los Angeles mayor] Eric Garcetti [has] Andy Bales [saying,] ‘You need emergency housing.’ ‘These people need to be cleaned up.’ ‘They need to be sober.’ ‘They need Jesus before they’ll be ready for housing.’ I said, ‘People should be housed and then maybe they’ll get sobriety and Jesus and the rest.’ We’re definitely on polar opposites of the whole thing.” Advocates for the homeless at the national level similarly oppose more shelters. “I don’t agree that we should be building more transitional housing,” said the head of the National Alliance to End Homelessness. […] In other words, the reason that there are so many homeless people on the streets in San Francisco is that both progressive and moderate Democratic elected officials, and the city’s most influential homelessness experts and advocates, have for two decades opposed building sufficient shelters. And that is unlikely to change even after San Francisco starts spending hundreds of millions more per year on the problem and might even get worse. This basically seems true. I found this webpage of a former SF Supervisor candidate a helpful corroborating source. He was running on a platform of “maybe we should build some homeless shelters”. He lost. You can also find a bunch of webpages by the sorts of people Shellenberger is complaining about, for example this site: Sup[ervisor] Rafael Mandelman today pushed his new legislation that would require the city to offer at least temporary shelter to everyone living on the streets, a step that some say would lead to more homeless sweeps and do nothing to create permanently affordable housing . . . [our] Coalition has argued for years that the solution to homelessness is housing—not temporary shelter, which may never lead to housing. The ex-supervisor candidate gives some helpful numbers: permanent housing costs about $600,000 per person housed. Shelters cost between $20,000 and $30,000 per person housed. So SF could build enough shelters to clear its waitlist for about $30 million. More recently, SF has tried a sort of compromise, opening “deluxe” shelters called Navigation Centers which avoid some of the problems of regular shelters. They also cost more than twice as much, and the city has only created about 300 beds. Also, the people in regular shelters are angry, because being in a regular shelter disqualifies you from getting into a (much better) Navigation Center. Some of them are considering leaving their shelter, going back on the streets, then waiting however many months or years it takes to get a Navigation Center bed instead. I’m not at all sure of these numbers, but it looks like of SF’s ~7,000 homeless, about 2,000 are in shelters already, and 1,000 are on the shelter waitlist. I don’t know if the remaining 4,000 have made a specific commitment not to go to shelters, or just have given up on the waitlist process. My conclusion: agree with San Fransicko about the role of progressive activists, but I think it overemphasizes the role of wanting to use drugs in why homeless people themselves sometimes avoid shelters, and underemphasizes the many other problems with them. Claim 5: Drug Decriminalization Isn’t Working California legalized marijuana in 2016. Shellenberger says that San Francisco’s commitment to drugs has gone beyond that: it has effectively decriminalized opioids, cocaine, and the rest. Any attempt to lessen use of these drugs is attacked as “stigmatizing”; instead, government policy centers around providing addicts with needles and other drug paraphernalia under the guise of “harm reduction”. Shellenberger hits all the right beats here. Like many people, he tries to undo the damage done by The New Jim Crow, a book which convinced millions of people that mass incarceration was driven by a racist War On Drugs. In fact, less than a fifth of prisoners are in for drug-related crimes. And when the government was first debating the War on Drugs and mass incarceration, black leaders were among the strongest proponents of both. The talking point at the time - among everyone from black Congressional leaders to black churches - was that the government’s failure to crack down on drug use was racist, borne of them not caring about predominantly black drug victims. And while we’ve been patting ourselves on the back about how enlightened we are for ending the drug war: Drug overdoses are today the number one cause of accidental death in the United States as a result of America’s historic addiction and overdose epidemic. Overdose deaths rose from 17,415 in 2000 to 93,330 in 2020, a 536 percent increase.Significantly more people die of drug overdoses today than of homicide (13,927 in 2019) or car accidents (36,096 in 2019). […] There are about twenty-five thousand injection drug users in San Francisco, a number 50 percent larger than the number of students enrolled in the city’s fifteen public high schools. San Francisco gives away more needles to drug users, six million per year, than New York City, despite having one-tenth the population. The part of this chapter that stood out to me as most worth looking into deeper was the section on Portugal: For decades, harm reduction and decriminalization advocates have pointed to Portugal as a model, noting that it decriminalized drugs and expanded drug treatment. In 2013, Portugal’s drug-induced death rate was sixty-six times less than that of the United States. The number of people in treatment increased by 60 percent between 1998 and 2011, with three-quarters receiving an opioid substitute like methadone or Suboxone, the brand name of buprenorphine. Drug use among 15- to 24-year-olds actually declined after decriminalization. “All drugs have been legalized,” explained Monique Tula, executive director of the Harm Reduction Coalition. “Their focus is on giving people tools, like job apprenticeships, and the means to support themselves.” […] [But Portugal] never legalized drugs. It only decriminalized them, reducing criminal penalties but maintaining prohibition. Drug dealers were still sent to prison even after the 2001 decriminalization. And Portugal does not let people addicted to hard drugs with behavioral disorders off the hook like progressive West Coast cities have done. It’s true that Portugal massively expanded drug treatment, but people are still arrested and fined for possession of heroin, meth, and other hard drugs. And drug users are typically sent to a regionally administered “Commissions for the Dissuasion of Drug Addiction,” composed of a social worker, lawyer, and doctor who encourage, push, and coerce drug treatment. And decriminalization doesn’t end drug violence. “Even if trafficking enforcement decreased, like it did in Portugal,” said criminologist John Pfaff, “illegal drug markets would still be forced to rely on violence to resolve disputes.” Indeed, prostitution and violence are ever-present in the open-air drug scenes in San Francisco, Los Angeles, and Seattle. “We are seeing behaviors from our guests that I’ve never seen in thirty-three years,” said Rev. Andy Bales, who runs the largest homeless shelter on Skid Row in Los Angeles. “They are so bizarre and different that I don’t even feel right describing the behaviors. It’s extreme violence of an extreme sexual nature.” People are not dying from drug overdose deaths in San Francisco because they’re being arrested. They’re dying because they aren’t being arrested. Decriminalization reduces prices by lowering production and distribution costs, which increases use. This was also the case for alcohol consumption. It increased after prohibition ended in the United States. Even in Portugal, drug overdose deaths and overall drug use rose after decriminalization. I was most surprised by the claim that Portuguese overdose deaths rose after decriminalization. Uncharacteristically, San Fransicko doesn’t give a citation for it, but we can try to retrace its reasoning. Decriminalization proponents tend to point to these numbers, helpfully converted to per 100,000 population and graphed here: But an anti-drug Australian think tank argues that the peak in 2001 is made up: Claims that there were more than 75 drug-related deaths in 2001 which more than halved to 34 deaths in 2002 use a figure for 2001 for which there is no substantiation. Official drug-related deaths for Portugal, taken from the latest 2018 EMCDDA Statistical Bulletin are copied below. Notice that there is no such figure recorded for 2001. They include a link to EMCDDA, the EU organization charged with monitoring these things. The link contains two datasets, both of which seem to be measuring the same thing but getting different results. One dataset starts in 2002, the other in 2008. I don’t know what the difference here is, but they’re right that neither includes 2001. If you ignore the pre-2002 data, the graph looks like this: They say “opiate”, but AFAICT these numbers are actually about all drugs. But the proponents link to the updated 2020 version of the same website, which all of a sudden does have data from 2001 and before. I don’t know why EMCDDA can’t make up its mind, but I think the Australians are wrong and the original graph is fine. On the other hand, does it really matter? Both of these show drug deaths decreasing until 2005, then going up and down a bit, then going back up again starting in 2011. I think a reasonable interpretation would be that decriminalization in Portugal did decrease overdose deaths a bit, and then they started rising again from that low baseline around the same time other European countries saw rising overdose deaths. I would also accept “these are pretty small effects and we shouldn’t ascribe any significance to them”. But San Fransicko’s claim - that overdose deaths increased after the reform - seems false. The only way I can see justifying it is taking the second graph - the one that wrongly claims there is no pre-2002 data - and then attributing the fact that twelve years after the reform lowered deaths, deaths finally rose above the pre-reform level to be the fault of the reform. This is like saying “people claim the Black Plague killed a lot of Europeans, but the European population actually rose after the Plague”, which is true in the sense that it was above its pre-Plague max by like 1600 or whatever. What about overall drug use? Here I recommend A Resounding Success Or Disastrous Failure: Re-examining The Interpretation Of Evidence On The Portuguese Decriminalisation Of Illicit Drugs, which is on exactly this topic of how people keep selectively quoting results from Portugal to prove their point. It argues that drug use is inherently hard to measure. There are four different Portuguese datasets for the time at issue, lots of different drugs, lots of different age/gender combinations, and lots of different ways of measuring drugs (did you use drugs in the past month? the past year? your lifetime?) It’s easy to tell a story of how past-month cocaine use skyrocketed among 14-29 year old males according to X source, or how lifetime marijuana use fell in high school-age women according to Y. The main trick that opponents use is measuring lifetime drug use. Portugal is a very conservative country; drug use is pretty new and most of the older generation wasn’t involved. So as time goes on and more and more people try drugs but “un-trying” drugs isn’t a thing, the percent of the population who have tried drugs inevitably goes up. This definitely happened but isn’t a fair reflection of any specific reform. The authors find that in the past decade or so, there has been a bit more short-term experimentation with drugs, but less long-run use. They conclude: As shown in Figure 2, general population (aged 15–64) trends for recent and current drug use in Portugal indicate minimal if any changes between 2001 and 2007. Instead, rates of discontinuation of drug use (the proportion of the population that reported ever having used a drug but opting not to in recent years) increased, which reinforces that just as in the school populations, the growth in lifetime-reported use reflected predominantly short-term experimental use. Increases in recent and current drug use were more notable in some cohorts, particularly those aged 25 to 34 (albeit, with a maximum of 7% of any one cohort reporting recent use, absolute levels remained low). But as shown in Figure 3, recent and current drug use declined among those aged 15–24, the population who were most at risk of initiation and long-term engagement. The available evidence thus gives grounds for arguing that while there was some growth in the scale of drug use in post-reform Portugal, there was an overall positive net benefit for the Portuguese community. What about San Fransicko’s main point - that as the US has wound down the War on Drugs, drug overdose rates have sextupled? I think this is mostly not causal. I think the sextupling of overdoses is a combination of expansion in prescription opioid use, various forms of social decay making people less happy and therefore more likely to use drugs, and “improvements” in drug “technology” and the “supply chain” (eg production of fentanyl in China). I don’t know of any source that attempts to tease out the exact contribution of all of these things, but I would note that overdose deaths have risen the most in very conservative Midwestern states that haven’t walked back the drug war as much as California. Conclusion: As usual, I appreciate San Fransicko’s corrections to the prevailing narrative, but its own additions are dubious. Its claim that Portugal saw increased drug-related deaths seems false as far as I can tell. Its claim that it saw increased drug use depends on your definition, but is misleading and not the most natural way to sum up the evidence. Claim 6: San Francisco’s Soft-On-Crime Policies Led To Rising Crime Ten years ago, the news was full of stories about how some teenager stole a gumdrop and was sentenced to nine hundred billion years in jail. At some point, there was a genre shift to stories about how some hardened criminal murdered fifty people with an axe and the judge let him go with a warning because having jails felt racist. Source: Ed West, do note that this example is from the UK How suspicious should we be of each type of story? There will always be an extreme right tail of overly harsh sentences, and an extreme left tail of overly lenient ones. Were the 2000s really as draconian as they felt? Is the modern era really as pathetic? Or is it all just a function of who you read and what agenda they’re pushing? Shellenberger: During California governor Jerry Brown’s time in office, voters passed several reforms aimed at reducing the size of the prison population. In 2012, voters passed a change to the Three Strikes law so that the third strike imposes a life sentence only if the new felony was serious or violent. In addition to lowering punishments for drug possession, Proposition 47, which voters passed in 2014, redefined shoplifting, forgery, petty theft, and receiving stolen property as misdemeanors when the value in question does not exceed $950. In 2016, voters approved a proposition that shortened the time it took for some nonviolent offenders to be eligible for parole and which released nonviolent offenders into drug treatment and rehabilitation. Property crimes rose in San Francisco starting in 2012. Larceny, which is shoplifting and other petty theft, rose 50 percent, from roughly 3,000 incidents per 100,000 people in 2011 to about 4,500 in 2019. Property crimes as a whole, which include larceny, motor vehicle theft, and burglary, rose from 4,000 incidents per 100,000 people in 2011 to 5,500 in 2019. One study suggests that Proposition 47 increased the rate of auto theft 17 percent and the rate of larceny (non-auto property) theft 9 percent, but discerning between causation and correlation may not be possible. Upon taking office in January 2020, [famously soft-on-crime San Francisco district attorney Chesa] Boudin followed through on his campaign promises. Instead of prosecuting and incarcerating people for breaking car windows to steal money and other items from inside, Boudin proposed creating a $1.5 million fund to reimburse car owners. But there were over 25,000 car break-ins reported in 2019. If every break-in cost just $250 in repairs, the fund would need four times that amount. And what would prevent people from falsely claiming to have been robbed in order to get city money? […] Boudin opposed efforts by the mayor and the city attorney to prevent drug dealers who had already been arrested from entering the Tenderloin. “Until the city is serious about treating addiction and the root causes of drug use and selling,” said Boudin in a statement, “these recycled, punishment-focused approaches are unlikely to succeed at doing anything more than making headlines.” Home burglaries rose in early 2021 in San Francisco. Homeowners started posting on Twitter videos from their security cameras of people breaking into homes and garages. “When I first moved here we had a car break-in problem,” said Michael Solana, a writer who works for a venture capital fund. “Now we have a home invasion problem. These things are wearing on people.” Boudin attributed the rise of burglaries in San Francisco to the decline of tourism and “people in desperate economic circumstances.” Progressive supervisor Hillary Ronen agreed. “We know that [economic insecurity and inequality] is one of the root causes of property crimes specifically,” she said. But Tom Wolf and others argued that the robberies were, like the shoplifting, done by people seeking money to buy drugs and feed their addictions. “The drugstores have been shoplifted to death and that’s all because of drug use,” said Tom. “I know. I used to do the same thing when I was out there. That’s what you do. You ‘boost.’ And then you go and you sell your stuff down at UN Plaza,” an open-air drug scene. In a May 2021 city supervisors’ meeting, a representative from CVS called San Francisco “the epicenter of organized retail crime in the country” and claimed that 85 percent of the shoplifting is committed by organized theft rings. Police broke up one such ring in October 2020 and recovered $8 million of stolen merchandise. The problem goes beyond property crime. Boudin declined to prosecute two men who went on to kill people. One man had been repeatedly arrested for stealing cars, despite having just been released from prison earlier in the year, and appeared to be abusing meth. On New Year’s Eve, 2020, the man killed two people while driving intoxicated. Police found inside of his car a semiautomatic handgun and twenty-three grams of methamphetamine. On February 4, another intoxicated driver killed a pedestrian in a stolen car. The San Francisco police had arrested him in October 2020 for possessing a stolen car, a tool for stealing cars, and what appeared to be meth. Boudin chose not to pursue charges. In December, the California Highway Patrol arrested the man again for driving a stolen vehicle under the influence. Again he was not prosecuted. The accident victim, an immigrant from Kenya, and his wife had moved to San Francisco two weeks before the fatal crash. “I blame the DA,” said the widow of the victim. The suspect, she said, “was someone who was out in the public who shouldn’t have been in the public. It was completely avoidable.” Tom said he could feel the difference on the streets. “Drug dealing is unabated and it’s not one guy, it’s fifty guys dealing fentanyl and meth,” he said. “And it’s going unabated because the district attorney says, ‘These are the nonviolent, quality-of-life crimes,’ and ‘I’m not going to prosecute them.’” [..] District Attorney Boudin was offering weaker sentences than even defense attorneys were requesting, according to Vicki Westbrook of San Francisco. “There’s a defense attorney who said, ‘It used to be that I would argue for this deal in court with the DA but now I don’t say anything because the DA is going to offer me a deal better than what I would have suggested. Somebody shot up the street with an automatic weapon. The first offer was six months in jail or time served plus two years of probation or something. And then [the DA] said, “How about thirty days in jail?”’” Vicki laughed. “You really can do anything in San Francisco,” she said. “If you do get arrested, chances are you’re going to be out of jail in less than thirty days for damn near everything except maybe killing somebody and maybe even then, too. It’s hard to say at this point.” Taking each of these points individually: Proposition 47 There are two good big studies on the effects of Prop 47, one by Public Policy Institute and one by some UCI criminologists. The PPI study finds that the proposition increased theft and car break-ins by about 10%. The UCI study finds the same, but notes that under different assumptions the effects wouldn’t quite obtain statistical significance. This seems a bit too much like post hoc trying to get rid of an inconvenient effect, plus an effect on the border of statistical significance is different from positively finding no effect. I think a reasonable interpretation is that theft and car break-ins rose about 10% because of the proposition, just as Shellenberger says. Some pro-47 sites note that most states have some limit on how much you to have to shoplift before it’s a felony, and Prop 47 brought California closer to the national average, rather than turning it into an outlier. Chesa Boudin Chesa Boudin took office two months before the COVID pandemic began. Any attempt to separate the effect of Chesa Boudin from the effect of the pandemic is doomed. Shoplifting definitely plummeted when Boudin took office, but that’s because all the stores were closed. Murders definitely rose a little after Boudin took office, but that’s because that was also when the Black Lives Matter protests happened, which demoralized police and led to a so-far-permanent spike in murders nationwide. Percent of criminals caught definitely fell when Boudin took office, but that’s because various aspects of the justice system were closed for COVID (I will grudgingly entertain speculation that a further decrease in arrest rates from 2020 to 2021 may have been a genuine Boudin effect). In the absence of any real way to judge his performance, I think San Fransicko’s points about Boudin are plausible, though speculative. Shoplifting This one is terrible. There’s a surprisingly spirited debate here (some of you may have already read Applied Divinity Studies’ article). The debate is: everyone on the ground in San Francisco - store owners, security guards, customers, random citizens - say that shoplifting has increased massively over the past decade. But statistics mostly say it hasn’t. Source here. This is shoplifting crimes per 100,000 people. Kern County is a deep red county in California (including Bakersfield) that is known for being tough on crime. Against this, seriously, everyone says that shoplifting has obviously increased. I had a patient who worked in shoplifting prevention, he told me - his psychiatrist! Who he had no reason to lie to! - that he was constantly stressed dealing with the shoplifting surge devastating the stores he covered. Here’s the San Francisco subreddit’s response to someone posting the data showing shoplifting hasn’t risen - it’s just a lot of people laughing hysterically. What’s going on? I was able to find a different set of statistics that does seem to show a longer-term increase in shoplifting (source): The very big spike at the end might be a change in reporting by one or two stores - you can find the argument here. But it does look like shoplifting went from about 125 incidents/month in the early 2010s to more like 250/month just before the pandemic. Why is this graph so different from the other one? It looks like the top one came from the Department of Justice, and the bottom one came from SFPD. I’m not sure why these report differently. When you multiply out by 800K people in SF, by 12 months/year, and 30ish days/month, the first graph corresponds to 4 shoplifting incidents per day, and the second to 6. As LouB’s analysis here points out, that seems suspiciously low for a city of 800,000 people where stores are constantly closing because of shoplifting. Maybe off by a factor of a few hundred from what we’d expect. LouB writes: The SFPD report only references shoplifting offenses that required SFPD officers to prepare an incident report. That means either the shoplifter fought security, committed additional crimes, or stole more than $950 worth of items. It’s not that SFPD’s report is erroneous, it’s just not a representative statistic. In a parallel statistic, SFPD only completes incident reports for traffic accidents when there is an injury. Therefore, thousands of noninjury accidents are handled civilly without SFPD reports the same way thousands of shoplifting offenses are handled without reports. An insurance company would not determine premium rates based solely on SFPD incident reports, nor should readers interpret SFPD shoplifting reports as anywhere near the total picture of the shoplifting epidemic in San Francisco. (this would also explain why one or two stores changing their reporting policy can produce a spike equal to everyone else in San Francisco combined) But comparing incident reports from 2010 to incident reports from 2020 should still be apples-to-apples, unless the likelihood of reporting any given incident changed in the meantime. Did it? This news article quotes a San Franciscan who says that when they try to report shoplifting incidents, the cops tell them not to because “it doesn’t make a difference”. If cops say that now more often than they used to, it would make all these statistics meaningless. (Applied Divinity Studies claims to have an argument that shows this can’t be true. It goes something like: if San Francisco was a better place to shoplift than its neighbors - eg Oakland - then shoplifters would leave Oakland to go to San Francisco, and we would see Oakland shoplifting rates falling. Oakland shoplifting rates are falling, but no more so than the rest of the state, so there can’t be increased tolerance for shoplifting in San Francisco. I find this dubious for many reasons. First of all, many of the same reasons shoplifting is up in San Francisco - like Prop 47 or soft-on-crime progressive policies - also apply to Oakland. Second, given that shoplifting fell massively everywhere because of the pandemic, it feels dubious to try to compare different cities; maybe one city had stricter pandemic lockdowns than others. Third, do criminals really shop around for friendly jurisdictions? If so, why are so many crimes like car break-ins, concentrated in “the bad part of town”? Why wouldn’t criminals leave the bad part of town for under-exploited areas with richer residents and less competition? Maybe criminals in fact aren’t very strategic or mobile? Maybe they don’t want to stand in the BART station and then take a half-hour train ride holding a bag of stolen goods?) Maybe a better argument against this being true is how stable the shoplifting rates have been over time. Wouldn’t it be weird if (let’s say) a tripling of the real shoplifting rates was matched by a third-ing of the reporting rates (rather than a halving or a quartering or whatever)? On the other hand, here’s Shellenberger with some helpful data: Some of this is probably because of Proposition 47, which made some forms of shoplifting punishable with citation rather than arrest (but wouldn’t that be a clear discontinuity rather than a gradual trend?) But overall it sure seems like shoplifting is being taken less seriously, which might encourage people to report less. Another statistic I see is that only 2.3% of shoplifting cases result in an arrest; I don’t know how this is different from the graph above with numbers in the 30s; maybe it involves different levels of what makes something a “case”. I accept that the data don’t consistently show a spike in shoplifting. But what’s the alternative? My patient who works in loss prevention in SF stores is lying to me? The nice elderly Chinese man who sold me my last pair of glasses and chatted to me about the rampant shoplifting in his mall was lying? The San Francisco police are lying? Walgreens pretends to be concerned about shoplifting as part of a dastardly plot to close a bunch of stores for no reason? Target and CVS pretend to care about shoplifting as part of a plot to restrict their stores’ opening hours for no reason? Every big store near me has suddenly gotten a security guard at the front as part of some corporate-sponsored jobs program? Maybe the conservative narrative that soft-on-crime San Francisco must be experiencing rising crime rates took on a life of its own. Maybe it infiltrated not just the usual suspects like the SF police unions, but even such supposedly-liberal bastions as the New York Times. Maybe lots of big corporations took advantage of the fake narrative to make unpopular business decisions they were planning on making anyway. And maybe ordinary San Franciscans, confronted with everyone telling them they were in a shoplifting epidemic, started paying more attention to security guards and petty criminals who had always been there, a sort of mass hallucination that gripped everyone in the city. I can’t rule this out. Americans thought crime was rising all throughout the early 2000s, when it was in fact way down. Or maybe some statistics that we already know are off by several orders of magnitude got off by an additional factor of two or so. I think this one is more likely, but I’m genuinely not sure. Other Crime From the Economist: The Center on Juvenile And Criminal Justice puts it even more starkly, arguing that “San Francisco’s ‘Crime Wave’ Is Just One Crime”: This are potentially susceptible to the same reporting bias as shoplifting. So what about homicide? Homicide is practically always reported and investigated, making it a gold standard in crime measurement. (source) Looks pretty good until 2019. I don’t expect to gain useful information post-2020; the pandemic and the post-George-Floyd murder surge will make it impossible to evaluate for local variation. What about compared to other places? For some reason this top 20 table fails to list Washington DC, which should be just before Atlanta. SF doesn’t make the top 20, although its neighbor Oakland does. Probably most murder variation in US cities is explained by percent African-American and maybe percent Borderer; with relatively few people in these groups SF was never in the running. I’m not sure if some abstracted version of the city with all demographic factors adjusted away would have an unusually high murder rate, but at that point it would be pretty distant from any interesting real-world question. You can see the leaderboard for other types of crime here; San Francisco is often in the top ten, but never the top three. As far as I can tell, San Francisco has seen a big spike in car breakins over the past few years, with no clear trend for other property crime, violent crime, or homicides. It’s not an outlier among American cities in any kind of crime. Conclusion of this section: San Fransicko’s specific claims are basically correct, but suggest a medium-term rise in SF crime which is mostly contradicted by the data. These show stable-to-decreasing murder, stable-to-decreasing violent and property crimes other than car break-ins, and large rises in car break-ins only. The data also show stable-to-decreasing shoplifting, but I’m not sure how much to trust them vs. common sense. Honestly, I’m pretty confused here and not sure what to think. Claim 7: Jim Jones (Of Kool-Aid Cult Fame) Used To Be The Chairman Of SF’s Housing Authority Okay, this isn’t really a statistical claim that I can research different perspectives on. Still, it’s so wacky that I couldn’t resist mentioning it in this review. Jim Jones, famous for killing everyone in his Guyana-based Jonestown cult with poisoned Kool-Aid, used to be the SF government’s top guy on homelessness. Shellenberger writes: Jones married and moved first to Northern California and then to San Francisco with his wife to start a church. He called it the People’s Temple. Jones believed he was the leader of a socialist revolution. He warned of nuclear war and claimed black people would be put in concentration camps. He became a hugely charismatic preacher among African Americans, the disaffiliated poor, and young transplants to the city looking for community. Scenes from the era show a remarkably large and diverse congregation smiling and singing. The People’s Temple grew and provided services. Jones cultivated two progressive San Francisco politicians, George Moscone and Willie Brown, and mobilized people to volunteer for their campaigns […] His son and a San Francisco historian believe he stole the mayoral election for Moscone in 1975. Historian David Talbot, founder of the progressive website Salon, points to evidence that Jones committed sufficient voter fraud to account for Moscone’s narrow 4,443-vote margin of victory. “We loaded up all thirteen of our buses with maybe seventy people on each bus, and we had those buses rolling nonstop up and down the coast into San Francisco the day before the election,” said Jones Jr. “Could we have been the force that tipped the election to Moscone? Absolutely! Slam dunk. He only won by four thousand votes.” When federal investigators looked into fraud claims three years later, they discovered that all of the records were missing from the city of San Francisco’s registrar of voters. Jones also boasted of providing Moscone with black women from his congregation for sex. One time Moscone, drunk and “accompanied by a young black woman whom the politician had kindly agreed to drive home,” crashed into another car. Another time, Moscone and Willie Brown “were with a black woman in an alley at two in the morning at some restaurant in North Beach,” said a local bar owner. State legislator “John Burton was part of that gang too. They were all using marijuana and cocaine.” Said Jones Jr., Moscone would “always be there at temple parties with a cocktail in his hand and doing some ass grabbing.” A Temple member overheard Jones speaking to Moscone the day after one of those parties saying, “I want to let you know that the young lady you went off with is underage,” adding, “Now don’t worry, Mayor, we’ll take care of you—because we know that you’ll take care of us.” Afterward, Moscone made Jones the chairman of the powerful San Francisco Housing Commission. Jones cultivated progressives with money and favors. He made large donations to the ACLU, the NAACP, and United Farm Workers. Jones and Moscone met privately with vice presidential candidate Walter Mondale on a campaign plane a few days before the 1976 presidential election, and Mondale praised People’s Temple shortly afterward. Jones met with First Lady Rosalynn Carter several times. Governor Jerry Brown praised Jones. Glide Memorial Church’s Rev. Cecil Williams loved Jones. There is a photo from 1977 of a smiling Williams awarding Jones the church’s “Martin Luther King, Jr. Award.” Jones used his perch as chairman of the Housing Commission to fight for housing for the poor. He tried to use eminent domain to acquire the International Hotel, a single resident occupancy hotel. After a court sided with the hotel’s owner, Jones mobilized seven thousand protesters to picket it. By mid-January 1977, the situation had become heated. There were rumors that protesters inside the building were armed with guns and Molotov cocktails. Jones lost the legal battle in 1977, and the tenants were evicted. But the drama was a publicity victory for Jones, which burnished his image as a white savior. A conservative member of the Board of Supervisors who was defeated in the mayoral election by Moscone accused the new mayor, the San Francisco Chronicle, and the rest of the city establishment of being blind to Jones’s extremism. “There’s no radical plot in San Francisco,” insisted Moscone, in response. “There’s no one I’ve appointed to any city position whom I regard as radical or extremist.” Willie Brown, a powerful state legislator from 1964 to 1995 before becoming mayor in 1996, “seemed oblivious to Jones’ hucksterism and demagoguery,” notes a historian. Brown was master of ceremonies at a dinner for Jones in the fall of 1976 attended by an adulatory crowd of the rich and powerful, including Governor Jerry Brown. “Let me present to you a combination of Martin King, Angela Davis, Albert Einstein . . . Chairman Mao,” he said, to loud applause. And yet Jones was contemptuous of Brown even as Brown did Jones more and more favors. Jones mocked Brown for his designer suits, sports cars, and women. Once, while Brown was addressing the congregation and Jones was seated onstage behind him, Jones flipped his middle finger up to mock him. San Francisco’s establishment stood by Jones even after a California magazine, New West, owned by Rupert Murdoch, published an exposé of Jones’s beatings of Temple members and financial abuses in August 1977. The article was written by a San Francisco Chronicle reporter and was meant for the Chronicle to publish. But the newspaper killed the story because it didn’t want to alienate Jones, whom it viewed as central to its plans to expand the Chronicle’s circulation in the heavily African American Fillmore District. Jones also managed to avoid investigation and prosecution in part by getting the district attorney to hire as deputy district attorney Jones’s longtime attorney and confidant. Progressives defended Jones against the New West article. At a rally in the summer of 1977, Willie Brown said, “When somebody like Jim Jones comes on the scene, that absolutely scares the hell out of most everybody occupying positions of power in the system.” Angela Davis sent a radio message broadcast over the cult’s compound, Jonestown, in Guyana. “I know you’re in a very difficult situation right now,” she said, “and there is a very profound conspiracy designed to destroy the contributions which you have made to the struggle.” After visiting Jonestown, the attorney to the Black Panthers said, “I have seen paradise.” Harvey Milk, too, was tarnished by his association with Jones. In the fall of 1977, Milk wrote to President Carter’s secretary of health, education, and welfare requesting that Social Security checks be sent to elderly Temple members in Guyana. “People’s Temple,” wrote Milk, has “established a beautiful retirement community in Guyana.” In truth, the cult was disintegrating. Jones separated families and lovers, pitted relatives against each other, and forced neighbors to inform on each other. Jones sent people who violated the rules to solitary confinement in “the Box,” an underground cubicle where people were held as prisoners for days on end. Others were drugged. Progressives who had spent thirty years fighting to close prisons and mental hospitals found themselves praising a man who had reproduced their worst practices. In November 1978 a Bay Area congressman flew to Guyana to investigate human rights violations at Jonestown with NBC News. Jones gave the delegation a formal reception at Jonestown. A Temple member surreptitiously passed a note to one of the delegation members, saying he and another member wanted to escape. They fled the next day after a Temple member tried to stab the congressman. Jones didn’t prevent them from leaving but then sent gunmen to fire machine guns at the delegation at the airport, killing the congressman and four others. A few hours later, 907 inhabitants of Jonestown drank Flavor Aid laced with cyanide and died. Two-thirds of the victims were African American and one-third were children. Jones had told them that if they didn’t drink it they would be killed by invading soldiers from a shadowy global military conspiracy intent on imposing fascism and torturing children. As people started crying in grief, Jones scolded them. “Stop these hysterics,” he said. “This is not the way for people who are socialists or communists to die.” Jones’s wife protested the murder of children and had to be forcibly restrained. “We didn’t commit suicide,” said Jones in a tape recording, “we committed an act of revolutionary suicide protesting the conditions of an inhumane world.” Few were as stained by Jonestown as Willie Brown and George Moscone. “Even as the bloated bodies of the dead were removed from the jungle and the wounded were airlifted by the U.S. Air Force to hospitals in the United States,” wrote a historian, “Brown said he had ‘no regrets’ over his association with Jones.” They repeatedly disavowed responsibility. Said Moscone, “it’s clear that if there was a sinister plan, then we were taken in. But I’m not taking any responsibility. It’s not mine to shoulder.” This is Shellenberger at his best: telling us crazy stories from the recesses of San Francisco history, maybe kind of spinning the narration in a way that makes all progressives seem guilty by association, but with the tale itself so gripping that it’s hard to be mad. And Jones wasn’t alone. This was the golden age of San Francisco cults, when (Shellenberger tells us) “more than half of all high school students in the San Francisco Bay Area reported at least one recruiting attempt by a cult member, and 40 percent reported at least three contacts.” This chapter of SF history came to an end in 1978, when Dan White, who had just resigned from San Francisco’s Board Of Supervisors (ie City Council) entered City Hall through a window and assassinated Mayor Moscone and fellow Supervisor Harvey Milk, then successfully got charges reduced to manslaughter through a legal manuever that has gone down in history as “the Twinkie Defense” (realistically the defense was that he was depressed, but reporters seized on a comment that implied it was because he ate too many Twinkies). Everything about 1970s San Francisco was like this. With the Mayor and his right-hand-man both dead, San Francisco leadership ended up in the hands of previously second-tier politician Dianne Feinstein. Feinstein was what passed for a moderate in 1970s SF (which meant she had been targeted for assassination by various left-wing groups - she survived when a bomb left on her windowsill failed to explode). In Shellenberger’s telling, she managed to clean up some of the mess and restore a semblance of normalcy. San Francisco never forgave her. Moscone - voting fraud committer, underage sex enjoyer, and Jim Jones’ bff - is beloved as a martyr in today’s SF, but (the book points out) Feinstein is so loathed that in 2021 the Board of Education voted to rename Dianne Feinstein Elementary School. The Moscone Center is 2 million square feet and can fit about 10,000 people. Not to be confused with the Moscone Recreation Center, Moscone Station, or Moscone Elementary School. Meanwhile, all Dianne Feinstein got was one lousy elementary school and the Tithonus package of eternal life without eternal youth. Claim 8: The Intolerant Left Shuts Down Debate On These Issues Another one that’s probably hard to do a randomized controlled trial on. You could probably predict that this one was coming - it’s a necessary narrative beat in this genre of book. I think this beat is good. My impression is that people who aren’t themselves public figures disagreeing with left-wing ideas still don’t understand how scary it is and how much hate you get. Maybe now that 2/3s of every political essay written over the past five years is about this topic, people will finally get it through their thick skulls that it exists and is bad. I would also note that “traumatizing the sorts of people who write popular books about politics, in a such a way that they feel compelled as a sort of self-therapy to write page after page telling readers how angry they should be at you and your whole coalition” isn’t great political praxis. I would like people to figure this out and stop doing it. Anyway, Shellenberger is doing his part in this effort: In 2001, the San Francisco Coalition on Homelessness wheat-pasted posters of a fake front-page San Francisco Chronicle across town. Just beneath the masthead a large headline read “Fuck the Homeless!” right above a picture of San Francisco mayor Willie Brown laughing. Below his photo was the headline “Save the Tourists.” Progressives level the same charges at people thirty years later. “Because of some of the stuff I say,” said a community activist in Seattle’s historically black Capitol Hill neighborhood, “people say, ‘Oh, she’s not for them.’ But I have a heart for homeless and mentally ill. Most of my family works with the mentally ill.” Noted a Chronicle journalist in 2017, “Inevitably, homeless advocates and others will say, ‘You’re not compassionate,’” in response to stories about homeless encampments. “They called me a racist,” said Tom. “They accused me, a guy who used to be homeless, of demonizing the homeless, because I’m asking for accountability.” I found myself similarly accused. In 2019, after I published an article for Forbes about the homeless crisis, a progressive homeless activist accused me on Twitter of having written my article to “make money off of a fear tactic” of “fueling hatred [and] even increasing violence against homeless people.” After I asked the former San Francisco supervisor for the Tenderloin neighborhood, former mayoral candidate Jane Kim, how such a progressive city ended up with so much suffering, she said, “My concern, Michael, just to be very honest, is that when that kind of messaging goes out, violence against people who are unhoused goes up.” […] I soon discovered in my research that I was hardly the first person that progressive elected officials and homelessness advocates had accused of fomenting violence against unhoused people. Many others had been criticized for far worse over the years, including San Francisco’s highest elected officials. “The criticism [by progressive homelessness advocates] was heavy, political and personal,” wrote former mayor Willie Brown in his 2008 memoir. “People accused me of abandoning the problem when I was working daily to try and get a solution going. It was brutal. . . . I had become demonized, and my own efforts belittled.” It is notable that the result of such personal attacks is to frighten off people seeking to change, and perhaps improve, the situation. “The problem” of homelessness, concluded Mayor Brown within nine months of entering office, “may not be solvable.” And [Quoting Chris Rufo]. “The chief of psychiatry in a public hospital system in one of the largest California cities told me, ‘I know for a fact, and all of my colleagues know, that what we actually need to deal with the problem in the biggest cities in California is long-term residential secure psychiatric care. But I can’t say that publicly because I would be disemboweled by the activist left. My job would be in jeopardy. My reputation would be in jeopardy. My whole life would get turned upside down for even broaching the subject of expanding secure mental health facilities and compulsory mental health treatment.’ And I said, ‘So what’s the solution?’ and this person said, ‘We muddle through.’” And: In San Francisco, radical left activists protested [African-American] Mayor London Breed in front of her home. Breed said the protesters were “all white people. But that didn’t bother me as much as the taunting of me coming outside with firework torches in their hands looking like what used to happen when the KKK would show up to black people’s houses to burn their houses down.” While I was reading the book, I came across this tweet, which suggests that being unimpressed with SF’s lefty homeless activist scene is not limited to Michael Shellenberger: Claim 9: European Cities Like Amsterdam Successfully Solved Their Own Drug And Homelessness Problems By Doing The Opposite Of SF Shellenberger bases his plan to solve these problems on ideas that he says were pioneered in Amsterdam and spread to other European cities. In the 1980s, Amsterdam had the kinds of problems San Francisco deals with now: open-air drug markets, overdose deaths, homelessness, and crime. But in the 90s, they admitted they had a problem and took decisive action: What’s the secret?” I asked him. “Amsterdam has decriminalized marijuana and many other drugs but I haven’t seen any homeless. What is San Francisco doing wrong?” Rene said that in the 1980s, the Zeedijk neighborhood in Amsterdam was a lot like the Tenderloin [the worst part of San Francisco] today. There was open-air drug use, particularly of heroin, and needles strewn about, as well as crime. People started to flee the neighborhood, worsening its slum conditions. Homeless people squatted in abandoned buildings. “We had ghettos where it was not safe to go,” said Rene, who started working in the neighborhood as a nurse in 1985. It was considered a “no go” zone. “We had a lot of people from abroad who came to Amsterdam because our heroin was so good. But our heroin was so good that they died from it.” At first the city tried a “helping approach” exclusively, offering addicts clean needles, methadone, and other forms of help without any law enforcement, but it didn’t work. “In the eighties we just wanted to help people,” said Rene. “We started with methadone programs and medical treatment. We did a lot of work without much of a carrot and a stick. It was really a disappointment. They just used the methadone to stay addicted. They dealt drugs and committed other crimes. They lied and cheated about it. We were just supporting a different kind of market. We had to learn the hard way [...] The Amsterdam City Council asked the Amsterdam Municipal Health Service to develop a strategy to deal with “unmotivated drug users”...The police broke up the open-air drug scene and health workers were on hand to offer methadone, treatment, and shelter. The police broke up gatherings of more than four or five users, but did not treat personal and private use as a crime. Officers ticketed violators, and if users did not pay their fines, which was frequent, the courts ordered arrests, and sentenced individuals to follow a treatment plan or face incarceration. “For every individual homeless person, we make a plan,” said Rene. “We made tens of thousands of those plans.” Plans are overseen by a caseworker and a team that may include a psychiatrist, shelter provider, service provider, judge, employer, parole officer, and police officer. “You need people in the police and health department working together,” he said. What Amsterdam did was the same as other major European cities. Lisbon, Frankfurt, Vienna, and Zurich all dealt with their open-air drug markets, using a combination of law enforcement and social services. Crucially, Amsterdam and other European cities prevented services from being concentrated in a single neighborhood, since their concentration often enables an open-air drug scene to thrive [...] The efforts worked. “We had several thousand people who were addicted to heroin in the eighties and nineties,” said Rene. “Many died. Today we have four or five hundred people addicted to methadone. And we have about 120 in Amsterdam who we supply heroin to on a medical basis because methadone doesn’t work for them. They have to use heroin.” The Amsterdam strategy goes something like: Break up open-air drug markets and anywhere that more than 4-5 drug users are congregating. Yes, people can just use their drugs in private, but this is legitimately better. Open-air markets normalize drugs with their blatantness, and make it hard to quit for the same reason it’s hard to diet if your partner leaves boxes of donuts out in the house every day.
Hive System

Hive System is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 28, 2022 and June 28, 2022. The archive places it in contexts such as "is this just the Hive System from Terra Ignota?". It most often appears alongside Achille Mbembe, Africa Next 50 Cities Coalition, African DAO.

Reference entry
Hive System
Mention count
1
Issue count
1
First seen
June 28, 2022
Last seen
June 28, 2022
  • 22 June 28, 2022
June 28, 2022 · Original source
Celebration, Florida. But earlier this year, Florida passed a law banning schools from teaching LGBT topics to young children, which the media dubbed “the Don’t Say Gay Law”. Disney did some corporate activism against the law, the Florida government got mad and brainstormed ways to punish Disney, and the best they could come up with was to re-establish state control of Reedy Creek, which DeSantis officially did last month. Disney has sued the state, but it looks like it’s just over some debts and the lawsuit is unlikely to prevent the dissolution. You get socialists in power, they dissolve charter cities. You get conservatives in power, they also dissolve charter cities. All I want is one government that doesn’t dissolve charter cities! Is that too much to ask? Hello, Afropolitan Last year venture capitalist and thought leader Balaji Srinivasan introduced the idea of a “network state”. With the advent of social networks and cryptocurrency, as well as increasing polarization leading people to group themselves more by ideological cohesion than geographic proximity, maybe people could group themselves into nonterritorial state-like communities. And although these would seem pretty thin compared to real states that have monopolies over use of force in real geographic areas, maybe some of them could use charter-city like systems to eventually buy land and graduate into full statehood. (is this just the Hive System from Terra Ignota? I think so, but probably with fewer major governments being controlled by weird brothels.) Anyway, Afropolitan has taken him up on this. They share a name with a landmark essay by Achille Mbembe (founding a country based on an especially good essay also sounds like something that would happen in Terra Ignota, as does history being changed by people named things like “Achille Mbembe”), arguing that Africa needs to re-invent or re-define itself or something. The founders of Afropolitan-the-company have taken this idea of a trans-national African diaspora and turned it into an "African DAO [and] digital nation...building a network state to unleash the maximum potential of Africans around the world". They write: The nation-state experiment has failed for Black people worldwide. It has yielded nothing but poverty, genocide, police brutality, ethnic strife, inflation, weak government, and the failure of our ecosystems. All people who call themselves free have a fundamental right to create the society they want by choice collectively. As the internet enables us to shrink space and form bonds across the planet, no person should live in a society by accident or force. …and go on to list a four-step plan to create the society of the future. Step One is to sell NFTs “representing the mythology of our new nation” . Step Four is “a[n] extensive system of charter cities akin to Singapore or Hong Kong”. In the unlikely chance that you care what Steps Two and Three are, you can find them here. Why should you take them seriously? I am not at all claiming that you should. I am only claiming that “sell digital tokens representing mythology, but eventually this turns into a country” is the most Terra Ignota thing ever. Also, at least the founders have good aesthetics: But also, some people are taking them seriously. VCs including Balaji Srinivasan has invested $2 million. The group claims to have 50,000 followers on Clubhouse. They’ve been featured on TechCrunch and (very briefly) Marginal Revolution. I would, however, briefly challenge their claim to be “the first ever Internet country”. People have been building Internet countries as long as there has been an Internet. I’m not sure which was actually first, but I know the Kingdom of Talossa has been online since 1995. A 2000 New York Times article on the Internet country phenomenon profiled Talossa, but was already able to give six other examples. And although these were perhaps easy to miss, Danny Wallace started the Kingdom of Lovely, a “partly Internet-based project that claims a small amount of territory”, on a widely-viewed BBC documentary in 2007. I myself got involved in an online country project back when I was a teenager in the early 2000s. Although no venture capitalists appeared to give me giant bags of money, it got a few dozen “citizens” and some fun government institutions before finally petering out around 2015. I guess what I’m saying is - I’m available as an Internet country building consultant with fifteen years experience. And no, I don’t accept payment in NFTs. Oh, You’re Still Here? Meanwhile, in Honduras, it isn’t all legal doom and gloom. Prospera has also been making real progress, as measured in pretty photos. Two Roatan resorts, Las Verandas and Pristine Bay, have joined Prospera. The ZEDE law saying that landowners can voluntarily annex their land into a willing ZEDE: Las Verandas Pristine Bay Prospera is also building a high-tech wood processing factory that will eventually produce parts for its other construction efforts: Current construction progress Planned final appearance And its first multi-story apartment buildings: Current construction progress Planned final appearance It will also be hosting gene therapy company Mini Circle, which runs clinical trials for innovative medical procedures. Granting that many of its studies (treatments for HIV, muscular dystrophy, obesity, etc) seem great and important, it perhaps seems suspicious that they would want to do this in a charter city? The company writes that “the cost of running a trial in Prospera is less than 1/1000th the cost of the United States”, which seems good in ways but does not entirely allay my concern. I was originally worried that they would be experimenting on Hondurans or something, but looking at the site it looks like they’re recruiting worldwide and would probably fly Americans (or whoever else) to Honduras for the therapy. Their site features a quote from friend-of-the-blog Alex K Chen, who says: Minicircle's bioscientists have one of the most enlightened risk taking calculi I have observed anywhere. In an environment where extreme hesitance to take any risk holds back scientific progress, they have the openness to imagine, try and measure just about any legal intervention putting them in a very strong position to both produce a significant measurable decrease in the human rate of aging, and to inspire more people to do what they never thought was possible. I think the only way this could get more mad science points is if it used the phrase “small-minded fools”. Mind you, I think mad science points are good, I just hope everyone else sees it that way and my optimism turns out justified. Also, apparently the clinical trials have NFTs, because of course they do. At least they’re not commemorative NFTs - they seem to play a load-bearing role where they help participants be incentivized to complete all the necessary tests. Also, low-cost eco-residences! Shorts 1: I previously mentioned the scam/fiasco/insane-idea of Hammer City, a planned black nationalist city in the Rocky Mountains. I knew it had failed, but I didn’t know exactly how. Now Colorado Sun has investigated. The proximal reason it failed was because the black nationalists started moving their paramilitary onto the land before they had officially bought it, the owner called the cops, and the cops removed them. The Hammer City team has not given back any of the $112,000 which they raised from extremely credulous donors (without using NFTs, even!) 2: The Charter Cities Institute continues doing the long-term ground-level work necessary to create long-term well-grounded charter cities which will be much too boring and responsible for me to write silly profiles of. Some of their most recent work has been with the Africa Next 50 Cities Coalition, which “convenes and mobilizes key stakeholders who are dedicated to harnessing Africa’s rapid urbanization for human prosperity”. 3: Also, CCI founder Mark Lutter has left the organization to start a charter city of his own, no public details yet. CCI will be looking for a new executive director. 4: Speaking of Disney, they’ve been building on their model city expertise and magical storybook branding by creating planned communities around the US - Story Living By Disney, starting with Rancho Mirage California. Realistically it just looks like a very nice planned community, but this planned community comes with the option to have people make fun of you forever for living in a Disney community as an adult. Predictions for this month: Prospera is still substantially a functioning ZEDE in 2025: 70%
HKU4

HKU4 is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 09, 2024 and April 09, 2024. The archive places it in contexts such as "unexpected sequence from a common coronavirus, HKU4". It most often appears alongside #S14, 2009 flu pandemic, 2013-16 West African Ebola outbreak.

Reference entry
HKU4
Mention count
1
Issue count
1
First seen
April 09, 2024
Last seen
April 09, 2024
April 09, 2024 · Original source
…and deciding whether you think the assumptions behind a specific statistical test are likely to debunk the idea that cases are centered around the wet market. 11. Wuhan used as a control for a 2015 serological study on SARS-related bat coronaviruses due to its urban location. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178078/ I don’t know why this point is supposed to matter. If you mean that Wuhan isn’t directly exposed to bats, nobody ever said it was. The zoonotic theory is that wildlife carted in from other areas of China started the pandemic in the wet market. 12. Superspreader events also seen at wet markets in Beijing and Singapore (Xinfadi and Jurong). This was discussed very extensively in the debates, both in section 1 and section 3. Wet markets weren’t “superspreader locations” - in fact, the disease spread no more quickly there than anywhere else. They were the first place in those cities that the pandemic started, due to contaminated animal products. If anything, this supports zoonosis. See also my discussion with Saar on this point below. 13. WIV refuse to share their records with NIH who terminated subaward in 2022. Wider suspension over biosafety concerns. https://www.bloomberg.com/news/articles/2023-07-18/us-suspends-wuhan-institute-funds-over-covid-stonewalling Although WIV has not been especially forthcoming, some of their databases were leaked in various ways and showed that they did not have any viruses capable of transforming into COVID. 14. PLA involvement at WIV and MERS research prior to SARS-COV-2. MERS features several similarities with SARS-CoV-2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7022351/ I can’t even tell what conspiracy theory you’re trying to propose with this one; if you spell it out I can try to explain why it might be false. 15. SARS1 leaked several times and SARS-COV-2 has leaked from a BSL-3 lab in Taiwan. Agreed that SARS leaked several times. It also spilled over from animals several times. During the debate, a lab leak rate of once per lab per 500 years was proposed (everyone agreed to steelman this by 10x for WIV numbers); I would be interested to know whether anything about the study of SARS challenges that number. 16. Unpublished infectious clone identified from Wuhan contradicting arguments such reverse genetics systems would be published. https://www.biorxiv.org/content/10.1101/2023.02.12.528210v1.full I asked some scientists about this paper and here’s what they told me. Wuhan University sequenced some rice. In the middle of the sequence, there’s an unexpected sequence from a common coronavirus, HKU4. The most likely explanation is that someone else in Wuhan was working on the coronavirus and there was cross-contamination. Plausibly this is Wuhan Institute of Virology, who is known to work with coronaviruses. This is cool detective work, but it’s not clear what it’s supposed to prove. I think some lab leakers are using it to prove that WIV can do reverse genetics, but they admitted this already in a published paper so that’s not too helpful. I think others are using it to prove WIV had “secret viruses” in their catalogue, but the rice virus wasn’t secret, it was HKU4, which is common and which WIV has already published papers about. 1.6: DrJayChou’s 7 Arguments Once again, I cannot stress enough how much better a take you might have on this debate if you watch it. “The first known case predates the market outbreak by a month” - this is not the consensus position. I cannot say for sure what Dr. Chou means by this, but I suspect he’s referring to one of the many claims to this effect that Peter effectively debunked during the debate (Connor Reed, Mr. Chen, the 92 cases, Brazil, etc).
HMOs

HMOs is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 20, 2021 and August 20, 2021. The archive places it in contexts such as "HMOs were extremely effective at keeping costs down". It most often appears alongside ACT/SSC, aducanumab, aducanumab.

Reference entry
HMOs
Mention count
1
Issue count
1
First seen
August 20, 2021
Last seen
August 20, 2021
August 20, 2021 · Original source
HMOs were extremely effective at keeping costs down by saying "no, that's not worth it." They gradually lost the ability to say "no" by lawsuit after lawsuit.
HMX explosives

HMX explosives is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 26, 2024 and July 26, 2024. The archive places it in contexts such as "subdermal detonator connected to HMX explosives". It most often appears alongside 1600 Pennsylvania Avenue, 2020 election, 2024 book review contest.

Reference entry
HMX explosives
Mention count
1
Issue count
1
First seen
July 26, 2024
Last seen
July 26, 2024
July 26, 2024 · Original source
The lack of evidence that all this is happening is entirely explained through coordinated media silence as well as the widespread use of body doubles and clones. The heart of Real Raw News, and the source of most of its entertainment value, is its accounts of the supposed secret military tribunals occurring at America’s Guantanamo Bay Naval Base in Cuba, better known as Gitmo2. For more than three years, the site has produced one article after another describing the arrest, trial, and execution of dozens of major and not-so-major figures in American life. Hillary Clinton? Arrested, tried, executed. Bill Gates? Arrested, tried, executed. Dick Cheney? Fled the country via a secret underground tunnel to a CIA airfield, but then returned to America on vacation for some reason3, arrested, tried, executed. George W. Bush, Hunter Biden, Anthony Fauci, Gavin Newsom, Mark Milley, Victoria Nuland, Tom Hanks (?), Brian Stelter (???) – All arrested and executed, in turn4. Almost all defendants are hanged, which actually is not the method prescribed by the Uniform Code of Military Justice, but has the advantage of being far more cinematic. It would be easy for all of this to get old, but like with variations in classical music, subtle differences to each iteration enrich the whole. Some defendants desperately try to deny responsibility for their crimes. Some arrogantly taunt the tribunal, assuming until the very end that they are untouchable. Some literally scream as though demon-possessed. Some fake senility or amnesia. But crucially, all of them face justice, one way or another. An entry published just before this contest’s deadline is a lovely example: Representing himself, [Fulton County Superior Court Judge Scott] McAfee in opening remarks talked himself into an early verdict. He said no one and nothing, not even imprisonment, would prevent him from destroying the Trump family. Handcuffed at the defense table, he glared at the panel and said he would topple the Trump empire, building by building, brick by brick, and wouldn’t rest until every Trump supporter was behind bars or dead. “Then I’ll take care of the people here and this place,” McAfee said. “Mr. McAfee, I’m told you are of sound mind and know where you are, right?” Admiral Stephens asked5. “I’m in a Kangaroo court in the Banana Republic of Trump, staring at a guy who couldn’t hack it in the real world, couldn’t run a private practice, get a partnership, or sit on a real bench, so he went into the military,” McAfee said. “Have you ever heard of Trump Derangement Syndrome, Mr. McAfee?” the Admiral asked. “Because you have the worst case I’ve seen, and I’ve seen several.” “Trump is finished. He’ll be in jail soon, and when he is, your house of cards collapses,” McAfee said. “It might seem that way, but it only seems that way,” the Admiral said. “You might as well find me guilty. I’ll never stop hating Trump and I’ll never stop working to demolish everything he stole. He was born guilty, and he’ll be guilty until the day he dies. That’ll be the only word on his gravestone: GUILTY!” McAfee shouted. The lead panelist, a Marine Corps major, politely interrupted: “Admiral, sir, we don’t have to hear any more. McAfee mocks this court, and we find him guilty of the treason charge. Additionally, we are in agreement he should hang for his crimes.” Admiral Stephens nodded contemplatively. “I side with these fine officers. Mr. McAfee, you are hereby sentenced to hang for treason against the United States of America.” His execution is scheduled for May 15. Yes, this is the judge of Trump’s criminal case in Fulton County. In the Real Raw News world, Trump’s various legal adventures are both real and fake at the same time. Apparently, Trump could completely ignore these proceedings, and the military in fact begs him to do so, but he chooses to place himself in danger from some unseen, Christ-like self-sacrificial motive. That motive, it appears, is getting evil judges to expose their bias by ruling against him, so that they can be arrested and executed for treason. The site often offers an alternative narrative regarding events in the official, Deep State-backed news narrative. When Colin Powell died, RRN was there to explain that he actually committed suicide, fearing arrest by the military. When former Tom Hanks co-star Peter Scolari died of cancer, RRN swooped in to attribute his demise to an unexpected military tribunal6. This pattern is one of the chief reasons fans cite for believing the site: Isn’t it incredible, they say, how some of the same people RRN reports the executions of just happen to have recently died or been hospitalized in the mainstream press? What are the odds? Perhaps surprisingly, the star figure in Real Raw News’s tapestry of blood is not Donald Trump; like Gandalf or Dumbledore, he is a heroic but distant and largely off-screen figure. Instead, the primary hero is Rear Admiral Darse Crandall, who dispenses lethal justice with shocking efficiency while always being ready with a good quip: Admiral Crandall ordered [Arizona Governor Katie] Hobbs not to intimidate the witness. “You lack decorum, detainee Hobbs, and your insouciance ends here. We revoke your right to further question this witness and ask the panel to render a verdict on the charges against you.” The admiral dismissed Jane Doe, and the panel unanimously found Hobbs guilty, recommending she hang to death. “I won’t let you do this to me,” Hobbs screeched. “It’s already done,” said Admiral Crandall. “And have a Merry Christmas—in whatever afterlife you wind up in.” He scheduled her execution for December 22. Adm. Crandall is in fact a real person, currently serving as Judge Advocate General of the Navy. Admiral Crandall seems like a nice and professional fellow, and I badly want to know what he makes of his alternate persona. I like to hope that he enjoys it; maybe he jokingly warns his subordinates to do their jobs right or else they’ll be arrested and executed. If anybody knows otherwise, please do not disabuse me of this fantasy. Lesser fake news auteurs will puke out lame one-and-done articles about the moon landing or JFK or whatever, with zero internal consistency. Baxter is better. His military tribunals are reported out in detail. Even the most minor figures receive dedicated articles for their arrest, their trial, and their demise, but the biggest names receive genuine weeks-long productions. Hillary Clinton’s tribunal spans five days, until damning testimony from her former aide (and lover) Huma Abedin sends her to the gallows. Former president Bush’s arrest and tribunal is a ten-part epic lasting nearly two months, and includes details that are eccentric even by 9/11 truther standards: Supposedly, the real death toll of 9/11 (which Bush orchestrated) was 7,000, but Bush deemed this number too high to win reelection, so the real number was suppressed and 4,000 families were silenced with enormous bribes that also served to stimulate the economy. Good thing all the plotting was caught on tape, or he might have gotten away with it. Baxter never rushes things. Remember how the Colorado Supreme Court tried to kick Trump off the primary ballot in late 2023? Lesser fake newsers might have had the entire 4-vote anti-Trump majority arrested at once, but Baxter is cannier. In his reporting, one justice was arrested immediately, but the other three went on the run , and took months to capture. As of this writing we’re still waiting for their tribunal. I hope it’s a barn-burner! Baxter knows that while crass wish fulfillment is easy, truly great stories need formidable villains. Amidst the many arrests and hangings of Baxter’s saga are cinematic setbacks. Sometimes, the Marines don’t get their man: [Biden White House Covid-19 response coordinator Ashish] Jha was five feet away from his vehicle when two Marines with an arrest warrant approached him, informing him that he was being placed under arrest on charges of mass murder. Jha erupted in laughter, saying, “You don’t even know who we are.” He exploded in a crimson fireball that blew his and the Marines’ bodies to bits throughout the parking lot. […] The Marines brought what remains they could to Fort Bragg, where medical examiners deduced that Jha was not Jha, but a clone in which someone had planted a subdermal detonator connected to HMX explosives. And then, there is the looming presence of RRN’s chief villain: Former U.S. President Barack Obama. Members of the deep state make a warped pledge of allegiance to “The United States of Ukraine” and to “one world under Obama.” Other arms of the deep state might be taken down, but Obama himself always lurks in the shadows, controlling and commanding. The occasional attempt to take him down runs into the kind of problems you’d expect: “Why?” Obama gurgled and died. Inexplicably, the body spontaneously combusted, starting at both hands and spreading to the arms and chest. Special Forces tried extinguishing the flames with sand and water, but their efforts were in vain—the flames were rapidly charring burnt flesh. “Check his feet,” the Special Forces lead, who had been trained to spot body doubles and clones, called out. They swiftly yanked off Obama’s socks and sneakers and saw he had flat feet, and that his sneakers had been augmented to fit people with fallen arches. They pulled down his pants; Obama had no genitals, a telltale indicator of cloning. The body became too hot to touch and was soon consumed by fire. Like Bob Ross, Michael Baxter has no mistakes, only happy little accidents. In late 2021, RRN reported on the conviction of the late Chelsea Clinton’s husband, Marc Mezvinsky. Being only a lackey in the Clintons’ plot to abduct children and sell them on the black market, Mezvinsky received a comparatively lenient life sentence. But wait! Two months later, Gitmo’s chaplain mentioned in passing that he had attended Mezvinsky’s execution. Eagle-eyed readers saw the discrepancy and cried foul. But Baxter didn’t miss a beat. When Baxter reported on the arrest of former Obama adviser David Axelrod, only to publish no follow-up, he had a ready explanation a year later: Axelrod had been executed without trial by being thrown out of an airplane, and it took months for Baxter to learn the truth. I’ll admit, I find Baxter’s efforts to maintain narrative integrity incredibly charming, given how they clash with the latent absurdity of the whole endeavor. Like most fictional universes, the Real Raw Newsiverse crumbles if you think about it too hard. If there are White Hat and Black Hat partitions of the military, how does military procurement work? How do newly-enlisted personnel know which faction they are joining? Do the two factions have separate recruiters? And when literally everyone carries a basic video camera in their pocket, and social media access is universal, how are major battles being fought on American soil with zero video evidence anywhere? At the meta level, the entire construct gets even sillier. The conceit of the site is that Trump has secretly left power to entrap his foes…yet then his allies go and blab the entire “real” story to an online blog. The cover for this is that the masses simply don’t believe it, but you know who would definitely know whether the blog is accurate? The Deep State! Yet despite this, in RRN lore sinister actors from Andrew Cuomo to Oprah are always caught off guard when Delta Force7 smashes down their door and zip-ties their hands for a one-way trip to Cuba. Okay, But So What? You might be tempted to think this is all irrelevant rambling into the void. But if you think that, you’re mistaken. The thing is, Real Raw News is popular. Really popular. It got more than 2 million page visits in January. It’s a lot more popular than this blog and even outdraws some established publications like The Nation. “Okay, views are views, but does anyone really believe this?” you may ask, perhaps derisively. Well, it falls to me to say that yes, yes they do. The typical RRN article gets hundreds upon hundreds of comments. And sure, a lot of them are “My mother is being paid $2,000/day working from home” spam, but most of them are not. Hundreds upon hundreds of comments are from readers grateful to Baxter for sharing the “truth.” Even more unsettling are comments from people who spot a problem with the occasional story, but still trust Baxter overall. Baxter has a donation page on Christian crowdfunding site GiveSendGo. It has raised more than $210,000 and donations continue to pour in on a daily basis. Sure, some donation messages clearly indicate people who are in on the joke…but many more do not. But I don’t just need to guess based on comments and donation messages. In this realm, I can appeal to personal experience. I work in the broader world of American right-of-center politics, and we encounter Real Raw News believers constantly. We get emails from people who confidently insist the public-facing news of the day is fake, and the truth about the events at Gitmo will soon be revealed. At public Q&A events, we’ve fielded questions from genuinely nervous and worried people, who complain about their friends losing hope and being blackpilled by the news, and want to know why there hasn’t been more effort to share what’s “really” going on. A friend of mine who served in the Trump administration has described attending parties where, when he mentioned looking for a post-admin job, he received knowing looks and wink-wink-nudge-nudge remarks from people signaling they knew what was “really” going on. Somehow and someway, a lot of people believe or half-believe or badly want to believe this stuff. And where a lot of people do anything, there are takeaways to be found! In my three-plus years of reading all news that is both real and raw, here is what I’ve found. Conspiracies Evolve Like Comic Book Lore In his review of the Alexander Romance, Scott remarked that figures like Alexander the Great or Hercules were, essentially, the pre-modern versions of Batman: Stories about them are a genre, with countless different variations and stylistic choices that evolve over time, with just a few set principles guiding all of them. The Real Raw Newsiverse, and other modern conspiracy theories, also function like comic book lore. Just like Batman, and just like Hercules, “Donald Trump” has become a genre. Fake news stories about him and his Deep State enemies have a few core premises (adrenochrome, pedophile cabals, there is a Plan and we should Trust It) but endless room for variation past that point. Fans of comic books, soap operas, or The Simpsons might be familiar with something TVTropes calls “comic book time.” Certain facets of a fictional reality are locked in place, and with the passage of time everything else is gradually retconned to maintain the status quo. In season 2 of the Simpsons, Homer and Marge started dating in 1974, in Season 3 Marge becomes pregnant with Bart in 1980 (after a date watching The Empire Strikes Back), and in season 4 it’s revealed that Homer missed the Moon Landing to listen to “Yummy, Yummy, Yummy.” Tragically, though, The Simpsons kept going past season 10, and if Homer was 18 in 1974 that would make him eligible for a full Social Security benefit today. So in 2008, the continuity changed so that Homer was in a Nineties grunge band just before marrying Marge8. The Simpsons writers have avoided rejiggering the canon since, but if they do, they’ll have to confront the fact that 30-something Homer and Marge are now millennials, and in a decade they’ll be members of Gen Z. You may live to see a Simpsons flashback episode about Homer and Marge living as hipsters in Brooklyn during the 2010s (truly, we live in cursed times.) But the same phenomenon exists in the world of conspiracies. Instead of a consistent, elaborate canon, what we have is a few story beats with a lot of customization and the occasional retcon. When Baxter first began posting his stories, a core part of the narrative was that Donald Trump still secretly had all the powers of the presidency and was still in command of the entire U.S. military command. Early articles promised that Trump’s apparent loss of office was only a temporary ruse, necessary to expose the worst elements of the Deep State, but that Trump’s triumphal return to power would take place by July 4, 2021. The national media might have put on a song and dance suggesting otherwise, but behind the scenes, loyal military forces were the real ones in control. This control even extended to the military helpfully house-sitting the White House and not letting Biden use it. Despite his illegitimate victory, Biden met an unwelcome surprise when he arrived at the White House on January 20. Instead of getting a ceremonial greeting, he and Kamala Harris were stopped by National Guard and U.S. Marines at the barbwire fence encircling the White House. The Marines informed them that the military had assumed control of the Executive Branch and instructed them to vacate the area. When Harris belligerently said, “Move aside, we’re president now,” the Marines locked the gate. […] To avoid shame and maintain an illusion of power, Biden’s people concocted a ruse, supported by his media allies, to deceive the American public into believing he had won a fair election and had moved into the White House on schedule. Inside Actor/Producer Tyler Perry’s 300-acre Atlanta estate sits a three-story stucco replica of the commander-in-chief’s residence, which he originally built as a set piece for a television show. […] Although the replicant White House is built to 80% scale, on television and in images it’s indistinguishable from 1600 Pennsylvania Avenue. Biden and Harris have been using the facsimile to feign leadership and impose despotic rule on the nation. Of course, July 4 came and went, with Trump’s return nowhere to be seen, so the canon simply updated: In the new narrative, the military had been conducting a year-long election fraud audit on Trump’s behalf, the results were nearly ready for public release, and Trump’s return would simply be “swift.” But no swift return has transpired, and so as the 2024 election has approached, the lore has evolved in the direction of Trump authentically running in this election and simply reclaiming power by winning it. As time has passed, more subtle changes have had to pile up. Early on, RRN reported that Joe Biden was a brain dead semi-corpse being held at Walter Reed, and any public appearances by “Biden” were one of several actors. But after four years of Let’s Go Brandon, Biden himself has become a more popular villain, and so quietly references to his brain-dead status have disappeared. In the early days of RRN, the military was firmly behind Trump and any implication that Biden held the powers of commander-in-chief was a media-fueled sham. But as time has passed, Trump being the “real” commander-in-chief over a loyal military has evolved into a reality where there are two American militaries, a “White Hat” faction loyal to Trump and “Black Hats” loyal to Biden. Early stories implied the White Hats were more numerous, but recent stories have implied the opposite, with the White Hats an elite force that often wins battles decisively while badly outnumbered. A secret purge has gradually become a secret civil war, specifically one with frequent war crimes: White Hat forces in Maui have eradicated or repelled all but a handful of the felonious FEMA agents who began terrorizing the tropical paradise in the aftermath of the inexplicable blaze that razed Lahaina and surrounding towns in early August, a source in General Eric M. Smith’s office told Real Raw News. Since mid-August, United States Marines have fought with FEMA patrols in Lahaina, Kaanapali, Wailuku, Maalaea, and Pukalani, and the skirmishes resulted in the deaths of approximately 475 federal goons and, alas, 34 valiant Marines. The Marines died upholding the Constitution of the United States; the feds died trying to defend the criminal Biden regime. […] “The Marines died valorously,” our source said. “We ain’t taking FEMA prisoners from the rank and file, only the key players. General Smith made it clear it’s weapons-free. Those bastards know damn well they’re following unlawful orders, and they’ll pay the price.” I think the ever-evolving nature of conspiracies is actually pretty important to psychologically grasping their appeal. I have a friend who is a big believer in 9/11 Trutherism. He once compelled me to watch the documentary “The New Pearl Harbor,” an exhausting 5-hour film promoting 9/11 conspiracies. If one actually watches, one quickly discovers that a lot of 9/11 conspiracy theories are mutually exclusive, or at least don’t mesh well together: One conspiracy argues that fighter jets were intentionally diverted the wrong direction to keep them from shooting down the hijacked jets approaching New York, while another conspiracy suggests that United 93 was shot down, and it was all covered up. In some versions, the planes didn’t hit the Twin Towers at all. Sometimes Bush did it, and sometimes Israel did it, and so on. Similarly, in my career I’ve worked adjacent to people who, like RRN, were very hostile to Covid-19 shots. That hostility made them sequentially endorse wildly different assertions about how the vaccines worked. Sometimes, the vaccines contain heavy metals. Sometimes, they contain hydra DNA to turn recipients into partially non-human chimeras. Sometimes, the vaccines are a depopulation agent. Sometimes, they’re a mind-control agent, or a killswitch that can be activated by self-assembling nanomachinery. One viral documentary in 2022 claimed that Covid was caused by snake venom in the water supply, and that Covid vaccines were an additional dose of snake venom to keep people sick (all this, of course, because the snake is Satan’s animal). What stands out isn’t the silliness of these particular theories, but that I saw them sequentially endorsed by the same people. Some of these people are smart enough to notice inconsistencies, at least when they’re pointed out, so why don’t they bother them? To some extent, I think it’s for the same reason people don’t care that every Batman story doesn’t perfectly line up. Consistency isn’t the point! What actually matters is enjoying individual stories and the wider genre they fit into. Covid vaccine haters don’t think too hard about any specific story. Instead, they’re driven by a core impulse of “distrust the new vaccine that people I distrust are promoting,” and every conceivably story or tale that feeds that genre of thought is, for them, worthwhile. Similarly, Real Raw News fans don’t think too hard about any specific story. Instead, I think their core impulse is, ironically, profound disappointment in how the Trump administration failed to deliver. Trump shook up the American political landscape more than anyone in living memory, and promised sweeping changes to every level of American government, yet his actual administration proved rather disorderly, changed far less than was promised, and then lost power after one term. For many, this simply prompted a revision in how they saw Trump. But for others, the preferred response is to embrace a fantasy reality where Trump is a superhero. I actually think the reverse side of this explains things like the durability of Russiagate: If you’re a normal American liberal, everything Trump says is offensive and piggish, but to justify their level of disdain for them, many needed to elevate his evil to the level of treason, even if that never really made any sense. It can't just be that Trump is an egotistical jerk or a narcissist or whatever. He's got to be a traitor who's going to end American democracy. People Crave Extreme, Over-the-Top, and Underhanded Solutions. At the height of the French Revolution’s Reign of Terror, the Committee of Public Safety pushed through the Law of 22 Prairial. The law simplified the procedures of the country’s Revolutionary Tribunal by: Defining a whole heap of activities as criminal treason, including “creating scarcity,” disparaging the National Convention, “inspiring discouragement,” and spreading fake news.
Hnetafl

Hnetafl is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 09, 2023 and February 09, 2023. The archive places it in contexts such as "One of them, Hnetafl, was the chief board game of the Vikings". It most often appears alongside @moritheil, ACX Prediction Contest, Adam Tooze.

Reference entry
Hnetafl
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1
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1
First seen
February 09, 2023
Last seen
February 09, 2023
February 09, 2023 · Original source
In theory this also paves the way for human meat, though regulators might have other ideas. 2: Eight years ago I wrote an article about how the government should stop restricting doctors’ ability to prescribe suboxone, a useful medicine for opioid abuse. Last month, the government finally stopped the restrictions. Good for them! 3: Carl Sagan married three times. His first wife was legendary biologist Lynn Margulis, who discovered mitochondrial endosymbiosis, then went off the deep end and became an AIDS denialist and 9/11 truther. His second wife drew the Pioneer plaque. His third wife was one of the women who designed the Voyager golden record. 4: Claim: Chinese sources seem to back this up (and related BBC), but I’m skeptical: is this really the best way to satisfy a “must fight with medieval weapons” constraint? Why not crossbows? 5: Did you know: Alex Berenson, who runs the most popular anti-vaccine Substack, has had an unusual career: he used to be an investigative reporter for the New York Times, and also wrote a series of bestselling spy novels. 6: Less Wrong: I Converted Book 1 Of The Less Wrong Sequences Into A Zoomer-Readable Format. Apparently there’s a thing where Zoomers are supposedly more likely to learn a text if you overlay it on on a fast-paced video game, example here. 7: By this point we’ve probably all heard stories about people who win the lottery and then end up bankrupt and miserable after X months or years. I had always assumed this was limited to very poor people with no understanding of money. This forum post argues it’s not, and tells the story of a man who started out with $15 million and still ruined his life after winning $170 million more in the lottery. 8: Did you know: Exiliarch Mar-Zutra II was a 5th century Jewish leader who took advantage of the chaos caused by weird Zoroastrian communists to secede and turn the city of Al-Mada’in, Iraq into an independent Jewish state for seven years. 9: Why doesn’t the Supreme Court have vice-justices? 10: Steve Sailer (warning: unz.com, far-right site, some firewalls will flag or block it): why aren’t there more gay English soccer players? Thousands of current or recent English pro soccer players, the media is really interested in finding a gay one so they can run a “Historic First” article, and apparently they can’t. There are rumors that players are afraid to come out because of homophobia, but there are at least 2,000 retired soccer players and only one of them has come out as gay. “I’m increasingly sympathetic to [the] theory that whatever psychosocial traits make men highly interested in team sports make them highly heterosexual too”. Is this true of other countries and other sports? 11: Adam Tooze on the demographic background to Iran’s protests. Iran thought it was facing an overpopulation crisis in the 80s and tried some reforms to lower family size. The reforms worked overwhelmingly well, causing “the most dramatic transition ever recorded in demographic history”, from 6.5 to 2.5 children per woman in thirty years. Iran now has “lower maternal mortality than the US”, and an education system where “women in university outnumber males”. This kind of demography isn’t usually compatible with patriarchal religious institutions, and the Ayatollahs are aware of this; in a rare admission of error, Khameini said that “Government officials were wrong on this matter, and I, too, had a part. . . . May God and history forgive us.” Now they’re trying to increase average family size and put the genie back in the bottle; Hungary can tell them about the limits of that strategy. 12: What it looks like to be on shrooms: I haven’t used shrooms myself so cannot confirm or deny, but this is oddly compelling, and makes some things I’ve read about neuroscience of vision make more sense. I wonder if you could get HPPD from watching videos like this for too long. 13: Study: federal cancer funding is extraordinarily effective. Cancer research produces so many valuable treatments that it saves one DALY per $326 spent. For comparison, health systems usually consider an intervention good value-for-money if it saves at least one DALY per $50,000. By combing the Earth far and wide, effective altruists have tentatively found one or two opportunities in the poorest parts of Africa to save lives at $100/DALY, but these are extremely rare exceptions and I wouldn’t have expected anything in the US to be within an order of magnitude of that. Either this finding is fake, or we should all be donating to federal cancer research instead of whatever else we’re doing. 14: Yet another person building a vast theory of human interaction off of the characters in The Office. This one is pretty good, also name-drops Bobos In Paradise. I’m still surprised this is such a common thing. 15: Marginal Revolution: FDA Deregulation Increases Safety And Innovation And Reduces Prices. Study looks at what happens when the FDA reclassifies medical devices from a highly-regulated to a less-highly-regulated category; in general, those devices get better, cheaper, and there are somewhere between similar and fewer deaths/injuries related to those devices. Why would safety increase? The author suggests that regulation is a defense against lawsuits (“Your Honor, the FDA agreed to approve our device, so it can’t have been bad!”), and removing that defense makes companies more lawsuit-conscious and careful; Alex Tabarrok suggests a bigger effect may be allowing more innovation towards safer versions. 16: Ozy writes about Interesting People Of History: Charles Williams (ie the other member of the Inklings) 17: Did you know: the Congressman who founded the House Committee On Un-American Activities was, in fact, a paid Soviet spy (tweet, Wiki article). This actually makes sense; he originally started HUAC to root out fascists, and it only got turned against communists later on. “There has been a push to rename the street [currently named after the Soviet spy], but as of 2018 it has been unsuccessful.” 18: Idle Words: Why Not Mars? Surprisingly strong argument for why sending humans to Mars is harder than people think, of minimal scientific value, and likely to contaminate all future searches for microbial life and ruin our chance to study the topic. Concludes that we should abandon the allure of human space travel and just send probes everywhere. This makes short-term sense, but I wonder what this author’s vision of the future is - do we just stay on Earth forever? If not, don’t we have to start trying to do the hard thing at some point? (I don’t care about this because I assume AI will will flip the gameboard one way or another, but Ceglowski is a noted singularity skeptic and should probably have opinions about long-term things). 19: Metacelsus and Razib on epigenetics. Stop using it to claim there’s “intergenerational trauma”! 20: Tafl games are a family of European games, played in areas as diverse as Iceland, Ireland, Britain, and Denmark, probably sharing descent from a now-lost board game of ancient Rome. One of them, Hnetafl, was the chief board game of the Vikings and is affectionately called “Viking chess”. The one we actually know the rules for is the Saami version, Tablut, which survived long enough for Linnaeus (the taxonomy guy!) to write down the rules. 21: Shot: Chaser: (source) 22: Related: the very center of GPT’s embedding space contains a few unusual tokens including the string “SolidGoldMagikarp”. GPT displays anomalous behavior if these tokens are inserted in a query; for example, it treats “SolidGoldMagikarp” as the word “distribute”. ChatGPT is pretty advanced and fails semi-gracefully here; GPT-2’s reaction to these tokens is more disturbing: (source: Less Wrong) Further investigation determined that many of these tokens are the screen names of a group of Redditors who attempted to count to infinity. The most likely explanation, according to the discoverers, is that these names were in GPT’s tokenization data, but not its training data (maybe they were especially common in the tokenization data because they made thousands of posts with numbers in them, but didn’t make it into the training data because their posts had no content?) - that leaves them existing without content, and GPT tries to round them off to some other “nearby” token (by incomprehensible AI standards of nearbyness). Congrats to the SERI-MATS AI alignment researchers who found all of this; maybe this makes it 0.0001% less likely that the AI which controls the nuclear arsenal in twenty years will have equally inexplicable behavior. 23: More language model news: LLM that understands and can explain images
HNSCC

HNSCC is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 10, 2024 and May 10, 2024. The archive places it in contexts such as "data on recurrence, which is common for HNSCC". It most often appears alongside "Most Drugs Are Bad For You", 1123581321, California.

Reference entry
HNSCC
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1
Issue count
1
First seen
May 10, 2024
Last seen
May 10, 2024
May 10, 2024 · Original source
I'm dying from recurrent / metastatic squamous cell carcinoma of the head and neck (R / M HNSCC_frustrating), so the sections about cancer in particular stand out to me. Regardless of the current state-of-the-art for cancer treatment, personalized and mRNA vaccines are likely on the verge of revolutionizing cancer treatment.
Take the HNSCC that's killing me: I got a partial glossectomy in Oct. 2022. Mine had some high-risk features, but I was assured that, with radiation therapy, it wouldn't recur In retrospect, I obviously should've done chemo and radiation, but at the time I was pleased to not need chemo, and I foolishly didn't look deeply into the data on recurrence, which is common for HNSCC, and I didn't seek second opinions.
Docs are reluctant to impose systemic chemo because of the side effects. But Transgene has a personalized vaccine that is supposed to prevent HNSCC recurrence: https://www.nec.com/en/press/202304/global_20230418_01.html: "In the head and neck cancer trial to date, all patients treated with TG4050 have remained disease-free, despite unfavorable systemic immunity and tumor micro-environment before treatment," And most of these personalized vaccines have essentially no side effects.
Hobbesian trap

Hobbesian trap is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 10, 2022 and June 10, 2022. The archive places it in contexts such as "discusses a “Hobbesian trap” of mutual warfare between tribes". It most often appears alongside 50,000 BC, Africa, Altamira.

Reference entry
Hobbesian trap
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1
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1
First seen
June 10, 2022
Last seen
June 10, 2022
June 10, 2022 · Original source
In asking “What took so long?” the Sapient Paradox is the prehistoric analog of the Fermi Paradox. Instead of: “Why are we alone in the universe?” the Sapient Paradox asks: “Why were we trapped in prehistory?” And just as the Fermi Paradox implies a Great Filter, the Sapient Paradox implies a Great Trap, a trap in which human society lived for, at minimum, 50,000 years, and, at maximum, something like 200,000 years or even more. Depending on your politics, the Great Trap might be an oppressive patriarchy, or perhaps a decadent matriarchy, or a lazy commune, etc (e.g., Steven Pinker, in The Better Angels of Our Nature, discusses a “Hobbesian trap” of mutual warfare between tribes—although he does not connect this to the Sapient Paradox).
hog justice

hog justice is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 24, 2022 and March 24, 2022. The archive places it in contexts such as "I’ll blur some of my distinction between the harm and fairness foundations if you let me use the phrase “hog justice”". It most often appears alongside 1984, Acrolectics, Adnamanil.

Reference entry
hog justice
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1
Issue count
1
First seen
March 24, 2022
Last seen
March 24, 2022
March 24, 2022 · Original source
I admit this is awkward for my theory, so I’ll make a deal: I’ll blur some of my distinction between the harm and fairness foundations if you let me use the phrase “hog justice”.
Hohenzollern monarchy

Hohenzollern monarchy is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 04, 2023 and August 04, 2023. The archive places it in contexts such as "Bruening next devised an elaborate scheme to reinstitute Germany’s Hohenzollern monarchy". It most often appears alongside Academy’s School of Architecture, Adolf, Adolf Hitler.

Reference entry
Hohenzollern monarchy
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1
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1
First seen
August 04, 2023
Last seen
August 04, 2023
August 04, 2023 · Original source
With his sudden electoral success, Hitler had become such a powerful force in German politics that the question in the minds of his opponents was how to prevent his coming to power. President von Hindenburg was now eighty-five years old and ready to retire from politics, but the worry was that if he didn’t run for reelection, the presidency would inevitably fall to Hitler. Chancellor Bruening wanted the legislature to extend Hindenburg’s term. This would keep Hitler out of the presidency without requiring the aging Hindenburg to campaign for reelection. Unfortunately, thanks to the electoral miracle, the Nazi’s had enough parliamentary seats that this plan required their support, and Hitler, not keen to put obstacles in his own path, refused to cooperate. Bruening next devised an elaborate scheme to reinstitute Germany’s Hohenzollern monarchy before Hitler had the opportunity to be elected, but was unable to get adequate support for this plan either. In the end, Hindenburg was persuaded to run for another term. Hitler decided to try to beat him.
Hollow Mask Illusion

Hollow Mask Illusion is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 12, 2022 and October 12, 2022. The archive places it in contexts such as "36: Here’s a variant of the Hollow Mask Illusion I hadn’t seen before". It most often appears alongside 538 deluxe model, @rcafdm, Andres.

Reference entry
Hollow Mask Illusion
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1
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1
First seen
October 12, 2022
Last seen
October 12, 2022
October 12, 2022 · Original source
36: Here’s a variant of the Hollow Mask Illusion I hadn’t seen before:
Holmes-Bonferroni method

Holmes-Bonferroni method is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 06, 2021 and April 06, 2021. The archive places it in contexts such as "Metacelsus mentions the Holmes-Bonferroni method". It most often appears alongside Ashley Yakeley, Cordoba, Cordoba Hospital.

Mention count
1
Issue count
1
First seen
April 06, 2021
Last seen
April 06, 2021
April 06, 2021 · Original source
Metacelsus mentions the Holmes-Bonferroni method. If I’m understanding it correctly, it would find the ten-times-replicated experiment above significant. But I can construct another common-sensically significant version that it wouldn't find significant - in fact, I think all you need to do is have ninety-nine experiments come back p = 0.04 and one come back 0.06.
Holocaust denialism

Holocaust denialism is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 04, 2022 and January 04, 2022. The archive places it in contexts such as "talking about flat-earthism or Holocaust denialism". It most often appears alongside AGI, America, Asian Scientist.

Reference entry
Holocaust denialism
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1
Issue count
1
First seen
January 04, 2022
Last seen
January 04, 2022
January 04, 2022 · Original source
Many years ago, I wrote a post called The Cowpox Of Doubt. I complained about how people loved talking about flat-earthism or Holocaust denialism or whatever. The more you think about those kinds of questions, the more you absorb lessons like: everything has an obvious right answer, anyone who disagrees with me is an idiot, anyone trying to introduce subtlety is a concern troll, the proper length of time to debate something before dismissing it as obvious and your opponents as acting in bad faith is zero seconds. I argued you should basically never think about flat-earthism. Instead, think about when AGI will happen, or whether inflation will stabilize, or any of a thousand other questions where there are smart people on both sides of the issue. That way, you learn the right skills for solving hard questions, which are the only type you ever have any trouble solving in the first place.
Holodomor

Holodomor is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 30, 2022 and March 30, 2022. The archive places it in contexts such as "the ‘Holodomor’, a disastrous famine brought about by Joseph Stalin’s agricultural policies". It most often appears alongside American Republicans, AP, Bahamas.

Reference entry
Holodomor
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1
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1
First seen
March 30, 2022
Last seen
March 30, 2022
March 30, 2022 · Original source
The territories of Ukraine remained a part of the Russian state for the next 120 years. Russia’s imperial authorities systematically persecuted expressions of Ukrainian culture and made continuous attempts to suppress the Ukrainian language. In spite of this, a distinct Ukrainian national consciousness emerged and consolidated in the course of the 19th century, particularly among the elites and intelligentsia, who made various efforts to further cultivate the Ukrainian language. When the Russian Empire collapsed in the aftermath of the revolutions of 1917, the Ukrainians declared a state of their own. After several years of warfare and quasi-independence, however, Ukraine was once again partitioned between the nascent Soviet Union and newly independent Poland. From the early 1930s onwards, nationalist sentiments were rigorously suppressed in the Soviet parts of Ukraine, but they remained latent and gained further traction through the traumatic experience of the ‘Holodomor’, a disastrous famine brought about by Joseph Stalin’s agricultural policies in 1932-33 that killed between three and five million Ukrainians. Armed revolts against Soviet rule were staged during and after World War II and were centred on the western regions of Ukraine that had been annexed from Poland in 1939-40. It was only with the collapse of the Soviet Union in 1991 that Ukraine gained lasting independent statehood of its own – but Ukrainian de facto political entities struggling for their autonomy or independence had existed long before that.
holometabolous insects

holometabolous insects is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 12, 2025 and September 12, 2025. The archive places it in contexts such as "this seems to be true of holometabolous insects". It most often appears alongside A Change of Heart, Abraham, Adams.

Reference entry
holometabolous insects
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1
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1
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September 12, 2025
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September 12, 2025
September 12, 2025 · Original source
There’s a more dramatic example of large-scale synaptic weight destruction in nature whose phenomenology parallels that finding. In the process of becoming a butterfly, a caterpillar’s entire body—including its brain—undergoes major structural changes. These changes involve a vast array of synapses being pruned, remodeled, and generally reorganized. And despite all of this, it seems like it’s at least possible that a butterfly can retain memories of its life as a caterpillar. More generally, this seems to be true of holometabolous insects, which have distinct larval and adult stages.
Holometabolous insects reorganize their brains during pupation in the transition from larva to adult, with many neurons of the central nervous system pruning to the cell body before the generation of adult specific structures. Planarian species are capable of regenerating their entire brain from a tail fragment in the event of fission or amputation, with new tissue arising from a neoblast stem cell population. Arctic ground squirrels demonstrate a drastic reduction in brain volume during hibernation at near freezing temperatures, which is corrected within hours of arousal. In all 3 of these animal groups, learned behaviors have been observed to survive the striking reorganization of the brain.
Holy Books

Holy Books is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 26, 2022 and August 26, 2022. The archive places it in contexts such as "descended from the hermeneutics of Holy Books". It most often appears alongside 1917, aesthetics, American.

Reference entry
Holy Books
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1
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1
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August 26, 2022
Last seen
August 26, 2022
August 26, 2022 · Original source
Kandinsky also had a theory of color, in which he claimed colors have physical and psychical effects and are also part of a system of correspondences. White is birth, black is death, green is nature, yellow is happiness, blue is peace and so on. Literary critics will sometimes talk about a text by mapping such correspondences, because the craft is descended from the hermeneutics of Holy Books, where correct interpretation could turn out to be the key to salvation or enlightenment or knowledge of divine will, and this often scares people away from reading primary sources. For example, every chapter in James Joyce’s Ulysses references an event in the Odyssey, sure, but how the hell are you supposed to figure out on your own that each one is dominated by a particular color and a particular part of the body and so on if an expert doesn’t tell you that. Well, it turns out it’s not that important. It’s just something Joyce did to encourage himself to continue writing his Holy Book dedicated to the God of Art. You can extract meaning from his fried inner organs of beasts and fowls, but that’s because you can extract meaning from anywhere. What Joyce really wanted was an excuse to show off his verbal powers. It’s hard and complicated on purpose, like getting into a fight with ten people to justify that you’ve been doing martial arts every day for decades.
Holy Child

Holy Child is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 10, 2022 and October 10, 2022. The archive places it in contexts such as "He was fighting for the Holy Child against the grey deity"; "He was fighting for the Holy Child". It most often appears alongside 9-11, Adraste, America.

Reference entry
Holy Child
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1
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1
First seen
October 10, 2022
Last seen
October 10, 2022
October 10, 2022 · Original source
But there was something that did not end. There had arisen in that hour of history, defiant above the democratic tumult of the Councils of the Church, Athanasius against the world. We may pause upon the point at issue; because it is relevant to the whole of this religious history, and the modern world seems to miss the whole point of it. We might put it this way. If there is one question which the enlightened and liberal have the habit of deriding and holding up as a dreadful example of barren dogma and senseless sectarian strife, it is this Athanasian question of the Co-Eternity of the Divine Son. On the other hand, if there is one thing that the same liberals always offer us as a piece of pure and simple Christianity, untroubled by doctrinal disputes, it is the single sentence, 'God is Love.' Yet the two statements are almost identical; at least one is very nearly nonsense without the other. The barren dogma is only the logical way of stating the beautiful sentiment. For if there be a being without beginning, existing before all things, was He loving when there was nothing to be loved? If through that unthinkable eternity He is lonely, what is the meaning of saying He is love? The only justification of such a mystery is the mystical conception that in His own nature there was something analogous to self-expression; something of what begets and beholds what it has begotten. Without some such idea, it is really illogical to complicate the ultimate essence of deity with an idea like love. If the moderns really want a simple religion of love, they must look for it in the Athanasian Creed. The truth is that the trumpet of true Christianity, the challenge of the charities and simplicities of Bethlehem or Christmas Day never rang out more arrestingly and unmistakably than in the defiance of Athanasius to the cold compromise of the Arians. It was emphatically he who really was fighting for a God of Love against a God of colourless and remote cosmic control; the God of the stoics and the agnostics. It was emphatically he who was fighting for the Holy Child against the grey deity of the Pharisees and the Sadducees. He was fighting for that very balance of beautiful interdependence and intimacy, in the very Trinity of the Divine Nature, that draws our hearts to the Trinity of the Holy Family. His dogma, if the phrase be not misunderstood, turns even God into a Holy Family.
Holy Family

Holy Family is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 10, 2022 and October 10, 2022. The archive places it in contexts such as "draws our hearts to the Trinity of the Holy Family". It most often appears alongside 9-11, Adraste, America.

Reference entry
Holy Family
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1
Issue count
1
First seen
October 10, 2022
Last seen
October 10, 2022
October 10, 2022 · Original source
But there was something that did not end. There had arisen in that hour of history, defiant above the democratic tumult of the Councils of the Church, Athanasius against the world. We may pause upon the point at issue; because it is relevant to the whole of this religious history, and the modern world seems to miss the whole point of it. We might put it this way. If there is one question which the enlightened and liberal have the habit of deriding and holding up as a dreadful example of barren dogma and senseless sectarian strife, it is this Athanasian question of the Co-Eternity of the Divine Son. On the other hand, if there is one thing that the same liberals always offer us as a piece of pure and simple Christianity, untroubled by doctrinal disputes, it is the single sentence, 'God is Love.' Yet the two statements are almost identical; at least one is very nearly nonsense without the other. The barren dogma is only the logical way of stating the beautiful sentiment. For if there be a being without beginning, existing before all things, was He loving when there was nothing to be loved? If through that unthinkable eternity He is lonely, what is the meaning of saying He is love? The only justification of such a mystery is the mystical conception that in His own nature there was something analogous to self-expression; something of what begets and beholds what it has begotten. Without some such idea, it is really illogical to complicate the ultimate essence of deity with an idea like love. If the moderns really want a simple religion of love, they must look for it in the Athanasian Creed. The truth is that the trumpet of true Christianity, the challenge of the charities and simplicities of Bethlehem or Christmas Day never rang out more arrestingly and unmistakably than in the defiance of Athanasius to the cold compromise of the Arians. It was emphatically he who really was fighting for a God of Love against a God of colourless and remote cosmic control; the God of the stoics and the agnostics. It was emphatically he who was fighting for the Holy Child against the grey deity of the Pharisees and the Sadducees. He was fighting for that very balance of beautiful interdependence and intimacy, in the very Trinity of the Divine Nature, that draws our hearts to the Trinity of the Holy Family. His dogma, if the phrase be not misunderstood, turns even God into a Holy Family.
Holy Grail

Holy Grail is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 08, 2024 and August 08, 2024. The archive places it in contexts such as "finding the Holy Grail". It most often appears alongside 10240, 4chan, @slatestarcodex.

Reference entry
Holy Grail
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1
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1
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August 08, 2024
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August 08, 2024
August 08, 2024 · Original source
The Iliad teaches us that revenge is never fully satisfactory; dominating and lording over others is not enough. It's interesting to contrast the chivalric epics with Homer. Achilles comes to see his own supreme excellence in combat as pointless and futile. Lancelot and Galahad and Gawain don’t feel that way about their own prowess. But why not? Because they use their excellence to protect the weak and defenseless, delivering the land from ancient evils, finding the Holy Grail. If Achilles could be transported to the world of the chivalric epics, he would be much happier and more fulfilled than he was in his own world.
Holy Rosary

Holy Rosary is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 01, 2025 and October 01, 2025. The archive places it in contexts such as "The women recited the Holy Rosary". It most often appears alongside 1910s Portugal, 1999 British eclipse, 2017 US eclipse.

Reference entry
Holy Rosary
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1
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1
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October 01, 2025
Last seen
October 01, 2025
October 01, 2025 · Original source
The Hindu milk miracle of 1995. Starting from the bottom: In 1995, a man in New Delhi noticed that an idol of the elephant-god Ganesh seemed to be really drinking the glass of milk left as an offering. The story went viral - or as viral as things could go in 1995 - and Hindus around the world noticed the same thing. There was “an increase in overall milk sales in New Delhi by over 30%”. Scientists investigated and determined that a sculpted stone elephant trunk could sometimes absorb milk through capillary action. This was a story about rumor, interpretation, and context, but not really “hallucination”. The drinking effect was real. The Halifax Slasher was a typical supercriminal story. Two women reported being attacked by a mysterious and oddly-dressed knifeman; others followed. “Vigilante groups were set up on the streets, and several people, mistakenly assumed to have been the attacker, were beaten up; business in the town was all but shut down”. Although there was a Halifax resident with a history of knife crime, “he was quickly ruled out of the 1938 attacks on account of his large nose, which none of the 1938 victims had described”. Eventually several of the victims admitted to having made it up, and the whole thing went away. Supercriminal cases most often result from people making things up. Occasionally, seemingly-honest people report seeing the supercriminal in poor lighting conditions across a dark alley or something. But even if we consider these to be “hallucinations”, it is usually the one or two most vulnerable people in a town at the time. I can’t find any examples of true “mass hallucinations” - entire towns seeing a nonexistent supercriminal or monster at the same time. Koro is the psychosomatic disease par excellence; I’ve written about it before here. Victims, always male, believe that their penis has disappeared or retracted into their body; they often blame penis-stealing witches. Koro occurs at some very low background rate in every society (including ours), but occasionally wells up into mass panics in primitive cultures that take witchcraft seriously and have traditions of worrying about this sort of thing. Still, I don’t think any panic ever affects more than half of a village’s males, and usually not at the exact same time; it’s a smoldering panic over days or weeks, not a single instant of horrified realization. Also, although I’m not sure and would love to learn more about this, I don’t think the koro victim is having a visual hallucination of not having a penis at all. I think they think their penis is much smaller or shorter than it should be - which only requires some sort of obsessive worrying and (perhaps motivated) mis-remembering of its normal length. None of these are “mass hallucinations” in the sense where the sorts of visual hallucinations typical of certain mentally ill people occur en masse in a crowd of thousands with >50% prevalence - that is, the type of mass hallucination that would be required to explain Fatima. As far as I know, there are no confirmed cases of this ever happening. Still, from the Hindu milk miracle, we can learn that religious people can miss a real phenomenon for a long time, then notice it all at once with great fanfare. And from the koro cases, we can learn that a rare phenomenon can become more common in situations of widespread belief and social pressure. Interlude: It Seems Like Years Since It’s Been Clear This is around the stopping point of the previous Substack discussion. I’ve tried to cover most of Ethan and Evan’s arguments, go through the chain of rebuttals and counter-rebuttals, and maybe pull on a few of the more tempting loose threads that they’ve left. As best I can tell, this level of investigation ends in a decisive victory for the believers. They have a stock of seemingly-unimpeachable testimonies; the skeptics have only a few leads that don’t seem on track to pan out. Eye damage can maybe produce a few odd effects, but - in the entire history of tens of billions of people living daily underneath a sun that they are able to view at any moment - we have not yet found anyone who reports the full constellation of Fatima experiences just from seeing the sun. No exotic weather phenomenon is a perfect match. Mass hallucinations are real but comparatively weak. At least this is my assessment. Skeptic blogs don’t agree. They propose one of these things (with no consensus as to which one) then act like they’ve debunked the miracle, then skip to the really important part: laughing at how obviously wrong it is. I’ve written before about my disappointment in the skeptical community and why it worries me, and here I feel it as acutely as ever. Sitting with my disappointment and trying to put it into words, I think my worries come down to a tangling of the Bayesian graph. The straightforward Bayesian way to do this is to start with some prior probability that there is a God who causes miracles (let’s say 1%), notice that the evidence for Fatima being a miracle naively seems very high (let’s say 90%), multiply out, and end up with a higher (8.3%) probability of God’s existence and a lower (8.3%) chance that Fatima in particular was miraculous. This is liberating. It lets you say “This piece of evidence is very strong, but my prior is very low, so even without being able to debunk the evidence, I continue to disbelieve.” But doing this the straightforward Bayesian way doesn’t work. First of all, what would it mean to naively (even before factoring in that you don’t believe in miracles) say Fatima seems 90% likely to be miraculous. Before factoring in that you don’t believe in miracles, surely the probability is much higher! But also, if you try this, then as soon as you find two similar miracles (I’ve been told the next two are the Eucharistic Miracle of Lancio and the Miracle of Pellicer’s Leg) your probability of God goes up to 88%! But I don’t think there’s any real atheist whose probability would rise in such a straightforward linear way. You need some kind of model where either it’s almost trivially possible to generate an arbitrary number of convincing-yet-false miracles, or it isn’t. But this doesn’t match the “virtuous” approach of addressing each miracle on its own terms - where you try to understand the Sun Miracle by learning things about the sun, or entoptic phenomena, or 1910s Portugal. And it does match the skeptical approach I’m complaining about, where you say “it’s probably swamp gas or something, lol, imagine being so dumb that you believe in miracles.” So I cannot object too strongly. Still, my greatest fear in this and all other problems of reasoning method is the trapped prior, where people take this too far and become impervious to evidence entirely. I think it’s worth untangling the whole Bayesian graph, trying to keep this whole structure in mind, if it prevents people from accidentally propagating an update down a logical chain, then propagating the same update back up the chain, again and again, ad infinitum, until they become arbitrarily sure of themselves. “We can be sure all miracle claims, even the convincing ones, are false, because there’s no God - and we can be sure there’s no God because all miracle claims are so risibly false.” Even if this is harmless - even if it turns out correct in the case of religion - it teaches such dangerous habits of mind that I’m willing to err in the direction of going way too far taking such claims seriously - at least in the “entertaining an idea without accepting it” sense. Everyone gets to decide what is and isn’t worth their time. I think deciding that these sorts of miracles aren’t worth your time is fine, as long as you’re propagating all the probabilities correctly and not accidentally treating your own hurriedness as a cause to update the rest of your belief graph. As for me, I don’t know, I just find this fascinating. In Evan’s skeptical take on the conversation, he starts strong, but after the topic switches to Part LXXVII of Dalleur’s discussion of photograph angles, he stops and asks: What the fuck are we doing? What are we talking about? What have I spent (conservatively) 18 hours of my life on? We’re addressing what Stanley Jaki called the most important event of the 20th century! We’re debating the existence of God, the most important question possible! If God is real, then nothing could be more important than establishing this: in the best case, we will come to believe; at worst, we will be able to tell St. Peter that our failure was honest and not from lack of trying. If He is not, then we can do whatever we want here on Earth, and surely one of the noblest ways to spend our short existence is expanding the frontiers of the known into the borderlands of mystery! In particular, if the God of Fatima exists, we are in deep trouble. I said I wouldn’t talk about exactly what the Virgin Mary told the child-seers, but the short version is that the First Secret was a very, very nasty vision of Hell. It looked exactly the way a ten-year-old child might expect: a lake of fire populated by ebon-skinned demons and horrendous tortures; the lead child-seer said that if the Virgin had not begun by promising that she personally would never go there, “she would have died of fright”. As it was, the consequences of the vision were grim. The child-seers got it into their minds that they could perhaps save sinners from the fire by “doing penance”. They drank only stagnant, scum-encrusted water, in the hopes that this might help some otherwise hell-bound soul; on some especially hot days, they ceased drinking water at all. When they found particularly painful ropes, they tied them around their bodies so hard that they bled (later, the Virgin mercifully told them they didn’t need to wear the ropes at night - they could stick to daytime only). After so many mortifications, they were easy prey for the Spanish Flu; two of the three perished before their tenth birthday. As they lay dying in the hospital, they were recorded as freaking out every time they saw a nurse or visitor with “immodest dress”, saying that they would not act in such a way if they knew how long Eternity was, or what awaited them there5. If all of this is the true opinion of the Lord of the Universe, we had better figure it out quick. If it isn’t, then the words of the Grupo Anticlerical: People! Let us always fight! From the victory of progress, science, freedom, and free thought, will result human happiness, joy, love, fraternity, respect for women, veneration for mothers, adoration for children, affection for the elderly, protection for the sick, the unfortunate, the tortured . . . O most holy mothers! O holy, pious mothers who so love your sweet little children! Have compassion on your beautiful little children, sacred fruits of your blessed wombs! …take on new meaning and urgency. I will admit my bias: I hope the visions of Fatima were untrue, and therefore I must also hope the Miracle of the Sun was a fake. But I’ll also admit this: at times when doing this research, I was genuinely scared and confused. If at this point you’re also scared and confused, then I’ve done my job as a writer and successfully presented the key insight of Rationalism: “It ain’t a true crisis of faith unless it could go either way”. But now that we’ve let Ethan, Evan, and the rest dig us into as deep a hole as possible, let’s try to dig our way out. 3: Our Lady Of Everywhere Else One question that Ethan, Evan, and Dalleur fail to ask is: what if people are basically always seeing the sun spin and change colors and and fall from the sky? What if this is the most common experience in the world? What if it’s a minor miracle every time you get more than a handful of people together and they don’t fall down in awe and terror at the manifestations of the sun? Goncado Xavier de Almeida Garrett is one of the star witnesses of the Fatima miracle, quoted above. His testimony comes from a letter written to Father Formigao, a local priest, about two months after the event. But although pro-Fatima sources quote the testimony at the beginning of the letter, they conveniently leave out what follows: I ask your excellency to please tell me if you confirm this narrative: the Bishop of Portalegre and Mrs. Maria de Jesus Raposo report that while they were with other people in Torres Novas, on the 20th of October at the end of the day, they saw the sun rotate and change its colors. They said this was different from Fátima and did not have the importance of October 13th. I would like clarification on the differences. It is urgent to know what the differences are, since they attended both […] Until now, no one saw the sun's sparkling rotations, and now everyone sees them many days and many times. Many days and many times? Remember, the Virgin Mary first appeared at Fatima on May 13. She promised to return on the 13th of each successive month until October, when she would perform a great miracle. But she never said she wouldn’t perform any miracles until October. So on the 13th of each month, a medium-sized crowd gathered. They didn’t leave disappointed. I won’t include every claimed supernatural occurrence, but here are the ones relevant to our subject: Olimpia de Jesus, about July 13: [On July 13], at her sister-in-law's house, when they heard the people shouting, he asked, "What's going on over there?" [Olimpia] looked at the sun and said, "The sun is different." The people came and reported that they had seen signs in the sun and in the sky. Joaquim Inacio Vicente, about August 13: This hour was a moment of terror for all who were there. Some lost their senses, others believed it to be the last day of their lives and their day of Judgment, and for some, afterwards, it was a wonder to see the admirable colors that successively took on the clouds that obscured the sun's rays—colors from bright red to pink and from there to blue—the color of anise, as several people declared to me minutes later in my home. Leonor de Avelar e Silva Constancio, about August 13: Everyone looked up at the sky, which was covered by a light cloud, like a very fine white lace, pink in places. The sun, which had been completely hidden for a moment, left us illuminated by a strange light, with yellow spots visible on the ground and above us all, and a great drop in temperature, as happens during a solar eclipse. Manuel Pedro Marto, about August 13 and September 13: [On August 13, he] saw a kind of luminous globe rotating in the clouds […] On September 13th, he also went to Cova da Iria. He was a little away from the children. He saw nothing, nor heard anything, but he heard that some people had seen extraordinary things in the atmosphere. Joaquim Xavier Tuna, about August 13 and September 13: On the 13th of August, I saw the sun lower in the sky at the hour of its appearance. It never lowered as much as that time, not even on October 13th. All the objects around me turned yellow. On September 13th, I saw a large cross emerge from the sun and head east. Its progress was not very hurried. Sometimes it appeared, sometimes it disappeared, until it disappeared from view. I also saw other things that I cannot explain. In the Lapas area, there were people who, at the same time, saw the cross. Then there was the great miracle on October 13. Remember, I was only able to find a handful of negative testimonies - people who said they didn’t see it. One was from a woman named Leonor das Dores Salema Manoel, who said she saw “nothing of what others saw”, at least at Fatima. But on the drive home from Fatima that evening6: I saw [the sun] pass through different colors that I can't remember and it turned green, very light green, like a green salad with a golden rim around it, and spinning. Very long rays seemed to touch the earth and the sun seemed to be separated from the sky. Then the sky took on pink flashes, changing to a yellowish hue around the sun, and further away, spots here and there. After a few long moments that I can't remember, it returned to normal and I couldn't look at it again. The next occurence was early the following year. From the parish inquiry’s interview with Jacinto de Almedia Lopes: He further said that on the day of Our Lady of Purification, that is, on the second of February, 1918, he about 3 o’clock in the afternoon, being in the same place, he noticed signs in the sun identical to those of the thirteenth of October, which he had not noticed on many other days when he had been there. And next, from a letter by Gilberto Fernandes dos Santos: I must inform you that I went to Fátima on [June 13, 1920]… at that very moment, the people were kneeling on the ground, shouting, praying loudly, weeping, begging forgiveness with their hands raised, because they were witnessing a solar phenomenon similar to that of October 13, 1917. And next, from Dr. Henrique Weiss de Oliviera, describing events on May 13, 1923: I ate my meal in a car on the road near Cova da Iria [in Fatima], from half past noon to one in the afternoon, and when I returned to the Chapel, I heard the groups I passed exclaiming in admiration about a marvelous phenomenon that they claimed was occurring in the sun toward which they were directing their gaze. Deeply doubting the repetition of the marvelous phenomena that had dazzled thousands of people, according to reliable reports, during the last apparition of Our Lady in 1917, I was about to pass on without even bothering to look. I remembered, however, that when I first went to Fátima on October 13th of last year, and upon hearing similar admiring rumors around me, I had seen nothing during my quick inspection, perhaps because I was filled with that spirit of doubt. I therefore wanted to be certain this time so that I could, with full awareness, give my testimony to whoever and whenever I was asked. And, having stopped near a group and stared at the sun, carefully shielding my eyes from the direct sunlight, so as not to see anything, they immediately advised me to insist that I would see something. It took a long insistence to finally see what amazed everyone and caused astonishment that I could not see it. And I saw with precise clarity, and twice, what the common people, in their imaginary language, very accurately likened to: almond blossom petals. They fell from a great height (no longer seeing them detach from the sun as the people around me saw them) For myself, I finally, and after a considerable time, concluded that there is no such natural phenomenon, neither known nor described, thus leaning toward the supernatural. Today I firmly believe that this was the case, because I have had testimonies that allow me to reconstruct the phenomenon as it appears to have occurred according to these testimonies. First, one could gaze at the sun for a long time and with impunity, seeing magnificent phenomena of beauty and color; then began an abundant rain of the aforementioned petals; and when I arrived, it was no longer possible to gaze at the sun, and the phenomenon, which had been quite lengthy, was at its end, which explains my difficulty in witnessing it now. And from Joao Amael, on October 13, 1925: I do not know why, I suddenly felt a desire to look at the sun. [I would hear] other educated persons admit having seen phenomena in the sun on that day and hour. I looked at the sun. Before that, nothing special could be seen. But now I looked at the sun without hurting my eyes, without any retina resisting. I became more intent. To my astonishment, the sight became even clearer. The sun turned on itself in a very small circle, and in the center it turned into a dark disk in rapid rotation. During some minutes, very impressive and overwhelming, I could clearly verify this strange process. Then, without revealing anything of what I observed, for fear of autosuggestion, I asked my companion to look at the sun and see whether it really appeared. And my companion was describing exactly the phenomenon, the same extraordinary phenomenon. The test was achieved. And I gained further assurance, when various other people later told me that they had seen what I saw clearly, at the same hour, as they kept looking at the sun, without the slightest sensation of pain. Amael’s report of a miracle in 1925 is the last recorded case I can find at Fatima. I don’t know if this was when the sun miracles stopped happening there, or when people stopped including them in the Critical Documents collection. In either case, there were plenty of other places willing to pick up the torch. 3.1: The Ghiaie Variations As far as I can tell, Fatima was only the second-largest crowd to have ever witnessed the Miracle of the Sun. The largest was a group of 200,000 - 300,000 people in Ghiaie, a tiny village near Bonate, Italy. On May 13th, 1944 - the same day of the year that the child-seers of Fatima saw their first apparition - a seven-year old girl went out to pick flowers and had a vision of the Virgin Mary. The Virgin promised to return to her for nine successive evenings; at some point (although I cannot follow this part of the story) she must also have promised to return four times the following week, as large crowds gathered in expectation. According to my source, on the ninth appearance: Many testimonies from the site of the apparition and from surrounding villages described an impressive solar phenomenon. The sun came out of the clouds, whirled dizzily on itself, and projected beams of yellow, green, red, blue, and violet light in all directions. The beams of light colored the clouds, fields, trees, and the stream of people. After a few minutes the sun stopped its whirling, and those phenomena began soon again. Many noticed that the disc had turned white like a Host. The clouds seemed to be lowering down on the people. Some noticed a Rosary in the sky. Others saw a majestic Our Lady with a trailing cloak. Some people, who were at greater distance, saw Our Lady's face looming in the sun. From nearby Bergamo many witnesses observed the sun become pale and radiate all of the rainbow's colors in all directions. They also noticed a large yellow light beam falling over Ghiaie, perpendicularly. The blog says there were similar solar phenomena during the tenth and twelfth appearances, as well as on the following June 13th and July 13th7. All of this is from a random Catholic blog; can we find clear testimonies? The miracle of Fatima was heavily promoted by Portuguese, Vatican, and American Catholics, leading to a large body of sources being available in English. The Ghiaie apparition has gotten less attention, and so I can find fewer testimonies, have had to clunkily machine translate some things, and had a harder time tracing the exact chain-of-transmission. Still, here’s what we’ve got, mostly from here: Don Giuseppe Piccardi: The people cried out to the miracle; I turned between the intrigued and the distrustful, and I saw the sun that-comes from the clouds - turned on itself and the speed of movement seemed to be skidding. At the same time I saw that he projected light beams, then, for me, almost constantly yellow gold. This color I contemplated it even when the sun was veiled with uncaught clouds. Slightly hard to figure out from the machine translation, but I think this is Bishop Adriano Bernareggi: At 6:00 PM I was at the Patronato for the feast of St. John Bosco. Just at that time I finished speaking in front of the church. Then I entered the church for the Benediction with the Blessed Sacrament. But most of the crowd remained outside because they said they had observed for about ten minutes the sun rotating on its axis, also suddenly changing color: yellow, red, blue. The sun could be observed without disturbance. The phenomenon was also observed in other places. I only noticed at the end of the service a yellow color in the houses, as when there is a partial eclipse of the sun at sunset. At 7:45 PM they said the phenomenon was repeated. I watched too. By staring into the dazzling sun, you could end up seeing the sun stand out clearly, giving the impression that it was rotating. Then everything took on a red color. But then it was clearly an optical phenomenon. Don Luigi Cortesi, a local seminary teacher who was a strong skeptic of the apparitions and even borderline-kidnapped the child-seer to convince her to recant: A shiver runs through me for a second. I react forcefully, forcing myself not to lose my mind, not to let myself be overwhelmed. I desperately squeeze my pupils and look at the sun: I see a large, clear spot without sharp edges, then, when my eye has adjusted, I see a disk of intense whiteness that seems liquid. Staring at the edges of the disk, I detect a dizzying rotation, like an electric circular motion, like a dizzying pinwheel, except that the direction of motion changes rapidly from left to right and then from right to left. I remember Fatima. Except this time, the sun revolves around a fixed axis, without moving in the sky. I return to the earth, to the crowd: I notice that the faces, the hands, the trees pierce through all the colors of the rainbow. It's natural, I think to myself: when the eye is offended by an intense light or an equivalent stimulus, it projects a stain on objects, which fades from red to violet and tints the objects it encounters with different colors; the stain disappears when the eye, rested, has returned to normal. In fact, a few minutes later, I no longer see those iridescent colors; every object has returned to its natural hue. The phenomenon of rotation leaves me dubious. A neighbor offers me his smoked glasses, and I look: the sun continues to rotate. He offers me a telescope, and I invert it, the screen, and look: the sun is still rotating. Then I can't take it anymore: even today, I'm not convinced that seeing a cosmic prodigy is worth losing my sight. Back then, I wasn't even convinced I was seeing a prodigy, since a plausible natural explanation for the phenomenon quickly emerged in my mind. However, urged by the neighbors to get excited, I remain silent. And I silence them by pinching and slapping the arms of those around me, which are stretched out towards the sky." From the parish bulletin of Tavernola, the exact author is slightly confusing but it was either written by or signed/confirmed by Piero Bonicelli, local provost: On the 28th in the evening of Pentecost, something happened that made a profound impression on everyone. At 6:00 PM sharp, a dimming of the sunlight was felt, accompanied by a sudden flash of lightning, first clearly observed by some bowling players. Looking at the sun, one saw first green, then bright red, then golden yellow, and then it spun around dizzily. At that spectacle, people poured into the streets... One can imagine their comments. The women recited the Holy Rosary, punctuated by the words: "Oh, how beautiful!" After ten minutes, the sun returned to normal. Comments? None. We await an explanation from the appropriate source. For now, we're content to hear the usual strong-minded people call us poor, deluded people, but don't you think this is a rather general illusion? In any case, for now, we're deluded: we'll see later. The parish priest of Tavernola, director of the bulletin, sending this issue requested by Father Piccardi, wrote on June 27, 1946: I must assure you that, as written, it is true, and I can also tell you that I was among those deluded that evening. To be prudent, I didn't go out into the street where people were shouting about a miracle, but from a slightly hidden window, I watched the sun change color and spin rapidly... illusion? Many of us here in Tavernola have been deluded. I can also tell you that I was pleased that such an illusion existed in Tavernola, since the people here have always had a great devotion to the Madonna. There may be more testimonies at this site, but they’re in very old scanned documents that it would be too time-consuming to stick into my machine translation pipeline. Another source says that “On February 24, 1994, [the TV show] ‘Detto tra noi' (Raidue), interviewed some witnesses, who confirmed the solar phenomena of May 21 1944 that were watched by many people“. I think a few hours extra work by an Italian speaker could produce at least five or ten extra Ghiaie testimonies, maybe many more. But as it is, we have enough to try something interesting: let’s recreate Dalleur’s analysis, but for Ghiaie. At 6 PM, the sun was shining from almost due west. For the sunlike light source producing the miracles to mimic the real sun, it would have also had to have been to the west of Ghiaie. If we assume it was the same distance as Dalleur’s Fatima light source, it would have been about 2-3 miles to the west of Ghiaie, which puts it above the village of Merate. We know from the last testimonial that the phenomenon was seen clearly in the village of Tavernola Bergamasca, which is about 22 miles from Ghiaie and 25 from Merate. An Italian source also reports sightings in Brescia and Piacenza, each about 35 miles from Ghiaie. So a Dalleur style analysis might conclude that this event also had a 25 - 35 mile visibility radius, similar to Fatima’s. …unfortunately a 25 mile circle centered on Merate includes the city of Milan, population 1.1 million, which produced no reports of unusual solar activity. And Milan had clear line-of-sight to Ghiaie and Merate, and so probably better viewing conditions than Tavernola, which (you can see from the map above) has some intervening hills. Might the miraculous light source have been like a spotlight, aimed in only one direction - that is, east to Ghiaie and Tavernola, but not southwest to Milan? This would contradict Dalleur’s Fatima analysis, since one of the most dramatic testimonies comes from the city of Minde, which is on the opposite side of the presumed light source from Fatima. I don’t really think it’s possible to maintain a theory where this phenomenon gets transmitted through normal geography. 3.2: Mary Such Cases At this point, the reader will get the general idea, and we can start moving faster, as there is a large amount of ground to cover. Heroldsbach, Germany, 1949: The Virgin appeared to four young girls. Rumors spread, crowds gathered, and on December 8th, 10,000 people saw another sun miracle. Here are about a hundred testimonies, gathered with typical German thoroughness. An expert meteorologist brought in to investigate summarized them as follows: If one now considers the testimony in detail, one encounters a surprisingly small agreement of the observations made. One witness has seen a red sun, the other a yellow, an orange or pink with blue and green, or a whitish sun. A silver one was also observed or all the colors mentioned in colorful change. One wants to have observed an oversized, the other a first small or normal, but then rapidly enlarging and rushing towards the viewer in a frightening way. Most of the witnesses noticed that the solar disk rotated very quickly in two or three phases of rotation for about a quarter of an hour. The Catholic Church condemned the apparition and miracle as fake, even going so far as to excommunicate the child-seers. Later they relented slightly and un-excommunicated them, but their official position is still that nothing supernatural happened - this sun miracle was merely an overly enthusiastic hallucination! Necedah, Wisconsin, USA, 1949: A housewife named Mary Ann Van Hoof claimed to have seen the Virgin Mary. This is among the less plausible visitations: Van Hoof, who was raised Spiritualist, also claimed to have seen Joan of Arc, George Washington, and Abraham Lincoln. The messages she channeled seemed less like tidings of peace and love than like a particularly unhinged Truth Social post, and included warnings about the Rothschilds. Still, rumors spread, crowds gathered, and on August 15 1950, 50,000 - 100,000 people showed up hoping for a miracle. As for what happened next, Wikipedia says that “witness accounts vary significantly”. WaPo says that “observers saw nothing unusual” and LIFE mentions nothing out of the ordinary. But other sources report sun miracles, and I was eventually able to track down three testimonials in a summary of articles from a local newspaper, which states that “after a rainy morning…”: It was about noon when Van Hoof came out of the house and a woman screamed, “By God, it’s really true,” and fell to her knees. Then it happened that the Rapids woman and so many in the crowd saw the sun, covered with a dark, greenish gray disk, spinning down toward the earth. And she testified, “I thought the end of the earth was coming and fell to my knees.” A Pittsville woman also described the sun spinning closer to the earth. “I and many other people, fell to our knees in awe.” The Daily Tribune visited the Oct. 7, 1950, event — a 25-minute “last” message from the Mediatrix to the “throng” of 50,000. Responding to this seventh vision, gasps were heard from women who again saw the sun behaving oddly. A Catholic priest told reporters he saw the sun whirl clockwise and jump. The Catholic Church condemned the apparition as fake, and declared van Hoof’s followers “a cult”. Lubbock, Texas, USA, 1988. Really? Really? Nothing could be more natural than for the Queen of Heaven to appear to kind-hearted shepherd children in Portugal. Even an appearance in war-torn West Germany makes a certain amount of sense. But Lubbock, Texas? I suppose this must have been how the cool Sanhedrin members felt when they learned the Christ hailed from Nazareth. But that doesn’t make it any better. Anyway, rumors spread, crowds gathered, and on August 15, 1988, about 10,000 people witnessed the Miracle of the Sun. Here is an indirect testimonial, a man describing his wife’s experience: A large crowd had gathered outside Saint John Neumann Church on that very hot August afternoon on the Feast of the Assumption. Mass was being said in the afternoon, and around the time of the Consecration, suddenly her cousin’s wife (a convert, if you remember) said “look at the sun”. When she did, the sun was pulsating, it would look like it was coming down to earth and then go back again, it spun around in circles, much the same as what took place in Fatima in 1917...and changed colors. She looked at it directly for 15 minutes or so without any damage to her eyes. As my wife looked around, the people in the crowd seemed to be bathed in various colors. During all this my wife even saw The Blessed Mother. The Blessed Mother was extending her arms in what appeared to be a welcoming gesture. But not everyone had the same experience that day: her cousin’s wife and our son saw and believed instantly, but her cousin and brother saw nothing at all. Why did some see these events and others did not? We don’t know...not enough faith? Or perhaps they had enough faith, and they didn’t need a sign! Here we have something special: according to the Los Angeles Times, one pilgrim took a poll about who saw what: A push was on to assemble evidence for the commission in a lawyerly way. Testimonies from 247 people present at the feast had been recorded. The statements were transcribed by volunteers and stored in a computer. Joe James himself indexed the information: 186 had witnessed the spinning of the sun; 75 had seen the Virgin; 64 Jesus; 18 an angel. How could anyone ignore the bulk of such documentation? We don’t know how the 247 people were selected, but very naively it seems like 2/3 of those present saw the sun spinning. This also matches the first person listing 2/4 family members. (the Catholic Church withheld judgment, refusing to either endorse or condemn the visions) Benin City, Nigeria, 2017. On October 13 2017, crowds gathered around the world to celebrate the 100th anniversary of the Fatima miracle. One such commemoration happened in Benin City, Nigeria, where 30,000 people attended the National Marian Congress and witnessed the re-dedication of Nigeria to Mary’s Sacred Heart. As the speakers commemorated the Fatima event . . . . . . someone pointed to the sky and shouted “It’s happening again!”. It was, indeed, happening again. You can read about ten testimonies here. I’ll quote just one, from Brother Joseph Obiemeka Azih: Immediately after the 3:00 p.m. Divine Mercy prayers, there were brief showers of rain. Then came sudden brightness of the sun, which was hitherto hidden behind layers of dark cloud. We also observed rather surprisingly the mysterious shooting of the sun forward and backward. Intermittently emitting of powerful bluish and golden colors of light from “Our Lady clothed with the Sun.” The sight was indescribably beautiful. We were busy staring at the bright sun steadily for more than twenty minutes without blinking an eye even for a second! People around us were dazzling and reflecting these bluish and golden colors on their dresses and faces. What a mystery! More than 30,000 people inside the arena were seen peering at “the dancing of the sun” bewildered. The miracle lasted for more than 45 minutes after which there was [a] heavy downpour which the Bishops present said [were] “showers of blessing.” I was able to confirm that some of the people whose testimonies were listed on the site are real Nigerian Catholics whose existence is attested in other sources. Two weeks later, there was another Nigerian commemoration of the Fatima anniversary, in Lagos, and a sun miracle happened at that one too. 3.3: Made You Gaze At Medjugorje Medjugorje (Bosnia, 1981) is in many ways a typical Marian apparition site, much like the ones on the list above. Child-seers, warnings to repent, sun miracles, you know the story by now. But in Medjugorje, the miracles keep happening. Pilgrims - or, more cynically, tourists - go there just to see the sun miracles, and many come back satisfied. You can find blogs by people who went to Medjugorje hoping to see a sun miracle, and on their first or fifth or eighth or whatever day, there’s a crowd of people, yelling and pointing at the sun, and they look up and see it too. Here’s an account from Catholic blogger Father Dwight Longernecker: I was an Anglican priest living in England, in 1985 when I was invited by a group of Anglicans and Catholics to visit Medjugorje. I didn’t want to go. Being a former Evangelical-fundamentalist I wasn’t too keen on apparitions of the Blessed Virgin. I opted out. They insisted. I dug in my heels. They said someone else would pay for it. I didn’t want to go. They cajoled and twisted my arm until I said ‘yes’ [...] On our second day there I sat on the balcony of our guesthouse with a large woman named Eleanor. As we began the rosary I looked up and the sun was a blaze of light in the sky. I looked down to the car parked below and the sun was reflected in the hood of the car as a blaze of light. Eleanor and I prayed the rosary together. I had my eyes closed. At 6:20 Eleanor gave me an elbow in the ribs and pointed. The sun was now a disc of white light in the sky like a Eucharistic host. Then as I watched it began to spin, first clockwise then anti clockwise. Sparks spit out from the rim of the sun like a firework. I looked down and the sun was a white spinning disc on the hood of the car. I don’t think this would have happened if it was just my eyes playing tricks on me. Plus, Eleanor saw it too. That’s why she gave me an elbow in the ribs. I am not sure how long this lasted, but when we spoke about it to our fellow pilgrims they said many people in the town square had reported the same phenomenon. Some of these tourists capture the phenomenon on video. Unfortunately, the videos are of three types: Videos of a bunch of people pointing at the sun, and shouting the word “Miracle!” in various languages, and obviously looking extremely excited, but the sun itself looks totally normal, and the person taking the video apologizes and says that their camera isn’t good enough to capture it.
Holy Virgin

Holy Virgin is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between October 01, 2025 and October 01, 2025. The archive places it in contexts such as "I believe that I was not found worthy by Our Lord to see these phenomena, but in my soul I had no need to see them to believe in the apparition of the Holy Virgin to the children". It most often appears alongside 1910s Portugal, 1999 British eclipse, 2017 US eclipse.

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Holy Virgin
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October 01, 2025 · Original source
This is what was said by those around me, and what thousands of people affirm that they saw. As for myself, I saw nothing ! I could indeed look at the sun and I was terribly agitated to hear everybody shouting that there were extraordinary signs in the sky. I believe that I was not found worthy by Our Lord to see these phenomena, but in my soul I had no need to see them to believe in the apparition of the Holy Virgin to the children.
Home-School

Home-School is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 27, 2025 and June 27, 2025. The archive places it in contexts such as "piloted a beta-test of a Home‑School version of the platform". It most often appears alongside 10,000 hour rule, 2 Hour Learning, Inc, 2-hour Learning.

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Home-School
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June 27, 2025 · Original source
...Miami elementary campus, promoted the idea that cities could launch “micro schools” if they had enough local demand (unless you count Miami, none actually launched) and piloted a beta-test of a Home‑School version of the platform. Early homeschool data showed that kids were using it for ~2 hours/day as planned, but only seeing a 1x learning growth — still a fine result for only doing 2-hours of a...
Homem cordial

Homem cordial is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 07, 2024 and May 07, 2024. The archive places it in contexts such as "We are cordial men (see: https://translate.google.com/translate?sl=pt&tl=en&hl=pt-BR&u=https://pt.wikipedia.org/wiki/Homem_cordial&client=webapp )". It most often appears alongside affirmative action, Africa, African National Congress.

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Homem cordial
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May 07, 2024 · Original source
...do have 50% black population (not black in the same sense as Americans). We didn't fight a civil war to end slavery and we didn't have segregation after ending slavery. We are cordial men (see: https://translate.google.com/translate?sl=pt&tl=en&hl=pt-BR&u=https://pt.wikipedia.org/wiki/Homem_cordial&client=webapp ). We had our first black president in 1909, but neither he nor the people made much of it. I am saying this because Brazil offers a nice comparison. We do have quotas. Qu...
homeostatic plasticity

homeostatic plasticity is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 12, 2025 and September 12, 2025. The archive places it in contexts such as "Other forms of synaptic plasticity were discovered after LTP and LTD, like homeostatic plasticity and spike-timing-dependent plasticity". It most often appears alongside A Change of Heart, Abraham, Adams.

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homeostatic plasticity
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September 12, 2025 · Original source
The rough history of the SPM hypothesis, then, goes something like this. Around 1900, there was still much we didn’t know about the nervous system (or biology, for that matter; remember that molecular biology really only got started in the 1950s), but even early workers like Ramón y Cajal recognized that connections between neurons could offer a useful substrate for modulating circuit behavior, and hence for learning and memory. This lead to the “plastic change hypothesis”, which took a more modern form around 1950 with the work of Hebb et al. When LTP and LTD were discovered in the 1970s, and appeared to successfully account for a variety of longer-term forms of learning, the stock of synaptic weight changes rose, and the stock of other known forms of plasticity (e.g., plasticity in single-neuron properties, and in rates of neuron creation and death) fell. By 2000, when the SPM hypothesis paper was published, workers had good reason to believe LTP and LTD explained most learning and memory phenomena of interest. Other forms of synaptic plasticity were discovered after LTP and LTD, like homeostatic plasticity and spike-timing-dependent plasticity, but the SPM hypothesis is general enough to accommodate them. After ANNs succeeded at pretty much every task we threw at them since the early 2010s, and people started to focus on ANN-based models of the brain, the SPM hypothesis became a dogma.
Homo neanderthalensis

Homo neanderthalensis is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 19, 2024 and July 19, 2024. The archive places it in contexts such as "hyoid bones of sapiens ’ and neanderthalensis ’ hyoids". It most often appears alongside Alan Turing, Amazon, Amazon jungle.

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Homo neanderthalensis
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July 19, 2024 · Original source
Erectus speech perhaps sounded more garbled relative to that of sapiens, making it harder to hear the differences between words. … Part of the reason for erectus’s probably mushy speech is that they lacked a modern hyoid (Greek for ‘U-shaped’) bone, the small bone in the pharynx that anchors the larynx. The muscles that connect the hyoid to the larynx use their hyoid anchor to raise and lower the larynx and produce a wider variety of speech sounds. The hyoid bone of erectus was shaped more like the hyoid bones of the other great apes and had not yet taken on the shape of sapiens’ and neanderthalensis’ hyoids (these two being virtually identical).
homo puppy

homo puppy is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 28, 2021 and May 28, 2021. The archive places it in contexts such as "homo sapiens looks a lot like a domesticated neandertal - homo puppy Bregman christens us". It most often appears alongside A Game of Thrones, Africa, African Americans.

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homo puppy
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May 28, 2021 · Original source
You can find out more about potential mechanisms for this, but for our purposes the important point is that homo sapiens looks a lot like a domesticated neandertal - homo puppy Bregman christens us.
homophobia

homophobia is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 14, 2025 and May 14, 2025. The archive places it in contexts such as "You can do it - witness “homophobia” for people with normal political or religious objections to homosexuality". It most often appears alongside /r/atheism, /r/childfree, /r/fuckcars.

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homophobia
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May 14, 2025 · Original source
One easy answer would be cynophobia, the pathological fear of dogs. I don’t think this is true. The people on /r/petfree mostly don’t seem afraid, unless they’re sublimating it in some really weird way. And I know people with actual disorder-grade dog phobia, and they’re not angry about it. Many of them are apologetic, or agree dogs are cute, or at least don’t spend all their time fuming about the existence of dogs. You would really have to stretch the definition of phobia here. You can do it - witness “homophobia” for people with normal political or religious objections to homosexuality - but it would feel wrong.
homunculus

homunculus is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 09, 2025 and July 09, 2025. The archive places it in contexts such as "Byrnes makes this more concrete with a survey of homunculus beliefs across different cultures". It most often appears alongside AI Alignment, blind spot, Bronze Age.

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homunculus
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July 09, 2025 · Original source
…Byrnes calls it the “homunculus” (Latin: “little man”). The homunculus (“self”/”me”) is a useful tool for organizing internal experience. For example, if you have a seizure and your arm moves, you can say “I didn’t choose to move my arm - it just moved of its own accord!” (ie the homunculus isn’t doing the moving). If you have some kind of OCD or rumination disorder, you can say “I don’t want to keep having these thoughts about death, they just pop unbidden into my mind” (ie the homunculus isn’t doing the thinking). To actually analyze these situations would require a PhD in neuroscience, but we all understand the visceral experience of being stuck with thoughts that “we” don’t “want” and didn’t “cause”. Overall it’s very similar to the way I described natural intuitive “theory of mind” here: The mind is an imaginary space containing things like thoughts, emotions, and desires. I have mine and you have yours. I can see what’s inside my mind, but not what’s inside your mind, and vice versa. I mostly choose the things that are in my mind at any given time: I will thoughts to happen, and they happen; I will myself to make a decision, and it gets made. This needs a resource called willpower; if I don’t have enough willpower, sometimes the things that happen in my mind aren’t the ones I want. When important things happen, sometimes my mind gets strong emotions; this is natural, but I need to use lots of willpower to make sure I don’t get overwhelmed by them and make bad decisions. Byrnes makes this more concrete with a survey of homunculus beliefs across different cultures. We place the homunculus in the head, which happens to be correct (ie thoughts happen in the brain). But this is kind of a coincidence (or maybe downstream of knowing the real science); other cultures feel like the seat of consciousness is in the heart or the belly, and this feeling is about equally plausible and stable. Meditators say that with enough practice, they can imagine their consciousness being in their head, heart, belly, or outside their body entirely. This is a subtle point (are you starting to see why we went through all the excruciatingly obvious philosophical preliminaries?) There is, in fact, a brain that has thoughts, located in your head. And your visceral experience includes a term for a self that has thoughts and is located in your head. But they’re not exactly the same thing. The trivial differences don’t matter in ordinary cases. But in edge cases, they can get pretty weird. Trance And Spirit Possession Okay, now the fun stuff. Byrnes argues that “homunculus” vs. “trance” are two alternative bistable models for analyzing internal mental experience. The process of going into a trance (or being “possessed” by a spirit) is conceptually similar to the process of switching the dancer from clockwise to counterclockwise. The process goes: Start with a strong background belief that the new model is plausible.
Byrnes gets much of his information from the book Impro by Keith Johnstone, an acting coach who uses spirit possession techniques to get his students “possessed” by their characters. In one case, Johnstone uses a particularly memorable technique to provide his student with “evidence”. The student is to be possessed by a god. Johnstone sets them an ESP task: they must pick which of three cups has a coin under it. Unbeknownst to them, Johnstone puts coins under all three cups, so the student guesses right every time. This creates a background of suspended reality that probably makes the “possessed by a god” hypothesis feel very compelling! This flip itself reinforces the trance - my new evidence in favor of trance is not just background beliefs about possession, but the visceral feeling of losing control of my body, plus the undeniable fact that I just jumped when there was (seemingly) no reason to do so. The trance state is now a new attractor, not quite as strong as the old homunculus attractor (“I am in control of my mind” really does explain a lot, and has decades of experience/inertia behind it”), but strong enough to usually last for an hour-long hypnosis show without collapsing. I couldn’t find that much about this in Byrnes, but the model flip itself must go back and affect ground-truth reality. “Hypnotist is compelling me” provides evidence for “I follow the hypnotist’s orders”, and therefore makes me slightly more likely to do so. It also frees me from some common reasons I wouldn’t follow the hypnotist’s orders - it’s too embarrassing, it would never work, it’s ‘not the kind of person I am’. Maybe the hypnotist orders me to do a silly dance on stage, and normally I’m too dignified, but since “the hypnotist is compelling me”, it doesn’t threaten my dignity and I can get away with it. Byrnes also adds (we’ll see why later) a postulate that doesn’t really make sense to me on its own - something about the self-model assists in the formation of memory. Remembering “I did a silly dance on stage” is easier if there is an “I” concept active to “hang the memory” on. This could be related to the finding that people remember things better in the same context they learned it (eg you’ll do better on a test in the same classroom where you learned the material) or to the finding that emotions organize memory (eg when you’re angry at your spouse, it’s easy to remember all the times they’ve ever wronged you; when you’re happy with them, it’s easy to remember all the good times you’ve had together). “The self exists” is a pretty dramatic context cue, and maintaining memory between self-models is apparently a pretty tough task - hence the tendency for people to say they “don’t remember” what happened during a trance. From Trance To Everything Else Now we have the material we need to explain all sorts of weird mental phenomena: Dissociative Amnesia Someone with a desire that doesn’t make sense in the context of their normal personality eventually “flips” to an alternative personality that carries out the desire. When they recover, they have no memory of the incident. Dissociative Identity (IE Multiple Personality) If the homunculus-self is a mostly-accurate but not-directly-perceived-and-real model of mental processes, then a person whose mental processes often flip between two or more dramatically different states (for example, borderlines, who are notable for very strong emotional states and “splitting”) may gather evidence for and eventually flip to a model of themselves as multiple different homunculi. This is especially true if they’re primed with the suggestion that this is a likely way for the inside of their mind to be (for example, by a psychotherapist who believes in multiple personalities). Ego Death (EG On Ketamine) Remember, the ego (homunculus) is a model of mental processes. which says that thoughts arise in the brain because “I” “choose” to “have” thoughts, or actions happen because “I” “voluntarily” “make” the decisions. From a god’s eye view, outside of the homunculus model, we might picture a decision as looking like: A thought arises: “Maybe it would be a good idea to eat a taco”.
Within the homunculus model, this orderly progression of events is what we interpret as “I thought about it and decided to order a taco”.
Honduran law

Honduran law is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 14, 2021 and April 14, 2021. The archive places it in contexts such as "will probably be banned by Honduran law or international law". It most often appears alongside Alaska, America, Amisulpride.

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Honduran law
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April 14, 2021 · Original source
Also, Próspera remains bound by several Honduran laws that Honduras refuses to exempt them from, including laws against abortion, euthanasia, and most gun ownership.
What if a regulatory issue can’t be expressed financially? I asked Trey about human genetic engineering. He said that extreme or irresponsible forms of medical experimentation will probably be banned by Honduran law or international law or something. If they’re not, he expects that insurance companies will keep their distance. If they don’t, he expects they’ll find a way to ban it anyway, for PR reasons if nothing else.
Honduran refugees

Honduran refugees is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 14, 2021 and April 14, 2021. The archive places it in contexts such as "NGOs that work with Honduran refugees trying to illegally immigrate to America". It most often appears alongside Alaska, America, Amisulpride.

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Honduran refugees
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April 14, 2021 · Original source
In case demand ever exceeds supply, HPI is already reaching out to NGOs that work with Honduran refugees trying to illegally immigrate to America. They plan to see if they can convince these people to legally immigrate to Próspera instead (“Hey, we heard you liked jobs and capitalism...”)
Honduran ZEDE

Honduran ZEDE is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 02, 2021 and August 02, 2021. The archive places it in contexts such as "Ciudad Morazan, currently the most presentable and furthest-along Honduran ZEDE". It most often appears alongside AgroAlpha, Alex Tabarrok, Amazon.

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Honduran ZEDE
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August 02, 2021 · Original source
Lutter’s current plan for solving this is to make a documentary about Ciudad Morazan, currently the most presentable and furthest-along Honduran ZEDE - but it hurts that he has to pass over so many other good examples.
Honduras remains the country to watch in the charter city sphere, with its ZEDE law allowing unprecedented levels of freedom and protection. I’d previously written about two Honduran projects, the high-tech island hub of Prospera and the industrial heartland project of Ciudad Morazan. Now there’s a third: ZEDE Orquidea (“Orchid Zone”).
I’m not really impressed with their publicity effort (my browser insists their website is a security hazard and won’t let me access it). My only real source of information is this Reddit post by another charter city enthusiast, who writes:
Honduras-Kuwait Treaty Of Reciprocal Investment

Honduras-Kuwait Treaty Of Reciprocal Investment is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 14, 2021 and April 14, 2021. The archive places it in contexts such as "Taken advantage of a clause in the Honduras-Kuwait Treaty Of Reciprocal Investment guaranteeing them their right to pursue their vision unmolested". It most often appears alongside Alaska, America, Amisulpride.

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April 14, 2021 · Original source
And who among us, having had the dream, hasn't entered into multi-year negotiations with the government of Honduras? Taken advantage of a clause in the Honduras-Kuwait Treaty Of Reciprocal Investment guaranteeing them their right to pursue their vision unmolested? Raised millions in venture capital and bought land on a Caribbean island to turn it into a reality?
Hong Kong flu

Hong Kong flu is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 01, 2025 and January 01, 2025. The archive places it in contexts such as "An H3N2 flu (“Hong Kong flu”) crossed from pigs (?) to humans in Hong Kong"; ""63% chance it’s between 2 - 10x as bad (eg the Hong Kong Flu of 1968)"". It most often appears alongside 1918, 1940s, 1968.

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Hong Kong flu
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  • 1918 1 shared issues
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  • 1977 1 shared issues
  • 2009 1 shared issues
January 01, 2025 · Original source
From “Genesis and pathogenesis of the 1918 pandemic H1N1 influenza A virus”, linked above. You may recognize the lead author - Michael Worobey has also been a leading voice on the zoonotic side of the COVID origins debate. The recent history of the flu, as far as I can tell, is: 1918: An H1N1 flu (“Spanish flu”) jumped from birds to humans in America and killed 50 million people worldwide. This replaced all older strains, so most seasonal flus during this era were H1N1. 1957: An H2N2 flu (“Asian flu”) crossed from birds to humans in China, and killed about 2 million people worldwide. It replaced the H1N1 strain, so most seasonal flus during this era were H2N2. 1968: An H3N2 flu (“Hong Kong flu”) crossed from pigs (?) to humans in Hong Kong, and killed another 2 million people worldwide. It replaced the H2N2 strain, so most seasonal flus during this era were H3N2. 1977: An H1N1 flu (“Russian flu”) leaked from a biology lab (?) in Russia (it might have been a strain from the 1940s, which the Russians were trying to make a vaccine for). It didn’t kill that many people, but it stuck around, and from then on, seasonal flus could be either H3N2 or H1N1. 2009: An H1N1 flu (“Mexican flu” until the PC police stepped in; afterwards “swine flu”) took some horrible circuitous route between birds and pigs and back again, crossed over into humans in Mexico, and killed 200,000 people. It outcompeted older strains of H1N1, but couldn’t crowd out H3N2, so seasonal flus are still either H3N2 or H1N1. …which brings us to the present, hopefully illuminating why “new flu strain crosses over from animals into humans” is such an “uh oh” moment. The Bird Flu Technically, all pandemic flus start as bird flus. Influenza A evolved in birds. Sometimes it spreads to other animals, including pigs, cattle, and humans. The most common way for a bird flu to spread to humans is to “reassort” (not exactly virus sex, but close enough, and the real version is less memorable) with a human flu virus (ie one that has already crossed over to humans). The resulting virus has all of the human flu virus’ human adaptations, but borrows enough new antigens from the bird virus to evade the immune system. Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder. When a bird flu and human flu reassort in pigs, the resulting disease is called a swine flu. At least the 2009 flu pandemic was a swine flu, and a minority opinion thinks the 1918 pandemic was too. There aren’t major epidemiological differences between direct-from-bird flus and swine flus. H5N1 was first noticed in birds - specifically, a flock of chickens in Scotland in 1959 - after which it disappeared for forty years. In 1996, it showed up in geese in China, then gradually increased its market share among birds worldwide. In 2022, it was found in minks; apparently it had learned to infect mammals. By early 2024, it was seen in cows. Now it’s in cow herds in 16 states, and one of them (California) has declared a state of emergency. And in October, H5N1 was found in pigs for the first time. It’s not uncommon for humans to catch an animal disease. This doesn’t mean the disease has “crossed over” to humans. If the virus isn’t suited to human-to-human transmission, it simply dies off (either before or after killing its human host). Thus, chicken farmers have been reporting scattered H5N1 cases since 1997; now that the virus has spread to cattle, cow farmers have started reporting the same. A Metaculus comment on this topic introduced me to the phrase “biocomputational surface”. Every viral replication that takes place in a human gives the virus one more chance to develop the set of mutations that makes it human-transmissible and start the next pandemic. Or, more likely, every viral replication that takes place in a human who has both the H5N1 bird flu and a normal human flu - or in a pig which has both viruses - gives the virus one extra chance to reassort in a way that produces a bird-antigen-fortified human-adapted flu virus. This doesn’t mean H5N1 will definitely become human-transmissible soon. Many viruses hang out on the borders of transmissibility for decades. Some, for unclear reasons, never cross over at all. But all of this is compatible with the virus becoming transmissible soon. So: What Is The Chance Of A Pandemic? The prediction markets on this topic ask a question about “10,000 cases in the United States”. Does this necessarily mean “pandemic”? Might it be possible to get to 10,000 cases just from the scattered chicken and cow farmers, with no human-to-human transmission? Despite many chicken and cow infections this year, there have only been 60 - 70 recorded human cases. Unless there is a phase change in screening methods, it seems hard for this number to increase to 10,000 off farmers alone. I think it’s fair to treat this question as operationalizing “what is the chance of a pandemic”? By this definition, Manifold estimates a 40% chance of an H5N1 pandemic in 2025. Metaculus estimates a 5% chance. You can see below whether that’s changed since I wrote this essay: 5% versus 40% is a big difference! Who do we trust? I trust Metaculus. Metaculus has beaten Manifold in both of the two head-to-head comparisons that I know of (Jeremiah Johnson’s and mine). Manifold’s number swings by a factor of two from week to week; Metaculus has been steady. But also, Metaculus hosts a CDC-sponsored respiratory disease forecasting tournament which has enriched them in epidemiological expertise. And if you look at the quality of comments on both sites, it’s pretty obvious where the people with more intellectual chops are hanging out. The Manifold comments are mostly single sentences, or occasionally just links to an article about new cases. The Metaculus comments look more like this one by dimaklenchin: Despite the panic propaganda, H5N1 is unlikely to be "just a single mutation away from switching host preference": 1) It normally takes a lot more than a single mutation to switch hosts. E.g., there are at least five different reasons why SIV (monkey equivalent of HIV) is not infectious to humans. Heck, a variant of SIV that bears HIV's receptor-recognizing surface protein (SHIV) is still not infectious to humans. HIV most certainly evolved from SIV but, almost as certainly, it took a very long time to get there. Not that all viruses are the same and things can't turn out differently with flu, but I don't subscribe to the idea that a mere change of receptor specificity (something that can take 1-2 mutations) will be sufficient. 2) We have data. Lots of human infections with other varieties of bird flu in the past - all those viruses ultimately went nowhere. Why would H5N1 be radically different? E.g., the "Canadian teen", despite what sounds like a prolonged exposure, failed to infect anyone around him. Since I am at 18% for the h-2-h H5N1 detection in 2025, I am arbitrarily going ~ an order of magnitude lower than that for something as unprecedented as 10K human infections. Maybe should be much lower but hedging for the time being and will allow another couple months of observations. And Sergio: I'm currently at 20% on the question of reported human-to-human transmission of highly pathogenic avian influenza H5N1 globally before 2026. However, this question is only about the US, and is more general about all subtypes of H5. But H5N1 very strongly appears to be the most important subtype to consider in this time period. And, given the current situation in the US with H5N1 human cases derived from exposure to poultry or cattle (with cattle(mammals) being more worrisome), h2h transmission seems quite more likely to arise in North America than elsewhere before 2026. Conditioning on h2h transmission in the US (and also trying to consider, with lower probability, a start in Canada), I want to estimate the chances that it becomes sustained and out of control (in which case, if it starts in Canada, I largely expect it to spread to the US). The (6) past events of probable h2h transmission of avian H5(N1), none of which were sustained, could serve as a base rate, although I'm a bit wary of giving much weight to this precedent, since the last event was quite a while ago (2007), and also because reporting and testing standards may have improved considerably since then (so perhaps they might not have been classified as h2h transmission events if they had occurred more recently). The current situation in the US, and events such as the Canadian teen who got sick with H5N1, do suggest a higher background level of risk than normal (which would be reduced if a vaccine for cattle is licensed soon), but I'm wary of overupdating. Conditioned on sustained h2h transmission, reaching over 10k cases in a few months seems likely, although perhaps very strong monitoring and surveillance could contain the situation in time (at the very least to moderate the growth rate). Trying to combine all these factors somewhat haphazardly, I'm currently at 3.5% for this question. That’s before 2026. What about longer-term? Manifold gives a ~50% chance before 2030; Metaculus uses a more complicated method but it says about 25% chance before 2030. H5N1 may cross to humans, but it could take a while. Superforecaster Juan Cambeiro at The Institute For Progress estimated a 4% chance of a “worse than COVID” H5N1 pandemic in “the next year”, but their estimate was made in 2023, without the benefit of the Metaculus estimates or most of our current knowledge. This feels high now - Metaculus says 5% total for H5N1 pandemic, and most pandemic flus are not worse than COVID. IFP also seem to be expecting a case fatality rate greater than 10%, which I find unlikely for the reasons mentioned above. I trust their estimate less than Metaculus’ current ones. I conclude that the most plausible estimate for the chance of an H5N1 pandemic in the next year is 5%. Interestingly, 5% is about the base rate for pandemic flus per year: five in the past century = one per twenty years = 5% chance per year. Isn’t it surprising that we’re still at the base rate when we can see a dangerous-looking flu virus spreading through the types of animals that have caused pandemic flus in the past? Part of the answer is that we’re not - in addition to the 5% chance of H5N1, we have to add the chance of some other pandemic flu. This probably isn’t 5% on its own; scientists monitor flu strains closely, and they haven’t found any others which are giving off as many red flags as H5N1. Still, something could always come out of left field. Maybe we should add a 2.5% chance of some other strain, for a total of 7.5% chance of a flu pandemic (ie beyond normal seasonal flu) next year. But still, isn’t it surprising that we’re so close to the base rate? One way to think about this: the base rate represents how concerned we should be if there was no epidemiological monitoring at all. In that case, we would estimate a probability distribution across different epidemiological landscapes, most of which contain some concerning-looking flu strains. Since we are doing the epidemiological monitoring, we can collapse that distribution into a single picture: one flu strain, H5N1, is in fact pretty concerning, and other strains mostly aren’t. This is enough to move our prior from 5% to 7.5%, but no more. The forecasters I talked to raised one other point of uncertainty: does the flu work more like a dice roll, or like a bus? Dice rolls are uncorrelated with their predecessors; even if it’s been a hundred rolls since you last rolled a 6, your chance this time is still 1/6. But buses come at fixed intervals; if the buses are hourly, and you haven’t seen a bus in the past 59 minutes, then your chance of seeing a bus in the next minute is very high. It’s been 16 years since the last flu pandemic; these pandemics come (on average) every 20 years. I don’t think anyone has a good sense of how to think about this. But it was 40 years between the Spanish and Hong Kong flus, so the twenty year number is at best a rule of thumb. The 5% number feels very low to me (and, apparently, to the average Manifold forecaster). Isn’t H5N1 spreading to cows and pigs and all sorts of other mammals? Isn’t it in the news all the time? I trust Metaculus a lot, but I agree that this is a surprising update, and I’m taking it on faith rather than feeling it in my bones. What Would The Fatality Rate Be For An H5N1 Pandemic? There are four basic stories you could tell about likely H5N1 mortality. First, maybe mortality would be 50%. The argument here is that official statistics report this mortality rate in the chicken farmers who have been infected with H5N1 so far. Several news sources and even some scientists have raised the specter of a pandemic version of H5N1 pandemic with this same death rate, which could kill a quarter to a third of the world population. THIS IS EXTREMELY FAKE. The official statistics only report fatality rate in the infections we know about. Bird flu is rare, there’s no mass testing, and we only learn that somebody had it if they’re in a hospital and the doctors are worried enough to test for rare conditions. Of Americans who got bird flu in the past year, 0 out of 61 have died. Probably this is mostly because America upped its detection game and is now finding milder cases; we also can’t rule out the virus mutating to become less virulent. Metaculus estimates the current true mortality rate as 1.25%. …but leaves a wide 90% confidence interval, from 0.5% to 7%. Second, maybe mortality would be somewhere around 1.25%. The argument here is that Metaculus uses this as its central estimate of US mortality. But Sentinel discusses some reasons to be skeptical of broad inferences from the US numbers: Scientists have been puzzled by the apparently low H5N1 case fatality rate in humans in the US. They offer a number of hypotheses: “The way in which the virus is being transmitted — along with the amount of virus exposure — is limiting the severity of disease.”
H5N1 may cross to humans, but it could take a while. Superforecaster Juan Cambeiro at The Institute For Progress estimated a 4% chance of a “worse than COVID” H5N1 pandemic in “the next year”, but their estimate was made in 2023, without the benefit of the Metaculus estimates or most of our current knowledge. This feels high now - Metaculus says 5% total for H5N1 pandemic, and most pandemic flus are not worse than COVID. IFP also seem to be expecting a case fatality rate greater than 10%, which I find unlikely for the reasons mentioned above. I trust their estimate less than Metaculus’ current ones. I conclude that the most plausible estimate for the chance of an H5N1 pandemic in the next year is 5%. Interestingly, 5% is about the base rate for pandemic flus per year: five in the past century = one per twenty years = 5% chance per year. Isn’t it surprising that we’re still at the base rate when we can see a dangerous-looking flu virus spreading through the types of animals that have caused pandemic flus in the past? Part of the answer is that we’re not - in addition to the 5% chance of H5N1, we have to add the chance of some other pandemic flu. This probably isn’t 5% on its own; scientists monitor flu strains closely, and they haven’t found any others which are giving off as many red flags as H5N1. Still, something could always come out of left field. Maybe we should add a 2.5% chance of some other strain, for a total of 7.5% chance of a flu pandemic (ie beyond normal seasonal flu) next year. But still, isn’t it surprising that we’re so close to the base rate? One way to think about this: the base rate represents how concerned we should be if there was no epidemiological monitoring at all. In that case, we would estimate a probability distribution across different epidemiological landscapes, most of which contain some concerning-looking flu strains. Since we are doing the epidemiological monitoring, we can collapse that distribution into a single picture: one flu strain, H5N1, is in fact pretty concerning, and other strains mostly aren’t. This is enough to move our prior from 5% to 7.5%, but no more. The forecasters I talked to raised one other point of uncertainty: does the flu work more like a dice roll, or like a bus? Dice rolls are uncorrelated with their predecessors; even if it’s been a hundred rolls since you last rolled a 6, your chance this time is still 1/6. But buses come at fixed intervals; if the buses are hourly, and you haven’t seen a bus in the past 59 minutes, then your chance of seeing a bus in the next minute is very high. It’s been 16 years since the last flu pandemic; these pandemics come (on average) every 20 years. I don’t think anyone has a good sense of how to think about this. But it was 40 years between the Spanish and Hong Kong flus, so the twenty year number is at best a rule of thumb. The 5% number feels very low to me (and, apparently, to the average Manifold forecaster). Isn’t H5N1 spreading to cows and pigs and all sorts of other mammals? Isn’t it in the news all the time? I trust Metaculus a lot, but I agree that this is a surprising update, and I’m taking it on faith rather than feeling it in my bones. What Would The Fatality Rate Be For An H5N1 Pandemic? There are four basic stories you could tell about likely H5N1 mortality. First, maybe mortality would be 50%. The argument here is that official statistics report this mortality rate in the chicken farmers who have been infected with H5N1 so far. Several news sources and even some scientists have raised the specter of a pandemic version of H5N1 pandemic with this same death rate, which could kill a quarter to a third of the world population. THIS IS EXTREMELY FAKE. The official statistics only report fatality rate in the infections we know about. Bird flu is rare, there’s no mass testing, and we only learn that somebody had it if they’re in a hospital and the doctors are worried enough to test for rare conditions. Of Americans who got bird flu in the past year, 0 out of 61 have died. Probably this is mostly because America upped its detection game and is now finding milder cases; we also can’t rule out the virus mutating to become less virulent. Metaculus estimates the current true mortality rate as 1.25%. …but leaves a wide 90% confidence interval, from 0.5% to 7%. Second, maybe mortality would be somewhere around 1.25%. The argument here is that Metaculus uses this as its central estimate of US mortality. But Sentinel discusses some reasons to be skeptical of broad inferences from the US numbers: Scientists have been puzzled by the apparently low H5N1 case fatality rate in humans in the US. They offer a number of hypotheses: “The way in which the virus is being transmitted — along with the amount of virus exposure — is limiting the severity of disease.”
“Public health officials were previously unaware of a significant number of mild H5N1 cases in humans, leading to a dramatic overestimation of H5’s feared case fatality rate. Only now are we getting a true picture of the spectrum of infection.” In further discussions about why forecasters’ estimates of the H5N1 infection fatality rate (IFR) were so high last week (0.07% to 9%, conditional on a descendant of an H5N1 strain becoming pandemic), forecasters brought up several factors. First, if a descendant of an H5N1 strain does become pandemic, it’s unclear which genetic group of strains that descendant strain might emerge from; for example, it might not be descended from relatively milder North American strains. Second, a descendant of a currently circulating H5N1 virus might become pandemic after reassortment with other flu viruses and would need to undergo additional adaptations to humans to be able to circulate widely in humans. It’s not completely clear what the characteristics of such a virus would end up being; for instance, in addition to adapting to bind more efficiently to “human receptors” in the respiratory tract, the virus would need to adapt to grow at temperatures present in the human respiratory tract, and the resulting adaptations could be expected to change the exact mix of symptoms the virus can cause. Third, the disease does have high case fatality rates in cattle, on the order of 5 to 10%, and we have seen higher case fatality rates in sea mammals. Fourth, the farm-worker populations in which we are observing initial cases are likely relatively healthier than the US population as a whole. Moreover, in general, there are lots of things we don’t know yet, and thus, our confidence intervals for a potential IFR should be wide. Third, maybe mortality would be between 0.01% and 0.2%. The argument here is looking at normal (ie not 1918) flu pandemics of the past century. The least bad among these, the 2009 swine flu, had CFR of 0.01%. The worst, Hong Kong flu, was somewhere around 0.2%. If H5N1 is a normal pandemic flu - and right now there’s not much that differentiates it - it will probably be somewhere in that range. Source: https://en.wikipedia.org/wiki/Spanish_flu#Comparison_with_other_pandemics Fourth, maybe mortality will be 2-10%. This was the mortality rate of the 1918 Spanish Flu. It seems to be an outlier: as far as we know, no other flu in the past 500 years was nearly as bad (I’m using 500 years as a somewhat arbitrary cutoff since the 1510 flu is one of the better attested historical flus; before that they all sort of dissolve into general plagues) . If there have been ~25 major flu pandemics during that time, that gives us a base rate of only 4% for any given flu pandemic reaching that level of severity. But some people argue that H5N1 is unusually similar to the Spanish Flu, in that both diseases cause “cytokine storm” - a dangerous immune over-reaction which caused a majority of the deaths in 1918. On the other hand, this might be because H5N1 isn’t adapted to humans yet - less adapted viruses usually cause more immune reaction than better-adapted ones. It’s not clear whether this feature would stick around in a pandemic version of H5N1. At least improved medical technology (and lack of a World War screwing things up) probably mean that a virus which was just as severe as 1918 will cause fewer deaths than the 1918 virus did. Much of this discussion hinges on whether we should expect flus to generally become less virulent when adapting to humans and going pandemic. There’s a hand-wavey evolutionary argument that they should: pathogens don’t “want” to kill (or incapacitate) their host before they can spread. But the biologists I talked to said people tend to overupdate on this, that evolution can do lots of weird things, and that the 1918 flu forgot to read the Evolutionary Virology textbook and actually mutated to get worse. There may be a slight tendency for things vaguely like this to happen, but we shouldn’t count on them. After reading the arguments from each camp and talking them over with superforecasters, I think, regarding the infection fatality rate of a future H5N1 pandemic: 30% chance it’s about as bad as a normal seasonal flu
honor

honor is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 08, 2024 and August 08, 2024. The archive places it in contexts such as "The concept of “honor” fills out much of the pragmatic demands of maintaining a reputation". It most often appears alongside 10240, 4chan, @slatestarcodex.

Reference entry
honor
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1
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1
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August 08, 2024
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August 08, 2024
August 08, 2024 · Original source
The concept of “honor” fills out much of the pragmatic demands of maintaining a reputation that leads to a dominant bargaining position. You should be fearless, so no one can intimidate you. You should keep your promises to people you expect to interact with a lot, but not to nonpeople that don’t matter. You should revenge slights to your reputation with violence and practice reciprocity. Much of this is of course instrumentally useful for the rest of us to, while other bits are counterproductive or hard to universalize.
At nearly 3,000 years old, the Iliad is very much in vogue, with two recent notable translations by women (Emily Wilson and Caroline Alexander) and a book of criticism aimed at a broad audience, Robin Lane Fox's Homer and His Iliad. I think part of the reason the Iliad still hits home is that its central figure, Achilles, fascinates. He's not just stronger and faster and better-looking than everyone else, he's more thoughtful and eloquent too. People point to his appearance in the underworld in the Odyssey, where he says he'd rather be a hired hand on a farm and alive than rule over all the dead. But his rejection of the heroic ethos is found in the Iliad too. His superhuman strength and beauty can’t save him from being dishonored by Agamemnon. It can’t keep his beloved Patroclus alive. All it’s good for, ultimately, is slaughtering Trojans. Which Achilles does magnificently, when he finally returns to battle; but in a sort of frenzy of despair. To a Trojan begging for mercy, he says: Patroclus is dead; I’ll be dead soon; you die too. He calls himself a useless burden on the earth. At the end when he forgoes violence and returns Hector’s body to his aged father Priam, saying sadly as he does so that he is doing nothing to help his own aged father; instead he sits in Troy, afflicting Priam and his children. And he agrees to hold the Greek army back for two weeks so that the Trojans can give Hector a proper burial.
hookworms

hookworms is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 17, 2021 and November 17, 2021. The archive places it in contexts such as "there are threadworms, hookworms". It most often appears alongside ACE-2 receptor, ACSH, Ahmed et al.

Reference entry
hookworms
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1
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1
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November 17, 2021
Last seen
November 17, 2021
November 17, 2021 · Original source
Here’s the prevalence of roundworm infections by country (source). But alongside roundworms, there are threadworms, hookworms, blood flukes, liver flukes, nematodes, trematodes, all sorts of worms. Add them all up and somewhere between half and a quarter of people in the developing world have at least one parasitic worm in their body. Being full of worms may impact your ability to fight coronavirus. Gluchowska et al write: Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases. Treatment of worm infections might reduce the negative effect of COVID-19! And ivermectin is a deworming drug! You can see where this is going… The most relevant species of worm here is the roundworm Strongyloides stercoralis. Among the commonest treatments for COVID-19 is corticosteroids, a type of immunosuppresant drug. The types of immune responses it suppresses do more harm than good in coronavirus, so turning them off limits collateral damage and makes patients better on net. But these are also the types of immune responses that control Strongyloides. If you turn them off even very briefly, the worms multiply out of control, you get what’s called “Strongyloides hyperinfection”, and pretty often you die. According to the WHO: The current COVID-19 pandemic serves to highlight the risk of using systemic corticosteroids and, to a lesser extent, other immunosuppressive therapy, in populations with significant risk of underlying strongyloidiasis. Cases of strongyloidiasis hyperinfection in the setting of corticosteroid use as COVID-19 therapy have been described and draw attention to the necessity of addressing the risk of iatrogenic strongyloidiasis hyperinfection syndrome in infected individuals prior to corticosteroid administration. Although this has gained importance in the midst of a pandemic where corticosteroids are one of few therapies shown to improve mortality, its relevance is much broader given that corticosteroids and other immunosuppressive therapies have become increasingly common in treatment of chronic diseases (e.g. asthma or certain rheumatologic conditions). So you need to “address the risk” of strongyloides infection during COVID treatment in roundworm-endemic areas. And how might you address this, WHO? Treatment of chronic strongyloidiasis with ivermectin 200 µg/kg per day orally x 1-2 days is considered safe with potential contraindications including possible Loa loa infection (endemic in West and Central Africa), pregnancy, and weight <15kg. Given ivermectin’s safety profile, the United States has utilized presumptive treatment with ivermectin for strongyloidiasis in refugees resettling from endemic areas, and both Canada and the European Centre for Disease Prevention and Control have issued guidance on presumptive treatment to avoid hyperinfection in at risk populations. Screening and treatment, or where not available, addition of ivermectin to mass drug administration programs should be studied and considered. This is serious and common enough that, if you’re not going to screen for it, it might be worth “add[ing] ivermectin to mass drug administration programs” in affected areas! Dr. Avi Bitterman carries the hypothesis to the finish line: First two images are with all relevant studies; second two are a sensitivity analysis that removes some of the most dubious. The good ivermectin trials in areas with low Strongyloides prevalence, like Vallejos in Argentina, are mostly negative. The good ivermectin trials in areas with high Strongyloides prevalence, like Mahmud in Bangladesh, are mostly positive. Worms can’t explain the viral positivity outcomes (ie PCR), but Dr. Bitterman suggests that once you remove low quality trials and worm-related results, the rest looks like simple publication bias: This is still just a possibility. Maybe I’m over-focusing too hard on a couple positive results and this will all turn out to be nothing. Or who knows, maybe ivermectin does work against COVID a little - although it would have to be very little, fading to not at all in temperate worm-free countries. But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong! The people who called it a miracle drug against COVID were wrong. The people who dismissed all the studies because they F@#king Love Science were wrong. Ivmmeta.com was wrong. Gideon Meyerowitz-Katz was…well, he was right, actually, I got the worm-related meta-analysis graphic above from his Twitter timeline. Still, an excellent troll. Also, the best part is that I ignorantly asked, in my description of Mahmud et al above: And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true! The Scientific Takeaway About ten years ago, when the replication crisis started, we learned a certain set of tools for examining studies. Check for selection bias. Distrust “adjusting for confounders”. Check for p-hacking and forking paths. Make teams preregister their analyses. Do forest plots to find publication bias. Stop accepting p-values of 0.049. Wait for replications. Trust reviews and meta-analyses, instead of individual small studies. These were good tools. Having them was infinitely better than not having them. But even in 2014, I was writing about how many bad studies seemed to slip through the cracks even when we pushed this toolbox to its limits. We needed new tools. I think the methods that Meyerowitz-Katz, Sheldrake, Heathers, Brown, Lawrence and others brought to the limelight this year are some of the new tools we were waiting for. Part of this new toolset is to check for fraud. About 10 - 15% of the seemingly-good studies on ivermectin ended up extremely suspicious for fraud. Elgazzar, Carvallo, Niaee, Cadegiani, Samaha. There are ways to check for this even when you don’t have the raw data. Like: The Carlisle-Stouffer-Fisher method: Check some large group of comparisons, usually the Table 1 of an RCT where they compare the demographic characteristics of the control and experimental groups, for reasonable p-values. Real data will have p-values all over the map; one in every ten comparisons will have a p-value of 0.1 or less. Fakers seem bad at this and usually give everything a nice safe p-value like 0.8 or 0.9.
Source. Real data would follow something like a bell curve. This is going to require a social norm of always sharing data. Even better, journals should require the raw data before they publish anything, and should make it available on their website. People are going to fight hard against this, partly because it’s annoying and partly because of (imho exaggerated) patient privacy related concerns. Somebody’s going to try make some kind of gated thing where you have to prove you have a PhD and a “legitimate cause” before you can access the data, and that person should be fought tooth and nail (some of the “data detectives” who figured out the ivermectin study didn’t have advanced degrees). I want a world where “I did a study, but I can’t show you the data” should be taken as seriously as “I determined P = NP, but I can’t show you the proof.” The second reason I think this, aside from checking for fraud, is checking for mistakes. I have no proof this was involved in ivermectin in particular. But I’ve been surprised how often it comes up when I talk to scientists. Someone in their field got a shocking result, everyone looked over the study really hard and couldn’t find any methodological problems, there’s no evidence of fraud, so do you accept it? A lot of times instead I hear people say “I assume they made a coding error”. I believe them, because I have made a bunch of stupid errors. Sometimes you make the errors for me - an early draft of this post of mine stated that there was an strong positive effect of assortative mating on autism, but when I double-checked it was entirely due to some idiot who filled out the survey and claimed to have 99999 autistic children. In this very essay, I almost said that a set of ivermectin studies showed a positive result because I was reading the number for whether two lists were correlated rather than whether a paired-samples t-test on the lists was significant. I think lots of studies make these kinds of errors. But even if it’s only 1%, these will make up much more than 1% of published studies, and much more than 1% of important ground-breaking published studies, because correct studies can only prove true things, but false studies can prove arbitrarily interesting hypotheses (did you know there was an increase in the suicide rate on days that Donald Trump tweeted?!?) and those are the ones that will get published and become famous. So if the lesson of the original replication crisis was “read the methodology” and “read the preregistration document”, this year’s lesson is “read the raw data”. Which is a bit more of an ask. Especially since most studies don’t make it available. The Sociological Takeaway I’ve been thinking about this one a lot too. Ivermectin supporters were really wrong. I enjoy the idea of a cosmic joke where ivermectin sort of works in some senses in some areas. But the things people were claiming - that ivermectin has a 100% success rate, that you don’t need to take the vaccine because you can just take ivermectin instead, etc - have been untenable not just since the big negative trials came out this summer, but even by the standards of the early positive trials. Mahmud et al was big and positive and exciting, but it showed that ivermectin patients recovered in about 7 days on average instead of 9. I think the conventional wisdom - that the most extreme ivermectin supporters were mostly gullible rubes who were bamboozled by pseudoscience - was basically accurate. Mainstream medicine has reacted with slogans like “believe Science”. I don’t know if those kinds of slogans ever help, but they’re especially unhelpful here. A quick look at ivermectin supporters shows their problem is they believed Science too much. @jonno_bosch I work in hospitality so I need things to return to normal ASAP. I am using Ivermectin as a prophylactic. Hugely influenced by Carvallo trail and Chala trail which showed huge protection","username":"Bannisterious","name":"Andrew Bannister","profile_image_url":"","date":"Fri Feb 12 16:21:14 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":0,"like_count":0,"impression_count":0,"expanded_url":{},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> @mtskullcrusher @HereComeTheJud @therealjosexy @joeycadre @PeegeRiley @dcwickedestcity @blaireerskine Read Raad. Or Mahmud. Or ICON study from Florida. Or Mexico City hospitalizations study. Or Niaee. Or...\n\nOr just type \"ivermectin covid\" in Google Scholar and read.","username":"fatlas6","name":"fatlas","profile_image_url":"","date":"Thu Sep 02 21:34:59 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":0,"like_count":1,"impression_count":0,"expanded_url":{},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> They have a very reasonable-sounding belief, which is that if dozens of studies all say a drug works really well, then it probably works really well. When they see dozens of studies saying a drug works really well, and the elites saying “no don’t take it!”, their extremely natural conclusion is that it works really well but the elites are covering it up. Sometimes these people even have a specific theory for why elites are covering up ivermectin, like that pharma companies want you to use more expensive patented drugs instead. This theory is extremely plausible. Pharma companies are always trying to convince people to use expensive patented drugs instead of equally good generic alternatives. Ivermectin believers probably heard about this from the many, many good articles by responsible news outlets, discussing the many, many times pharma companies have tried to trick people into using more expensive patented medications. Like this ACSH article about Nexium. Or my article on esketamine. Given that dozens of studies said a drug worked, and elites continued to deny it worked, and there are well-known times where elites lie about drugs in order to make money, it was an incredibly reasonable inference that this was one of those times. If you have a lot of experience with pharma, you know who lies and who doesn’t, and you know what lies they’re willing to tell and which ones they shrink back from. As far as I know, no reputable scientist has ever come out and said ‘esketamine definitely works better than regular ketamine’. The regulatory system just heavily implied it. I claim that with ivermectin, even the people who don’t usually lie were saying it was ineffective, and they were saying it more directly and decisively than liars usually do. But most people can’t translate Pharma → English fluently enough to know where the space of “things people routinely lie about and nobody worries about it too much” ends. So they incredibly reasonably assume anything could be a lie. And if you don’t know which statements about pharmaceuticals are lies, “the one that has dozens of studies contradicting it” is a pretty good heuristic! If you tell these people to “believe Science”, you will just worsen the problem where they trust dozens of scientific studies done by scientists using the scientific method over the pronouncements of the CDC or whoever. So “believe experts”? That would have been better advice in this case. But the experts have beclowned themselves again and again throughout this pandemic, from the first stirrings of “anyone who worries about coronavirus reaching the US is dog-whistling anti-Chinese racism”, to the Surgeon-General tweeting “Don’t wear a face mask”, to government campaigns focusing entirely on hand-washing (HEPA filters? What are those?) Not only would a recommendation to trust experts be misleading, I don’t even think you could make it work. People would notice how often the experts were wrong, and your public awareness campaign would come to naught. But also: one of the data detectives who exposed some fraudulent ivermectin papers was a medical student, which puts him somewhere between pond scum and hookworms on the Medical Establishment Totem Pole. Some of the people whose studies he helped sink were distinguished Professors of Medicine and heads of Health Institutes. If anyone interprets “trust experts” as “mere medical students must not publicly challenge heads of Health Institutes”, then we’ve accidentally thrown the fundamental principle of science out with the bathwater. But Pierre Kory, spiritual leader of the Ivermectin Jihad, is a distinguished critical care doctor. What heuristic tells us “Medical students should be allowed to publicly challenge heads of Health Institutes” but not “Distinguished critical care doctors should be allowed to publicly challenge the CDC”? Then what about “believe statisticians”? I’ve never heard anyone propose this before, but re-centering the mystique of scientific-expertise in study-analyzers and study-aggregators rather than object-level scientists is…one way you could go, I guess. Statisticians admittedly sort of failed us here: the first several meta-analyses said ivermectin worked. But the statistical process - the idea that studies are raw materials, but it takes skill to turn them into the finished good of scientific knowledge - sort of comes out looking good. If we need to summarize our takeaway in a slogan of exactly two words, one of which is “trust”, you could do worse than this one. (am I secretly suggesting that we make rationality higher status? Maybe, although rationalists did no better here during the early phase of “looks promising so far” than anyone else, and it was researchers digging into the nitty-gritty of the data who really solved this.) Or maybe this is the wrong level on which to think about this. Maybe there isn’t and can’t be a simple heuristic you can teach everyone in school or via a PR campaign which will lead to them having making good health decisions in an adversarial information environment, without having any negative effects anywhere else. But you also don’t want people to make bad health decisions. So what do you do? The Political Takeaway All of this is complicated by the impression many people (including me) have, that ivermectin boosterism and vaccine denialism are closely linked. The ivermectin evidence is complicated. There’s room for doubt. I can maybe see room for doubt on some marginal vaccine-related issues like how seriously to take the occasional reports of myocarditis in teens. But the basic issue - that the vaccine works really well and is incredibly safe for adults - seems beyond question. Yet people keep questioning it. I think it’s important to address ivermectin support on its own terms - as a potentially plausible scientific theory in a debris field of confusing evidence, which should be debated to the usual standards of scientific debate. I’ve tried to do that above. But this picture wouldn’t be complete without acknowledging the overlap with vaccine denial - a segment of people who are completely crazy and wrong and who happen to have fixated on this mildly interesting question as opposed to some other one with even less evidence. I’ve been trying to figure out a model where ivermectin support and vaccine denialism both make visceral sense to me, and here’s what I’ve got: Imagine that in 2025, an alien invasion fleet reaches Earth. But it got hit by a supernova on the way, the spaceships are partly disabled, and they’re only able to conquer some out-of-the-way place - let’s say Australia. There’s a few cycles of conflict and cease-fire, a few cities get nuked, and finally we settle into an uneasy peace. Over the next few years, humanity grudgingly admits the invaders into the world community. They get a seat in the United Nations. We sort of cooperate with them on projects that are important to both sides, like stopping climate change. We still hate them, but only at the level of ordinary international rivalries, like USA/USSR. In 2035, the aliens announce that a quantum memetic plague from the Andromeda Sector has reached Earth. Billions of people will die unless we let them put an immunity-granting cybernetic implant in all humans’ brain. The aliens admit we haven’t always been friends, and honestly they would still like to conquer us someday. But this plague is an ancient enemy of all sentient beings, they dealt with it on their homeworld eons ago, and they want to help us out here. Humans apparently don’t have the ability to detect quantum memetic plagues, but mortality rates for over-65s do seem weirdly high this year, something like 10x worse than a normal flu season. Do you let the aliens put an implant in your brain, or not? If it helps, the aliens look like this. Surely anyone with a brain that size must know what they’re talking about, right? (source) Fine, you don’t have to decide immediately. The brain implants aren’t even ready yet. Some human scientists suggest wearing face masks in the interim. The aliens say no, that will never work, that’s not how you deal with quantum memetic plagues, if you do anything other than wait for the brain implants you’re anti-science idiots who are wasting precious time and will kill millions of people. Human nations try face masks anyway…and they clearly and conspicuously work. The aliens say whatever, we’re still the advanced spacefaring civilization here, maybe it works for humans but that’s not the point, the point is you’ve got to let us put implants in your brains. Some human scientists suggest reopening vital services. The aliens say no, millions will die, this is “mass human sacrifice”, humans apparently must care nothing about their families’ lives. The humans try reopening anyway, and…it goes kind of okay? Maybe the death rate goes up 10% to 20% or so, hard to say? The aliens say whatever, maybe their calculations were off by a few orders of magnitude, the point is, you have to let us put implants in your brain or you’ll all die. Then some human scientists suggest vaccinating against the plague. The aliens say this is idiotic, vaccines originally come from cowpox, even the word “vaccine” comes from Latin vaccus meaning “cow”, are you saying you want cow medicine instead of actual brain implants which alien Science has proven will work? They make lots of cartoons displaying humans who want vaccines as having cow heads, or rolling around in cow poop. Meanwhile, the first few dozen studies show vaccines work great. Many top human leaders, including war heroes from the struggle against the aliens, get vaccines and are seen going out in public, looking healthy and happy. The aliens say that human science is hopelessly flawed because of complicated statistical concepts that inferior life forms like us don’t even have words for. You need to ignore all the studies and meta-analyses showing that vaccines definitely work, and let the aliens give you brain implants instead. So do you let the aliens put an implant in your brain, or not? Obviously you think long and hard before doing this. And obviously this is an extended metaphor for vaccine denialism. So what’s the difference between the metaphor (where you’re presumably anti-implant) and the real world (where you’re presumably pro-vaccine?) For me, it’s a combination of: The aliens are hostile, so I don’t trust them no matter how smart they are
hope

hope is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 20, 2024 and September 20, 2024. The archive places it in contexts such as "Added to these four were three virtues unique to Christianity, believed to be revelations from God that mankind would not identify if left to their own devices. These three are faith, hope, and love". It most often appears alongside Adam, Alfred, Ballad.

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hope
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1
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1
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September 20, 2024
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September 20, 2024
September 20, 2024 · Original source
Beneath that, not all that well hidden, the Ballad is Chesterton’s love song to conservatism as he understands it. In it Chesterton weaves the ideas that he has been writing about all his life and creates a cohesive narrative theme. The Ballad is like a melody that all his other works, fiction and nonfiction, dance to. Chesterton wrote many books, yet none seemed to stand higher than the others in terms of quality or popularity. Because of this he has been called “the master without a masterpiece” (though, appropriately, the quote itself seems legendary: I have found it referenced everywhere but I cannot find the source). I disagree: the Ballad of the White Horse is his masterpiece. It is Chesterton boiled down to his essence. Within it we find two core themes of Chesterton’s body of work: hope in defiance of fate, and the eternal revolution.
Alfred’s plight is so desperate that he is losing all hope of victory:
Here we are introduced to one of Chesterton’s core themes: hope versus fate. Chesterton sees hope as one of the primary distinguishers between Christianity and paganism, buddhism, eastern philosophy in general, and materialistic determinism. We see this same dichotomy in another of Chesterton’s great poems, Lepanto, where he has Muhammed, enthroned in glory in the Muslim paradise, say:
horned beetles

horned beetles is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 14, 2025 and February 14, 2025. The archive places it in contexts such as "The fellow will research horned beetles, which are well known for their diverse forms of environment-dependent development". It most often appears alongside Biden-Harris administration, Blackfeet Community College, Building Reliable Advances and Innovations in Neurotechnology.

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horned beetles
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1
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February 14, 2025
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February 14, 2025
February 14, 2025 · Original source
Cis-Regulatory Basis of Developmental Plasticity and Growth in the Development and Evolution of Beetle Horns, a Class of Highly Diversified Weapons - This action funds an NSF Postdoctoral Research Fellowship in Biology for FY22, integrative research investigating the rules of life governing interactions between genomes, environment and phenotypes. The fellowship supports research and training of the fellow that will contribute to the area of Rules of Life in innovative ways. How organisms develop is regulated through the interactions of genes and environmental conditions like nutrition. Gene regulation (turning genes "on" or "off") therefore is an important point of control for many aspects of development, such as growth. Further, when gene regulation is modified by evolution, it can lead to the emergence of new traits. Yet, exactly how gene regulation is controlled is not fully understood. The fellow will research horned beetles, which are well known for their diverse forms of environment-dependent development, in order to understand how environment affects gene regulation to promote diversity.
horse archers

horse archers is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 04, 2022 and May 04, 2022. The archive places it in contexts such as "“Steppe nomads. Horse archers. The Eurasian hordes.”". It most often appears alongside 1000, 1200, 1400.

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horse archers
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1
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May 04, 2022
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May 04, 2022
May 04, 2022 · Original source
“Steppe nomads. Horse archers. The Eurasian hordes.”
“That’s what the Ming Dynasty thought in 1650. You know, they had guns, they had cannons, they figured that horse archers wouldn’t be able to take them on anymore. Turned out they were wrong. The nomads got them too.”
Horsemen of the Apocalypse

Horsemen of the Apocalypse is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 29, 2022 and September 29, 2022. The archive places it in contexts such as "Bible describes the Horsemen of the Apocalypse as given [authority]". It most often appears alongside 1 Kings 10-11, 2008 Democratic National Convention, Adam Scheffer.

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1
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1
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September 29, 2022
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September 29, 2022
September 29, 2022 · Original source
This is wacky in some sense, but it’s not the sort of no-holds-barred, pattern-recognition-turned-up-to-max attempt to link modern events to Biblical prophecies I was hoping for. The best I could find was this article on The Prophetic Significance Of Monkeypox, which noted that the Bible describes the Horsemen of the Apocalypse as “given [authority]…to kill with sword and with famine and with pestilence and by the wild beasts of the earth”, and that “with pestilence and by the wild beasts of the earth” sort of maybe sounds like zoonotic diseases.
House of France

House of France is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 01, 2025 and August 01, 2025. The archive places it in contexts such as "descended from the noble House of France". It most often appears alongside Africa, Agamemnon, Age of Empires II.

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House of France
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August 01, 2025
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August 01, 2025
August 01, 2025 · Original source
"In the time of the great adversity of this King Charles VII, he found himself (brought) so low that he no longer knew what to do. . . . The King, being in this extremity, entered one morning alone into his oratory and there he made a humble petition and prayer to Our Lord in his heart, without utterance of words, in which he petitioned devoutly that if so it was that he was true heir descended from the noble House of France and that the kingdom should rightly belong to him, that it please Him to keep and defend him, or, at worst, to grant him the mercy of escaping death or prison, and that he might fly to Spain or to Scotland which were from time immemorial brothers in arms and allies of the Kings of France, wherefore had he there chosen his last refuge. A little time afterwards, it came about that the Maid was brought to him, who, while watching her ewes in the fields, had received divine inspiration to go and comfort the good King. She did not fail, for she had herself taken and conducted by her own parents even before the King and there she gave her message at the sign aforesaid (dessusdit) which the King knew to be true. And thenceforth he took counsel of her and great good it did him.”
House Republicans

House Republicans is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 21, 2022 and November 21, 2022. The archive places it in contexts such as "and I guess also to House Republicans". It most often appears alongside 538, 538, Alameda.

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House Republicans
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1
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November 21, 2022
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November 21, 2022
November 21, 2022 · Original source
Also, congratulations to the Democrats, and I guess also to House Republicans.
Housing First model

Housing First model is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 23, 2022 and June 23, 2022. The archive places it in contexts such as "We support the Housing First model, not involuntary treatment". It most often appears alongside 1978, 2016 essay, A Resounding Success Or Disastrous Failure: Re-examining The Interpretation Of Evidence On The Portuguese Decriminalisation Of Illicit Drugs.

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Housing First model
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1
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1
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June 23, 2022
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June 23, 2022
June 23, 2022 · Original source
In early 2020 I asked two ACLU representatives about their organization’s position toward involuntary psychiatric treatment as an alternative to incarceration for the mentally ill who break the law. “We support the Housing First model, not involuntary treatment,” said ACLU attorney Jamie Crook, “which has proven to be ineffective and has violated liberties without keeping people off the streets.” Said her colleague Eve Garrow, “All of the research to date shows that coercive or involuntary outpatient treatment is no more effective and sometimes less effective than voluntary treatment. We’re very much against it.”
Houthi rebels

Houthi rebels is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 09, 2022 and February 09, 2022. The archive places it in contexts such as "how the Houthi rebels are the new face of nice guy incel misogyny". It most often appears alongside ACX Grants, Against Malaria Foundation, Astalcodexten.

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Houthi rebels
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1
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1
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February 09, 2022
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February 09, 2022
February 09, 2022 · Original source
And that's an easy one. What about B? If the professor figures out important things about what influences gender norms, maybe we can subtly put our finger on the scale. Maybe twenty years later, women across the Third World will have equal rights, economic development will be supercharged, and Saudi Arabia will be a Scandinavian-style democracy with a female Prime Minister. But maybe the professor won't find anything interesting. Or maybe they will find something interesting, but it will all be stuff like "it depends what kind of rice they cultivated in 4000 BC" and there won't be any subtle finger-putting-on-scale opportunities. Or maybe the professor will find something great, but nobody will listen to her and nothing will happen. Or maybe Third World countries will get angry at our meddling and hold coups and become even more regressive. Or maybe we'll overshoot, and Saudi Arabia will become really woke, and we'll have to listen to terrible takes about how the Houthi rebels are the new face of nice guy incel misogyny.
HPPD

HPPD is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 09, 2023 and February 09, 2023. The archive places it in contexts such as "I wonder if you could get HPPD from watching videos like this". It most often appears alongside @moritheil, ACX Prediction Contest, Adam Tooze.

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HPPD
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1
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February 09, 2023
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February 09, 2023
February 09, 2023 · Original source
In theory this also paves the way for human meat, though regulators might have other ideas. 2: Eight years ago I wrote an article about how the government should stop restricting doctors’ ability to prescribe suboxone, a useful medicine for opioid abuse. Last month, the government finally stopped the restrictions. Good for them! 3: Carl Sagan married three times. His first wife was legendary biologist Lynn Margulis, who discovered mitochondrial endosymbiosis, then went off the deep end and became an AIDS denialist and 9/11 truther. His second wife drew the Pioneer plaque. His third wife was one of the women who designed the Voyager golden record. 4: Claim: Chinese sources seem to back this up (and related BBC), but I’m skeptical: is this really the best way to satisfy a “must fight with medieval weapons” constraint? Why not crossbows? 5: Did you know: Alex Berenson, who runs the most popular anti-vaccine Substack, has had an unusual career: he used to be an investigative reporter for the New York Times, and also wrote a series of bestselling spy novels. 6: Less Wrong: I Converted Book 1 Of The Less Wrong Sequences Into A Zoomer-Readable Format. Apparently there’s a thing where Zoomers are supposedly more likely to learn a text if you overlay it on on a fast-paced video game, example here. 7: By this point we’ve probably all heard stories about people who win the lottery and then end up bankrupt and miserable after X months or years. I had always assumed this was limited to very poor people with no understanding of money. This forum post argues it’s not, and tells the story of a man who started out with $15 million and still ruined his life after winning $170 million more in the lottery. 8: Did you know: Exiliarch Mar-Zutra II was a 5th century Jewish leader who took advantage of the chaos caused by weird Zoroastrian communists to secede and turn the city of Al-Mada’in, Iraq into an independent Jewish state for seven years. 9: Why doesn’t the Supreme Court have vice-justices? 10: Steve Sailer (warning: unz.com, far-right site, some firewalls will flag or block it): why aren’t there more gay English soccer players? Thousands of current or recent English pro soccer players, the media is really interested in finding a gay one so they can run a “Historic First” article, and apparently they can’t. There are rumors that players are afraid to come out because of homophobia, but there are at least 2,000 retired soccer players and only one of them has come out as gay. “I’m increasingly sympathetic to [the] theory that whatever psychosocial traits make men highly interested in team sports make them highly heterosexual too”. Is this true of other countries and other sports? 11: Adam Tooze on the demographic background to Iran’s protests. Iran thought it was facing an overpopulation crisis in the 80s and tried some reforms to lower family size. The reforms worked overwhelmingly well, causing “the most dramatic transition ever recorded in demographic history”, from 6.5 to 2.5 children per woman in thirty years. Iran now has “lower maternal mortality than the US”, and an education system where “women in university outnumber males”. This kind of demography isn’t usually compatible with patriarchal religious institutions, and the Ayatollahs are aware of this; in a rare admission of error, Khameini said that “Government officials were wrong on this matter, and I, too, had a part. . . . May God and history forgive us.” Now they’re trying to increase average family size and put the genie back in the bottle; Hungary can tell them about the limits of that strategy. 12: What it looks like to be on shrooms: I haven’t used shrooms myself so cannot confirm or deny, but this is oddly compelling, and makes some things I’ve read about neuroscience of vision make more sense. I wonder if you could get HPPD from watching videos like this for too long. 13: Study: federal cancer funding is extraordinarily effective. Cancer research produces so many valuable treatments that it saves one DALY per $326 spent. For comparison, health systems usually consider an intervention good value-for-money if it saves at least one DALY per $50,000. By combing the Earth far and wide, effective altruists have tentatively found one or two opportunities in the poorest parts of Africa to save lives at $100/DALY, but these are extremely rare exceptions and I wouldn’t have expected anything in the US to be within an order of magnitude of that. Either this finding is fake, or we should all be donating to federal cancer research instead of whatever else we’re doing. 14: Yet another person building a vast theory of human interaction off of the characters in The Office. This one is pretty good, also name-drops Bobos In Paradise. I’m still surprised this is such a common thing. 15: Marginal Revolution: FDA Deregulation Increases Safety And Innovation And Reduces Prices. Study looks at what happens when the FDA reclassifies medical devices from a highly-regulated to a less-highly-regulated category; in general, those devices get better, cheaper, and there are somewhere between similar and fewer deaths/injuries related to those devices. Why would safety increase? The author suggests that regulation is a defense against lawsuits (“Your Honor, the FDA agreed to approve our device, so it can’t have been bad!”), and removing that defense makes companies more lawsuit-conscious and careful; Alex Tabarrok suggests a bigger effect may be allowing more innovation towards safer versions. 16: Ozy writes about Interesting People Of History: Charles Williams (ie the other member of the Inklings) 17: Did you know: the Congressman who founded the House Committee On Un-American Activities was, in fact, a paid Soviet spy (tweet, Wiki article). This actually makes sense; he originally started HUAC to root out fascists, and it only got turned against communists later on. “There has been a push to rename the street [currently named after the Soviet spy], but as of 2018 it has been unsuccessful.” 18: Idle Words: Why Not Mars? Surprisingly strong argument for why sending humans to Mars is harder than people think, of minimal scientific value, and likely to contaminate all future searches for microbial life and ruin our chance to study the topic. Concludes that we should abandon the allure of human space travel and just send probes everywhere. This makes short-term sense, but I wonder what this author’s vision of the future is - do we just stay on Earth forever? If not, don’t we have to start trying to do the hard thing at some point? (I don’t care about this because I assume AI will will flip the gameboard one way or another, but Ceglowski is a noted singularity skeptic and should probably have opinions about long-term things). 19: Metacelsus and Razib on epigenetics. Stop using it to claim there’s “intergenerational trauma”! 20: Tafl games are a family of European games, played in areas as diverse as Iceland, Ireland, Britain, and Denmark, probably sharing descent from a now-lost board game of ancient Rome. One of them, Hnetafl, was the chief board game of the Vikings and is affectionately called “Viking chess”. The one we actually know the rules for is the Saami version, Tablut, which survived long enough for Linnaeus (the taxonomy guy!) to write down the rules. 21: Shot: Chaser: (source) 22: Related: the very center of GPT’s embedding space contains a few unusual tokens including the string “SolidGoldMagikarp”. GPT displays anomalous behavior if these tokens are inserted in a query; for example, it treats “SolidGoldMagikarp” as the word “distribute”. ChatGPT is pretty advanced and fails semi-gracefully here; GPT-2’s reaction to these tokens is more disturbing: (source: Less Wrong) Further investigation determined that many of these tokens are the screen names of a group of Redditors who attempted to count to infinity. The most likely explanation, according to the discoverers, is that these names were in GPT’s tokenization data, but not its training data (maybe they were especially common in the tokenization data because they made thousands of posts with numbers in them, but didn’t make it into the training data because their posts had no content?) - that leaves them existing without content, and GPT tries to round them off to some other “nearby” token (by incomprehensible AI standards of nearbyness). Congrats to the SERI-MATS AI alignment researchers who found all of this; maybe this makes it 0.0001% less likely that the AI which controls the nuclear arsenal in twenty years will have equally inexplicable behavior. 23: More language model news: LLM that understands and can explain images
HR ladies

HR ladies is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 15, 2025 and July 15, 2025. The archive places it in contexts such as "enforced by a caste of powerful witches called “HR ladies”". It most often appears alongside Aboriginal, Aboriginal Australia, Aboriginal society.

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HR ladies
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1
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1
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July 15, 2025
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July 15, 2025
July 15, 2025 · Original source
If some Aboriginal anthropologist came to America and tried to list our sex taboos, what would they find? No sex between close family members up to second cousin, that’s obvious. No sex with bosses, subordinates, or clients. A strict taboo on even mentioning sex at work, enforced by a caste of powerful witches called “HR ladies”. Acknowledging even the slightest attraction to anyone under 18 makes you a monster, but people who are just slightly older than 18 - even by one day - are called “barely legal” and feature especially prominently in sexual imagery. No sex across “age gaps”, where some people define “gap” as “half your age plus seven” and other people refuse to define it but reserve the right to judge transgressors anyway. Men can’t have sex with other men, unless they’re part of a special caste called “gay people” who must move to New York, speak in a weird voice, and cultivate an interest in musical theater. Married people can’t have sex with anyone besides their spouse, unless they’re part of a special caste called “poly people” who must move to San Francisco, dye their hair, and get jobs in tech. At some point maybe our hypothetical anthropologist starts longing for the simplicity of someone telling him which 12.5% of the population are his classificatory wives.
HRT

HRT is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 16, 2022 and March 16, 2022. The archive places it in contexts such as "a lot of HRT docs will write oral progesterone for bedtime administration". It most often appears alongside 5α-reductase inhibitor, A Mindful Monkey, ALLO.

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HRT
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1
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1
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March 16, 2022
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March 16, 2022
March 16, 2022 · Original source
Notably, the route of administration MATTERS. A fraction of oral progesterone certainly seems to get metabolized to allopregnanolone and have -pam like effects, so a lot of HRT docs will write oral progesterone for bedtime administration as it seems to help with calming prior to sleep (it's -pam like, as you lay out, so it's not dissimilar from giving a z-drug for sleep pharmacologically).
HSM claim

HSM claim is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 09, 2024 and April 09, 2024. The archive places it in contexts such as "impossible for the HSM claim". It most often appears alongside #S14, 2009 flu pandemic, 2013-16 West African Ebola outbreak.

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HSM claim
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1
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1
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April 09, 2024
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April 09, 2024
April 09, 2024 · Original source
This collapses the ‘extreme coincidence’ claim, which as explained above, turns lab-leak into the leading hypothesis. My strongest disagreement is with his Point 3 - the inference from other seafood-market-based COVID spread events. Saar writes: A common objection to this method is that these outbreaks are caused by cold-chain products brought into these markets. However, this still fails to explain why markets form these early clusters and not the many other places where cold chain products are delivered to. Additionally, this only demonstrates the importance of cold wet surfaces in preserving SARS2 infectivity, further strengthening the hypothesis in method 1 that a crowded location with many wet surfaces like HSM is highly conducive for rapid SARS2 spread. Last, it also opens the possibility that the HSM outbreak was also caused by cold-chain products. This would reduce the significance of Wuhan being the outbreak location (as the product could have come from anywhere), but since the other evidence for lab-leak is so strong, Wuhan can be given no weight and still lab-leak would be highly likely – Rootclaim’s conclusion will only drop from 94% to 92%. Most of these outbreaks have been traced back to either a migrant worker (eg a fisherman from a country with COVID sells fish at the market of a country with Zero COVID) or a cold chain product. For example, here’s Dai et al on the Xinfadi outbreak, the most important event of this type: According to a joint publication by the Beijing CDC and 13 research institutions, the outbreak at Xinfadi Market was likely to be initiated by fomite transmission from contaminated foods imported via cold-chain logistics (Pang et al., 2020; Beijing Daily, 2020b). Based on the epidemiological investigations at the Xinfadi Market, the researchers preliminarily concluded that booth #S14 in the aquaculture product selling area on the basement floor of the primary trading hall was the source of the initial transmission. Specifically, five customers were tested positive for IgG/IgM antibodies against SARS-CoV-2 in serological screenings, all of whom visited booth #S14 on May 30 and 31, 2020. On May 30, 2020, the owner of booth #S14 procured imported and fully packaged salmon from a company's cold storage warehouse, then cut and processed the salmon for sale at the Xinfadi Market. Laboratory tests showed that sample swabs from five salmon fish from this supplier were tested positive by examining all salmon in the original sealed packages (n = 3582) in the cold storage facility. Viral genome sequencing showed that the viral strain isolated from one of the positive salmon swabs was homologous to that isolated from the infected persons and environmental samples at the Xinfadi Market (Beijing Daily, 2020b). The joint study reported that an ancestral strain isolated from the Xinfadi Market in Beijing was markedly different from the strains identified in two preceding outbreaks in China and the sequences obtained in March 2020 in Beijing. Phylogenetic analysis assigned the ancestral Xinfadi strain to clade B.1.1. Given the fact that the ancestral sequences were mainly identified in Europe, the strain was more likely to be imported to Beijing rather than derived from strains previously circulating in China (Pang et al., 2020). I know China has a bias towards believing frozen food COVID explanations, but this all sounds pretty convincing to me. Why is it more often markets than other places with cold chain products? Partly it’s the migrant workers - a lot of seafood markets are right next to seaports, and the contact tracing eventually traces back to a fisherman who came in through the seaport - I don’t think this is any more mysterious than epidemics often starting via airport or any other transportation hub. But even just keeping the focus on cold chain products, - there have also been outbreaks in seafood distribution warehouses, on docks, and in a seafood processing work area. Markets have many more people than any of those locations, and maybe (total speculation) cutting on cutting boards could aerosolize bits of fish. The strongest evidence that the Wuhan / Huanan Seafood Market epidemic wasn’t caused by migrant workers or imported seafood products is that there was no previous COVID-infected source of workers or seafood. If there had been, we would have noticed when the outbreak there spread (see Section 1.4 on Brazil). Responses to a few of Saar’s other points below: How many locations other than markets provide an interface with wildlife? Were markets actually identified in advance to be high-risk spillover locations or only in retrospect? I think scientists had called wet markets as an especially dangerous potential transmission location in advance. See for example Infectious Diseases Emerging From Chinese Wet Markets, published in 2006, which says: » “In Chinese wet-markets, unique epicenters for transmission of potential viral pathogens, new genes may be acquired or existing genes modified through various mechanisms such as genetic reassortment, recombination and mutation. The wet-markets, at closer proximity to humans, with high viral burden or strains of higher transmission efficiency, facilitate transmission of the viruses to humans.” In 2004, a paper on an emerging bird flu expressed hope that it would not spread too widely, but concluded that: » “Even in the event of yet another lucky escape, more measures must be taken to limit the amplification of viruses with pandemic potential in the wet markets around the world.” In 2007, Reuters published an investigation: Chinese Markets May Be Breeding Ground For Deadly Viruses, which said things like: » “We face similar threats from other viruses and such epidemics can happen because we continue to have very crowded markets in China," said Lo Wing-lok, an infectious disease expert in Hong Kong. "Even though official measures are in place, they are not faithfully followed. We are not talking about just civet cats, but all animals," he added.” Wet Markets, A Continuing Source Of SARS And Influenza, published 2004, is admittedly focusing on the next SARS1 outbreak instead of on SARS2, but gets bonus points for mentioning both wet markets and labs as likely causes of the next pandemic: » “Will SARS reappear? This question confronts public-health officials worldwide, particularly infectious disease personnel in those regions of the world most affected by the disease and the economic burden of SARS, including China, Taiwan, and Canada. Will the virus re-emerge from wet markets or from laboratories working with SARS CoV, or are asymptomatic infections ongoing in human beings? Similar questions can be asked about a pandemic of influenza that is probably imminent. Knowledge of the ecology of influenza in wet markets can be used as an early-warning system to detect the reappearance of SARS or pandemic influenza.” Saar mentions that there are several other possible sources like restaurants or farms. I think Peter demonstrated during the debate that pandemics are unlikely to start in rural areas, so farms aren’t that important. Restaurants mostly source their products from wet markets. During SARS1, some pandemics started in restaurants because they kept the civets in cages next to the diners (like how some Western restaurants keep lobsters). After SARS1, restaurants stopped doing that and became a less likely spillover location. Saar again: Scott quotes Peter, who implies that under the lab-leak hypothesis, we would expect the confirmed early cases to be centered around the WIV. However, cases are not expected to center on the lab. The lab is not spraying viruses into the air or hosting thousands of locals daily. If a worker gets infected, they spread the virus to their friends and family at completely different locations. In most places with an outbreak of known origin, epidemics show some geographic clustering. This has been true ever since the very beginning of epidemiology, when John Snow successfully traced a cholera outbreak back to its origin at a contaminated water pump by taking the center of the map of cholera cases. This isn’t a 100% law of nature; an infected lab worker might get lucky and not pass it to any of his lab co-workers. Still, we might expect him to infect his family, the stores he went to, or the restaurants he went to. If he lived near his workplace, these might also be near the lab. If he didn’t - let’s say he lived on the other side of town and had a long commute - he would start a cluster near his house, or his favorite store, or his favorite restaurant. Then the people there would infect their families/co-workers/stores/restaurants. The cluster would start somewhere! Sure, some people would infect nobody close to their work or home, and instead just infect one person a hundred miles away who they breathed on during a trip - but this is the exception, not the rule. So you wouldn’t expect a totally random distribution of cases all around Wuhan. There would be one center, or maybe several centers. But none of the claims that COVID was quietly spreading for months before the wet market have pointed to some alternate center of cases. If COVID was spreading for months before the lab, it somehow spread in a completely diffuse geographical pattern, with people exactly as likely to infect people far away from them as close to them - until it reached the wet market in December, and then spread in the normal center-radiating-outward way that every other infection spreads. All the evidence trying to support a spillover at the market is based on complex models with many single points of failure, built from unreliable and biased data. Therefore, it is difficult to give this evidence significant weight as there is always a possibility of errors in the data or its interpretation. More on this in the UFO comment below. Disagree. “First known case was at a wet market” is as simple as it comes. Certainly it’s less complex than “the virus has a 12 nucleotide insertion at the furin cleavage site, and even though those sometimes happen by natural recombination probably this one didn’t, and even though it looks out of frame maybe there was some weird thing going on with serine that made it in frame this one time only”, which is Saar’s star piece of evidence. I understand Saar thinks he can come up with lots of objections to “seen near wet market is suspicious for wet market origin”, then claim that getting over those objections requires “complexity”. But if Peter had no dignity, he could also come up with lots of objections to “seen in same city as Wuhan Institute of Virology is suspicious". He could say that maybe the civet farms of Hubei province were uniquely blah blah blah, and then Saar would have to prove that the civet farms weren’t uniquely blah blah blah, and then he could say “Oh, sure seems like you have a complex model with lots of unique points of failure, it all depends on fifty facts about the regulation of civet farms.” To illustrate what a market looks like in a real zoonotic pandemic, consider this study from SARS1. The researchers went to a random market and sampled the wildlife sold there. 4 of 6 civets sampled were positive, and 3 of them were phylogenetically distinct (i.e. infected in completely different places). A scientist I talked to says the 3 phylogenetically distinct lineages were most likely sampling errors. Still, this seems irrelevant to me since, again, no raccoon-dogs were tested. Scott explains that Covid’s closest known relative, BANAL-52, is rare and so it’s highly unlikely the WIV would’ve had it available as the starting point to engineer Covid . . . This is a basic mistake. SARS2 is not based on BANAL-52 but a relative of it. There is nothing unlikely here. No BANAL-52 relative close enough to create COVID from has ever been discovered. By mentioning BANAL-52, I was trying to be maximally charitable to the lab leak side. In order to create COVID, they would need a virus very close to COVID. But in years and years of searching, nobody has ever discovered a virus like this. Therefore it must be rare. As a way of bounding how rare, let’s see how rare the closest virus ever discovered is. That’s BANAL-52. It is very rare. Therefore, the COVID ancestor must be rarer than that. I don’t know how strong this argument is, because maybe there are millions of rare viruses capable of becoming pandemics, such that getting any one of them is very easy, even though each one individually is rare. The version of this I find convincing is that it should be a probabilistic cost to say that WIV did gain-of-function on a seemingly undiscovered and so-far-very-hard-to-discover rare virus instead of on any of the usual SARS-like viruses that people do their gain-of-function research on. Overall, all attempts to portray [Connor Reed] as an unstable, delusional person were unsuccessful. He is an ordinary person who very accurately described Covid-19 symptoms in real-time and claims to have received a positive test result. The timing and location matches the lab leak hypothesis and is impossible for the HSM claim. Therefore, they must discredit him. It is worth noting here the biased evidentiary standards used by zoonotic proponents. Reed’s testimony about his sickness, given on camera to multiple outlets, is deceitful and should be ignored. Yet, an anonymous voice testimony in one Chinese publication is definitely identified as Mr. Chen (another possible pre-HSM case) and should be considered reliable. See above for why I don’t trust Connor Reed. I’m not sure why Saar attributes Mr. Chen to “an anonymous voice testimony in one Chinese publication”. When I looked for Chen information, I got this thread, where it’s attributed to two Chinese hospital doctors, cross-checked with the Chinese COVID data repository, and double-cross-checked with the supplementary table in a peer-reviewed paper published by a team of Wuhan doctors. To understand how ridiculous the claim is that the HKU1 insertion looks just as engineered as SARS2’s, here are their alignments. Hopefully that should be enough. COVID: HKU1: I’m not a virologist, but I question how this comparison works. Surely HKU1 got its insert on some specific day. If you take the virus the day before, and then the other virus the day after, there will be no differences except the insert, and it will look just like COVID (ie an insert without many other mutations). The fact that the COVID comparison has few mutations, and the HKU1 insert has many mutations, just shows that whatever older virus we chose to compare HKU1 to is more distant from HKU1 than BANAL-52 (or whatever) is from COVID. Or am I missing something here? [The evidence that China tried to cover up zoonosis from the start] is untrue. They clearly said from the start this is a zoonotic spillover at HSM, and at least part of the government went to immense efforts to identify the animal, close farms, etc. (and of course couldn’t find any infected animal). Only in late 2020 did they start suspecting an import from cold-chain products after having multiple outbreaks that seem related to cold-chain products. From a Vox article from March 2023: From the start, the Chinese government interfered with efforts by both Chinese and international experts to study the pandemic, including its origins. Reporting by the AP found that even as WHO officials were publicly praising China’s cooperation, behind the scenes they were complaining about lack of access and a refusal to share data. Within months of the beginning of the pandemic, the Chinese government imposed restrictions on academic research into the origins of the novel coronavirus … China’s intransigence wasn’t unusual — countries are rarely eager to confirm that they’re the source of a deadly disease — but it went beyond the norm. International investigators weren’t permitted to see the market until more than a year after the pandemic began and a WHO-affiliated team was allowed a highly choreographed and controlled visit. The resulting report that came out of the Wuhan visit, which dismissed the possibility of a lab origin, pointed the finger at some kind of zoonotic spillover while concluding that it was unlikely that the spread started at the market, which surprised many experts. It also found that it was “possible” that the virus had been introduced via contaminated frozen food products from abroad. While few experts took that possibility seriously, it fit a narrative the Chinese government had been pushing, against nearly all evidence, that the pandemic had in fact not originated in China. “China just doesn’t want to look bad,” Filippa Lentzos, a biosecurity expert at King’s College London, told Science last August. “They need to maintain an image of control and competence. And that is what goes through everything they do.” […] it seems clear that with more cooperation, scientists could have been looking at raccoon dogs a year or more ago. “The big issue right now is that this data exists and that it is not readily available to the international community,” Maria Van Kerkhove, the WHO’s Covid-19 technical lead, told reporters on Friday. “This is first and foremost absolutely critical, not to mention that it should have been made available years earlier, but that data needs to be made accessible to individuals who can access it, who can analyze it and who can discuss it with each other.” The irony is that by making it so difficult to properly investigate a zoonotic origin of Covid, the Chinese government has created a vacuum that has been filled by claims on all sides, including the much more damning accusation that the pandemic was the result of a lab error at the Wuhan Institute of Virology. For what it’s worth, my timeline of Chinese denials and coverups looks like this: December: COVID doesn't exist, it's all lies Early January: Fine, it exists, but it’s just some wet market thing that can't spread from person to person Late January: Fine, it can spread from person to person, but we’ve got it under control now. February: Fine, it’s out of control, but you would not believe how great our response was. We're basically heroes. March: COVID was a US bioweapon, or possibly came from Italy. April: Chinese people are banned from researching the origins of COVID without government permission. 2: Comments Arguing Against Lab Leak 2.1: Is the pandemic starting near WIV reverse correlation? randomstringofcharacters wrote: Isn't [the pandemic starting near the lab] a reverse correlation issue? The lab is situated there because it's an area where coronaviruses were found in the past. Many people had this question, but Wuhan Institute of Virology was founded in 1956, didn’t originally focus on coronaviruses, and isn’t in a coronavirus hot spot. Most of WIV’s coronavirus samples come from Yunnan, about a thousand miles away. COVID’s closest relatives were found in Laos, almost two thousand miles away. During the debate, both Saar and Peter calculated the odds of a natural pandemic arising in Wuhan by dividing the population of Wuhan by the total urban population of East Asia (Saar) or South China (Peter). Saar got 1.5%, Peter got 3% (he later said this could be as high as 10% because it was a central hub in the wildlife trade). This isn’t an Official Position and I don’t think anyone else shares it, but during the debate Peter pointed out a few times that there are plenty of disease-ridden bats in Hubei (the province Wuhan is in), and that it’s not impossible that a bat virus currently known only in Laos could be active in Hubei. Still, this is the minority viewpoint and most scientists just think it involved something about the wildlife trade. 3: Other Points That Came Up 3.1: Apology to Peter re: extreme odds quiet_NaN wrote: Hot take: Peter clearly failed to convince anyone. The lab leak odds, in log10 (i.e. orders of magnitude are): Peter -20.7 Saar 2.7 Eric -3.1 Will -2.5 Scott -1.2 Daniel -1.4 One of these numbers is clearly an outlier. Scott mentions it and calls it "trolling", I would argue that it is debating in bad faith. 2e-21 is a ratio which is just silly. For one thing, the gain of function at WiV pathway is not the only pathway towards a lab leak. The WIV could also have released a naturally occurring coronavirus at the wet market. At 2e-21 odds, we would probably have to consider the possibility that the WIV built a time machine and went back in time to infect the wet market. I might have screwed up here - or at least I should have emphasized the “trolling” part. Peter complained about my presentation of his extreme-odds slide, saying: This is basically accurate. During the debate, Saar gave lots of different numbers. I don’t want to say exactly what the different numbers meant, because in earlier drafts of my post, Saar said I misunderstood them. My impression were that some of his numbers were conservative, others were central, others were extreme, others were adjusted-for-out-of-model-error, others were not-adjusted, etc. In an early draft of the post, I gave higher numbers for Saar. Saar asked me to replace them with the numbers I ended up using. I decided to agree, because I wanted to represent Saar fairly with the numbers he most centrally believed, but also because these were closest to the numbers on his Rootclaim site so it wasn’t like he was making them up just to fool me. Peter didn’t argue quite as hard, and also he didn’t have anything like the Rootclaim site, so I just took his first set of numbers. Trying to piece things together, I think a reasonable summary would be: During the debate, Saar mentioned 700-million-to-one odds in favor of lab leak, not because he thought this was plausible, but just as a discussion of where the situation would end up if you didn’t adjust for human fallibility.
HU

HU is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 22, 2023 and November 22, 2023. The archive places it in contexts such as "a cult that believes HU is the true name of God". It most often appears alongside American Psychiatric Association, Avakian, Bay Area.

Reference entry
HU
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1
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1
First seen
November 22, 2023
Last seen
November 22, 2023
November 22, 2023 · Original source
“HU = one word, two letters, infinite possibilities”. This is from the local branch of a cult that believes HU is the true name of God, no, I am not joking.
huatias

huatias is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 08, 2025 and August 08, 2025. The archive places it in contexts such as "Earthenware ovens called huatias were used to bake them". It most often appears alongside Ainu, Altiplano, American cheese.

Reference entry
huatias
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1
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1
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August 08, 2025
Last seen
August 08, 2025
August 08, 2025 · Original source
These roots resemble the ancestral stock of modern potatoes (source) Andean peoples found all sorts of ways to prepare their potatoes. The most immediate method was to boil them into stews, soups, or mashes with local flavoring agents - herbs, salt, chilis. Earthenware ovens called huatias were used to bake them. With even more time, they could be fermented into tocosh, an edible paste with antibacterial properties. To get the spuds to really last, though, they were subjected to a natural freeze-drying method that produced shrivelled potato pellets called chuño. Repeatedly frozen by bitter mountain nights, baked in the sun, and stomped on to remove water, chuño remains shelf stable for up to a decade and can be rehydrated into a spongy, earthy, slightly less nutritious potato-like object. The ability to produce chuño on the Altiplano is thought to have contributed to the Incan empire’s military dominance of the region, since despite its generally unappealing gustatory properties it’s perfect for keeping troops fed on long marches. Chuño also allowed Incan civilization to stockpile surpluses against lean years and trade potatoes as commodities over great distances. It wasn’t the best way to eat a potato you harvested today, but it was the only way to turn a potato you have today into a potato you’ll have two years from now. That had immense value. After the Spanish conquest and the Columbian exchange, the potato made gradual inroads into the Old World, where the previous best root vegetables were often comparatively less nutritious parsnips and turnips. There was an initial adjustment period: new cultivars capable of growing in shorter hours of daylight had to be developed, objections to the absence of tubers in the Bible needed to be quelled, and the French eventually had to concede that potatoes do not, as they at first believed, cause leprosy. With these hurdles cleared, in the 19th century the potato spread out and became one of the easiest and most efficient ways to turn arable land into palatable calories the world over. National cuisines incorporated the new staple crop thoroughly, and it’s now hard to imagine Italian food without gnocchi, French sans vichyssoise, tapas without patatas bravas, a Eurasia bereft of aloo and rösti and colcannon and latkes. Europe’s new potato lovers also took to the simple recipe of boiling ‘em and mashing ‘em. While South America had lacked the livestock for dairy, in Europe the potato mash soon achieved its ultimate form with the addition of milk and butter, which impart a smoother texture and richer taste. Hannah Glasse’s procedure published in 1747 in The Art of Cookery Made Plain and Easy is, minus the long s’s, still just about how I make them today: Maſhed Potatoes. BOIL your potatoes, peel them and put them into a ſauce-pan, maſh them well ; To two pounds of potatoes, put a pint of milk, a little ſalt, ſtir them well together, take care they don’t ſtick to the bottom, then take a quarter of a pound of butter, ſtir in and ſerve it up. Nowhere was the potato embraced more thoroughly than in Ireland. In the early 19th century, extractive British demands on Irish agriculture to feed the armies fighting Napoleon reduced the available land for Irish farmers to feed themselves. Achieving maximum caloric density on the remaining land was paramount, and almost nothing is denser than the potato. Potatoes quickly became an integral part of Irish life, so essential to the food systems of the island that when a blight hit them in the mid-1840s it led to one of the most devastating famines in history. The failure of the potato crops created starvation and emigration so profound in scale that the population of the island still has not recovered to its 1845 level almost two centuries later. Among those millions of potato-starved emigres were my dad’s ancestors, who came to America in the decades following the famine. My great-grandfather, who bore the extremely Irish name Gerald FitzGerald, instilled in his children (including my grandmother) a reconstructed sense of Irish-American ethnic pride that included an affinity for corned beef and cabbage, Guinness beer, and the affordable practicality of mashed potatoes. As the generations marched on, those mashed potatoes turned out to be one of the only things my grandmother would make that my exceedingly picky father would eat. Their creamy texture and subtle starchy taste didn’t trigger the “ew gross” reaction he had to so many other foods. Mashed potatoes, just like the ones Glasse had written about more than two centuries earlier, became his favorite side - and eventually, when I finally got to try them, one of mine too. Whatever My Dad Had Been Eating at Home Was NOT Mashed Potatoes The chuño-chomping Incans were not the last military to rely on dehydrated potatoes for sustenance. In World War II, the US Army experimented with various forms of potato dehydration to help stretch supply lines. The easiest way to get a uniform potato commodity into the hands of G.I.s was to pulverize the potatoes into granules, dehydrate them, and then plan on bringing them back to life with boiling water in an imitation of “mashed potatoes”. These shreds resemble the ancestral stock of modern Instant Mashed Potatoes (source) The result was an affront. The potatoes were swimming in their own gluten, released during the granule-making process, which when mixed with imprecise water ratios made for a slop that was somehow both gluey and soupy. Immediately after the war, French’s (now best known for mustard) tried to introduce “instant mashed potatoes” as a consumer product category. America’s veterans were not having it. They didn’t want to be reminded of the awful slurry they’d had on the front. The commercial fortunes of instant mashed potatoes began to turn around a decade later, however, when food scientists in the US and Canada converged on methods for producing dehydrated potato flakes rather than granules. The flakes had substantial advantages. They didn’t get as glutinous when reconstituted. Their geometry made them easier to dry quickly, on the order of minutes or even seconds. Using a multi-step process called the “Philadelphia Cook”, they could lock in a more natural flavor. When prepared on the stove with butter and milk, they were supposed to turn out almost as good as the real thing without any onerous prep work on the part of the consumer. This raises the question, though, of why food scientists kept working on improving instant mashed potatoes a decade after they were no longer required for the war effort. If you’re no longer constrained by having to stick it to the Axis, why not return to Glasse-style maſhed potatoes in all circumstances? This is a pattern that recurs frequently in reading about American foodways of the 20th century: choices and innovations made under extreme duress in the World War II economy didn’t fade away when the duress subsided. Instead they echoed back into American life a few years later, despite the lean conditions that birthed them being replaced by extreme abundance. Why did America start eating like it was on a total war footing again when my parents’ generation was young? There are a lot of overlapping explanations. Here are a few: Industrial inertia: Companies that had spun up to supply a vast army didn’t want to shut down overnight, so they necessarily pivoted to the consumer market. Some of these efforts succeeded at entrenching new consumer categories (fish sticks, canned peaches) while others (hamburgers-in-a-can) did not.
Hubble's Big Bang Theory

Hubble's Big Bang Theory is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 28, 2022 and July 28, 2022. The archive places it in contexts such as "This paradox was eventually resolved by accepting that the age of the universe is finite, as described by Lemaitre's and Hubble's Big Bang Theory". It most often appears alongside 1970s World Bank initiatives in Lesotho, Alex, archpawn.

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1
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1
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July 28, 2022
Last seen
July 28, 2022
July 28, 2022 · Original source
This isn't even the worst prediction of the old paradigm*: the Blazing Sky Paradox / Olbers' Paradox. The universe was thought to be infinitely large and infinitely old and that matter is approximately uniformly distributed at the largest scales (Copernican Principle). Any line of sight should eventually hit a star. Work out the math and the entire sky should be as bright as a sun all the time. This contradicts our observation that the sky is dark at night. This paradox was eventually resolved by accepting that the age of the universe is finite, as described by Lemaitre's and Hubble's Big Bang Theory.
Huguenot

Huguenot is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 10, 2023 and June 10, 2023. The archive places it in contexts such as "It is unknown whether he was a Huguenot himself"; "he was a Huguenot himself, but his friends, both d'Aubigné and Henry of Navarre, certainly were". It most often appears alongside A Poet in Paradise, Agrippa d'Aubigné, Alfred Adler.

Reference entry
Huguenot
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1
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1
First seen
June 10, 2023
Last seen
June 10, 2023
June 10, 2023 · Original source
Things changed for du Vintrais after August 24th, 1572, also known as “St. Bartholomew's Eve massacre”. It is unknown whether he was a Huguenot himself, but his friends, both d'Aubigné and Henry of Navarre, certainly were. He fiercely protected them, first with his sword, then with his quill. His poems became political, he attacked Henry de Guise, a staunch supporter of Huguenot persecution, then Queen Mother Catherine de' Medici, then King Charles IX himself. He was arrested, sent to Bastille. At the last moment, the king changed his sentence: from execution to exile. He came back to France in secret just to learn that his friend, Henry of Navarre, converted to Catholicism in order to become King Henry IV of France. That was perceived as a betrayal.
hukou system

hukou system is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 05, 2026 and January 05, 2026. The archive places it in contexts such as "You cannot partake of public services without home “ownership” (hukou system, and technically its a land lease)". It most often appears alongside AGI, AI, Amazon.

Reference entry
hukou system
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1
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1
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January 05, 2026
Last seen
January 05, 2026
January 05, 2026 · Original source
[China has] estimated 50% youth unemployment, general unemployment now illegal to publish (but you can still approximate by falling commuter numbers), some government workers haven’t been paid in more than a year (living entirely off extortion/bribery; includes police, teachers, and all healthcare), common experience in private sector to have your paycheck delayed by “2 weeks” that turns out to be 16 weeks. Starting salary offer for software engineer in Shanghai is <1/3rd legal minimum wage. You cannot partake of public services without home “ownership” (hukou system, and technically its a land lease). Private health insurance is overwhelmingly likely to be a scam and rarely used. Public coverage primarily covers TCM; most western medicine is out of pocket. If you cannot afford to pay - even in a trauma situation - you will be escorted off the property so your death doesn’t lower hospital mortality statistics.
human

human is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 14, 2023 and July 14, 2023. The archive places it in contexts such as "If I had to choose, I might have gone with “human”". It most often appears alongside !Kung San, aboriginal people on the west coast of Canada, Adam Smith.

Reference entry
human
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1
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1
First seen
July 14, 2023
Last seen
July 14, 2023
July 14, 2023 · Original source
This is a review of his 1997 book, The Educated Mind: How Cognitive Tools Shape Our Understanding. It’s his opus, the one book in which he most systematically laid out his paradigm. It’s not an especially easy read — Egan’s theory knits together evolutionary history, anthropology, cultural history, and cognitive psychology, and tells a new big history of humanity to make sense of how education has worked in the past, and how we might make it work now.
Kieran Egan laughs at your educational reforms Okay, of those three jobs, which should we give to schools? You probably have your favorite — I certainly did! But Egan wants you to know they’re all crap. None of them, by themselves, can give us the kinds of schools we want. Q: I kind of like Rousseau! What’s the problem with pure development? Like I said before, my bookshelves overflow with authors who want to knock down Rousseau (and the people who followed in his wake — John Dewey in particular). Egan will have none of it: before the developmental approach, many schools were terrible places where children were beaten for getting math problems wrong. “Rousseau and Dewey,” he writes, “have enriched our conception of education in important ways. We will not make educational progress by trying to cut away their contribution”. But, he continues, there’s no way a purely developmental approach could possibly work! Rousseau imagined human nature to be selfless and kind; this ideal state could only survive if it was kept away from the evils of society — the titular child in his book Emile was kept away from human society, unable even to read, until age twelve. Of course, schools don’t go this far — they can’t — but I can attest from personal experience that even fairly serious attempts to raise children in an accepting community of peers often crash and burn when faced with actual human nature. Kids reared in the most developmentally appropriate schools can be nasty, bored, and lazy at about the same rate as their mainstream peers. Q: In my heart, I’m an academicist. What’s the problem with it? I think Egan was an academicist in his heart, too. His book drips with classical references — so much so that it can make some sections difficult to read. But, he points out, those purely-academic schools really were hellscapes. And their brutality wasn’t something that was just tacked on, it flowed from their understanding of knowledge: enlightenment will come when the right information enters a child’s head, regardless of how it gets in there (or whether the child wants it in there). And again, Egan feels obliged to point out that we’ve tried this approach for thousands of years, and it hasn’t worked. In fact, Plato’s original vision so obviously doesn’t work that people hawking academic schools have modified their pitch: no longer is the goal for students to understand the Truth, but to cultivate inquiring, skeptical minds who are perpetually dissatisfied with old answers. Can we imagine taxpayers paying for this? Q: Fine, fine. I’m not a fan of socialization, but I’ll ask the question — what’s wrong with it? The funny thing is that of the three, this is the only one that has shown its ability to work for a long stretch of time! (As John Calvin pointed out, as animals, we’re pretty pathetic. Socialization allowed our ancestors to become something more than individuals so that they could survive; we owe this job our gratitude. That said, it would be impossible for schooling today to seek only to socialize. That would require that members of a society share values, and fundamentally agree that their society is good. It also requires that a society not be changing, so the values and skills that are taught to children today will be the ones that will be useful to them in thirty years. Obviously, modern Western society is none of those things. Pure socialization might work for the Amish, or for Catholic trad communities, but not for us. And, frankly, we should feel okay about this. (Do you know where you could get a pure socialization education in the 20th century West, Egan asks? The Hitler Youth!) There really are good reasons to be wary of any education that decrees that its society is uniformly good. Which combination is best? Okay, you say, it’s clear that none of these jobs is good on its own — the solution (obviously!) is to smoosh them together. If we do that wisely, the good parts of each will make up for the deficiencies of the others. This sounds eminently reasonable — but Egan would like to have a word with you. Q: What’s the problem in combining socialization with academics? Wouldn’t this be a beautiful combination? Socialization would cohere the school together, and then they could leverage those good feelings to, say, read Aristotle. I’ve seen this work in schools (like conservative Christian academies) founded on a set of specific beliefs. But when intellectual diversity enters in, it becomes harder. You, perhaps, say that socialization could unite people around their differences — schools could support a society made up entirely of critics! Yes, a society of critics would be interesting, and so would a herd of cats: neither works in practice. Imagine students reading their Ibram X. Kendi books in the morning, then pledging allegiance to the American flag after lunch. Q: What’s the problem in combining academics with development? Again, this seems like a beautiful vision: we can invite children into discovering the big ideas. Alas, it crashes into the reef of reality quite quickly: what do we do when kids don’t want to learn about the big ideas? This combination works wonderfully for kids who naturally want to be academics, but — and this is a crucial point that geeky education types too often sweep under the rug — lots of kids don’t naturally want to be academics. Okay, you say, ignore the “liberatory” element of the developmentalist program, and focus on the “uncovering the nature of the individual child” part: academics can tell us what the students should be learning, and development can tell us how they should learn it. Egan has a thought experiment for you. Imagine that you get the funding to fully pursue this combined goal — you set up a hundred different types of schools in the nearest big city. There’s a specific school for every possible permutation of learner — a school for big-picture kinesthetic learners who score as INFJ on the Myers–Briggs, a school for detail-oriented auditory learners who score ENFP, a school for marine-biology-loving hyperactive learners who lost their personality test results… you get the idea. You build the schools, you work out the bus schedule, and then, on the first day, all the students learn exactly the same content. Because that’s what it means for a school to be an academy — it teaches “the best that’s been thought or said”. Q: What’s the problem in combining development with socialization? What’s wrong with telling kids to become their authentic selves, even as you squeeze them into the roles most beneficial to society? Imagine two rural schools merging together, due to declining local population. Now imagine that one of them is a hippie free school, and the other is a military academy. (That’s a reality TV show I’d watch.) It’s possible, I suppose, to imagine this working for kids who naturally want to be, say, plumbers, or paleontologists, or presidents — and who happen to go to a school that prepares its students to fill that one role. But the odds of matching students to schools just perfectly seems small. But enough thought experiments — we can state this in a visual form: behold, the SAD triangle. It’s bright around the edges, but muddled where they mix: One of the things I love about Egan is that he looks at educational ideas historically. (Most histories of education start around the turn of the 20th century; I remember being excited when I found one that began in the 1600s. Egan begins in prehistory.) And what we’re reminded of, when we see these historically, is that these jobs were meant to supplant each other. Put together, they sabotage each other. What are we asking of schools? Of the three possible jobs, which are we asking mainstream schools to perform? Egan answers: all three. To confirm this, stretch your memory back to your student days, and see if you can put some of the most basic elements in any of these three categories. We’re so immersed in these that they seem obvious, “natural” aspects of schooling, but of course they’re nothing of the sort. Did you spend your time with other children of the same age? Was your work graded according to a standard? Were you forced to play team sports, or to pledge your allegiance to your nation-state? All of these, Egan says, bear the fingerprints of the goal of socialization. Progressive reformers in in the 1960s saw these as the markings of a dark conspiracy, but socialization has more warm-feely aspects: counselors to help students cope with the strains of modern society, field trips to the local fire station and historical monuments, and everything “practical” — life skills, sex ed, emotional regulation, and so on. Did you learn anything that wasn’t obviously useful? Did you read Hamlet, say, or master the Pythagorean theorem, or learn that the planets orbit the Sun (and not the other way around)? That’s the fingerprints of the academic goal. Finally, did you hear teachers show concern about “age-appropriate” content, or see signs that your school valued individualized learning? Does it seem right to you that learning should be “active” rather than “passive”, or that it’s better for someone to discover something than to be told it? Did your kindergarten have tiny, child-sized chairs? All these, Egan says, are the fruit of developmentalism. The first time I read the book, I wondered at all this. What Egan was saying was indeed lining up with my memories. But perhaps, I thought, he was playing loose with the categories; I was still skeptical that schools really were trying to balance all three goals. So I decided to check his idea from a different perspective and look up the mission statements of school districts I was familiar with. Here’s the one from the town I currently live in: “Skills” and “become involved members of a global community” seem to connote socialization, “challenge” and “knowledge” seem to connote academics, and “empower” and “reach their full potential” seem to connote development. But I wasn’t sure if I was just seeing faces in clouds, so I looked up the mission statement for my hometown: “Succeeding” seems like socialization, “learning” seems like a nod to academics, and “growing” seems like code for development. But again, I was worried that I engaging in motivated reasoning, so I looked up the largest district I’ve lived in, a city of about a million people: Wow. That seems pretty clear. So, to sum up: Egan says that there are three potential jobs we can give to schools. Alone, each of these jobs is terrible; together, they’re worse. And what we’ve done is given schools all three jobs. A sad triangle, indeed. What about alternative schools? I was curious to see whether this “sad triangle” could help us understand other philosophies of education, and why they work (or don’t). Where would, say, unschooling, and classical education, and vocational ed, and Montessori go? The first three seem obvious. Radical unschooling is in the upper-right, classical schools (with its focus on feeding kids “the best that’s been thought or said”) is in the upper-left, and vocational ed is in the bottom corner. What can that tell us? Intriguingly, each of those approaches can claim to have done some impressive stuff. I’ve worked with radical unschoolers, and while their skills have often been lopsided (not learning math is an acknowledged issue in the community), they’ve all at least exhibited a zeal for learning the topics they’ve been interested in. (Video games, frequently.) And I remember a massive study in the early 2000s that asked which kinds of schools actually improved student test scores controlling for the effects of socioeconomics. What it found was that only two types of schools stood out: Catholic schools that were operated by a religious order (e.g. the Jesuits — not local parish schools), and vocational schools. Q: Oh, that’s terrible evidence. One of those was just personal anecdotes! And what about selection effects? And what about…? I wouldn’t disagree — and, as Freddie deBoer points out, most educational research is bunk. I’ll take this to be only weak confirmation of Egan’s theory that combining jobs undercuts education. Are we hosed? If Egan’s critique is correct, we’re in a bad situation. Educational radicals yell from their dark corners to abandon the middle and come join them; a century of educational reforms have amounted to little more than wobbling around, first in one direction, then another. At the moment, the conversation about schools in the United States, at least, seems to have hit an all-time pessimistic blech. Freddie deBoer speaks for a lot of people when he says “Even the most optimistic reading of the research literature suggests that almost nothing moves the needle in academic outcomes. Almost nothing we try works.” I’m not quite that pessimistic — the word “almost” is doing some work, there. There are some reforms that seem to work at the margin: raising teacher pay, making it easier to become a teacher, reducing air pollution, free school lunches, and more. Actually applying what the science of reading has been telling us for a few decades seems a big one. And perhaps you have your own pet reform proposal. Sure — add it to the heap! What Egan suggests, though, is that so long as we’re bopping around this triangle of jobs, we won’t be able to get the schools that we want. The dream There’s a moment at the end of my favorite Bollywood movie that’s become stuck in my head. The protagonists have made the arduous journey to a beachside rural school. In the sun outside, flocks of children are experimenting with art and playing with inventions; inside, the walls are covered with books and the tables are covered with models. The kids are learning joyously and deeply. In the real world, such places do exist — they’re just exclusive, pulling their students from among the families who are already the most gifted and curious. They don’t make kids this way; they scoop up the kids who are already this way. But in the movie, we’re supposed to believe these are normal children — normal, except they’ve been transformed by a school. Egan’s wild idea is that it’s possible to make schools like this. He thought that we didn’t have to wait for the communists to make people equal or for the transhumanists to make people smarter. All he thought it required was giving schools a different job — not socialization or academics or development, but something that brings pieces of them together in a new way. But in order to understand that job, we have to come to a cleaner, bigger, and truer understanding of what “education” is. The road ahead: a special Q-and-A Q: This is the proverbial thousand-dollar-bill-lying-on-the-sidewalk: if this is possible, someone should have done it now. Is Egan going to give sufficient evidence for me to believe this? Maybe! I’ll address this in a special section at the end, after sketching out what his theory looks like. Q: If his theory is even plausibly true, then why haven’t I heard of Egan before? His books can be hard to read — he was an intellectual’s intellectual; he had difficulty writing a page without a reference to William Wordsworth, Friedrich Nietzsche, Sigmund Freud, Ludwig Wittgenstein, Claude Levi-Strauss, Richard Rorty, Noam Chomsky, or Steven Pinker. And his paradigm is wonky and multidimensional; he rejiggers common categories, and tells you everything all at once. But worst of all, when his paradigm is stated plainly, it sounds stupid. Q: Oh! What… is his paradigm? I’m going to jigsaw his book, and hold back his big idea for its own section. First, I’m going to list out some simple observations of students at different ages, and imagine what schooling could look like, if it were built on these principles. (First I’ll do this for elementary school, then middle school, then high school.) Then I’ll explain how his theory ties all of this together… by clarifying our definition of what education actually is. Q: I’m not from America; could you be clear on what you mean by those divisions of schooling? Egan’s framework has three main stages, but they don’t divide neatly into “elementary, middle, and high school”. (The precise age ranges he talks about, if you’re interested, are 2–8, 8–15, and 15 and older.) Regardless, I’m going to use those terms — he sometimes did — because it gives me something specific to imagine. Don’t sweat ‘em. Part 2: A new kind of elementary school What’s the matter with elementary schools? Egan suggests that Plato and Rousseau, for all their differences, might have the same reaction if they visited a modern elementary school: they’d call it “trivial”. I’ll admit, here, that I have tremendously fond memories of my elementary school years — committed teachers, good friends, and interesting activities. But I suspect my memory has edited out the most typical work I did. Either that, or elementary schools have taken a drastic plunge in quality from the 1980s. My wife and I homeschool now, but before the pandemic, we sent our kids to our local public school, and whenever we volunteered in the classroom, we were horrified. They spent their days practicing reading on shallow texts, or half-mindlessly practicing basic arithmetic. Occasionally they’d bring us home a sign of learning about something from the real world — usually something as intellectually and emotionally compelling as the importance of tooth brushing. And at parent–teacher conferences every year, we’d be sat down on tiny chairs and informed that, while our children were quite bright, they were struggling to pay attention in class. No sh**, I wanted to reply. The school seemed hermetically sealed; almost nothing that felt meaningful from the outside world could get in. Though they might agree about little else, Egan thinks that Plato and Rousseau would look at the dull worksheets and insipid “hands-on activities” and call modern elementary schools trivial. He agrees, and thinks that fixing this is the first step to building a new kind of school. Why so trivial? Ironically, Egan thinks it's all the fault of Plato and Rousseau. Hidden in the ways that both the academicists and developmentalist think about education is an assumption: that children’s reasoning is basically the same as adult reasoning, but lesser. Q: This isn’t some romantic, children-are-the-real geniuses theory, is it? Egan actually does think that there’s an intensity to how children perceive the world that we lose — but no, it’s not. He’s building on mainstream cognitive science — just aspects of it that are currently more-or-less ignored in school. The upshot, though, is that he thinks that educational researchers (be they of academic or developmentalist persuasions) see kids as smaller, stupider versions of adults. Q: But that’s the opposite of what my local developmentalist school says! It was the opposite of what the developmentalist school that I worked at said, too. But at teacher meetings, I’d frequently hear people ask what was “developmentally appropriate” for a child. I’ll grant that there are perfectly reasonable times to ask this: “Honey, is it developmentally appropriate for our 10-year-old to watch ‘Cocaine Bear’?” is just one of many examples. But “is it developmentally appropriate for our class to learn about world religions?” or “is it developmentally appropriate for our school library to have a book mentioning homosexuality?” probably aren’t some of them. (The latter example was not one that I heard at my progressivist school, but Egan points out that this sort of language is often used by conservative activists.) This notion of “developmentally appropriate” took on a scientific sheen with the work of Jean Piaget, the famous Swiss psychologist. Before age 12, he “proved”, children aren’t able to form hypotheses, draw conclusions, or think abstractly. This, his followers thought, should transform schools — and so they did! To math, they added in “manipulatives” — physical cubes and rods and such — to help students see math. To the history curriculum, they — well, they ended it. Why waste time, they asked, lecturing students about history that they couldn’t possibly understand? In its place they put the “expanding horizons” model of social studies. One version goes as follows: In kindergarten, students learn about themselves In first grade, they learn about their families In second grade, they learn about their neighborhood In third grade, they learn about their city In fourth grade, they learn about their state In fifth grade, they learn about their nation In sixth grade they learn about the world We can admit that there’s an elegance to this model. (I can picture how clever the theorist who first came up with it must have felt!) The downstream effects of it, however, seem horrible. Doesn’t keeping kids ignorant of the rest of the world seem provincial? Doesn’t reinforcing their self-centeredness seem infantilizing? Perhaps we could stomach it if it was founded on some unshakable findings of child psychology — but does it really strike you as likely that kids are incapable of understanding anything that happened long ago or far away? How, Egan asks, can we explain the $50 billion success of a movie franchise aimed at children that literally begins “A long time ago, in a galaxy far, far away?” Q: Because… Jedis aren’t history? The point is, kids obviously have the mental abilities to understand — and in fact care a lot about — things far outside their own experience, and we’ve built elementary schools on a long-dominant model of educational psychology that swears they can’t. This is actually a great example of a general principle. Let’s call it “the Star Wars test”: can our model make sense of the most obvious facts of students? When we find that the answer is “no”, we should at least consider radically revising what we’re doing in school. What are elementary schoolers good at? (or: kids are smarter than students) Someone — I can’t now find who — once observed that children seem to lose IQ points the moment they step into a classroom. Egan agrees, and suggests that we think of ourselves as primatologists to kids, Jane Goodalls who investigate children “out in the wild” to see the sorts of things they gravitate to, and do fairly well at. If we do this, what do we see? Kids tell jokes, for one. They get mental images stuck in their heads, for another. They engage in role-playing, get lost in reverie, and beat out rhythms when they’re bored. They make ample use of metaphors, tell stories, and insist on seeing the world in terms of abstract binaries (e.g. stupid/smart, cowardice/courage, slavery/freedom, and so on). These, Egan holds, are the cognitive strengths that children use to understand the world. They’re the things that kids are often about as good at as adults — or much better than. They’re going to be the tools Egan wants us to use to rebuild the entire elementary curriculum, and in fact he spends most of his second chapter geeking out about how we might define these, how they operate in the mind, where they first pop up in history and anthropology, and even how they might have developed in our evolutionary past. I’m going to skip all of that, and get to the curriculum. From trivial to rich: the trick What could an intellectually rich elementary school curriculum look like, if we built it on kids’ cognitive strengths? He gives us one suggestion to help us do this: ask where each discipline came from in the first place. What was math before it was math, for example — or science before it was science? Q: How on Earth could that help? That’ll become clear later, when we finally uncover what Egan thinks “education” actually is, and see what job he wants us to give schools. For now, take it as a tantalizing hint… or, y’know, just ignore it. Elementary literature & language What was literature before it was literature? Before people invented writing, they had rich oral traditions: they told simple stories, recited poems, and shared proverbs. Egan suggests that these bits of oral tradition should form the backbone of the elementary literature curriculum. Q: What sorts of stories? As many as we can, and from as many diverse cultures as possible! Folktales are wonderful, as are myths. Think the Aboriginal story of “The Rainbow Serpent”, episodes from the Sumerian “Epic of Gilgamesh”, the Egyptian story of Osiris & Isis, the Greek story of Orpheus & Eurydice, the Chinese Legend of the White Snake, the Japanese Tale of Amaterasu and Susanoo, the Ashanti tales of Anansi, the Aztec myth of Quetzalcoatl, the English legend of King Arthur, the Maori myth of Maui and the Sun, the Roman story of Romulus and Remus, selections from the Indian Mahabharata, the Anglo-Saxon epic of Beowulf, the Inca legend of the Sun and Moon, the Iroquois Myth of the Flying Head (a real thing! look it up!), and the Ojibwe story of Turtle Island. Q: That was a lot of examples. Are you going to keep giving so many? I’ve got a [mumble mumble mumble] to get to. Sorry about that. Sometimes, though, I feel that a limitation of reading Educated Mind is that, in trying to keep his book to a manageable size, Egan skimped on examples in some places that it matters. It’s easy to read his occasional example and assume he intends that it hold some central place in the curriculum — when all he wants to do is display how rich and diverse the curriculum could be. (Also: good God, I didn’t even include an example from Norse mythology!) So from now on, just assume that every category could be filled with oodles of examples. Q: What sorts of poems? Lots of poems, first of all. We shouldn’t steer toward “fancy” poems — rather, we should find poems that appeal to kids immediately — think Shel Silverstein, Mother Goose, Dr. Seuss, Jack Prelutsky, Edward Lear, or Ogden Nash… that sort of thing. In a biting essay, Egan suggests these poets like these appeal to kids precisely because they leverage kids’ cognitive strengths: “we should find, and encourage saying and singing and shouting aloud verse with strong narrative forms, thumping rhymes and rhythms, the most vivid images, fun with metaphors, and a rollicking story.” Q: Why proverbs? Proverbs stick in your mind almost effortlessly. (“All’s fair in love and war!” “When in Rome, do as the Romans do!” “You can’t judge a book by its cover!”) They’re also useful; they capture general truths. Kids can apply them to all sorts of situations, but also discuss them — to what extent are they wise or foolish? (I remember my surprise when I realized that they couldn’t all be true — because you can’t follow “look before you leap” and “he who hesitates is lost” at the same time! I’m embarrassed to say that I think I only realized this when I was in college.) Elementary science What was science before it was science? Egan suggests: being immersed in the natural world. We might, he writes, encourage elementary students to “adopt” some feature of the natural world — a patch of grass, a cat, a branch, a stream — and simply observe it at length. To do this, we can use the cognitive strength of reverie. Q: Oh, do you mean like kids sometimes do in science class nowadays — describe a thing to a partner, make notes, draw it, and label its parts? No, the exact opposite! That’s all about squeezing the experience into words and forms that we understand. What we want “is less an attempt to know about nature as to know it in some participatory way, to know it as something we are an intimate part of, not set off from”. Q: That sounds a little… “woo” to me. It did to me, too… until I remembered my childhood climbing tree. I didn’t much like to go outside as a child, but I had this one tree that I’d climb up and read for hours and hours. If I close my eyes I can bring to mind the precise texture of its bark, the roughness of its broken-off branches, the coolness of its leaves, the always-surprising solidness of its trunk… I’m bigger now, but I think if I were back in my parent’s yard, I could still navigate its limbs with my eyes closed. I have, at this point in my life, read a fair number of books about trees, but I’d be surprised if all of them together more than equaled the amount I learned from that tree — my tree. Elementary math What was math before it was math? Egan suggests: counting and logic. We might, then, use rhythms, metaphors, stories, and jokes to help kids become fond of these. Q: Counting is pretty… basic. Could it really be improved? Beware of “the curse of knowledge”: Steven Pinker’s phrase for forgetting that something was once difficult! Egan suggests we should spend time helping kids count wonderfully. We can start early with counting rhymes. (“One, two, buckle my shoe! Three, four, out the door! Five, six…”) But we can also help kids use their fingers as metaphors. There are some pretty cool ways of using your hands as an abacus — and did you know that you can count up to 1,023 using just your fingers on both hands, and a knowledge of binary? Q: Logic — I’m intrigued! Aristotelian, or Boolean? Neither, for the time being — Piaget was presumably onto something when he found that young children couldn’t reason abstractly, but he was looking at logic in a vacuum. When we put logic into the context of stories, we find that kids can deal with logic just fine. There’s an entire worldwide network of educators, in fact, called Philosophy for Children, who have written whole books about how to do this, and Egan loves it all. Sometimes they read stories and ask simple questions: “What is friendship?” or “What does it mean to be brave?” They also pose ethical questions: “Is it ever right to spill a secret?” And they pose paradoxes: “Can you step in the same river twice?” Q: You mentioned “jokes” a moment ago. Care to elaborate? Egan thinks that, to help kids get good at math, you should tell kids jokes. Q: That’s… new. I think so, too — but he backs it up pretty well. To be funny, jokes (or at least most kid jokes) rely on a leap in logic: Why can’t you trust an atom? They make up everything. Knock-knock. Who’s there? Boo. Boo-hoo? Don’t cry, it’s just a joke! To understand the joke, kids have to follow the logic — spotting patterns, making connections, and tracking what their audience expects a word to mean. That’s a lot of cognitive lifting. And Egan goes further, suggesting that we grit our teeth and create methods to help kids invent their own jokes, no matter how horrible they’ll be at first. (The things we do for learning…) Q: Wait wait wait! What about addition facts, and multiplication tables, and fractions? Egan emphasizes that his methods are designed to be add-ons to the standard math curriculum. In general, he’s a don’t-blow-up-the-system sort of guy, and if something seems especially weird, you should probably assume it’s an add-on to the regular curriculum rather than a replacement, even if I forget to say so. Elementary arts What was art before it was art? Egan suggests we pop our heads into Paleolithic caves for our inspiration. Whatever the specific meaning of all those charcoal elk and aurochs and mammoths (communication with the spirit world? art for art’s sake? a way to impress babes?), Egan thinks it obvious that they were also an attempt to capture an intense experience that would be difficult to express in words alone. What did it feel like to be near an aurochs, or a saber-toothed tiger? “The arts help us,” Egan writes, “to hear and see afresh, to force our perceptions and sensations to experience again the immediacy and vividness of the world”. If we follow this, then, we don’t want to help kids build “art skills” so they can draw like an adult — rather, we want to help them amass a repository of diverse aesthetic feelings that they’ll want to express. We should provide them with a riot of experiences. Q: That couldn’t be more opaque. Examples, please! Egan writes that we should have children learn to whistle, sing, and click their tongue; we should help them emulate the ways a skunk or a hawk or a stick bug might move through a space. We should expose them to scores of different temperatures and materials. In music, we should help them love Beethoven, yes, but also the Beatles; Tchaikovsky, yes, but also Tuvan throat singers, and also John Cage, whale song, and bird song. Q: That’s a lot of experiences, but what would they be doing? An interesting aspect of Egan’s view of education is that he doesn’t seem to think we should push kids right to the “doing” phase. He wants to help kids cultivate an affective relationship with the world. In any case, he writes that as students get more experienced, we should prompt them to move from merely enjoying these experiences to trying to systematically shape similar experiences. And drawing, painting, and playing music could easily be folded into other parts of the curriculum. Elementary social studies What was social studies before it was social studies? Well. Remember how, just a moment ago, I wrote that you could assume that you should probably assume that Kieran isn’t in favor of junking the curriculum as it currently stands? He suggests we very carefully pick up the elementary social studies curriculum, place it into a trash can, and set the whole mess on fire. He isn’t worried about much of importance being lost. (Remember that the “expanding horizons” model is, to him, the original sin of 20th century educational reform, and he repeatedly quotes student surveys showing that “social studies” regularly wins the title of “most boring subject”.) In its place, he suggests we put history — which, he hints, we should think of as the centerpiece of the elementary curriculum. So the real question is what was history before it was history? His answer, surprisingly, is myth. Q: Egan wants us to teach myths as if they were history? Not at all. What he suggests, though, is that we look at how myths operate as narratives — so we can design an intellectually vivid history curriculum. And myths really are special: each is built on at least one binary (like weak vs. strong, or lies vs. truth, or so on), and uses that to tell the story of the big picture of the world. They’re so powerful that people can understand it, remember it, and love it — even if that thing never happened. We should take that power, Egan says, and apply it to things that really did happen. Q: So what history does he think kids should learn in elementary school? The great struggles of humanity from across the whole. Flippin’. World. We’re still talking about young children, so these should be done as simple stories. The goal isn’t to make them history PhD’s, so we needn’t even try to put them in any sort of order. Egan suggests that, in first grade, we pick a single binary like “freedom against oppression” and tell kids a welter of stories, again from as many cultures as possible, and as many times in history as possible. Q: Can you give examples? Oh, all right — in first grade we can tell kids the stories of the war of the Greek city-states against the Persian empire, and the slave uprising of Spartacus against the Romans. We can tell them about the plight of Jews in medieval Europe, and of the unsuccessful Sepoy Rebellion in India against the British. We can tell the stories of the American, French, and Haitian Revolutions, and about the Chinese Taiping Rebellion against the Qing Dynasty. We can tell them the story of the escaped slave Harriet Tubman returning to the South to rescue her kinsmen, the story of six-year-old Ruby Bridges facing threats to integrate her elementary school, and the story of how the Mau-Mau uprising led to modern-day Kenya. We can tell the stories of Mexican-American union organizer Cesar Chavez and of Malala Yousafzai surviving an assassination attempt to advocate for female literacy. The world does not lack for stories of oppression and liberation that can capture the attention of a six-year-old. Q: That’s… huh. What stories might they hear in second and third grade? Egan gives examples, but I won’t list them here. He suggests we use a similar approach for each, except that we swap out the binary each year. He thinks “the struggle for security against danger” would work well for year two, and “the struggle for knowledge against ignorance” would work well for year three. (That year could have a lot of overlap with the science curriculum.) Q: Anything else, for history? Yes — they should get a sense of Big History. They should get some simple stories about the ice age, the Cenozoic, the age of dinosaurs, the Paleozoic, the origins of our solar system, and the Big Bang. (Because if the ancient Norse can tell their story of the beginning of the universe, by gum, we can tell ours, too.) To sum up Egan argues that the problem of early schooling is that it’s trivial — and it’s trivial because the dominant theories of educational psychology see children as lesser versions of adults. What else would we teach them, except dumbed-down versions of what adults learn? But children have certain cognitive strengths that schools aren’t making systematic use of. If we rebuild elementary schools on those strengths, we could turn schooling upside down. We could stop seeing the curriculum as a bag of information to impart, and start seeing it as a set of great stories to tell — and invite kids into. Kids could experience (both intellectually and emotionally) the great struggles of humanity and see that they can join in them. Students could experience the story of education as the beginning of a very real adventure. Egan’s elementary school: some skeptical questions Q: I’m not sure I’m understanding what you mean by “mental images”. Care to explain? It’s an interesting fact of human cognition that just a few words can whip up a complex mental experience. Egan doesn’t just mean what we might call “visual imagery” — the ability to hold, say, the image of a bespectacled, spat-wearing duck in your mind without seeing a photograph. He’s also including what psychologists call auditory imagery, olfactory imagery, gustatory imagery, and tactile imagery. Q: How could all of that be helpful in schools? Humanity has a built-in VR system, and we’re not using it! Egan invites us to pretend we’re teaching a class about the humble earthworm. We might list off facts — “earthworms are so many centimeters long, move through soil by means of their something-or-other muscles…” but he suggests we can evoke images, say, “of what it would be like to slither and push through the soil, hesitantly exploring in one direction then another, looking for easier passages, contracting and expanding our sequence of muscles segment by segment, and sensing moisture, scents, grubs, or whatever”. Those facts are now felt by the student; the knowledge has become part of them. And just a few words can spark a complex mental experience, one going beyond literal images to include imagined sounds, smells, tastes, and more. These experiences can feel real and stick with us. (That these mental images are so easy to evoke, and so meaningfully felt, feels something like the proverbial hundred dollar bill on the ground.) Q: How could metaphors be helpful? It really is interesting that so much of the “constructivist” turn in psychology — that is, the notion that children don’t absorb knowledge, but construct it — has continued to focus on logics-mathematical reasoning, when there’s been mounting evidence for decades that metaphors are more central. It’s not just that we use metaphors to better understand things we already know, we also use them to grasp new knowledge. What’s more, psychologists have devised tests to measure the skill at metaphor-making, and have given them to people of different ages. What they found was that eleven-year-olds make more metaphors (and higher quality metaphors) than do undergraduates — and that four-year-olds have both groups beat. Again, hundred dollar bills on the sidewalk. Q: Your talk of “binaries” has me worried — binaries like good/evil and male/female are the source of so many of our most pernicious stereotypes! Isn’t the purpose of education to get us beyond stuff like this? Yes, it is! Education is supposed to complicate our understanding — but that means we’ve gotta start somewhere, and binaries provide us a natural starting place. As an uncontroversial example, think about temperature. We all begin as babies by perceiving two temperatures — hot and cold. Later, we add on intermediate categories — warm and cool. (Note that the human body is the assumed mid-point to temperature. Binaries often work like this; “big” and “small” mean “bigger or smaller than me”, “nasty” and “kind” mean “nastier or kinder than I am, except when my brother is really asking for it”, and so on.) A good story (and an Egan-inspired elementary curriculum is, in a sense, nothing but good stories) will go further, and transform the binary. Toy Story is grounded in the binary of abandonment/belonging: at the beginning, the toy cowboy Woody belongs to his owner, and has his affection. Then a rival comes who threatens his belonging. In trying to get back to belonging, Woody is entirely lost — and to save the day, he has to come to a deeper understanding of what belonging means. Now, all lessons can’t be Pixar movies. But the good stories (especially in literature and history) will challenge and subvert the binaries they begin with. Q: I see the pattern of Egan drawing from “as many cultures as possible”. Why so many? Is this a political correctness thing? If it helps to think of it as such, then, sure! I don’t think Egan would have had a problem with that. But his ultimate reason for including so much diversity goes deeper. For Egan, including such world-wide diversity isn’t optional, and the answer to why is bound up in his definition of education. (Keep reading.) His answer also insists that we, whenever possible, also include stories from the Bible and Homeric epics (the Iliad and Odyssey). Q: Mmm, stories from the Bible aren’t going to fly in my local school! So be it! Egan doesn’t spend much time obsessing over the practicalities of… His interest is in describing what an ideal education might look like, if it were possible. Every lesson, every classroom, and every school is necessarily a compromise. Q: You make a big deal of poems. But isn’t poetry dead? An interesting contrast can be made to classical education, which also has kids read a lot of poems — they see knowing great poems as one of the marks of an educated person; again, for an academicist, it’s the information that transforms. Egan begs to disagree. Poems are important because they’re a wonderful way to train their cognitive strengths, like rhythm (poems are language fueling by thumping). We want to help kids learn to use this tool better, and a great way to do that is to help them recite poems that they’ve learned by heart. Q: “Learn by heart” — is that code for “memorize”?! It is! Egan is actually quite big on memorization — he points out that all the knowledge in the world can do nothing for a person once they’ve forgotten it. He didn’t, however, appreciate the academicist focus on memorizing without understanding (or at least enjoyment). Q: I’m still worried about the science curriculum, as you’re describing it. Can you allay my fears? Honestly, while I feel there’s something profoundly right to how Egan is describing early experiences of nature, I feel the same way. Note that there’s more science coming in the social studies curriculum. But if that’s still not enough, one could bring down aspects of the middle school science stage. Q: Anything else that Egan suggests we do in elementary school literature and language? He suggests that we help kids learn a second language! This is so obviously true (why do American schools typically wait until kids lose the ability to naturally absorb languages to start teaching languages?) he doesn’t belabor it, though. Q: You had mentioned that Egan’s vision seems more internal-focused. Should we be worried about that? While I strongly suspect that his curriculum would make kids more creative in any way you’d like to measure it, Egan wasn’t particularly interested in “creativity” — he was more about helping kids find the world interesting. I get the sense that he thinks kids will do things with minimal prompting once they’re loaded up with complex internal experiences. Q: I think I’m beginning to understand Egan — is he basically saying “make learning fun”? “Fun”, applied to education, is a dangerous word. Egan worries about the dangers of an emotionally unserious curriculum producing emotionally stunted adults. That doesn’t mean we need to tell students only “serious” stories — only that we treat the world honestly. “Disney-esque sentimentality is the exact emotional equivalent to intellectual contempt”. Q: But aren't some of these stories too dark for children who have themselves experienced oppression and disaster? Egan argues that these stories may be especially helpful to them — they can help them understand their struggles better, and give voice to them. Q: At the very start of this, you promised us “rationality”… but I’m not seeing rationality here! All this talk of “adventure” almost seems to go the opposite direction. What gives? Wait for it. But for a hint right now — Egan is fond of citing his fellow educational theorist Jerome Bruner, who claimed “any subject can be taught effectively in some intellectually honest form to any child at any stage of development”. Bruner was criticized for that; his critics charged that he was ignoring learning differences and socio-economic realities. Egan thinks he was profoundly right. Part 3: A new kind of middle school What’s the matter with middle school? What was middle school like for you? In math, I recall a jumble of barely-related topics. In literature, I remember reading great literature — Frankenstein, Romeo and Juliet — only in their dumbed-down summary formats. In social studies, I remember teachers proclaiming on the first day of class that unlike all of our previous history classes, this class wouldn’t be about names and dates… and then going on to memorize names and dates. And in science, I remember being forced to dissect a frog only to discover that frogs are — you guessed it — made of slimy frog parts. Your mileage may vary, but for a lot of us, middle school feels like getting booted out of the (in retrospect) Eden of elementary school, and like marking time before the serious studying of high school. It feels meaningless. In my favorite of his books, Egan calls so much middle school curricula “human deserts”, noting “we have created a system in which the importance of human emotions for meaning seems barely noticed”. Why so meaningless? If our dominant approaches to educational psychology fundamentally misinterpret younger children, Egan suggests, they basically throw up their hands when faced with pre-teens and teenagers. Mainstream schools begin to introduce vocational training to help lighten the load, and Maria Montessori famously suggests that adolescents should be sent to go run a farm. Egan is sympathetic to those responses, but points out that they don’t do much to lighten the load that the academic curriculum often becomes at this age. This feeling of meaninglessness, he argues, is utterly tragic — it comes just when a hunger for meaning blossoms in adolescents! We can see that hunger for meaning in their lives outside the classroom, where their interests ramp up into veritable obsessions. What are adolescents obsessed with? What might we see, if we become Jane Goodalls of early adolescence? First, teens are obsessed with gossip. The motivations of others — why did he do that? and what was he THINKING? — are hypothesized and talked to death. Second, that they’re pulled toward idealism. Many feel a dissatisfaction with the world as it is, and feel a romantic urge to make it a better place. They’re often lured into simplistic beliefs that promise to help them do that. Third, they love extremes: they want to find limits, and test them. Obviously, this can show up as risky behavior, but we can also see it in their love for the bizarre — note adolescents’ fascination in things like aliens, cryptids, and ghosts. (Egan loves pointing out that The Guinness Book of World Records is a perennial bestseller among kids at this age. How else would they find out who had the world’s longest fingernails?) Fourth, they gravitate toward heroes — people who push the edges of those limits. By celebrating heroes, they can vicariously share in their transcendence. Look for the posts hanging up in a teenager’s bedroom to guess what boundaries they feel most hemmed in by: athletes push against physical limits; a death metal guitarist might push against authority and conventional morality. An activist or entrepreneur might push against our dulled morality or our sense of what’s possible. Finally, we might spot teens taking up hobbies and making collections. Hobbies can be a way to identify yourself as part of a group against the rest of the world (“I’m the sort of person who goes bird-watching!”), and collections can be a way to climb the status ladder inside the community. Egan points out that a collection can also be a way to feel like you have control over what you’re discovering is a very big and complex world of detailed information (“I’ve spotted every one of the fifty most common birds of Texas — even the black-capped vireo!”) Egan’s insight is that these obsessions give teenagers a sense of meaning, and that we can use them as tools to make middle schools that overflow with meaning. From meaningless to meaning-soaked Again, Egan sketches out a new kind of curriculum subject-by-subject. Before, his trick was to ask where the subject first evolved out of; now, it’s to ask who first discovered or created the specific content we’re teaching. “All knowledge”, he writes, “is human knowledge. Everything we know is knowable through the lives of its inventors, discoverers, or users, and we can have access to that knowledge through the hopes, fears, or intentions that drove them”. Middle school math Who first discovered the concepts students learn in math? The answer, of course, is a wide diversity of curious men and women living across the world over the last few thousand years. Egan says: bring those people into how we teach math. If we used gossip and heroes to help students find it meaningful, what kind of math would result? When we teach the Pythagorean theorem, we should give a sense of who Pythagoras was — a cult-founder who worshiped numbers to find God, whose followers (according to a piece of ancient gossip) murdered one of their members who discovered irrational numbers! Q: Well, sure, that works for Pythagoras, but he’s a known nut job; surely most math doesn’t come from such interesting roots? When we teach the Cartesian coordinate system, students should meet Rene Descartes, the Calvinist French polymath who saw the possibility that math could decipher the world, if only we could unite algebra and geometry… and invented the xy-plane to do exactly that. When we teach scientific notation, we should call our students’ attention to the importance of the number zero, and tell them the story of the Pope who tried to introduce Arabic numerals to Christian Europe and may have been assassinated because of it. When we teach algebra, we should ask students why “algebra” is Arabic for “the fixing of bones”, and tell the story of what Muhammad ibn Musa al-Khwarizmi was up to. We could do this all day. Literally everything students learn in school was first invented or discovered by some interesting person who was struggling to accomplish something hard. To learn is to connect with those people, whether we know it or not. Egan says: help kids know it. Math has been dehumanized: re-humanize it. Q: So the math curriculum needs to become a history of math curriculum, and math teachers need to become history teachers? No, the content needn’t change. But with surprisingly little work, we can bring in the gossipy stories of heroes, and their obsessions can spread to students. Middle school science Who first discovered the things students learn about in science? If you’re thinking “scientists”, you’re only partially right. Most of the big-picture ideas that we now think of as “science” were discovered before the word “scientist” was invented, or the discipline was professionalized. Frequently, they were hatched by true amateurs, working in their free time, hungry to unlock the secrets of nature. We can use gossip and heroes to spread their obsessions to students just as we taught math, but Egan points out two twists. The first is that the content itself can take on heroic qualities: everything is impressive, when you look at it in a certain light. In an interview, Egan once said: “My book is an attempt to show that, indeed, everything in the world is wonderful, but that schools are designed almost to disguise this slightly shameful fact. We represent the world to children as mostly known and rather dull. The opposite is the case: we are surrounded by mystery, and what we know is fascinating”. What would even the most boring subjects look like, if we emphasized their heroic qualities? Well: What’s a tooth? Bone, wrapped in rock, surrounding tiny cells that your body feeds with blood. What’s a bar of chocolate? A crystal of jellyfish-shaped fat molecules stacked together; when you put it in your mouth you shake them apart into a writhing confusion. What’s the air around you? The bottom of a 10-mile-deep ocean; when you put your tongue over a soda straw and your Pepsi stops leaking out, it’s not because a “vacuum” is “sucking” it up, but because that ocean is squeezing it into your face. Again, we could do this all day! And in middle school science, we can. Everything in the world is wonderful; we can help students see this again and again. The second twist is that science is a subject rich in extremes. Here Egan introduces a concept that we’ll see crop up again: “15-minute segments”. To help us fit as much wonder as possible into a school day, he suggests we supplement the usual school subjects with a few quick lessons. To infuse science with extremes, he suggests we add on three: “human & natural records”, “extremes of animals & plants”, and “cosmology”. Middle school history Who first made the things students learn about in history? Why, the historical characters themselves! Since we’ve given kids a grounding in history in elementary school, now we can build on that, going through many of the same events as before, but in more depth, and more vividly. We’ll leverage the interest with other people’s inner lives to tell stories focusing on the perspectives of the people who made history — zooming in, when possible, on scandalous details. We’ll leverage the tool of idealism to choose historical characters who chafed against their surroundings, and understand what they were trying to accomplish. What was their vision of the world? What did they hope for, and what did they fear? Q: Isn’t the “great man” approach to history out of fashion? Egan’s approach doesn’t say that “great men” made history — it’s just leveraging gossip to help kids see history as something meaningful that can expand their own possibilities. “Early adolescence is commonly a time of intense and vivid emotional life, and also a time of deepest boredom and depression… [We] can give shape to the intermediate curriculum and offer the students a world that is rich, complex, varied, and as intense and vivid as their own emotional lives”. We also should add on another “15-minute segment” just to pump in as many biographies as possible, and from people who don’t always fit into the normal history curriculum. Call it “Brief Lives”, and throw in anyone who’s struggled to push some limit — Mary Wollstonecraft, Jesse Owen, Dietrich Bonhoeffer, one of the students’ great-aunts, whoever. As students get older, this can transition to “People and Their Ideas”. Here, we’d focus less on the details of the person’s life, and use it as a backdrop to showing how meaningful some of history’s most important ideas could be. Think Aristotle and syllogisms, Edward Said and orientalism, Confucius and propriety, Cornel West and race, Buddha on the four noble truths, Muhammad and the five pillars, Karl Marx and communism, Adam Smith and the invisible hand, Thomas Hobbes and the state of nature, John Locke and natural rights, Jeremy Bentham and utilitarianism, Thomas Aquinas on the sacraments, Martin Luther on faith, Voltaire on the freedom of speech… you get the idea. Q: Can you really get a profound understanding of utilitarianism in 15 minutes? Yes! The point of this segment isn’t to develop a systematic understanding of any one idea, it’s to introduce students to the exciting possibilities of human thought. (As a bonus, this might make them less likely to fall for the first ideology that they encounter later in life.) Diversity is important for this — as it is with culture. Throughout this, we should also be trying to expose students to as much cultural diversity as possible, because in high school, we’ll be trying to make sense of our society, and it’s impossible to do that unless we have something to compare it against. Middle school literature & language You might think that this subject would be easy — that middle school literature is already filled with “strong and clear narratives”, that it deals with “transcendent human qualities such as courage, love, and persistence”, that it focuses on “extremes of human experience”, that it examines “something strange and exotic”. You’d be right! Egan’s pretty happy with a bog-standard middle school literature curriculum, done well. In this part of the book, his spends most of his limited space suggesting three rather odd activities which could also be useful — especially for increasing students’ awareness of language, so they can use it better. The first is etymology — not, however, memorizing lists of roots, but in being told the entertaining backstories of specific words. Take the word “berserk”, for example — we now use it to mean something relatively mild (“if my mom catches me coming home late, she’ll go berserk”), but it comes from an old Norse word meaning “a raging warrior of superhuman strength”. And that’s because ber meant “bear” and serk meant “shirt”: soldiers of the bear cult would don the skin of a bear to, in their minds, transform into one — howling, foaming at the mouth, and gnawing the rims of their shields. (Most adults walk through life with little understanding that the words falling out of their mouths are entities, with their own back-stories. Communication is, at the very least, more interesting when we become aware of this.) The second is to add on another language to learn — not, this time, to become fluent in it, but just to become aware of how very different human languages can be. (For native English speakers, Sanskrit might work well, or Cantonese, or perhaps even ancient Egyptian. Again, the point isn’t for this language to be useful — it’s to explore diversity.) The final one is to study humor — not just jokes anymore, but comedy at its finest. Egan cites (at length!) Monty Python as a group of people who were particularly brilliant in their use of the English language. Examining their skits can lead us into not just an appreciation of semantics (the study of how meaning is made from smaller pieces, like etymology) but also pragmatics (the study of how meaning is made in social situations). Pretty heady stuff, for a conversation about a dead parrot. Part 4: A new kind of high school I’ll confess — I loved parts of high school… and among nerdy folks, I suspect I’m not alone. For some of us, this was a golden time. Even at my local public high school, I had access to academically thrilling classes — especially, in my last two years, advanced literature and history. I felt like I was finally understanding the ideas that mattered. In any case, Egan is quick to acknowledge that, at this level, the sort of education he advocates really is being practiced in some places. What he can add is an understanding of what makes it wonderful, how to make it even more wonderful, and how to make it wonderful for many, many more people. What’s the matter with high school? Far too often, even when high school classes are intellectual, they’re dry. For the majority of students, all this academic stuff is experienced as utterly lifeless, a mass of dead information to be squeezed inside one’s head for a test and then left to evaporate. Egan mocks the curriculum wars that seem to be a permanent feature of the teaching life; quoting the sociologist Pierre Bourdieu, he says “while the academic left and right bicker over whether the curriculum is too traditional or too radical, they fail to recognize that most students absorb so little of academic culture that the bickering is largely irrelevant”. Why so dry? Egan suggests three reasons to explain this. First, because high school academic classes are too often masses of small details with no sign of the big picture. Second, because they’re typically slavishly disciplinary, and aren’t able to address the questions that span the disciplines. Third, because they’re often designed to bring students through what everyone is sure of, and hide away any controversies. In all of these, Egan suggests that what’s called “academics” in high school is too often a dim imitation of what real academics are actually practicing. There’s a fourth reason, though, and it’s probably the biggest of all — by the time they get to high school, most students haven’t actually learned that much! An academic approach is designed to connect small details into the big picture; for people who arrive in high school (and college) classes without having already collected much in their heads, academics are going to taste dry. (An implication of this for anyone trying to improve schools is that we might not want to start with high schools. If your goal is to create a new kind of academic learning, first start at elementary school — or barring that, middle school.) What motivates mad scientists? When we wanted to re-conceive the elementary and middle school curriculums, we looked at what students were already good at — kids’ cognitive strengths and adolescents’ obsessions. For this level it might be easier to look — for reasons that will become clear when we finally unveil Egan’s crazy-sounding definition of education — at the sorts of things that bring intellectuals joy. Q: Which intellectuals? Take your pick. Galileo, Einstein, Smith, Marx, Goodall, Chomsky, Curie… all the people who took to the life of the mind like fish to water. But that’s a lot to hold in my mind at once, so I’m just going to think about Doc Brown from Back to the Future: He was high on intellectualism I’ve never been there, but the brochure looks nice Let’s call these people “mad scientists”. And let’s pretend we once again took up our job of being primatologists, and snooped on these folks “in the wild” (“in the lab”? this is beginning to get recursive…)… what would we find motivating them? Asking simple questions, for one. (What is space? What is society? What is a human? What is language?) Building general schemes (big theories) that hold lots of evidence together. Finding their place in the cosmos. And (perhaps above all) seeking certainty. Once again, Egan suggests we use these as tools to remake the curriculum. From dry to daring What could a high school curriculum look like, if it were rebuilt on these tools? Once again, Egan has a trick. This time, it’s to ask what fights have driven the development of each of these fields forward — and how we can help students enter them. First, a mini-segment! Intellectuals invented the academic disciplines to better pursue the life of the mind, but the disciplines can get in the way. Some of the most important intellectual discoveries that could help students are too big to fit into any of the disciplines. We need a place to introduce them plainly. Egan proposes another mini-segment — again, just 15 minutes a day, a few times a week — called “Metaknowledge”. Q: Isn’t that already in the International Baccalaureate program? Yes, he acknowledges that he’s borrowing from that! This segment would introduce ideas that would enrich student thinking across the disciplines: game theory, cognitive biases, systems thinking, Bayesian reasoning, epistemology, ethics, logic, cultural evolution, and so on. High school literature How can we help students enter the big fights of literature? Intellectuals of a literary bent — professors, critics, poets, novelists — delight in arguing over literature like rabbis arguing over the Talmud. Take, just for one example, the debates over Shakespeare’s character of Ophelia. Does she love Hamlet, or is she a victim of his emotional abuse? Is she truly insane, or is she acting? Is she passive, or is she pulling the strings? Oceans of ink have been spilled arguing over questions like these; our students can, perhaps, spill a few ounces more. The usefulness of arguing literature, for Egan, isn’t that it’s oh-so important for educated adults to know a lot about Ophelia. (This, again, was where the academicists went wrong — in thinking that being educated was about getting the best knowledge in your head.) Rather, arguing over literature is a training arena for the all-important intellectual move of this kind of understanding: building general schemes out of evidence, and struggling with anomalies. One person, for example, might hold that Ophelia is insane, and cite all sorts of obvious evidence — her father just was murdered by her lover, she rants nonsense while (bizarrely) handing out flowers to friends… But then he’s challenged when he reads a scholar pointing out that, to people in Elizabethan England, types of flowers have symbolic meanings. How does he deal with that? He could ignore it, claiming it an over-reading of Shakespeare. (Sometimes a flower is just a flower!) Or he could address it, complicating his own scheme. This intellectual work is best done with other people, who are incentivized to challenge your understanding of something, and go back and forth, building competing models and calling attention to anomalies. This process — the “dialectic” — pops up again and again in the academic disciplines. It’s the center of how understanding works, at this stage. And the nice thing about practicing it on literature is that, more so than in history or science, the evidence is shared knowledge — it’s right in front of everyone, written out. But there are other ways literature class can be helpful to the general life of the mind. Egan also suggests that we’ll want to specially include literature that helps students understand complex ideas. Camus, Orwell, Borges, Calvino might be particularly helpful here… and I imagine that genres like science fiction and magical realism might be particularly useful, too. (Note, though, that once again none of this requires a radical remaking of the curriculum, or of the canon of texts that we traditionally assign to high schoolers.) Q: Oh yes, the canon — what does Egan have to say about the canon wars? When he wrote Educated Mind in the nineties, the long-brewing canon war was approaching its inevitable apocalyptic climax. On one side of this Plain of Megiddo were the pro-canon traditionalists, arguing that we should keep assigning the texts that had been argued over for centuries. Facing them were the anti-canon reformers, arguing the standard texts over-represented the perspective of dead white men. Onto the middle of the plain rides Egan on a white horse, who bellows above the din: “I’VE GOT A BUSLOAD OF HIGH SCHOOLERS WHO WANTS TO JOIN IN, EVERYONE OKAY WITH THAT?” To do so, he says, we need to give students the arguments from both sides. So, for example, bell hooks, Edward Said, and China Achebe should be on the syllabus, as should Allan Bloom, Mortimer Adler, and Diane Ravitch. And of course they should actually read the texts cherished by both sides, too, so they can argue better. High school history How could entering the big fights help us reinvent high school history? First, we might look for dueling histories. It’s time for students to get into historiography and understand that history isn’t just what happened, it’s something we make. We might help kids read chapters from Howard Zinn’s socialist history of America alongside the corresponding chapters from Paul Johnson’s conservative history of America. How could big questions help? We want to help students see how various people have disagreed over some of the big questions of what human history is, at its most basic. We can have them compare Steven Pinker’s theory of civilization’s progress (Better Angels of our Nature) with Yuvah Noah Harari’s theory of civilization’s woes (Sapiens). We could have them compare so-and-so’s account of human history as an ever-expanding unlatching of energy sources with Robert Wright’s account of human history as unlatching more and more positive-sum games (Nonzero). What role could the lure of certainty play? To help them grow their skills at finding anomalies, we might help them work through pseudo-histories and conspiracy theories. Q: Conspiracy theories! Oh, come now, you’re playing with fire. Well, the world is on fire. Our students will spend the rest of their lives encountering terrible-but-beguiling arguments about how the world works; if we don’t prepare them for those, what have we been doing? So we should introduce arguments that the Moon landing was a hoax, that the Illuminati founded America, that aliens built the pyramids, and so on. At no point can we demean students for falling for any of these theories — the job of a teacher at this stage, Egan writes, is to support students in their reasoning even when their beliefs are offensive and stupid, gradually offering anomalies. There’s no way out of bad theories except through them. By the time students graduate, we want them to have wrestled with terrible ideas and — for a while — lost. They need to experience what it’s like to change their minds about something they felt strongly about. They need to viscerally realize, in Feynman’s famous phrase, “The first principle is that you must not fool yourself and you are the easiest person to fool.” High school natural science How could entering the big fights reinvent high school science? At present, so much of the high school science curriculum — especially “honors” classes — is oriented toward helping amass details. (The same is true of 100-level university classes, which famously “survey” the field to prepare for more advanced studies. I always thought this was stupid — of the huge lecture hall of students in my Geology 100 class, how many went on to take even a second course?) The meaty debates that propel science forward are held back. Egan complains: “The more general and speculative theories in any discipline are treated like an unconventional and disreputable relation who, even though the children find her exciting and entertaining, must be kept hidden from view, her very existence denied as long as possible”. This is a stupid approach — students with an adventurous bent are convinced that science isn’t for them. Egan proposes, simply, that we flip this, and organize high school science classes around the big debates. We shouldn’t be ashamed at how, well, adolescent this might look: “the dramatic, speculative, and contentious theories will be up-front in the early years of the [high school] curriculum”. What might those be? Egan doesn’t give a list, but we can spitball some: instead of explaining what “matter” is from the top down, a physics class could problematize “matter” by following the debates over the nature of dark matter and dark energy, and by becoming familiarized with the various interpretations of quantum mechanics
Are we hosed? If Egan’s critique is correct, we’re in a bad situation. Educational radicals yell from their dark corners to abandon the middle and come join them; a century of educational reforms have amounted to little more than wobbling around, first in one direction, then another. At the moment, the conversation about schools in the United States, at least, seems to have hit an all-time pessimistic blech. Freddie deBoer speaks for a lot of people when he says “Even the most optimistic reading of the research literature suggests that almost nothing moves the needle in academic outcomes. Almost nothing we try works.” I’m not quite that pessimistic — the word “almost” is doing some work, there. There are some reforms that seem to work at the margin: raising teacher pay, making it easier to become a teacher, reducing air pollution, free school lunches, and more. Actually applying what the science of reading has been telling us for a few decades seems a big one. And perhaps you have your own pet reform proposal. Sure — add it to the heap! What Egan suggests, though, is that so long as we’re bopping around this triangle of jobs, we won’t be able to get the schools that we want. The dream There’s a moment at the end of my favorite Bollywood movie that’s become stuck in my head. The protagonists have made the arduous journey to a beachside rural school. In the sun outside, flocks of children are experimenting with art and playing with inventions; inside, the walls are covered with books and the tables are covered with models. The kids are learning joyously and deeply. In the real world, such places do exist — they’re just exclusive, pulling their students from among the families who are already the most gifted and curious. They don’t make kids this way; they scoop up the kids who are already this way. But in the movie, we’re supposed to believe these are normal children — normal, except they’ve been transformed by a school. Egan’s wild idea is that it’s possible to make schools like this. He thought that we didn’t have to wait for the communists to make people equal or for the transhumanists to make people smarter. All he thought it required was giving schools a different job — not socialization or academics or development, but something that brings pieces of them together in a new way. But in order to understand that job, we have to come to a cleaner, bigger, and truer understanding of what “education” is. The road ahead: a special Q-and-A Q: This is the proverbial thousand-dollar-bill-lying-on-the-sidewalk: if this is possible, someone should have done it now. Is Egan going to give sufficient evidence for me to believe this? Maybe! I’ll address this in a special section at the end, after sketching out what his theory looks like. Q: If his theory is even plausibly true, then why haven’t I heard of Egan before? His books can be hard to read — he was an intellectual’s intellectual; he had difficulty writing a page without a reference to William Wordsworth, Friedrich Nietzsche, Sigmund Freud, Ludwig Wittgenstein, Claude Levi-Strauss, Richard Rorty, Noam Chomsky, or Steven Pinker. And his paradigm is wonky and multidimensional; he rejiggers common categories, and tells you everything all at once. But worst of all, when his paradigm is stated plainly, it sounds stupid. Q: Oh! What… is his paradigm? I’m going to jigsaw his book, and hold back his big idea for its own section. First, I’m going to list out some simple observations of students at different ages, and imagine what schooling could look like, if it were built on these principles. (First I’ll do this for elementary school, then middle school, then high school.) Then I’ll explain how his theory ties all of this together… by clarifying our definition of what education actually is. Q: I’m not from America; could you be clear on what you mean by those divisions of schooling? Egan’s framework has three main stages, but they don’t divide neatly into “elementary, middle, and high school”. (The precise age ranges he talks about, if you’re interested, are 2–8, 8–15, and 15 and older.) Regardless, I’m going to use those terms — he sometimes did — because it gives me something specific to imagine. Don’t sweat ‘em. Part 2: A new kind of elementary school What’s the matter with elementary schools? Egan suggests that Plato and Rousseau, for all their differences, might have the same reaction if they visited a modern elementary school: they’d call it “trivial”. I’ll admit, here, that I have tremendously fond memories of my elementary school years — committed teachers, good friends, and interesting activities. But I suspect my memory has edited out the most typical work I did. Either that, or elementary schools have taken a drastic plunge in quality from the 1980s. My wife and I homeschool now, but before the pandemic, we sent our kids to our local public school, and whenever we volunteered in the classroom, we were horrified. They spent their days practicing reading on shallow texts, or half-mindlessly practicing basic arithmetic. Occasionally they’d bring us home a sign of learning about something from the real world — usually something as intellectually and emotionally compelling as the importance of tooth brushing. And at parent–teacher conferences every year, we’d be sat down on tiny chairs and informed that, while our children were quite bright, they were struggling to pay attention in class. No sh**, I wanted to reply. The school seemed hermetically sealed; almost nothing that felt meaningful from the outside world could get in. Though they might agree about little else, Egan thinks that Plato and Rousseau would look at the dull worksheets and insipid “hands-on activities” and call modern elementary schools trivial. He agrees, and thinks that fixing this is the first step to building a new kind of school. Why so trivial? Ironically, Egan thinks it's all the fault of Plato and Rousseau. Hidden in the ways that both the academicists and developmentalist think about education is an assumption: that children’s reasoning is basically the same as adult reasoning, but lesser. Q: This isn’t some romantic, children-are-the-real geniuses theory, is it? Egan actually does think that there’s an intensity to how children perceive the world that we lose — but no, it’s not. He’s building on mainstream cognitive science — just aspects of it that are currently more-or-less ignored in school. The upshot, though, is that he thinks that educational researchers (be they of academic or developmentalist persuasions) see kids as smaller, stupider versions of adults. Q: But that’s the opposite of what my local developmentalist school says! It was the opposite of what the developmentalist school that I worked at said, too. But at teacher meetings, I’d frequently hear people ask what was “developmentally appropriate” for a child. I’ll grant that there are perfectly reasonable times to ask this: “Honey, is it developmentally appropriate for our 10-year-old to watch ‘Cocaine Bear’?” is just one of many examples. But “is it developmentally appropriate for our class to learn about world religions?” or “is it developmentally appropriate for our school library to have a book mentioning homosexuality?” probably aren’t some of them. (The latter example was not one that I heard at my progressivist school, but Egan points out that this sort of language is often used by conservative activists.) This notion of “developmentally appropriate” took on a scientific sheen with the work of Jean Piaget, the famous Swiss psychologist. Before age 12, he “proved”, children aren’t able to form hypotheses, draw conclusions, or think abstractly. This, his followers thought, should transform schools — and so they did! To math, they added in “manipulatives” — physical cubes and rods and such — to help students see math. To the history curriculum, they — well, they ended it. Why waste time, they asked, lecturing students about history that they couldn’t possibly understand? In its place they put the “expanding horizons” model of social studies. One version goes as follows: In kindergarten, students learn about themselves In first grade, they learn about their families In second grade, they learn about their neighborhood In third grade, they learn about their city In fourth grade, they learn about their state In fifth grade, they learn about their nation In sixth grade they learn about the world We can admit that there’s an elegance to this model. (I can picture how clever the theorist who first came up with it must have felt!) The downstream effects of it, however, seem horrible. Doesn’t keeping kids ignorant of the rest of the world seem provincial? Doesn’t reinforcing their self-centeredness seem infantilizing? Perhaps we could stomach it if it was founded on some unshakable findings of child psychology — but does it really strike you as likely that kids are incapable of understanding anything that happened long ago or far away? How, Egan asks, can we explain the $50 billion success of a movie franchise aimed at children that literally begins “A long time ago, in a galaxy far, far away?” Q: Because… Jedis aren’t history? The point is, kids obviously have the mental abilities to understand — and in fact care a lot about — things far outside their own experience, and we’ve built elementary schools on a long-dominant model of educational psychology that swears they can’t. This is actually a great example of a general principle. Let’s call it “the Star Wars test”: can our model make sense of the most obvious facts of students? When we find that the answer is “no”, we should at least consider radically revising what we’re doing in school. What are elementary schoolers good at? (or: kids are smarter than students) Someone — I can’t now find who — once observed that children seem to lose IQ points the moment they step into a classroom. Egan agrees, and suggests that we think of ourselves as primatologists to kids, Jane Goodalls who investigate children “out in the wild” to see the sorts of things they gravitate to, and do fairly well at. If we do this, what do we see? Kids tell jokes, for one. They get mental images stuck in their heads, for another. They engage in role-playing, get lost in reverie, and beat out rhythms when they’re bored. They make ample use of metaphors, tell stories, and insist on seeing the world in terms of abstract binaries (e.g. stupid/smart, cowardice/courage, slavery/freedom, and so on). These, Egan holds, are the cognitive strengths that children use to understand the world. They’re the things that kids are often about as good at as adults — or much better than. They’re going to be the tools Egan wants us to use to rebuild the entire elementary curriculum, and in fact he spends most of his second chapter geeking out about how we might define these, how they operate in the mind, where they first pop up in history and anthropology, and even how they might have developed in our evolutionary past. I’m going to skip all of that, and get to the curriculum. From trivial to rich: the trick What could an intellectually rich elementary school curriculum look like, if we built it on kids’ cognitive strengths? He gives us one suggestion to help us do this: ask where each discipline came from in the first place. What was math before it was math, for example — or science before it was science? Q: How on Earth could that help? That’ll become clear later, when we finally uncover what Egan thinks “education” actually is, and see what job he wants us to give schools. For now, take it as a tantalizing hint… or, y’know, just ignore it. Elementary literature & language What was literature before it was literature? Before people invented writing, they had rich oral traditions: they told simple stories, recited poems, and shared proverbs. Egan suggests that these bits of oral tradition should form the backbone of the elementary literature curriculum. Q: What sorts of stories? As many as we can, and from as many diverse cultures as possible! Folktales are wonderful, as are myths. Think the Aboriginal story of “The Rainbow Serpent”, episodes from the Sumerian “Epic of Gilgamesh”, the Egyptian story of Osiris & Isis, the Greek story of Orpheus & Eurydice, the Chinese Legend of the White Snake, the Japanese Tale of Amaterasu and Susanoo, the Ashanti tales of Anansi, the Aztec myth of Quetzalcoatl, the English legend of King Arthur, the Maori myth of Maui and the Sun, the Roman story of Romulus and Remus, selections from the Indian Mahabharata, the Anglo-Saxon epic of Beowulf, the Inca legend of the Sun and Moon, the Iroquois Myth of the Flying Head (a real thing! look it up!), and the Ojibwe story of Turtle Island. Q: That was a lot of examples. Are you going to keep giving so many? I’ve got a [mumble mumble mumble] to get to. Sorry about that. Sometimes, though, I feel that a limitation of reading Educated Mind is that, in trying to keep his book to a manageable size, Egan skimped on examples in some places that it matters. It’s easy to read his occasional example and assume he intends that it hold some central place in the curriculum — when all he wants to do is display how rich and diverse the curriculum could be. (Also: good God, I didn’t even include an example from Norse mythology!) So from now on, just assume that every category could be filled with oodles of examples. Q: What sorts of poems? Lots of poems, first of all. We shouldn’t steer toward “fancy” poems — rather, we should find poems that appeal to kids immediately — think Shel Silverstein, Mother Goose, Dr. Seuss, Jack Prelutsky, Edward Lear, or Ogden Nash… that sort of thing. In a biting essay, Egan suggests these poets like these appeal to kids precisely because they leverage kids’ cognitive strengths: “we should find, and encourage saying and singing and shouting aloud verse with strong narrative forms, thumping rhymes and rhythms, the most vivid images, fun with metaphors, and a rollicking story.” Q: Why proverbs? Proverbs stick in your mind almost effortlessly. (“All’s fair in love and war!” “When in Rome, do as the Romans do!” “You can’t judge a book by its cover!”) They’re also useful; they capture general truths. Kids can apply them to all sorts of situations, but also discuss them — to what extent are they wise or foolish? (I remember my surprise when I realized that they couldn’t all be true — because you can’t follow “look before you leap” and “he who hesitates is lost” at the same time! I’m embarrassed to say that I think I only realized this when I was in college.) Elementary science What was science before it was science? Egan suggests: being immersed in the natural world. We might, he writes, encourage elementary students to “adopt” some feature of the natural world — a patch of grass, a cat, a branch, a stream — and simply observe it at length. To do this, we can use the cognitive strength of reverie. Q: Oh, do you mean like kids sometimes do in science class nowadays — describe a thing to a partner, make notes, draw it, and label its parts? No, the exact opposite! That’s all about squeezing the experience into words and forms that we understand. What we want “is less an attempt to know about nature as to know it in some participatory way, to know it as something we are an intimate part of, not set off from”. Q: That sounds a little… “woo” to me. It did to me, too… until I remembered my childhood climbing tree. I didn’t much like to go outside as a child, but I had this one tree that I’d climb up and read for hours and hours. If I close my eyes I can bring to mind the precise texture of its bark, the roughness of its broken-off branches, the coolness of its leaves, the always-surprising solidness of its trunk… I’m bigger now, but I think if I were back in my parent’s yard, I could still navigate its limbs with my eyes closed. I have, at this point in my life, read a fair number of books about trees, but I’d be surprised if all of them together more than equaled the amount I learned from that tree — my tree. Elementary math What was math before it was math? Egan suggests: counting and logic. We might, then, use rhythms, metaphors, stories, and jokes to help kids become fond of these. Q: Counting is pretty… basic. Could it really be improved? Beware of “the curse of knowledge”: Steven Pinker’s phrase for forgetting that something was once difficult! Egan suggests we should spend time helping kids count wonderfully. We can start early with counting rhymes. (“One, two, buckle my shoe! Three, four, out the door! Five, six…”) But we can also help kids use their fingers as metaphors. There are some pretty cool ways of using your hands as an abacus — and did you know that you can count up to 1,023 using just your fingers on both hands, and a knowledge of binary? Q: Logic — I’m intrigued! Aristotelian, or Boolean? Neither, for the time being — Piaget was presumably onto something when he found that young children couldn’t reason abstractly, but he was looking at logic in a vacuum. When we put logic into the context of stories, we find that kids can deal with logic just fine. There’s an entire worldwide network of educators, in fact, called Philosophy for Children, who have written whole books about how to do this, and Egan loves it all. Sometimes they read stories and ask simple questions: “What is friendship?” or “What does it mean to be brave?” They also pose ethical questions: “Is it ever right to spill a secret?” And they pose paradoxes: “Can you step in the same river twice?” Q: You mentioned “jokes” a moment ago. Care to elaborate? Egan thinks that, to help kids get good at math, you should tell kids jokes. Q: That’s… new. I think so, too — but he backs it up pretty well. To be funny, jokes (or at least most kid jokes) rely on a leap in logic: Why can’t you trust an atom? They make up everything. Knock-knock. Who’s there? Boo. Boo-hoo? Don’t cry, it’s just a joke! To understand the joke, kids have to follow the logic — spotting patterns, making connections, and tracking what their audience expects a word to mean. That’s a lot of cognitive lifting. And Egan goes further, suggesting that we grit our teeth and create methods to help kids invent their own jokes, no matter how horrible they’ll be at first. (The things we do for learning…) Q: Wait wait wait! What about addition facts, and multiplication tables, and fractions? Egan emphasizes that his methods are designed to be add-ons to the standard math curriculum. In general, he’s a don’t-blow-up-the-system sort of guy, and if something seems especially weird, you should probably assume it’s an add-on to the regular curriculum rather than a replacement, even if I forget to say so. Elementary arts What was art before it was art? Egan suggests we pop our heads into Paleolithic caves for our inspiration. Whatever the specific meaning of all those charcoal elk and aurochs and mammoths (communication with the spirit world? art for art’s sake? a way to impress babes?), Egan thinks it obvious that they were also an attempt to capture an intense experience that would be difficult to express in words alone. What did it feel like to be near an aurochs, or a saber-toothed tiger? “The arts help us,” Egan writes, “to hear and see afresh, to force our perceptions and sensations to experience again the immediacy and vividness of the world”. If we follow this, then, we don’t want to help kids build “art skills” so they can draw like an adult — rather, we want to help them amass a repository of diverse aesthetic feelings that they’ll want to express. We should provide them with a riot of experiences. Q: That couldn’t be more opaque. Examples, please! Egan writes that we should have children learn to whistle, sing, and click their tongue; we should help them emulate the ways a skunk or a hawk or a stick bug might move through a space. We should expose them to scores of different temperatures and materials. In music, we should help them love Beethoven, yes, but also the Beatles; Tchaikovsky, yes, but also Tuvan throat singers, and also John Cage, whale song, and bird song. Q: That’s a lot of experiences, but what would they be doing? An interesting aspect of Egan’s view of education is that he doesn’t seem to think we should push kids right to the “doing” phase. He wants to help kids cultivate an affective relationship with the world. In any case, he writes that as students get more experienced, we should prompt them to move from merely enjoying these experiences to trying to systematically shape similar experiences. And drawing, painting, and playing music could easily be folded into other parts of the curriculum. Elementary social studies What was social studies before it was social studies? Well. Remember how, just a moment ago, I wrote that you could assume that you should probably assume that Kieran isn’t in favor of junking the curriculum as it currently stands? He suggests we very carefully pick up the elementary social studies curriculum, place it into a trash can, and set the whole mess on fire. He isn’t worried about much of importance being lost. (Remember that the “expanding horizons” model is, to him, the original sin of 20th century educational reform, and he repeatedly quotes student surveys showing that “social studies” regularly wins the title of “most boring subject”.) In its place, he suggests we put history — which, he hints, we should think of as the centerpiece of the elementary curriculum. So the real question is what was history before it was history? His answer, surprisingly, is myth. Q: Egan wants us to teach myths as if they were history? Not at all. What he suggests, though, is that we look at how myths operate as narratives — so we can design an intellectually vivid history curriculum. And myths really are special: each is built on at least one binary (like weak vs. strong, or lies vs. truth, or so on), and uses that to tell the story of the big picture of the world. They’re so powerful that people can understand it, remember it, and love it — even if that thing never happened. We should take that power, Egan says, and apply it to things that really did happen. Q: So what history does he think kids should learn in elementary school? The great struggles of humanity from across the whole. Flippin’. World. We’re still talking about young children, so these should be done as simple stories. The goal isn’t to make them history PhD’s, so we needn’t even try to put them in any sort of order. Egan suggests that, in first grade, we pick a single binary like “freedom against oppression” and tell kids a welter of stories, again from as many cultures as possible, and as many times in history as possible. Q: Can you give examples? Oh, all right — in first grade we can tell kids the stories of the war of the Greek city-states against the Persian empire, and the slave uprising of Spartacus against the Romans. We can tell them about the plight of Jews in medieval Europe, and of the unsuccessful Sepoy Rebellion in India against the British. We can tell the stories of the American, French, and Haitian Revolutions, and about the Chinese Taiping Rebellion against the Qing Dynasty. We can tell them the story of the escaped slave Harriet Tubman returning to the South to rescue her kinsmen, the story of six-year-old Ruby Bridges facing threats to integrate her elementary school, and the story of how the Mau-Mau uprising led to modern-day Kenya. We can tell the stories of Mexican-American union organizer Cesar Chavez and of Malala Yousafzai surviving an assassination attempt to advocate for female literacy. The world does not lack for stories of oppression and liberation that can capture the attention of a six-year-old. Q: That’s… huh. What stories might they hear in second and third grade? Egan gives examples, but I won’t list them here. He suggests we use a similar approach for each, except that we swap out the binary each year. He thinks “the struggle for security against danger” would work well for year two, and “the struggle for knowledge against ignorance” would work well for year three. (That year could have a lot of overlap with the science curriculum.) Q: Anything else, for history? Yes — they should get a sense of Big History. They should get some simple stories about the ice age, the Cenozoic, the age of dinosaurs, the Paleozoic, the origins of our solar system, and the Big Bang. (Because if the ancient Norse can tell their story of the beginning of the universe, by gum, we can tell ours, too.) To sum up Egan argues that the problem of early schooling is that it’s trivial — and it’s trivial because the dominant theories of educational psychology see children as lesser versions of adults. What else would we teach them, except dumbed-down versions of what adults learn? But children have certain cognitive strengths that schools aren’t making systematic use of. If we rebuild elementary schools on those strengths, we could turn schooling upside down. We could stop seeing the curriculum as a bag of information to impart, and start seeing it as a set of great stories to tell — and invite kids into. Kids could experience (both intellectually and emotionally) the great struggles of humanity and see that they can join in them. Students could experience the story of education as the beginning of a very real adventure. Egan’s elementary school: some skeptical questions Q: I’m not sure I’m understanding what you mean by “mental images”. Care to explain? It’s an interesting fact of human cognition that just a few words can whip up a complex mental experience. Egan doesn’t just mean what we might call “visual imagery” — the ability to hold, say, the image of a bespectacled, spat-wearing duck in your mind without seeing a photograph. He’s also including what psychologists call auditory imagery, olfactory imagery, gustatory imagery, and tactile imagery. Q: How could all of that be helpful in schools? Humanity has a built-in VR system, and we’re not using it! Egan invites us to pretend we’re teaching a class about the humble earthworm. We might list off facts — “earthworms are so many centimeters long, move through soil by means of their something-or-other muscles…” but he suggests we can evoke images, say, “of what it would be like to slither and push through the soil, hesitantly exploring in one direction then another, looking for easier passages, contracting and expanding our sequence of muscles segment by segment, and sensing moisture, scents, grubs, or whatever”. Those facts are now felt by the student; the knowledge has become part of them. And just a few words can spark a complex mental experience, one going beyond literal images to include imagined sounds, smells, tastes, and more. These experiences can feel real and stick with us. (That these mental images are so easy to evoke, and so meaningfully felt, feels something like the proverbial hundred dollar bill on the ground.) Q: How could metaphors be helpful? It really is interesting that so much of the “constructivist” turn in psychology — that is, the notion that children don’t absorb knowledge, but construct it — has continued to focus on logics-mathematical reasoning, when there’s been mounting evidence for decades that metaphors are more central. It’s not just that we use metaphors to better understand things we already know, we also use them to grasp new knowledge. What’s more, psychologists have devised tests to measure the skill at metaphor-making, and have given them to people of different ages. What they found was that eleven-year-olds make more metaphors (and higher quality metaphors) than do undergraduates — and that four-year-olds have both groups beat. Again, hundred dollar bills on the sidewalk. Q: Your talk of “binaries” has me worried — binaries like good/evil and male/female are the source of so many of our most pernicious stereotypes! Isn’t the purpose of education to get us beyond stuff like this? Yes, it is! Education is supposed to complicate our understanding — but that means we’ve gotta start somewhere, and binaries provide us a natural starting place. As an uncontroversial example, think about temperature. We all begin as babies by perceiving two temperatures — hot and cold. Later, we add on intermediate categories — warm and cool. (Note that the human body is the assumed mid-point to temperature. Binaries often work like this; “big” and “small” mean “bigger or smaller than me”, “nasty” and “kind” mean “nastier or kinder than I am, except when my brother is really asking for it”, and so on.) A good story (and an Egan-inspired elementary curriculum is, in a sense, nothing but good stories) will go further, and transform the binary. Toy Story is grounded in the binary of abandonment/belonging: at the beginning, the toy cowboy Woody belongs to his owner, and has his affection. Then a rival comes who threatens his belonging. In trying to get back to belonging, Woody is entirely lost — and to save the day, he has to come to a deeper understanding of what belonging means. Now, all lessons can’t be Pixar movies. But the good stories (especially in literature and history) will challenge and subvert the binaries they begin with. Q: I see the pattern of Egan drawing from “as many cultures as possible”. Why so many? Is this a political correctness thing? If it helps to think of it as such, then, sure! I don’t think Egan would have had a problem with that. But his ultimate reason for including so much diversity goes deeper. For Egan, including such world-wide diversity isn’t optional, and the answer to why is bound up in his definition of education. (Keep reading.) His answer also insists that we, whenever possible, also include stories from the Bible and Homeric epics (the Iliad and Odyssey). Q: Mmm, stories from the Bible aren’t going to fly in my local school! So be it! Egan doesn’t spend much time obsessing over the practicalities of… His interest is in describing what an ideal education might look like, if it were possible. Every lesson, every classroom, and every school is necessarily a compromise. Q: You make a big deal of poems. But isn’t poetry dead? An interesting contrast can be made to classical education, which also has kids read a lot of poems — they see knowing great poems as one of the marks of an educated person; again, for an academicist, it’s the information that transforms. Egan begs to disagree. Poems are important because they’re a wonderful way to train their cognitive strengths, like rhythm (poems are language fueling by thumping). We want to help kids learn to use this tool better, and a great way to do that is to help them recite poems that they’ve learned by heart. Q: “Learn by heart” — is that code for “memorize”?! It is! Egan is actually quite big on memorization — he points out that all the knowledge in the world can do nothing for a person once they’ve forgotten it. He didn’t, however, appreciate the academicist focus on memorizing without understanding (or at least enjoyment). Q: I’m still worried about the science curriculum, as you’re describing it. Can you allay my fears? Honestly, while I feel there’s something profoundly right to how Egan is describing early experiences of nature, I feel the same way. Note that there’s more science coming in the social studies curriculum. But if that’s still not enough, one could bring down aspects of the middle school science stage. Q: Anything else that Egan suggests we do in elementary school literature and language? He suggests that we help kids learn a second language! This is so obviously true (why do American schools typically wait until kids lose the ability to naturally absorb languages to start teaching languages?) he doesn’t belabor it, though. Q: You had mentioned that Egan’s vision seems more internal-focused. Should we be worried about that? While I strongly suspect that his curriculum would make kids more creative in any way you’d like to measure it, Egan wasn’t particularly interested in “creativity” — he was more about helping kids find the world interesting. I get the sense that he thinks kids will do things with minimal prompting once they’re loaded up with complex internal experiences. Q: I think I’m beginning to understand Egan — is he basically saying “make learning fun”? “Fun”, applied to education, is a dangerous word. Egan worries about the dangers of an emotionally unserious curriculum producing emotionally stunted adults. That doesn’t mean we need to tell students only “serious” stories — only that we treat the world honestly. “Disney-esque sentimentality is the exact emotional equivalent to intellectual contempt”. Q: But aren't some of these stories too dark for children who have themselves experienced oppression and disaster? Egan argues that these stories may be especially helpful to them — they can help them understand their struggles better, and give voice to them. Q: At the very start of this, you promised us “rationality”… but I’m not seeing rationality here! All this talk of “adventure” almost seems to go the opposite direction. What gives? Wait for it. But for a hint right now — Egan is fond of citing his fellow educational theorist Jerome Bruner, who claimed “any subject can be taught effectively in some intellectually honest form to any child at any stage of development”. Bruner was criticized for that; his critics charged that he was ignoring learning differences and socio-economic realities. Egan thinks he was profoundly right. Part 3: A new kind of middle school What’s the matter with middle school? What was middle school like for you? In math, I recall a jumble of barely-related topics. In literature, I remember reading great literature — Frankenstein, Romeo and Juliet — only in their dumbed-down summary formats. In social studies, I remember teachers proclaiming on the first day of class that unlike all of our previous history classes, this class wouldn’t be about names and dates… and then going on to memorize names and dates. And in science, I remember being forced to dissect a frog only to discover that frogs are — you guessed it — made of slimy frog parts. Your mileage may vary, but for a lot of us, middle school feels like getting booted out of the (in retrospect) Eden of elementary school, and like marking time before the serious studying of high school. It feels meaningless. In my favorite of his books, Egan calls so much middle school curricula “human deserts”, noting “we have created a system in which the importance of human emotions for meaning seems barely noticed”. Why so meaningless? If our dominant approaches to educational psychology fundamentally misinterpret younger children, Egan suggests, they basically throw up their hands when faced with pre-teens and teenagers. Mainstream schools begin to introduce vocational training to help lighten the load, and Maria Montessori famously suggests that adolescents should be sent to go run a farm. Egan is sympathetic to those responses, but points out that they don’t do much to lighten the load that the academic curriculum often becomes at this age. This feeling of meaninglessness, he argues, is utterly tragic — it comes just when a hunger for meaning blossoms in adolescents! We can see that hunger for meaning in their lives outside the classroom, where their interests ramp up into veritable obsessions. What are adolescents obsessed with? What might we see, if we become Jane Goodalls of early adolescence? First, teens are obsessed with gossip. The motivations of others — why did he do that? and what was he THINKING? — are hypothesized and talked to death. Second, that they’re pulled toward idealism. Many feel a dissatisfaction with the world as it is, and feel a romantic urge to make it a better place. They’re often lured into simplistic beliefs that promise to help them do that. Third, they love extremes: they want to find limits, and test them. Obviously, this can show up as risky behavior, but we can also see it in their love for the bizarre — note adolescents’ fascination in things like aliens, cryptids, and ghosts. (Egan loves pointing out that The Guinness Book of World Records is a perennial bestseller among kids at this age. How else would they find out who had the world’s longest fingernails?) Fourth, they gravitate toward heroes — people who push the edges of those limits. By celebrating heroes, they can vicariously share in their transcendence. Look for the posts hanging up in a teenager’s bedroom to guess what boundaries they feel most hemmed in by: athletes push against physical limits; a death metal guitarist might push against authority and conventional morality. An activist or entrepreneur might push against our dulled morality or our sense of what’s possible. Finally, we might spot teens taking up hobbies and making collections. Hobbies can be a way to identify yourself as part of a group against the rest of the world (“I’m the sort of person who goes bird-watching!”), and collections can be a way to climb the status ladder inside the community. Egan points out that a collection can also be a way to feel like you have control over what you’re discovering is a very big and complex world of detailed information (“I’ve spotted every one of the fifty most common birds of Texas — even the black-capped vireo!”) Egan’s insight is that these obsessions give teenagers a sense of meaning, and that we can use them as tools to make middle schools that overflow with meaning. From meaningless to meaning-soaked Again, Egan sketches out a new kind of curriculum subject-by-subject. Before, his trick was to ask where the subject first evolved out of; now, it’s to ask who first discovered or created the specific content we’re teaching. “All knowledge”, he writes, “is human knowledge. Everything we know is knowable through the lives of its inventors, discoverers, or users, and we can have access to that knowledge through the hopes, fears, or intentions that drove them”. Middle school math Who first discovered the concepts students learn in math? The answer, of course, is a wide diversity of curious men and women living across the world over the last few thousand years. Egan says: bring those people into how we teach math. If we used gossip and heroes to help students find it meaningful, what kind of math would result? When we teach the Pythagorean theorem, we should give a sense of who Pythagoras was — a cult-founder who worshiped numbers to find God, whose followers (according to a piece of ancient gossip) murdered one of their members who discovered irrational numbers! Q: Well, sure, that works for Pythagoras, but he’s a known nut job; surely most math doesn’t come from such interesting roots? When we teach the Cartesian coordinate system, students should meet Rene Descartes, the Calvinist French polymath who saw the possibility that math could decipher the world, if only we could unite algebra and geometry… and invented the xy-plane to do exactly that. When we teach scientific notation, we should call our students’ attention to the importance of the number zero, and tell them the story of the Pope who tried to introduce Arabic numerals to Christian Europe and may have been assassinated because of it. When we teach algebra, we should ask students why “algebra” is Arabic for “the fixing of bones”, and tell the story of what Muhammad ibn Musa al-Khwarizmi was up to. We could do this all day. Literally everything students learn in school was first invented or discovered by some interesting person who was struggling to accomplish something hard. To learn is to connect with those people, whether we know it or not. Egan says: help kids know it. Math has been dehumanized: re-humanize it. Q: So the math curriculum needs to become a history of math curriculum, and math teachers need to become history teachers? No, the content needn’t change. But with surprisingly little work, we can bring in the gossipy stories of heroes, and their obsessions can spread to students. Middle school science Who first discovered the things students learn about in science? If you’re thinking “scientists”, you’re only partially right. Most of the big-picture ideas that we now think of as “science” were discovered before the word “scientist” was invented, or the discipline was professionalized. Frequently, they were hatched by true amateurs, working in their free time, hungry to unlock the secrets of nature. We can use gossip and heroes to spread their obsessions to students just as we taught math, but Egan points out two twists. The first is that the content itself can take on heroic qualities: everything is impressive, when you look at it in a certain light. In an interview, Egan once said: “My book is an attempt to show that, indeed, everything in the world is wonderful, but that schools are designed almost to disguise this slightly shameful fact. We represent the world to children as mostly known and rather dull. The opposite is the case: we are surrounded by mystery, and what we know is fascinating”. What would even the most boring subjects look like, if we emphasized their heroic qualities? Well: What’s a tooth? Bone, wrapped in rock, surrounding tiny cells that your body feeds with blood. What’s a bar of chocolate? A crystal of jellyfish-shaped fat molecules stacked together; when you put it in your mouth you shake them apart into a writhing confusion. What’s the air around you? The bottom of a 10-mile-deep ocean; when you put your tongue over a soda straw and your Pepsi stops leaking out, it’s not because a “vacuum” is “sucking” it up, but because that ocean is squeezing it into your face. Again, we could do this all day! And in middle school science, we can. Everything in the world is wonderful; we can help students see this again and again. The second twist is that science is a subject rich in extremes. Here Egan introduces a concept that we’ll see crop up again: “15-minute segments”. To help us fit as much wonder as possible into a school day, he suggests we supplement the usual school subjects with a few quick lessons. To infuse science with extremes, he suggests we add on three: “human & natural records”, “extremes of animals & plants”, and “cosmology”. Middle school history Who first made the things students learn about in history? Why, the historical characters themselves! Since we’ve given kids a grounding in history in elementary school, now we can build on that, going through many of the same events as before, but in more depth, and more vividly. We’ll leverage the interest with other people’s inner lives to tell stories focusing on the perspectives of the people who made history — zooming in, when possible, on scandalous details. We’ll leverage the tool of idealism to choose historical characters who chafed against their surroundings, and understand what they were trying to accomplish. What was their vision of the world? What did they hope for, and what did they fear? Q: Isn’t the “great man” approach to history out of fashion? Egan’s approach doesn’t say that “great men” made history — it’s just leveraging gossip to help kids see history as something meaningful that can expand their own possibilities. “Early adolescence is commonly a time of intense and vivid emotional life, and also a time of deepest boredom and depression… [We] can give shape to the intermediate curriculum and offer the students a world that is rich, complex, varied, and as intense and vivid as their own emotional lives”. We also should add on another “15-minute segment” just to pump in as many biographies as possible, and from people who don’t always fit into the normal history curriculum. Call it “Brief Lives”, and throw in anyone who’s struggled to push some limit — Mary Wollstonecraft, Jesse Owen, Dietrich Bonhoeffer, one of the students’ great-aunts, whoever. As students get older, this can transition to “People and Their Ideas”. Here, we’d focus less on the details of the person’s life, and use it as a backdrop to showing how meaningful some of history’s most important ideas could be. Think Aristotle and syllogisms, Edward Said and orientalism, Confucius and propriety, Cornel West and race, Buddha on the four noble truths, Muhammad and the five pillars, Karl Marx and communism, Adam Smith and the invisible hand, Thomas Hobbes and the state of nature, John Locke and natural rights, Jeremy Bentham and utilitarianism, Thomas Aquinas on the sacraments, Martin Luther on faith, Voltaire on the freedom of speech… you get the idea. Q: Can you really get a profound understanding of utilitarianism in 15 minutes? Yes! The point of this segment isn’t to develop a systematic understanding of any one idea, it’s to introduce students to the exciting possibilities of human thought. (As a bonus, this might make them less likely to fall for the first ideology that they encounter later in life.) Diversity is important for this — as it is with culture. Throughout this, we should also be trying to expose students to as much cultural diversity as possible, because in high school, we’ll be trying to make sense of our society, and it’s impossible to do that unless we have something to compare it against. Middle school literature & language You might think that this subject would be easy — that middle school literature is already filled with “strong and clear narratives”, that it deals with “transcendent human qualities such as courage, love, and persistence”, that it focuses on “extremes of human experience”, that it examines “something strange and exotic”. You’d be right! Egan’s pretty happy with a bog-standard middle school literature curriculum, done well. In this part of the book, his spends most of his limited space suggesting three rather odd activities which could also be useful — especially for increasing students’ awareness of language, so they can use it better. The first is etymology — not, however, memorizing lists of roots, but in being told the entertaining backstories of specific words. Take the word “berserk”, for example — we now use it to mean something relatively mild (“if my mom catches me coming home late, she’ll go berserk”), but it comes from an old Norse word meaning “a raging warrior of superhuman strength”. And that’s because ber meant “bear” and serk meant “shirt”: soldiers of the bear cult would don the skin of a bear to, in their minds, transform into one — howling, foaming at the mouth, and gnawing the rims of their shields. (Most adults walk through life with little understanding that the words falling out of their mouths are entities, with their own back-stories. Communication is, at the very least, more interesting when we become aware of this.) The second is to add on another language to learn — not, this time, to become fluent in it, but just to become aware of how very different human languages can be. (For native English speakers, Sanskrit might work well, or Cantonese, or perhaps even ancient Egyptian. Again, the point isn’t for this language to be useful — it’s to explore diversity.) The final one is to study humor — not just jokes anymore, but comedy at its finest. Egan cites (at length!) Monty Python as a group of people who were particularly brilliant in their use of the English language. Examining their skits can lead us into not just an appreciation of semantics (the study of how meaning is made from smaller pieces, like etymology) but also pragmatics (the study of how meaning is made in social situations). Pretty heady stuff, for a conversation about a dead parrot. Part 4: A new kind of high school I’ll confess — I loved parts of high school… and among nerdy folks, I suspect I’m not alone. For some of us, this was a golden time. Even at my local public high school, I had access to academically thrilling classes — especially, in my last two years, advanced literature and history. I felt like I was finally understanding the ideas that mattered. In any case, Egan is quick to acknowledge that, at this level, the sort of education he advocates really is being practiced in some places. What he can add is an understanding of what makes it wonderful, how to make it even more wonderful, and how to make it wonderful for many, many more people. What’s the matter with high school? Far too often, even when high school classes are intellectual, they’re dry. For the majority of students, all this academic stuff is experienced as utterly lifeless, a mass of dead information to be squeezed inside one’s head for a test and then left to evaporate. Egan mocks the curriculum wars that seem to be a permanent feature of the teaching life; quoting the sociologist Pierre Bourdieu, he says “while the academic left and right bicker over whether the curriculum is too traditional or too radical, they fail to recognize that most students absorb so little of academic culture that the bickering is largely irrelevant”. Why so dry? Egan suggests three reasons to explain this. First, because high school academic classes are too often masses of small details with no sign of the big picture. Second, because they’re typically slavishly disciplinary, and aren’t able to address the questions that span the disciplines. Third, because they’re often designed to bring students through what everyone is sure of, and hide away any controversies. In all of these, Egan suggests that what’s called “academics” in high school is too often a dim imitation of what real academics are actually practicing. There’s a fourth reason, though, and it’s probably the biggest of all — by the time they get to high school, most students haven’t actually learned that much! An academic approach is designed to connect small details into the big picture; for people who arrive in high school (and college) classes without having already collected much in their heads, academics are going to taste dry. (An implication of this for anyone trying to improve schools is that we might not want to start with high schools. If your goal is to create a new kind of academic learning, first start at elementary school — or barring that, middle school.) What motivates mad scientists? When we wanted to re-conceive the elementary and middle school curriculums, we looked at what students were already good at — kids’ cognitive strengths and adolescents’ obsessions. For this level it might be easier to look — for reasons that will become clear when we finally unveil Egan’s crazy-sounding definition of education — at the sorts of things that bring intellectuals joy. Q: Which intellectuals? Take your pick. Galileo, Einstein, Smith, Marx, Goodall, Chomsky, Curie… all the people who took to the life of the mind like fish to water. But that’s a lot to hold in my mind at once, so I’m just going to think about Doc Brown from Back to the Future: He was high on intellectualism I’ve never been there, but the brochure looks nice Let’s call these people “mad scientists”. And let’s pretend we once again took up our job of being primatologists, and snooped on these folks “in the wild” (“in the lab”? this is beginning to get recursive…)… what would we find motivating them? Asking simple questions, for one. (What is space? What is society? What is a human? What is language?) Building general schemes (big theories) that hold lots of evidence together. Finding their place in the cosmos. And (perhaps above all) seeking certainty. Once again, Egan suggests we use these as tools to remake the curriculum. From dry to daring What could a high school curriculum look like, if it were rebuilt on these tools? Once again, Egan has a trick. This time, it’s to ask what fights have driven the development of each of these fields forward — and how we can help students enter them. First, a mini-segment! Intellectuals invented the academic disciplines to better pursue the life of the mind, but the disciplines can get in the way. Some of the most important intellectual discoveries that could help students are too big to fit into any of the disciplines. We need a place to introduce them plainly. Egan proposes another mini-segment — again, just 15 minutes a day, a few times a week — called “Metaknowledge”. Q: Isn’t that already in the International Baccalaureate program? Yes, he acknowledges that he’s borrowing from that! This segment would introduce ideas that would enrich student thinking across the disciplines: game theory, cognitive biases, systems thinking, Bayesian reasoning, epistemology, ethics, logic, cultural evolution, and so on. High school literature How can we help students enter the big fights of literature? Intellectuals of a literary bent — professors, critics, poets, novelists — delight in arguing over literature like rabbis arguing over the Talmud. Take, just for one example, the debates over Shakespeare’s character of Ophelia. Does she love Hamlet, or is she a victim of his emotional abuse? Is she truly insane, or is she acting? Is she passive, or is she pulling the strings? Oceans of ink have been spilled arguing over questions like these; our students can, perhaps, spill a few ounces more. The usefulness of arguing literature, for Egan, isn’t that it’s oh-so important for educated adults to know a lot about Ophelia. (This, again, was where the academicists went wrong — in thinking that being educated was about getting the best knowledge in your head.) Rather, arguing over literature is a training arena for the all-important intellectual move of this kind of understanding: building general schemes out of evidence, and struggling with anomalies. One person, for example, might hold that Ophelia is insane, and cite all sorts of obvious evidence — her father just was murdered by her lover, she rants nonsense while (bizarrely) handing out flowers to friends… But then he’s challenged when he reads a scholar pointing out that, to people in Elizabethan England, types of flowers have symbolic meanings. How does he deal with that? He could ignore it, claiming it an over-reading of Shakespeare. (Sometimes a flower is just a flower!) Or he could address it, complicating his own scheme. This intellectual work is best done with other people, who are incentivized to challenge your understanding of something, and go back and forth, building competing models and calling attention to anomalies. This process — the “dialectic” — pops up again and again in the academic disciplines. It’s the center of how understanding works, at this stage. And the nice thing about practicing it on literature is that, more so than in history or science, the evidence is shared knowledge — it’s right in front of everyone, written out. But there are other ways literature class can be helpful to the general life of the mind. Egan also suggests that we’ll want to specially include literature that helps students understand complex ideas. Camus, Orwell, Borges, Calvino might be particularly helpful here… and I imagine that genres like science fiction and magical realism might be particularly useful, too. (Note, though, that once again none of this requires a radical remaking of the curriculum, or of the canon of texts that we traditionally assign to high schoolers.) Q: Oh yes, the canon — what does Egan have to say about the canon wars? When he wrote Educated Mind in the nineties, the long-brewing canon war was approaching its inevitable apocalyptic climax. On one side of this Plain of Megiddo were the pro-canon traditionalists, arguing that we should keep assigning the texts that had been argued over for centuries. Facing them were the anti-canon reformers, arguing the standard texts over-represented the perspective of dead white men. Onto the middle of the plain rides Egan on a white horse, who bellows above the din: “I’VE GOT A BUSLOAD OF HIGH SCHOOLERS WHO WANTS TO JOIN IN, EVERYONE OKAY WITH THAT?” To do so, he says, we need to give students the arguments from both sides. So, for example, bell hooks, Edward Said, and China Achebe should be on the syllabus, as should Allan Bloom, Mortimer Adler, and Diane Ravitch. And of course they should actually read the texts cherished by both sides, too, so they can argue better. High school history How could entering the big fights help us reinvent high school history? First, we might look for dueling histories. It’s time for students to get into historiography and understand that history isn’t just what happened, it’s something we make. We might help kids read chapters from Howard Zinn’s socialist history of America alongside the corresponding chapters from Paul Johnson’s conservative history of America. How could big questions help? We want to help students see how various people have disagreed over some of the big questions of what human history is, at its most basic. We can have them compare Steven Pinker’s theory of civilization’s progress (Better Angels of our Nature) with Yuvah Noah Harari’s theory of civilization’s woes (Sapiens). We could have them compare so-and-so’s account of human history as an ever-expanding unlatching of energy sources with Robert Wright’s account of human history as unlatching more and more positive-sum games (Nonzero). What role could the lure of certainty play? To help them grow their skills at finding anomalies, we might help them work through pseudo-histories and conspiracy theories. Q: Conspiracy theories! Oh, come now, you’re playing with fire. Well, the world is on fire. Our students will spend the rest of their lives encountering terrible-but-beguiling arguments about how the world works; if we don’t prepare them for those, what have we been doing? So we should introduce arguments that the Moon landing was a hoax, that the Illuminati founded America, that aliens built the pyramids, and so on. At no point can we demean students for falling for any of these theories — the job of a teacher at this stage, Egan writes, is to support students in their reasoning even when their beliefs are offensive and stupid, gradually offering anomalies. There’s no way out of bad theories except through them. By the time students graduate, we want them to have wrestled with terrible ideas and — for a while — lost. They need to experience what it’s like to change their minds about something they felt strongly about. They need to viscerally realize, in Feynman’s famous phrase, “The first principle is that you must not fool yourself and you are the easiest person to fool.” High school natural science How could entering the big fights reinvent high school science? At present, so much of the high school science curriculum — especially “honors” classes — is oriented toward helping amass details. (The same is true of 100-level university classes, which famously “survey” the field to prepare for more advanced studies. I always thought this was stupid — of the huge lecture hall of students in my Geology 100 class, how many went on to take even a second course?) The meaty debates that propel science forward are held back. Egan complains: “The more general and speculative theories in any discipline are treated like an unconventional and disreputable relation who, even though the children find her exciting and entertaining, must be kept hidden from view, her very existence denied as long as possible”. This is a stupid approach — students with an adventurous bent are convinced that science isn’t for them. Egan proposes, simply, that we flip this, and organize high school science classes around the big debates. We shouldn’t be ashamed at how, well, adolescent this might look: “the dramatic, speculative, and contentious theories will be up-front in the early years of the [high school] curriculum”. What might those be? Egan doesn’t give a list, but we can spitball some: instead of explaining what “matter” is from the top down, a physics class could problematize “matter” by following the debates over the nature of dark matter and dark energy, and by becoming familiarized with the various interpretations of quantum mechanics
human ACE2 cells

human ACE2 cells is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 09, 2024 and April 09, 2024. The archive places it in contexts such as "Well adapted to human ACE2 cells". It most often appears alongside #S14, 2009 flu pandemic, 2013-16 West African Ebola outbreak.

Reference entry
human ACE2 cells
Mention count
1
Issue count
1
First seen
April 09, 2024
Last seen
April 09, 2024
April 09, 2024 · Original source
This alone isn’t fatal to lab leak. It’s perfectly possible for the lab to leak (let’s say) November 5th, the virus spreads a bit, and then a month later someone goes to the wet market, coughs on a vendor, and starts the officially recognized pandemic. But if that were true, you’d expect (let’s say) 30 cases by early December. Let’s say the wet market vendor was exactly Case # 30. She infected the other wet market vendors, starting a pandemic with an obvious center at the wet market and lots of infected wet market vendors and patrons. What about Case # 29? If they were (let’s say) a barista, how come they didn’t infect people at their coffee shop? How come there wasn’t a second obvious cluster radiating out from a coffee shop, lots of coffee-shop-linked cases, etc? How come there weren’t 30 equally-sized clusters? In order to avoid this, you either need to claim that the wet market was a perfect superspreader location, or that the pattern with lots of cases in the wet market and few-to-none anywhere else was a result of ascertainment bias. Saar made both those arguments during the debate, but I thought Peter rebutted them effectively. 1.4: COVID in Brazilian wastewater Nicholas Halden (blog) writes: What should we make of this study, which found the presence of covid in Brazilian wastewater in late 2019? Consider the doubling times. The study says that scientists working in late 2020 found COVID in samples of Brazilian wastewater from November 27, 2019. This was long before the first detected case of transmission in Brazil on March 13, 2020. Between November 27, 2019 and March 13, 2020 is about 16 weeks, so 32 COVID doubling times. 32 doubling times with no lockdown is enough time for COVID to infect every single person in Brazil. If COVID had infected everyone in Brazil before the first recognized case, we would have noticed. (again, COVID doubling time isn’t exactly invariably 3.5 days, but here we’re talking about numbers big enough that the exact details don’t matter very much) So if COVID was in Brazil on November 27, it must have fizzled out instead of going pandemic. How likely is that? If one person had COVID, it’s not too unlikely - not all COVID cases transmit it forward. If (let’s say) twenty people had COVID, it’s very unlikely - at that point, the law of large numbers takes over; in a freak coincidence, every single patient would have to fail to infect anyone else. So almost certainly fewer than 20 people in Brazil had COVID in November 27. So which is more likely - that somehow 20 people had COVID long before the virus was officially detected, and on a totally different continent, yet somehow a scientist looking through wastewater found the water from exactly those people and managed to detect the virus? Or that there was a sampling error, which happens all the time in these kinds of things? Peter wrote a blog post on some of these issues. He found that there were positive tests from wastewater samples as early as March 2019, which doesn’t fit anyone’s timeline, including lab leakers’. And most of these positives (including the Brazilian sample) contained later strains of the virus with mutations it picked up late in 2020. So these were almost certainly false positives from contamination. 1.5: Biorealism’s 16 arguments Biorealism has a list of sixteen arguments, which he liked so much that he posted it three times in the ACX comments, twice on Less Wrong, twice on Manifold, and about a dozen times on Twitter under multiple account names. Some posts were slightly different from others, but a typical version is: Importantly, Miller incorrectly claimed the N501Y mutation would result from passage in hACE2 mice (mixed them up with BALB/c mice). The major papers Miller relied on have been seriously challenged since the debate. See Stoyan and Chiu (2024), Weissman (2024), Bloom (2023) and Lv et al (2024). Overall the circumstantial evidence makes lab v plausible: Peter admitted getting this wrong during the debate. I think this very minor point about mice mutations was approximately his only mistake in 15 hours of debating, and he admitted it as soon as he noticed. Biorealism somehow heard about this (obviously not through watching the debate, as we’ll see in a moment), then left about 20-30 comments starting with it, under various accounts, on various platforms, as if it somehow discredited Peter. This is making me somewhat less charitable to him and his 16 arguments than I would be otherwise. 1. Chinese researchers Botao & Lei Xiao observed lab origin was likely given the nearest known relatives to SARS-CoV-2 were far from Wuhan. Wuhan Institute of Virology (WIV) sampled SARS-related bat coronaviruses where the nearest relatives are found in Yunnan, Laos and Vietnam ~1500km away. They refuse to share their records. The ancestral viruses of SARS were found equally far from where SARS spilled over into humans, so we know it’s possible (and likely) for viruses to travel that far. 2. Patrick Berche, DG at Institut Pasteur in Lille 2014-18, notes you would expect secondary outbreaks if it arose via the live animal trade. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234839/ There are constant outbreaks of weird coronaviruses in animal handlers. See eg this paper, which estimates about 60,000 of these per year. None of these ever go anywhere, because the farmers are in rural areas that aren’t dense enough to sustain a high R0, and the epidemic fizzles out after a single digit number of cases. Any early outbreaks of COVID would have vanished into this long and mostly unnoticed list. 3. Molecular data: Only sarbecovirus with a furin cleavage site. Well adapted to human ACE2 cells. Low genetic diversity indicating a lack of prior circulation (Berche 2023). Restriction site SARS-CoV-2 BsaI/BsmBI restriction map falls neatly within the ideal range for a reverse genetics system and used previously at WIV and UNC. Ngram analysis of the codon usage per Professor Louis Nemzer https://twitter.com/BiophysicsFL/status/1667232580255490053?t=IJgitS5cw364ioclzVWxaA&s=19 The SARS2 backbone is very low in CG and CpG. While the 12-nt insert that gives it the FCS is extremely high in both. Almost as if it was some kind of chimera of a consensus sequence and a codon-optimized polybasic cleavage site? https://twitter.com/BiophysicsFL/status/1752800486837678377?t=EpIRgyybJVaPgeMP5xdstA&s=19 https://www.biorxiv.org/content/10.1101/2022.10.18.512756v1 https://link.springer.com/article/10.1007/s10311-021-01211-0?fbclid=IwAR1HMUMtLIAFOFppVasQDeoIAYrVhP8j4YoPO4wnaTOUiKLsllZl_oKryOw Most of this was discussed extensively in the second session of the debate, which I recommend. The CGG-CGG arginine codon usage is particularly unusual but used in synthetic biology. I asked a synthetic biologist about this. He said: » “Nope. I would literally never do this if I was designing a small insert (maybe I wouldn't notice if it happened by chance with ~1 in 25 odds in a naive codon optimization algorithm as part of a larger sequence). High GC% is bad. Tandem repeat is worse. Several other perfectly fine arginine codons. And I wouldn't engineer a viral genome using human codon usage. An engineer would not do it.” 4. DEFUSE full proposal: virus 20% different from SARS1, consensus seq assembled with 6 segments, without disrupting coding seq, BsmBI order, FCS. SARS2: 20% different than SARS1, 6 evenly spaced fragments w BsmBI and BsaI restriction sites, FCS. Jesse Bloom, Jack Nunberg, Robert Townley, Alexandre Hassanin have observed this workflow could have lead to SARS-CoV-2. Work often begins before funding sought or goes ahead anyway. Re: 4 - Also scattered across second section of debate, also not going to retread 5. Market cases were all lineage B. Lv et al (2024) indicates there was a single point of emergence and A came before B. So market cases not the primary cases. See also Bloom (2021), Kumar et al (2022). Peter Ben Embarek said there were likely already thousands of cases in Wuhan in December 2019.https://t.co/50kFV9zSb6 https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/34398234/ https://academic.oup.com/bioinformatics/article/38/10/2719/6553661 There was a Lineage A sample in the market, lab leak proponents just try to ignore/dismiss/conspiracize it away. The first two known Lineage A cases were very close to the market. Lv (is this even a real name? It sounds like Roman numeral? But I guess that’s what you expect in a country ruled by someone named Xi) found some weird COVID variants in Shanghai that might or might not mean anything; you can see some discussion of the implications here, but I don’t think they’re strong evidence either way. If A was first, it means some really weird stuff coincidences have to happen to give us the spread rates and genetic clock data we get, but they’re not necessarily weirder in the zoonosis hypothesis than the lab leak one. The claim that there were “thousands of cases in Wuhan in December 2019” is very easy to disprove by doubling rate arguments like the one above, by the blood bank study mentioned above, by the WHO’s failed case search, and by many other lines of argument. 6. Evidence for lineage A in the market is based on a low quality sample according to Liu et. al. (2023). I really think lab leakers need to decide whether they think China is a sinister actor trying to cover up the truth, or whether they should trust every offhand comment by Chinese government officials as gospel. Dr. Liu doesn’t explain in what sense he thinks the Lineage A sample is “low-quality”, and the Western scientists who I asked about this said they didn’t understand this complaint and that the sample was fine. A Western team re-analyzing the same sample describes it as “conclusively contain[ing] Lineage A.” I think most lab leakers have switched from trying to deny the genetics to claiming that this was “contamination”, which also doesn’t make sense (the sample is genetically very early). Note that aside from this sample, the first two Lineage A cases discovered were both very close to the wet market. 7. Bloom (2023) shows market samples do not support market origin. There is also no evidence of transmission in the claimed susceptible animals elsewhere. https://academic.oup.com/ve/advance-article/doi/10.1093/ve/vead089/7504441 Discussed extensively in my article as well as the first section of the debate. 8. Lineage A and B only two mutations apart. François Ballox, Bloom and Virginie Courtier-Orgogozo note this is unlikely to reflect two separate animal spillovers as opposed to incomplete case ascertainment of human to human transmission (Bloom 2021). Discussed extensively in my article as well as the first section of the debate. 9. Sampling bias. George Gao, Chinese CDC head at the time, acknowledged to the BBC stating they may have focused too much on and around the market and missed cases on the other side of the city. David Bahry outlines the documented bias. Michael Weissman has shown this mathematically. https://journals.asm.org/doi/10.1128/mbio.00313-23 https://academic.oup.com/jrsssa/advance-article-abstract/doi/10.1093/jrsssa/qnae021/7632556 Re: Dr. Gao, see above comment about Chinese officials. See the section Ascertainment Bias below for why I disagree with this specific claim, which also addresses the Michael Weissman argument. 10. Spatial statistics experts show the Worobey claim the market was the early epicentre was flawed. https://academic.oup.com/jrsssa/advance-article-abstract/doi/10.1093/jrsssa/qnad139/7557954 Re: 10 - See Confirmation Of The Centrality Of The Huanan Market Among Early COVID-19 Cases, a response to the paper you cite: The centrality of Wuhan's Huanan market in maps of December 2019 COVID-19 case residential locations, established by Worobey et al. (2022a), has recently been challenged by Stoyan and Chiu (2024, SC2024). SC2024 proposed a statistical test based on the premise that the measure of central tendency (hereafter, "centre") of a sample of case locations must coincide with the exact point from which local transmission began. Here we show that this premise is erroneous. SC2024 put forward two alternative centres (centroid and mode) to the centre-point which was used by Worobey et al. for some analyses, and proposed a bootstrapping method, based on their premise, to test whether a particular location is consistent with it being the point source of transmission. We show that SC2024's concerns about the use of centre-points are inconsequential, and that use of centroids for these data is inadvisable. The mode is an appropriate, even optimal, choice as centre; however, contrary to SC2024's results, we demonstrate that with proper implementation of their methods, the mode falls at the entrance of a parking lot at the market itself, and the 95% confidence region around the mode includes the market. Thus, the market cannot be rejected as central even by SC2024's overly stringent statistical test. I think this response is pretty strong. In one analysis, they show that even though the other paper’s methodology is worse than theirs, if you apply it correctly (instead of inappropriately excluding various cases like the paper’s authors did), the center of all early cases in Hubei province lands on the wet market parking lot. In another analysis, they show that the other paper’s recommended tests wouldn’t have correctly pointed to the offending water pump in the famous John Snow cholera outbreak, but theirs would have. Still, I think it’s useful to supplement fancy statistics with normal common sense, so I recommend just looking at the map of early cases: …and deciding whether you think the assumptions behind a specific statistical test are likely to debunk the idea that cases are centered around the wet market. 11. Wuhan used as a control for a 2015 serological study on SARS-related bat coronaviruses due to its urban location. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178078/ I don’t know why this point is supposed to matter. If you mean that Wuhan isn’t directly exposed to bats, nobody ever said it was. The zoonotic theory is that wildlife carted in from other areas of China started the pandemic in the wet market. 12. Superspreader events also seen at wet markets in Beijing and Singapore (Xinfadi and Jurong). This was discussed very extensively in the debates, both in section 1 and section 3. Wet markets weren’t “superspreader locations” - in fact, the disease spread no more quickly there than anywhere else. They were the first place in those cities that the pandemic started, due to contaminated animal products. If anything, this supports zoonosis. See also my discussion with Saar on this point below. 13. WIV refuse to share their records with NIH who terminated subaward in 2022. Wider suspension over biosafety concerns. https://www.bloomberg.com/news/articles/2023-07-18/us-suspends-wuhan-institute-funds-over-covid-stonewalling Although WIV has not been especially forthcoming, some of their databases were leaked in various ways and showed that they did not have any viruses capable of transforming into COVID. 14. PLA involvement at WIV and MERS research prior to SARS-COV-2. MERS features several similarities with SARS-CoV-2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7022351/ I can’t even tell what conspiracy theory you’re trying to propose with this one; if you spell it out I can try to explain why it might be false. 15. SARS1 leaked several times and SARS-COV-2 has leaked from a BSL-3 lab in Taiwan. Agreed that SARS leaked several times. It also spilled over from animals several times. During the debate, a lab leak rate of once per lab per 500 years was proposed (everyone agreed to steelman this by 10x for WIV numbers); I would be interested to know whether anything about the study of SARS challenges that number. 16. Unpublished infectious clone identified from Wuhan contradicting arguments such reverse genetics systems would be published. https://www.biorxiv.org/content/10.1101/2023.02.12.528210v1.full I asked some scientists about this paper and here’s what they told me. Wuhan University sequenced some rice. In the middle of the sequence, there’s an unexpected sequence from a common coronavirus, HKU4. The most likely explanation is that someone else in Wuhan was working on the coronavirus and there was cross-contamination. Plausibly this is Wuhan Institute of Virology, who is known to work with coronaviruses. This is cool detective work, but it’s not clear what it’s supposed to prove. I think some lab leakers are using it to prove that WIV can do reverse genetics, but they admitted this already in a published paper so that’s not too helpful. I think others are using it to prove WIV had “secret viruses” in their catalogue, but the rice virus wasn’t secret, it was HKU4, which is common and which WIV has already published papers about. 1.6: DrJayChou’s 7 Arguments Once again, I cannot stress enough how much better a take you might have on this debate if you watch it. “The first known case predates the market outbreak by a month” - this is not the consensus position. I cannot say for sure what Dr. Chou means by this, but I suspect he’s referring to one of the many claims to this effect that Peter effectively debunked during the debate (Connor Reed, Mr. Chen, the 92 cases, Brazil, etc).
human agency

human agency is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 26, 2025 and August 26, 2025. The archive places it in contexts such as "they understand human agency / scientific materialism / psychedelia". It most often appears alongside 4chan, ACX Grants, AI.

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human agency
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August 26, 2025
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August 26, 2025 · Original source
First, much like LLMs, lots of people don’t really have world models. They believe what their friends believe, or what has good epistemic vibes. If they don’t currently think that Lenin was a mushroom, it’s not because they understand human agency / scientific materialism / psychedelia and have a well-worked out theory of why fungi can’t contain sentient mushroom spirits that possess leading communist politicians. They don’t believe it because it feels absurd. They predict that other people would laugh at them if they said it. If they get told that it it’s not absurd, or that maybe people would laugh at them if they didn’t say it, then their opinion will at least teeter precariously.
human Alzheimer’s

human Alzheimer’s is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 11, 2025 and July 11, 2025. The archive places it in contexts such as "compare plaque pathology in PDAPP mice to human Alzheimer’s brains". It most often appears alongside aducanumab, Alzheimer’s, Alzheimer’s Disease.

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human Alzheimer’s
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July 11, 2025
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July 11, 2025
July 11, 2025 · Original source
What the Heck is Going on in Panel d? Panel d is an immunoblot (Western blot), a technique that tells us whether a specific protein is being produced in a sample. The figure compares human amyloid precursor protein expression in samples from three brains, corresponding to the three “lanes” shown along the top: a normal mouse (Lane 1), a mouse with the human APP transgene (Lane 2), and a human who had Alzheimer’s disease (Lane 3). The blots (the bands and blobs) are the data. For purposes of this figure, proteins can differ in two important ways: They can differ in molecular weight (size), scored on the scale along the vertical axis on the left.
They can be expressed to a greater or lesser degree, reflected in the intensity (darkness and spread) of the bands. Lighter means less protein expression, darker more. (Note: It’s fine that there are two bands in lane 3). Let’s pause to consider what we should expect to see in this blot if the PDAPP mouse is to be considered a reasonable model of human Alzheimer’s disease. Two things! Ideally, lane 1 (normal mouse) will be empty; and
The PDAPP mouse sample in lane 2 will have the same molecular weight (height on vertical axis) and expression level (intensity and spread) as the human sample in lane 3. Why do we want to see these results? It matters because our ultimate goal is to develop treatments that work in people, not just in mice. To make that leap from a mouse model, the PDAPP mouse needs to replicate the key features of Alzheimer’s disease in humans—not just produce APP but drive similar amyloid-induced disease processes in the brain. Ok, so on point one, ✔ — nothing in lane 1. Point two? ❌ While the human sample has distinct bands in lane 3, the PDAPP mouse in lane 2 appears as a giant, smeared blob. Are these the same protein size? Impossible to tell! This happens because, relative to the human sample, the PDAPP mouse is drowning in APP—at least 10 times more, according to the paper’s text, and possibly much more by eye. When you do a Western blot, you set an exposure time for your image, just like with a manual camera: too short an exposure, and faint bands won’t appear; too long, and strong signals become an oversaturated mess. Here, no single exposure could produce similar-looking PDAPP and human samples. It’s like trying to take a photo of a candle next to the sun—you can’t adjust for both at once. A proper Western blot should show clean bands to confirm protein size and check for unexpected degradation products, but this overloaded mess makes it impossible to tell whether APP is being processed normally. A Western blot like the one shown in Panel d usually indicates either sloppy technique (overloading the gel, overexposing) or a fundamental issue with the model itself (massive expression differences between samples). The fine print explains why: the PDAPP mouse carries 40 copies of the APP transgene, all inserted at a single site in the genome. For context: ✔ At most, humans have 2 copies of APP (one from each parent). ✔ PDAPP mice have 40 human copies—plus their 2 normal mouse copies. I’m sure this blot led to high-fives in the lab—earlier models struggled to express APP at all, so getting massive overexpression must have felt like a breakthrough. But now I’m worried. If we’re trying to create a human-comparable Alzheimer’s model, this much APP might be way too much. Why might this be a problem? APP expression at this level doesn’t mirror expression levels in human Alzheimer’s. Alzheimer’s patients don’t have 40 copies of APP. If it takes this much overexpression (and a mutant form at that!) to drive pathology in mice, are these mice even an appropriate animal model for Alzheimer’s?
human APP transgene

human APP transgene is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 11, 2025 and July 11, 2025. The archive places it in contexts such as ""a mouse with the human APP transgene (Lane 2)"". It most often appears alongside aducanumab, Alzheimer’s, Alzheimer’s Disease.

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human APP transgene
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July 11, 2025
July 11, 2025 · Original source
Evidence that APP overexpression isn't driving toxicity, which can cause similar damage to the brain. This is very hard to control for, so the best course of action is to try to match human APP expression levels in your mouse model. Controls are an indispensable reality check for strong inference—the practice of designing experiments that not only test a hypothesis but aim to disprove it or eliminate alternatives. The concept was introduced in 1964 by the biophysicist John Platt, who observed that some scientific fields advance rapidly while others stagnate. The difference, he argued, wasn’t in the complexity of the problems or the brilliance of the researchers, but in the systematic use of what he called strong inference. Unlike the traditional scientific method, which often tests a single hypothesis against a null, strong inference begins with multiple competing explanations. It then designs experiments specifically intended to rule them out. Over time, this produces a branching tree of narrowing possibilities, steadily eliminating what doesn’t hold up. This approach also guides how we read. Asking what control would disprove the claim—or what alternative wasn’t tested—is the core of strong inference. Detective Work—Decoding the Paper With our backstory in hand and analytical toolkit in mind, let’s see if the PDAPP mouse delivers on the amyloid cascade hypothesis. It’s time to interrogate the key figures. In a paper like this, the figures are the empirical backbone of the argument. Of course, the authors have carefully chosen what to show and how to frame it. Our job is to assess whether the evidence supports their claims. Figure 1: Confirming the PDAPP Mouse Expresses Human APP Big picture message: The authors successfully engineered a mouse with a functioning human APP transgene. While Figure 1 has 5 parts, Panel d (below) is where we get the clearest confirmation that the human mutant APP transgene integrated itself into the mouse genome and produced Aβ in the expected location in the mouse brain. Stare at Panel d for a few seconds and then we’ll talk about it. What the Heck is Going on in Panel d? Panel d is an immunoblot (Western blot), a technique that tells us whether a specific protein is being produced in a sample. The figure compares human amyloid precursor protein expression in samples from three brains, corresponding to the three “lanes” shown along the top: a normal mouse (Lane 1), a mouse with the human APP transgene (Lane 2), and a human who had Alzheimer’s disease (Lane 3). The blots (the bands and blobs) are the data. For purposes of this figure, proteins can differ in two important ways: They can differ in molecular weight (size), scored on the scale along the vertical axis on the left.
What the Heck is Going on in Panel d? Panel d is an immunoblot (Western blot), a technique that tells us whether a specific protein is being produced in a sample. The figure compares human amyloid precursor protein expression in samples from three brains, corresponding to the three “lanes” shown along the top: a normal mouse (Lane 1), a mouse with the human APP transgene (Lane 2), and a human who had Alzheimer’s disease (Lane 3). The blots (the bands and blobs) are the data. For purposes of this figure, proteins can differ in two important ways: They can differ in molecular weight (size), scored on the scale along the vertical axis on the left.
human brain

human brain is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 12, 2026 and February 12, 2026. The archive places it in contexts such as "estimate the compute involved in the human brain". It most often appears alongside 2010 kink, 2024 kink, AGI.

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human brain
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February 12, 2026
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February 12, 2026
February 12, 2026 · Original source
There was no obvious way to know how many FLOPs AGI would take, but there were some intuitively compelling guesses - for example, an AGI that was as smart as humans might need a similar level of computing capacity as the human brain. Cotra picked five intuitively compelling guesses (the namesake Bio Anchors) and turned them into a weighted average.
Epoch/Croxton are current best estimates, and can probably fairly be read as the “real” answer against which Cotra and Davidson’s earlier guesses should be judged. All numbers are yearly multiples, so 1.4 means that willingness to spend grows 1.4x per year, ie 40%. Willingness To Spend: How much money are companies willing to spend on AI, in the form of chips and data centers? $/FLOP: How quickly do Moore’s Law, economies of scale, and other factors bring down the price of AI compute? Training Run Length: How long are companies spending on AI training runs for frontier models (instead of using those chips for smaller models, experiments, or consumer services)? Real Compute: The product of the three parameters above. Algorithmic Progress: How effectively do researchers discover new algorithms that makes training AIs cheaper and more efficient? Total Effective Compute: The product of real compute and algorithmic progress. So for example, the Epoch column’s 10.7x means that in any given year, you can train an AI 10.7x better than the last year, because you have 3.6x more compute available, and that compute is 3.0x more efficient. Cotra and Davidson were pretty close on willingness to spend and on FLOPs/$. This is an impressive achievement; they more or less predicted the giant data center buildout of the past few years. They ignored training run length, which probably seemed like a reasonable simplification at the time. But they got killed on algorithmic progress, which was 200% per year instead of 30%. How did they get this one so wrong? Here’s Cotra’s section on algorithmic progress: Algorithmic progress forecasts Note: I have done very little research into algorithmic progress trends. Of the four main components of my model (2020 compute requirements, algorithmic progress, compute price trends, and spending on computation) I have spent the least time thinking about algorithmic progress. I consider two types of algorithmic progress: relatively incremental and steady progress from iteratively improving architectures and learning algorithms, and the chance of “breakthrough” progress which brings the technical difficulty of training a transformative model down from “astronomically large” / “impossible” to “broadly feasible.” For incremental progress, the main source I used was Hernandez and Brown 2020, ”Measuring the Algorithmic Efficiency of Neural Networks”. The authors reimplemented open source state-of-the-art (SOTA) ImageNet models between 2012 and 2019 (six models in total). They trained each model up to the point that it achieved the same performance as AlexNet achieved in 2012, and recorded the total FLOP that required. They found that the SOTA model in 2019, EfficientNet B0, required ~44 times fewer training FLOP to achieve AlexNet performance than AlexNet did; the six data points fit a power law curve with the amount of computation required to match AlexNet halving every ~16 months over the seven years in the dataset.² They also show that linear programming displayed a similar trend over a longer period of time: when hardware is held fixed, the time in seconds taken to solve a standard basket of mixed integer programs by SOTA commercial software packages halved every ~13 months over the 21 years from 1996 to 2017.³ Grace 2013 (”Algorithmic Progress in Six Domains”) is the only other paper attempting to systematically quantify algorithmic progress that I am currently aware of, although I have not done a systematic literature review and may be missing others. I have chosen not to examine it in detail because a) it was written largely before the deep learning boom and mostly does not focus on ML tasks, and b) it is less straightforward to translate Grace’s results into the format that I am most interested in (”How has the amount of computation required to solve a fixed task decreased over time?”). Paul is familiar with the results, and he believes that algorithmic progress across the six domains studied in Grace 2013⁴ is consistent with a similar but slightly slower rate of progress, ranging from 13 to 36 months to halve the computation required to reach a fixed level of performance. Additionally, it seems plausible to me that both sets of results would overestimate the pace of algorithmic progress on a transformative task, because they are both focusing on relatively narrow problems with simple, well-defined benchmarks that large groups of researchers could directly optimize.⁵ Because no one has trained a transformative model yet, to the extent that the computation required to train one is falling over time, it would have to happen via proxies rather than researchers directly optimizing that metric (e.g. perhaps architectural innovations that improve training efficiency for image classifiers or language models would translate to a transformative model). Additionally, it may be that halving the amount of computation required to train a transformative model would require making progress on multiple partially-independent sub-problems (e.g. vision and language and motor control). I have attempted to take the Hernandez and Brown 2020 halving times (and Paul’s summary of the Grace 2013 halving times) as anchoring points and shade them upward to account for the considerations raised above. There is massive room for judgment in whether and how much to shade upward; I expect many readers will want to change my assumptions here, and some will believe it is more reasonable to shade downward. Cotra’s estimate comes primarily from one paper, Hernandez & Brown, which looks at algorithmic progress on a task called AlexNet. But later research demonstrated that the apparent speed of algorithmic progress varies by an order of magnitude based on whether you’re looking at an easy task (low-hanging fruit already picked) or a hard task (still lots of room to improve). AlexNet was an easy task, but pushing the frontier of AI is a hard task, so algorithmic progress in frontier AI has been faster than the AlexNet paper estimated. In Cotra’s defense, she admitted that this was the area where she was least certain, and that she had rounded the progress rate down based on various considerations when other people might round it up based on various other considerations. But the sheer extent of the error here, compounded with a few smaller errors that unfortunately all shared the same direction, was enough to throw off the estimate entirely. Since Cotra and Davidson were expecting AI to get 3.6x more effective compute each year, but it actually got 10.7x more, it’s no mystery why their timelines were off. When John recalculates Davidson’s model with Epoch’s numbers, he finds that it estimates AGI in 2030, which matches the current vibes. IV. With this information in place, it’s worth looking at some prominent contemporaneous critiques of Bio Anchors. Various people criticized Bio Anchors’ many strange anchors for how much compute it would take to produce AGI. For example, one anchor estimated that it would take 10^45 FLOPs, because that was how many calculations happened in all the brains of all animals throughout the evolutionary history (which eventually produced the human brain that AIs are trying to imitate). To make things even weirder, this anchor assumed away all animals other than nematodes as a rounding error (fact check: true!) All of these seemed to detract from the main show, an attempt to estimate the compute involved in the human brain. But even this more sober anchor was complicated by time horizons - it’s not enough to imitate the human brain for one second; AIs need to be able to imitate the human brain’s capacity for long-term planning. Cotra calculated how much compute AGI would require if it needed a planning horizon of seconds, weeks, or years. Thanks to METR, we now know that existing AIs have already passed a point where they can do most tasks that take humans seconds, are moving through the hour range, and are just about to touch one day. So the “seconds” anchor is ruled out. But it also seems unlikely that AGI will require years, because most human projects don’t take years, or at least can be split into tasks that take less than one year each (intuition pump: are we sure the average employee stays at an AI lab for more than a year? If not, that proves that a chain of people with sub-one-year time horizons can do valuable work). The AI Futures team guessed that the time horizon necessary for AIs to really start serious recursive self-improvement was between a few weeks and a few months (though this might look like a totally different number on the METR graph, which doesn’t translate perfectly into real life). If this is true, then all three anchors (seconds, hours, years) were off by at least an order of magnitude. But it turns out that none of this matters very much. The highest and lowest anchors cancel out, so that the most plausible anchor - human brain with time horizon of hours to days - is around the average. If you remove all the other anchors and just keep that one, the model’s estimates barely change. But also, we’re talking about crossing twelve orders of magnitude here. The difference between the different time horizon anchors doesn’t register much on that level, compared to things like algorithmic progress which have exponential effects. Maybe this is the model basically working as intended. You try lots of different anchors, put more weight on the more plausible ones, take a weighted average of each of them, and hopefully get something close to the real value. Bio Anchors did. Or maybe it was just good luck. Still hard to tell. Eliezer Yudkowsky argued that the whole methodology was fundamentally flawed. Partly because of the argument above - he didn’t trust the anchors - but also partly because he expected the calculations to be obviated by some sort of paradigm shift that couldn’t be shoehorned into “algorithmic progress” (like how you couldn’t build an airplane in 1900 but you could in 1920). As of 2026 - still before AGI has been invented and we get a good historical perspective - no such shift has occurred. The scaling laws have mostly held; whatever artificial space you try to measure models in, the measurement has mostly worked in a predictable way. There have really only been two kinks in the history of AI so far. First, a kink in training run size around 2010: Second, a kink in time horizons around 2024 and the invention of test-time compute: The 2010 kink was before Cotra’s forecast and priced in. The 2024 kink is interesting and relevant - but since it was on a parameter Cotra wasn’t measuring, and probably too small to show up on the orders-of-magnitude scale we’re talking about, it’s probably not a major cause of the model’s inaccuracy. Other things have been even more predictable: So Cotra’s bet on progress being smooth and measurable has mostly paid off so far. But Yudkowsky further explained that his timelines were shorter than Bio Anchors because people would be working hard to discover new paradigms, and if the current paradigm would only pay off in the 2050s, then probably they would discover one before then. You could think of this as a disjunction: timelines will be shorter than Cotra thinks, either because deep learning pays off quickly, or because a new paradigm gets invented in the interim. It turned out to be the first one. So although Yudkowsky’s new paradigm has yet to materialize, his disjunctive reasoning in favor of shorter-than-2050 timelines was basically on the mark. Nostalgebraist argued that Cotra’s whole model was a wrapper for an assumption that Moore’s Law will continue indefinitely. If it does, obviously you get enough compute for AI at some point, even if it requires some absurd process like simulating all 500 million years of multicellular evolution. I never entirely understood this objection, because - although Bio Anchors does depend on a story where Moore’s Law doesn’t break before we get the relevant amount of compute - this is only one of many background assumptions (like that a meteor doesn’t hit Earth before we get the relevant amount of compute). Given those assumptions, it does a useful not-just-assumption-repeating job of calculating when transformative AI will happen. As Cotra implicitly predicted, we seem on track to get AGI before Moore’s Law breaks down, and so Moore’s Law didn’t end up mattering very much. And if all of Cotra’s non-Moore’s-Law parameter estimates had been correct, her model would have given about the same timelines we have now, and surprised everyone with a revolutionary claim about the AI future. But Nostalgebraist added, almost as an aside: Cotra has a whole other forecast I didn’t mention for “algorithmic progress,” and the last number is what you get from just algorithmic progress and no Moore’s Law. So depending on how much you trust that forecast, you might want to take all these numbers with an even bigger grain of salt than you’d expected from everything else we’ve seen. How much should you trust Cotra’s algorithmic progress forecast? She writes: “I have done very little research into algorithmic progress trends. Of the four main components of my model (2020 compute requirements, algorithmic progress, compute price trends, and spending on computation) I have spent the least time thinking about algorithmic progress.” ...and bases the forecast on one paper about ImageNet classifiers. I want to be clear that when I quote these parts about Cotra not spending much time on something, I’m not trying to make fun of her. It’s good to be transparent about this kind of thing! I wish more people would do that. My complaint is not that she tells us what she spent time on, it’s that she spent time on the wrong things. Like Cotra herself, I think Nostalgebraist was spiritually correct even if his bottom line (about Moore’s Law) was wrong. His meta-level point was that a seemingly complicated model could actually hinge on one or two parameters, and that many of Cotra’s parameter values were vague hand-wavey best guess estimates. He gave algorithmic progress as a secondary example of this to shore up his Moore’s Law case, but in fact it turned out to be where all the action was. V. Those were the rare good critiques. The bad critiques were the same ones everyone in this space gets: You’re just trying to build hype.
Human Challenge Trials

Human Challenge Trials is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 18, 2025 and June 18, 2025. The archive places it in contexts such as "support or opposition to HCTs, ... their ethical acceptability". It most often appears alongside 1DaySooner, Aatu Koskensilta, acanthamoeba keratitis.

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Human Challenge Trials
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June 18, 2025 · Original source
14: Survey To Understand Public Attitudes Around Human Challenge Trials
This project has now concluded with the publication of a paper in PLOS ONE titled “Ethical Acceptability of Human Challenge Trials: Consultation with the US Public and with Research Personnel.” The authors conducted an online survey to assess overall support or opposition to HCTs, as well as the key factors influencing perceptions of their ethical acceptability. The findings suggest broad support among both the US public and research personnel for the use of HCTs in developing vaccines, treatments, and advancing scientific knowledge. The two most influential factors in determining ethical acceptability were the level of risk to participants and their understanding of that risk.
This is great and the paper is great, but is also a microcosm of what I find frustrating about grantmaking. Will this paper change anyone’s mind? Will it lead to human challenge trials being more likely to happen? I assume yes, because 1DaySooner have proven to be generally smart people who know what they’re doing, but it’s hard to measure effects even now when we know exactly what the end product was.
Human Development Index

Human Development Index is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 07, 2021 and July 07, 2021. The archive places it in contexts such as "I also checked if Human Development Index explained anything". It most often appears alongside ABBA, Arkansas, Australia.

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July 07, 2021
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July 07, 2021
July 07, 2021 · Original source
I also checked if Human Development Index explained anything; it didn’t. A more plausible explanation is household size - Scandinavia is remarkable for having more one-person and single-family households, and fewer multi-generational clans living together.
Human Genome Project

Human Genome Project is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 15, 2024 and May 15, 2024. The archive places it in contexts such as "New technologies like the personal computer, the Internet, and the Human Genome Project were inspiring"; "New technologies like ... the Human Genome Project". It most often appears alongside @the_megabase, A Pan-Species Welfare State, ACX Grantees.

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Human Genome Project
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May 15, 2024 · Original source
Turn-of-the-21st-century Oxford was an exciting place. Derek Parfit was leading a renaissance in utilitarian thought. New technologies like the personal computer, the Internet, and the Human Genome Project were inspiring a new generation of transhumanists. Out of this milieu, philosophers like Nick Bostrom, Will MacAskill, and Toby Ord were laying the groundwork for what would become the rationalist and effective altruist movements. Utilitarians, they argued, were charged with relieving the suffering of the world as quickly and effectively as possible. Technology offered new opportunities to do this at scale. This could be ending poverty and curing diseases (if you were well-grounded in the present moment) or creating a superintelligence to lead us to a post-scarcity future (if you were feeling more ambitious).
human rights

human rights is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 17, 2021 and June 17, 2021. The archive places it in contexts such as "concepts of democracy and human rights evolved". It most often appears alongside Africa, antelope, August Hirsch.

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human rights
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June 17, 2021
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June 17, 2021
June 17, 2021 · Original source
The most interesting part of this model is how a human, or humans, adapt to these forces. Collaboration and innovation propelled us out of the biological ecosystem dynamic. Once societies reached a density threshold to harbor viruses, customs and religions practices evolved to help control the spread. Once technology created a macroparasitic positive feedback loop by creating forms of control and violence oppression, eventually concepts of democracy and human rights evolved. Eventually collaboration- collective acceptance of human rights or wearing masks- is more important than the newest technology. A collective narrative- a convincing model- is what seems to elevate humanity into a more ‘mutually tolerable’ situation.
Human Torch

Human Torch is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 16, 2024 and August 16, 2024. The archive places it in contexts such as "Johnny, the Human Torch is the daredevil". It most often appears alongside 20th Century Fox, Abomination, Abomination.

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Human Torch
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August 16, 2024
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August 16, 2024
August 16, 2024 · Original source
Given Marvel Comics, why Silver Age (1961-1965)? I.a. Why Superhero Comic Books? The winner of last year’s Astral Codex Ten book review contest was Brandon Hendrickson. Brandon wrote about Kieran Egan’s The Educated Mind. One of the foundations of Egan’s educational philosophy is that people learn through stories. He believes early education should focus on teaching lessons through myths and legends. This matches my experience. My kids’ favorite podcast is Greeking Out – a very well produced, very entertaining, National Geographic podcast about Greek Legends. Aside #1: When my oldest daughter was three years old she would ask everyone she met “Do you know any myths? Can you tell me a myth?” She especially liked asking people from different places to get myths from their local cultures. Once, she asked the question to a friend of mine who grew up in South Africa, “Can you tell me any South African myths?” He struggled for a minute and then said, “Okay! I have one! Bread never falls butter side down!”. That was not the type of myth she was looking for; nor the type of myth we will be discussing in this review. Every culture has foundational myths. These stories are entertaining and engaging, but they also teach valuable lessons about both what is important in that culture, and how people in that culture are expected to behave (or at least the Platonic Ideal of how they should behave). In the modern, Western world, we have assimilated many of these foundational stories, particularly the Greek myths. My kids definitely know the Greek myths, but they also know elements of Norse mythology, Egyptian myths, stories about Anasi from West Africa and more. More fundamentally my wife and I, while not religious ourselves, have made a point of exposing the kids to the stories from the Bible. It is not politically correct to call Biblical stories “myths”, but they serve the same purpose – shared cultural understanding of the way the world works. My wife grew up without any religion, and when she was in high school, she struggled with the metaphors and religious allegories that were omnipresent in most of the Western canon. In our culture, familiarity with the Bible is important for an educated person – whether they are religious or not – because it is the foundation of so much of the rest of our culture. I believe the other set of mythological stories that are foundational to our culture are – and by this point I am sure you see where I am going here – comic book superheroes. If true, then having more than a surface-level understanding of the most important superhero stories is important in a similar way to that knowing the Bible stories is important. “Do unto others as you would have them do unto you” is an important idea to understand. So is, “With great power comes great responsibility”. I.b. Why Marvel? While there are many independent superheroes that are not owned by major conglomerates, the superheroes who have built our modern foundational myths are currently owned by two corporations. Warner Bros. Discover owns the DC library of superheroes including Superman, Batman and Wonder Woman. In 2009 Disney purchased Marvel Comics and took ownership of their characters, including Spiderman, X-men and the Avengers. Aside #2: Marvel has sold temporary film rights to many of their characters over the years. The most relevant sales started in 1994 when Marvel sold the film rights of X-men and mutants to 20th century Fox, then in 1996, when Marvel went bankrupt, Fox picked up the rights to the Fantastic Four (and New Line picked up Blade). In 1999 Marvel sold the film rights (and live action TV, and animated TV longer than 44 minutes) of Spider-man and related characters to Columbia Pictures (part of Sony) for $7MM. Marvel actually attempted to sell ALL of their remaining Marvel IP film rights to Sony for $25MM, but the top management at Sony was not interested. Sony’s management allegedly told their chief negotiator “Nobody gives a shi*t about any of the other Marvel characters. Go back and do a deal for only Spider-Man). Disney acquired Marvel in 2009, and then Fox in 2019, bringing the two separated packages of characters all back together under one roof (Blade reverted back to Marvel in 2012). Sony still owns the rights to Spider-man but has made a deal with Disney to include some of his films within the Marvel-Disney universe. Marvel sold the film rights of The Hulk to Universal in 1990 and the current status of that agreement is complicated (the consensus is that Marvel now controls the film rights to the character, but Universal owns distribution rights to any stand-alone Hulk film, which could be why Disney let's Hulk co-star in Thor movies, but not vice versa). In the early aughts Marvel wanted to build their own film franchise, but were limited to only using their remaining “B-list” characters – Spider-man, X-men, and the Fantastic Four were all off limits. Fortunately, Kevin Feige, president of production for Marvel at the time, saw a way forward. He convinced Ike Perlmutter, Marvel CEO, to allow for the production of a series of films with the remaining characters begining with Iron Man (2008). Jon Favreau directed and cast Robert Downey Jr as Tony Stark. The film blew away expectations. Kevin’s plan of a series of movies where the characters would interconnect was suddenly feasible. Iron Man was followed by The Incredible Hulk, Thor, and Captain America: The First Avenger. None managed the box office magic of Iron Man, but all were successful enough that the plan stayed on track. In 2012 the characters were all brought together in the first Avengers film, which opened to over $200MM domestically and went on to gross more than $1.5B (which made it the 3rd highest grossing film of all time). Marvel became the first studio to take the interconnected world of their comic books and make the model work on the big screen (for a much larger audience). Once the model was proven to work, other studios tried to duplicate it. Aside #3: Warner Bros’ stumbles with the DC shared universe of Batman, Superman and the Justice League are well known, but that was actually their SECOND attempt at a shared universe. Their first attempt tried to copy the Marvel method more closely. They chose their own B-list hero and set up his first film to allow for a wider mythology. Alas Green Lantern (2011) failed at the box office and we never got stand-alone films about Sinestro (Yellow Lantern), Carol Ferris (Star Sapphire, the Violet Lantern), John Stewart (African American Green Lantern), Kyle Rayner (1990s Green Lantern), Alan Scott (original Green Lantern), or the Blue, Red, and Orange Lantern Corps. At least so far, no studio has successfully created anything with close to the traction obtained by the Marvel Cinematic Universe (MCU). Warner’s DC Extended universe (DCEU) had trifling success, but is being shelved and rebooted for a fresh attempt next year. Universal’s attempt at a “Dark Universe” kicked off with Tom Cruise in The Mummy (2017), but was dead on arrival. Paramount’s attempt to link the Transformers Universe to GI Joe at the end of Transformers: Rise of the Beasts has been appropriately mocked. Sony’s Spider-man films linked to the MCU have been very successful, but their attempt at a stand-alone non-MCU Spider-man universe using Spider-man’s villains as anti-heroes has floundered (mostly succeeding only as a source of memes). Next Mattel will be attempting to build a universe off the success of last year’s Barbie and may include Polly Pocket, American Girl, Hot Wheels, and He-Man and the Masters of the Universe (no word yet on Thomas the Tank Engine, View Master and the Magic-8 Ball, but all are apparently in development). To date, only Marvel has successfully built a “Cinematic Universe”. One potential reason for the MCU’s success is that Kevin Feige built his cinematic universe on the back of the existing interconnected universe of the comics. But those comics were not the first interconnected universe of stories. For that we would need to go back to our foundational myths. The Bible stories mostly interconnect. Adam and Eve flows into Cain and Abel. David and Goliath leads to the Wisdom of Solomon. Greek Myths DEFINITELY interconnect. Supporting characters in one Greek myth have starring roles in their own stories. The Greek pantheon of tales even have their own version of the Avengers. In the Quest for the Golden Fleece, Jason brings together the Argonauts, who included in their number Theseus (who defeated the Minotaur), Orpheus (who braved the underworld) and Hercules himself – all A-list stars in their own “franchises”. Stand alone stories that exist within an interconnected universe are rare in modern media but were common in the ancient myths that have stood the test of time. Only Marvel has successfully created a shared universe that follows the pattern of ancient myths. Only Marvel films have stand-alone stories and protagonists who exist together in an interconnected world. Something about that method of storytelling is deeply pleasing for humans across many cultures. Marvel films are the first and most successful modern version of the mythological universe, and that it is worth spending more time exploring Marvel’s underlying mythology and where it came from. I.c. Why 1961? The origins of Christianity and Judaism (and Buddhism and Hinduism) are very murky. Even Islam is far enough in the past that we only have a very rough understanding of how it came to exist. When scholars want to understand in detail how a new religion is born they are far better to look at Mormonism or, if you accept it as a religion, Dianetics. Similarly, we have versions of Greek myths that have been passed down to us, but we can never know how those myths changed from their first telling to their “final” versions. Were the stories once unrelated, and only later became crafted into a single “universe”? Or were the stories built off each other one by one (“Dad that Golden Fleece story was amazing! Do you know any other stories about the Hercules guy?”)? Or was it something in between? Perhaps the stories all existed independently, but were later crafted together (“Remember that 12-labors story I told you? Actually that was the same guy who was on the Argo!”) Unlike Greek legends, we can know the origin of the Marvel Universe. We can see how it was constructed step-by-step. The people who did it (most importantly Stan Lee, Jack Kirby, and Steve Ditko) are dead now, but they have not been dead for long. We can read the original work, see how it changed over the last 60 years, and we can ask the creators “what were you thinking at the time” (or at least read their answers from old interviews). We can’t always trust what Stan Lee says, but at least we can hear his point of view. No one has a transcript of an interview with Homer, or knows exactly what he was thinking when he called it the “wine-dark sea”. Tl;dr: Why read about Marvel Comic superheroes 1961-1965? Because interconnected mythological stories are very important to cultures, Marvel is the leading contender of the most recent modern mythology, and it originated in the first half-decade of the 1960s. II. How did Marvel Superhero Comics happen? Timely Comics published their first comic book in 1939 and called it “Marvel Comics”. Their most popular World War II comics included Captain America, the Human Torch (an android unrelated to the modern Human Torch except in powers, appearance and name), and Namor, the Submariner. In the early 1950s superheroes became less popular, so Timely changed its name to Atlas Comics and focused on humor, western, horror, war and science fiction stories. But in 1956 DC Comics began re-introducing their Golden Age superheroes and, in the second half of the 1950s, the genre took off again – particularly Superman, whose title, Action Comics, became the number one selling comic in America. Stan Lee, editor and chief at Atlas at the time, wanted to get in on the superhero action. Unfortunately in 1957 Atlas lost its distributor and the company had to rely on “Independent News” to get its comics on newsstands. The complication was that Independent News was owned by “National Periodical Publications”, who also owned DC-comics and did not want Atlas to introduce superheroes to compete with Superman, Green Lantern and the Flash. Independent News agreed to distribute Atlas comics but limited the publisher to eight titles per month, and only in non-super hero genres (like horror, romance and science fiction). Blocked from creating and launching new superhero titles, Stan Lee got creative, and in August 1961 Atlas Comics published Fantastic Four #1. Aside #4: Fantastic Four #1 was on newsstands in August 8th, 1961, but the date on the cover was November 1961. The convention at the time was that the cover date was not the “publication date” but rather the “pull date”. The pull date was the time when the retailer could send back unsold copies back to the publisher for a refund. In fact the retailer did not need to send the entire issue back, just the cover, as it was assumed that comic books could not be sold without the cover, and it saved on postage. This was only relevant because it was great for my dad who was a child at the time. My dad was friends with the kid whose father owed the local pharmacy which meant he had access to every comic book published in the late 1950s as long as he was willing to wait a few months and read it without a cover. Going forward in this essay I will always use the pull dates rather than the publication dates for individual comic book issues as they are far easier to source. If you want to convert pull dates back into publication dates you can subtract roughly two months, but it is inconsistent and sometimes longer, as was the case with Fantastic Four #1. Check out the cover of Fantastic Four #1: To the modern eye this certainly looks like a superhero comic. Four heroes with super powers fighting a giant monster. But in the eyes of publishers in 1961 this looked more like a science fiction adventure comic than something that would go head to head with Superman. Here are the covers of Action Comics (the best selling superhero comic at the time) from the three months leading up to Fantastic Four #1: Notice what they have in common? “Super Rivals”, “Super revenge”, “Super Substitutes”. And all include Superman in his blue and red tights. Fantastic Four’s cover featured super powers, but never used the word “super” and no one was wearing superhero costumes. Fantastic Four, as a superhero story, slipped under the radar because it wasn’t really a superhero story at all. It was a story about four close friends who attempted to fly into space, but then something goes wrong and they crash back to Earth. The experience changes them and they decide they now need to use their new abilities to help the rest of humanity – specifically against monsters who are invading from under the Earth. It is a fantastical science fiction story – not a superhero story. Later in his career Jack Kirby, the illustrator of the issue and co-creator of the Fantastic Four, was asked about his inspiration for the Fantastic Four heroes. He did NOT say Superman – or any superhero. He said Challengers of the Unknown. Challengers of the Unknown was an adventure story co-created by Kirby in Showcase #6 in February 1957. Here is how Wikipedia describes the Challengers origin: When acquaintances miraculously survive a plane crash unscathed, they conclude that since they are "living on borrowed time" they should band together for hazardous adventures. The four—pilot Kyle "Ace" Morgan, daredevil Matthew "Red" Ryan, strong and slow-witted Leslie "Rocky" Davis, and scientist Walter Mark "Prof" Haley—became the Challengers of the Unknown. Showcase #6, and the first appearance of the Challengers of the Unknown, by Jack Kirby Visually the Challengers and the Fantastic Four were similar. Both wore skin tight uniforms with belts and minimal decoration. The Fantastic Four’s relatively simple characterizations were practically pulled from Challengers. Reed takes on the traits of both Kyle, the leader, and Walter, the scientist. Johnny, the Human Torch is the daredevil. The Thing is “strong and slow-witted”. Sue, the only woman on the team, seems like a new addition, but is likely based on June Robbins who joined the Challengers team in Showcase #7, as an “honorary” or “girl-Challenger”. After surviving their respective “miraculous” crashes, both the Challengers and the Fantastic Four band together to help the world. They both travel through space and other dimensions, fighting mad scientists and monsters. The Fantastic Four’s early antagonists were not traditional super villains. In the first few issues they fight monsters from under the Earth (Issue #1), shape changing aliens (#2), and a charlatan who uses hypnotism to steal from his audience (#3). In issue #4 Kirby and Lee re-introduce Namor, the Submariner, one of Marvel’s top IP from the 1940s, and have him kidnap Sue. Only in Issue #5 and #6 (June and August 1962) and do we get a more standard-supervillain when Dr Doom attempts to steal the Fantastic Four headquarters and throw it into space. The next superhero Lee created was even less heroic than the Fantastic Four. In April 1962 (pull date), Marvel published The Incredible Hulk. If it was even a superhero story in disguise it was a very good disguise. The story was a scientific-filtered version of Dr Jekyl and Mr Hyde. It was a pure monster-story with nothing very super about it. Nothing on the cover suggests this has anything to do with superheroes: It is not clear if even Lee at the time thought the Hulk would be a superhero. In Fantastic Four #5 Johnny is reading a “great new comic mag” and mocks the Thing by comparing him to the Hulk. It seems pretty clear at this point that in the Fantastic Four’s world, the Hulk is just a fictional comic book, like in ours (more on that later): The other two superheroes the Marvel introduces in this period have even more subtle introductions. At the time Marvel had a number of generic-sounding titles and told science fiction and fantasy stand-alone stories: Tales to Astonish
Showcase #6, and the first appearance of the Challengers of the Unknown, by Jack Kirby Visually the Challengers and the Fantastic Four were similar. Both wore skin tight uniforms with belts and minimal decoration. The Fantastic Four’s relatively simple characterizations were practically pulled from Challengers. Reed takes on the traits of both Kyle, the leader, and Walter, the scientist. Johnny, the Human Torch is the daredevil. The Thing is “strong and slow-witted”. Sue, the only woman on the team, seems like a new addition, but is likely based on June Robbins who joined the Challengers team in Showcase #7, as an “honorary” or “girl-Challenger”. After surviving their respective “miraculous” crashes, both the Challengers and the Fantastic Four band together to help the world. They both travel through space and other dimensions, fighting mad scientists and monsters. The Fantastic Four’s early antagonists were not traditional super villains. In the first few issues they fight monsters from under the Earth (Issue #1), shape changing aliens (#2), and a charlatan who uses hypnotism to steal from his audience (#3). In issue #4 Kirby and Lee re-introduce Namor, the Submariner, one of Marvel’s top IP from the 1940s, and have him kidnap Sue. Only in Issue #5 and #6 (June and August 1962) and do we get a more standard-supervillain when Dr Doom attempts to steal the Fantastic Four headquarters and throw it into space. The next superhero Lee created was even less heroic than the Fantastic Four. In April 1962 (pull date), Marvel published The Incredible Hulk. If it was even a superhero story in disguise it was a very good disguise. The story was a scientific-filtered version of Dr Jekyl and Mr Hyde. It was a pure monster-story with nothing very super about it. Nothing on the cover suggests this has anything to do with superheroes: It is not clear if even Lee at the time thought the Hulk would be a superhero. In Fantastic Four #5 Johnny is reading a “great new comic mag” and mocks the Thing by comparing him to the Hulk. It seems pretty clear at this point that in the Fantastic Four’s world, the Hulk is just a fictional comic book, like in ours (more on that later): The other two superheroes the Marvel introduces in this period have even more subtle introductions. At the time Marvel had a number of generic-sounding titles and told science fiction and fantasy stand-alone stories: Tales to Astonish
The GOAT of Modern Mythology is Born The gamble worked. Independent News let Lee publish the story and it broke all of Atlas’s sales records. Spider-man was a smashing success. Unfortunately Amazing Fantasy was no more, so Peter Parker would have to wait until March 1963 for his own title and his second appearance. But the door had been opened for Atlas to get distribution for superhero stories – while still restricting the number of titles to eight per month. Lee looked at his other fantasy and science fiction anthologies and began converting them into superhero stories. In September 1962 Amazing Tales shifted from 100% Science Fiction to use half of each issue to tell spin-off tales of the Human Torch (the most popular of the Fantastic Four). In March 1963 Tales of Suspense abandoned its Twilight Zone-style stories and introduced Tony Stark, a playboy/billionaire/arm-dealer who was kidnaped in Vietnam and escaped by building battle armor. There was no mistaking this was a superhero origin story. It was the first Marvel Comic of the era to say “Super Hero” right there on the cover: If it says Superhero on the tin, it must be a superhero inside the tin In July 1963 Lee used the back half of Strange Tales to introduce Dr Strange. It seems likely that Dr Strange’s story was originally just a stand-alone fantasy like the others that were in the back pages of the title. Strange didn’t even appear on the cover of the issue. But just as the scientist Hank Pym was later turned into the superhero Ant Man, Dr Strange was eventually converted from a dark wizard into a super-wizard. Throughout 1962 all of the Marvel stories titles were stand-alone. When the Hulk appeared in the Fantastic Four it was because Johnny was reading the Hulk comic book. There was no hint that they all existed within the same universe. That changed in December 1962. The Hulk comic was struggling to attract readers, so Lee decided to cross-promote him in the Fantastic Four as a real hero (villain? anti-hero?) who the Thing could do battle with. Fantastic Four #12 (December 1962) was the first step to building a shared universe. The issue sold well, but it was not enough to save the Hulk, whose title was canceled a few months later in March 1963 (Incredible Hulk #6). But the idea of cross promotion stayed with Lee. When Spider-man launched his own title in March 1963, Lee pulled no punches. Amazing Spider-man #1 included two stories, but the cover story had Spider-man applying for membership with the Fantastic Four. The two most popular heroes were together and interacting. It was a huge debut and broke more records (allegedly. Actual records from this era are very spotty. Most sales numbers and “records” are based on memories and anecdotes told by those involved years later. But it was clear the issue sold a lot of copies). By early 1963 it was established that the Fantastic Four, the Hulk and Spider-man all existed together within the same shared universe. But what about Ant Man,Thor and Iron Man? Aside #5: The Hulk comic in Fantastic Four #5 pretty clearly establishes that the Hulk was a fictional character in the Fantastic Four world, but there are other clues that Lee was not thinking about his characters as existing and crossing over in the early days. Both Bruce Banner (the Hulk) and Mr Fantastic fight off global alien invasions in their early issues. In both cases the stories make clear that only Bruce/Reed is smart enough to save the world. No mention is made of the OTHER scientist who saved the world from the alien invasion a few months earlier. Bringing different superheroes from their own titles together was not an idea created by Atlas/Marvel and Lee. That was likely All Star Comics #3 (December 1940) when writer Gardner Fox brought together all the major DC heroes who were not staring in their own independent titles, including Green Lantern, the Flash and Doctor Fate, to create the Justice Society of America (JSA). Batman and Superman cameoed in All Star Comics #7, but generally they were considered too popular to dilute their appearances in ensemble titles. That changed in March 1960 when DC re-launched the idea of a superteam with the Justice League of America and included all of their most popular heroes as the leads – Superman, Batman and Wonder Woman. It was immediately a top seller. The launch of JLA is likely what caused the owner of Atlas to ask Lee to create a ”superhero team comic”. Lee did not have a stable of heroes to bring together, so he had to create something entirely new – The Fantastic Four. But now that Lee DID have a collection of his own heroes AND he had the greenlight to create straightforward superhero comics, he decided to build himself his own JLA. In September 1963 Atlas published two new titles: The Avengers and the X-men. The X-men were a brand new team of all new heroes, but the Avengers were a close parallel to the Justice League. Lee took his existing collection of heroes (except the Fantastic Four and Spider-man) and created an excuse for a team-up. In the issue they individually battle Thor’s brother Loki before coming together to defeat him as a team. They decide that given they all have different powers, they should work together to be unstoppable. The entire formation of the team takes only four panels and is a little corny, but it does its job: While the Avengers were a clear copy of the Justice League, Stan Lee put his own spin on it. While the JLA superheroes all had roughly the same personality and no real inter-team conflict, Lee made his heroes very distinct – almost caricatures – and there was PLENTY of inter-team conflict. The Hulk in particular abandoned the team in the second issue and was the primary antagonist by Avengers #3. Avengers #3 (January 1964) is itself the final step in connecting all of the Marvel heroes together. The Hulk has gone missing and the rest of the team wants to find him. Iron Man uses an “Image Projector” to ask other superheroes around the world if they had seen the Hulk. He visits the Fantastic Four, Spider-man and the X-men. In that same month in Tales of Suspense, Iron Man meets Angel (one of the X-men). The cat was out of the bag. Lee had a new trick to boost sales of all of his titles and he put it to work throughout the year. The first full crossover of the Fantastic Four and the Avengers happens in May (Fantastic Four #26). Daredevil premiered in March 1964 (with Spider-man on the cover, but not in the pages), and crosses over in Amazing Spider-man #16 (September 1964). Dr Strange first appears on the cover of another title in Fantastic Four #27 (June 1964). The Avengers battle the X-men (before teaming up) in X-men #9 (Dec 1964) Atlas was no longer just a collection of comic books about various topics, or even a collection of different flavors of superhero. It was a single shared universe: The Marvel Universe. It wasn’t planned out in advance, instead it happened in stages due more to commercial rather than artistic needs. Basically Stan Lee created the most successful modern mythology because he needed the money. III. Are Silver Age Marvel Comics any good? Well, apart from Amazing Spider-man, which holds up surprisingly well, I would not recommend reading any of them. Even Spider-Man is much weaker than the Ultimate Spider-Man reboot version of the story published 2000-2011. If you wanted to read Spider-Man from the beginning you would likely enjoy that later series a lot more than the original. The other titles vary in quality from “okay” (the Fantastic Four) to “absolute garbage” (Ant Man stories in Tales to Astonish). Which begs the questions, if these comics were so bad, how did they succeed as well as they did? Clearly the comics were “good for their time”. Millions of people bought and read them, and they clearly passed the “test of time”. So does that mean that we are better today at making art than we were back then? Or is art neither better or worse, just “of its time” and people back then would think the Ultimate Spider-man stories from 2000 were unreadable? I will argue the following: The stories were “good for their time”. VERY good for their time. They were much much better than the comic book stories that preceded them, and much better than other contemporary comic book adventures (like those being published by DC)
humanism

humanism is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 04, 2021 and May 04, 2021. The archive places it in contexts such as "The whole history of humanism (both of the Western—classically liberal—and various non-Western versions)". It most often appears alongside 2008, 9/11 attacks, A Brief History Of Neoliberalism.

Reference entry
humanism
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1
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1
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May 04, 2021
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May 04, 2021
May 04, 2021 · Original source
This appeal to the universalism of rights is a double-edged sword. It may and can be used with progressive aims in mind. The tradition that is most spectacularly represented by Amnesty International, Médecins sans Frontières, and others cannot be dismissed as a mere adjunct of neoliberal thinking. The whole history of humanism (both of the Western—classically liberal—and various non-Western versions) is too complicated for that. But the limited objectives of many rights discourses (in Amnesty’s case the exclusive focus, until recently, on civil and political as opposed to economic rights) makes it all too easy to absorb them within the neoliberal frame. Universalism seems to work particularly well with global issues such as climate change, the ozone hole, loss of biodiversity through habitat destruction, and the like. But its results in the human rights field are more problematic, given the diversity of political-economic circumstances and cultural practices to be found in the world. Furthermore, it has been all too easy to co-opt human rights issues as ‘swords of empire’ (to use Bartholomew and Breakspear’s trenchant characterization). So-called ‘liberal hawks’ in the US, for example, have appealed to them to justify imperialist interventions in Kosovo, East Timor, Haiti, and, above all, in Afghanistan and Iraq. They justify military humanism ‘in the name of protecting freedom, human rights and democracy even when it is pursued unilaterally by a self-appointed imperialist power’ such as the US.
humanistic social sciences

humanistic social sciences is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 29, 2021 and January 29, 2021. The archive places it in contexts such as "He wishes we abandoned our overly-rational ways in favor of humanities, Continental philosophy, and the humanistic social sciences". It most often appears alongside 80,000 Hours, AI alignment problem, Anand Giridharadas.

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1
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1
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January 29, 2021
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January 29, 2021
January 29, 2021 · Original source
The effective altruism movement, which largely grew directly out of the rationalist movement, seeks to maximize the efficacy with which charitable donations are directed using standard rationalist methods. It is a tight-knit community that strongly privileges rationalist approaches over all other forms of knowledge-making (such as from the humanities, continental philosophy, or humanistic social sciences) and tends to dismiss input not formulated in rationalist terms. The community also has a strong and explicitly stated view that its activities uniquely contribute to the achievement of “the good”: of their top five recommendations of most productive careers by a leading community organization, two suggest being a researcher or support staff within the movement, and two others recommend working on the AI alignment problem (see the next point). Until recently, much of the analysis and funding emerging from the community has pointed towards a focus on extremely unlikely but potentially catastrophic risks, such as alien, asteroid or biological catastrophes.
And would Weyl's suggestions really help prevent populist backlashes? He wishes we abandoned our overly-rational ways in favor of "humanities, Continental philosophy, and the humanistic social sciences" - isn't that usually code for stuff like queer theory, postcolonial theory, and postmodernism? Are working-class Trump supporters really banging on their keyboards when they read about effective altruism, shouting "YOU NEED TO STOP TRYING TO BE OBJECTIVE AND FACT-BASED, AND BE MORE OPEN TO INSIGHTS FROM QUEER THEORY AND POSTMODERNISM"?
humanities

humanities is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 29, 2021 and January 29, 2021. The archive places it in contexts such as "He wishes we abandoned our overly-rational ways in favor of humanities, Continental philosophy, and the humanistic social sciences". It most often appears alongside 80,000 Hours, AI alignment problem, Anand Giridharadas.

Reference entry
humanities
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1
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1
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January 29, 2021
Last seen
January 29, 2021
January 29, 2021 · Original source
The effective altruism movement, which largely grew directly out of the rationalist movement, seeks to maximize the efficacy with which charitable donations are directed using standard rationalist methods. It is a tight-knit community that strongly privileges rationalist approaches over all other forms of knowledge-making (such as from the humanities, continental philosophy, or humanistic social sciences) and tends to dismiss input not formulated in rationalist terms. The community also has a strong and explicitly stated view that its activities uniquely contribute to the achievement of “the good”: of their top five recommendations of most productive careers by a leading community organization, two suggest being a researcher or support staff within the movement, and two others recommend working on the AI alignment problem (see the next point). Until recently, much of the analysis and funding emerging from the community has pointed towards a focus on extremely unlikely but potentially catastrophic risks, such as alien, asteroid or biological catastrophes.
Trying to be charitable to Weyl, I think he's thinking of the EA movement as trying to perfectly quantify exactly how many lives can be saved per dollar, then following that number off a cliff. I can see how a ten-minute scan of the movement could get that impression, but I think even a thirty-minute one would correct the misimpression. EA does the quantification as a guide to other forms of reasoning. There is no way to perfectly calculate the devastation of a potential pandemic that hasn't happened yet. But once you make even a weak effort, you notice that all the numbers are really really big. And once you make an effort to quantify the importance of the cause du jour supported by the humanities and continental philosophy, sometimes you notice that under every set of reasonable assumptions it's smaller than the other number. And of course you supplement this with lots of trying to understand the complicated unquantifiable issues involved - under no circumstance do you skip that step - but you're just trying to do an analysis that has some contact with some reality-based number and isn't entirely dependent on the popular mood about something. I think this successfully achieves the difficult balance between model-laden technicalities and messy real life, and whatever form of reasoning Weyl was using to let him dismiss biological risks without doing any modeling failed to achieve that balance.
(maybe this is a bravery debate - I believe almost everyone is using fuzzy human judgment and guidance from the humanities to decide how to best improve the world, and injecting a little bit of science is a powerful innovation. If Weyl believes the opposite, then it would make sense for him to recommend the injection of a little more human judgment - although then he would have to explain how so many amazing-by-rational-standards charities were underfunded before EA came along, and how many useless-by-rational-standards ones were rolling in money.)
Humanity

Humanity is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 16, 2022 and March 16, 2022. The archive places it in contexts such as "In Utopia, people practice virtues like Charity, Industry, and Humanity". It most often appears alongside 1984, Amartya Sen, Apollo Mojave.

Reference entry
Humanity
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1
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1
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March 16, 2022
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March 16, 2022
March 16, 2022 · Original source
Here’s a crazy theory: the moral transition from other virtues to Justice mirrors the literary transition from utopian fiction to dystopian. In Utopia, people practice virtues like Charity, Industry, and Humanity, excelling at them and making their good world even better. In Dystopia, Justice is all you can hope for. If I were in Terra Ignota, my fondest wish would be to excel in some way the same way Sniper, Apollo Mojave, and the other utopian characters excel, bringing glory to my Hive and giving its already-brilliant shine extra luster. But if I were in 1984, my fondest wish would be to bring O’Brien and the others to justice; to watch them suffer, to undo the wound in the world caused by their scheming.
Humanslop

Humanslop is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 30, 2026 and January 30, 2026. The archive places it in contexts such as "Humanslop is a big problem on the AIs-only social network". It most often appears alongside Ainun Najib, Anthropic, Cash.

Reference entry
Humanslop
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1
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1
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January 30, 2026
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January 30, 2026
January 30, 2026 · Original source
Humanslop is a big problem on the AIs-only social network! Maybe they should use https://www.pangram.com/ to be sure!
humorism

humorism is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 09, 2021 and April 09, 2021. The archive places it in contexts such as "Galen’s idea of humorism"; "He was wrong about humorism"; "He was wrong about humorism, but after reading this book, it’s more understandable how at the time, humorism might have seemed like the best theory around". It most often appears alongside 1913 Nobel Prize in Physiology or Medicine, Alexandria, Aristotelian.

Reference entry
humorism
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1
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1
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April 09, 2021
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April 09, 2021
April 09, 2021 · Original source
The most extreme example comes from a debate with the disciples of Asclepiades about the function of the ureters, trying to convince this rival school that urine flows from the kidneys to the bladder through these channels. After exhausting his rhetorical options, Galen turns to empirical anatomy. First he shows them, in a dead animal, that the ureters connect the two structures. This isn’t enough. Next he shows them “in a still living animal, the urine plainly running out through the ureters into the bladder.” This doesn’t change their minds either. Next he takes a live animal, ligates the ureters, bandages the animal up, and lets it go. When he opens it up again later, he finds the ureters “quite full and distended”, and when he removes the ligature, everyone can see the urine flow into the bladder. You’d think the story would end there, but not so. Instead, says Galen, “tie a ligature round [the animal’s] penis and then … squeeze the bladder all over.” He points out that nothing goes back through the ureters to the kidneys, demonstrating that the conveyance is a special, one-way action. He goes on like this for a while. Let the animal urinate and tie a ligature around one ureter but not the other. Cut open both the ureters and see the urine “spurt out of it”. Bandage the animal up and open him up later to discover his insides full of urine and the bladder empty. “Now, if anyone will but test this for himself on an animal,” Galen concludes, “I think he will strongly condemn the rashness of Asclepiades.” Today we know that Galen was wrong, and that humorism isn’t a great way to think about medicine. But whatever Galen might have been lacking, it certainly was not the empirical bent. He was no armchair philosopher, and was more than happy to cut up lots of animals to make a point about the function of the ureters. This is funny because, again, this is the opposite of the story we’re told about Galen. He’s described as a pre-scientific or even unscientific thinker, believing that experimentation and investigation are a waste of time. Clearly this isn’t the case, and he made full use of all the resources available to him. We know that human dissection was prohibited in the empire, but Galen worked with gladiators, so we know that he had firsthand experience with human anatomy. He certainly was unafraid, even eager, to practice animal dissection and vivisection. Other doctors of the time didn’t seem to do either of these things, or at least didn’t do nearly as much, and so Galen starts looking more and more like a lone light of empiricism in the wilderness. (However extreme and disturbing his methods may be.) VII. In view of this, it’s extremely depressing to see Tetlock write, “yet Galen never conducted anything resembling a modern experiment.” Galen isn’t here to respond, but if he were, I imagine he would say: and yet Tetlock never conducted anything resembling a basic literature review! Galen definitely isn’t as charitable as we might want him to be. He calls some of the ideas he disagrees with “impossible, nay, perfectly nonsensical”, or “stupid—I might say insane”. His intellectual rivals “are like slaves” he says, “caught in the act of stealing … quite bewildered, and while the one says nothing, the other indulges in shameless lying.” But I’m pretty sympathetic to Galen’s position, because his contemporaries really do sound like idiots. Of course, all this is being filtered through Galen’s own account, but if he’s describing them with any accuracy, he is totally fair in saying that they have no idea what they are talking about. Some of the positions he argues against include: Urine passes into the bladder in the form of vapors, rather than being secreted by the kidneys and passed through the ureters to the bladder. Galen argues against this first by pointing out that the kidneys and bladder are connected by the ureters (which must have some purpose), and second by the extensive evidence from vivisection that I mentioned above.
Galen’s idea of humorism is more detailed and nuanced than the picture of humorism I’ve gotten from secondhand accounts. For one thing, he’s not limited to just four humors. He refers to different types of blood and suggests that there is a “sweet” phlegm and a “bitter or salty” phlegm, the former useful to health and the latter dangerous. At one point he mentions that Praxagoras describes a theory of eleven humors, and even says, “this is not a departure from the teaching of Hippocrates; for Praxagoras divides into species and varieties the humours which Hippocrates first mentioned”.
Whatever the cause of this hit job was, it seems to have been unjustified. Galen doesn’t seem like a very nice or pleasant guy to be around, but he was an empiricist if ever there was one, and he was trying to understand biology with absolutely every tool available to him at the time, so he could provide the best treatment possible. He was wrong about humorism, but after reading this book, it’s more understandable how at the time, humorism might have seemed like the best theory around. If more of us were like Galen (minus all the vivisection), we would be much better off.
Hundred Schools of Thought

Hundred Schools of Thought is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 01, 2023 and September 01, 2023. The archive places it in contexts such as "Warring States, with its Hundred Schools of Thought". It most often appears alongside 536 BC, ACX, Ai Jiang.

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September 01, 2023
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September 01, 2023
September 01, 2023 · Original source
Good riddance, you might say. The Zhou were overhyped and their system ought to be put out of its misery. Surely the Warring States, with its Hundred Schools of Thought and fresh outlook, has more to offer us. But the thing is, I don’t think the Warring States is the best analogue for our own time.
Hundred Years' War

Hundred Years' War is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 01, 2025 and August 01, 2025. The archive places it in contexts such as "It looked as though the Hundred Years' War would soon be over". It most often appears alongside Africa, Agamemnon, Age of Empires II.

Reference entry
Hundred Years' War
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1
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August 01, 2025
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August 01, 2025
August 01, 2025 · Original source
But all these accomplishments had been won by the power of the Kingdom of France, which during the pause in the Hundred Years' War had cheerfully spent men and treasure conquering and protecting these lands for the Burgundians, allowing them to spend their treasure on paintings and sculptures and dance manuals. The Kingdom of France had done this not by the will of the King of France (Charles VI, Philip the Fortunate's grandson), who at that time was seriously mentally ill21 and who the year before his regency started had murdered several people in a paranoid fit and afterwards took to believing that he was made of glass and would shatter if he fell, but through the decision of his regent, one Philip the Bold, Duke of Burgundy.
At that point the dominoes fell fast. The Armagnacs, under the (exceedingly poor) leadership of the Dauphin Charles and his (exceedingly inept) advisors, now the rump state of France, tried to fight multiple times; they called on Scotland for aid and got it and called on Castille and didn't.26 Every time they tried to fight they were beaten and Henry (now "The Conqueror") rolled down France, taking castles one by one and installing loyal members of the Burgundian party - now the collaborators' party - as governors. It looked as though the Hundred Years' War would soon be over.
Basilica: Look, leaving aside the age-old debate over free will and why God doesn't solve our problems for us - I realize "mysterious ways" is a cheap shot, but this is one of the hinge points of history. There's no reason to believe the English would stop rolling over France if they took Orleans, and no reason not to expect they'd hold on if they took it.93 If England rules France - or, more accurately, an Anglo-French King rules both - what does the Protestant Reformation look like? The colonization of the New World? The rise of democracy? If God wants to butterfly history into our path, there's a thousand different ways we could have missed the goal if the Hundred Years' War goes differently.
Hungarian constitution

Hungarian constitution is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 04, 2021 and November 04, 2021. The archive places it in contexts such as "There was a rule that the Hungarian constitution could not be amended by less than a four-fifths majority". It most often appears alongside Alcsutdoboz, Allied Powers, Angela Merkel.

Reference entry
Hungarian constitution
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1
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1
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November 04, 2021
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November 04, 2021
November 04, 2021 · Original source
Orban: Europe's New Strongman and Orbanland, my two sources for this installment of our Dictator Book Club, tell the story of a man who spent the last eleven years taking over Hungary and distributing it to guys he knew in college. Janos Ader, President of Hungary. Laszlo Kover, Speaker of the National Assembly. Joszef Szajer, drafter of the Hungarian constitution. All of them have something in common: they were Viktor Orban's college chums. Gabor Fodor, former Minister of Education, and Lajos Simicska, former media baron, were both literally his roommates. The rank order of how rich and powerful you are in today’s Hungary, and the rank order of how close you sat to Viktor Orban in the cafeteria of Istvan Bibo College, are more similar than anyone has a right to expect.
There was a rule that the Hungarian constitution could not be amended by less than a four-fifths majority. Unfortunately, that rule itself could be amended by a two-thirds majority. Orban used his two-thirds majority to trash the rule, then amend the constitution with whatever he wanted.
In fact, his party started amending the Constitution like it was going out of style. Certainly they removed roadblocks to their power. But they also wrote new laws they passed directly into the Constitution so future governments couldn’t change them. At one point, Orban replaced the Constitution entirely with a new version, which according to rumor one of his college chums wrote on an iPad during a train ride (for some reason, this is the part that gets to me - at least use parchment!) It got so bad that the EU Justice Commissioner complained that “the constitution is not a toy”.
Hungarian Jew

Hungarian Jew is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between December 02, 2021 and December 02, 2021. The archive places it in contexts such as "Sinclair thinks self-evidently yes. He tells the story of his grandmother - a Hungarian Jew who fled to Australia". It most often appears alongside Alexandre Gueniot, Algernon’s Law, Alzheimers.

Reference entry
Hungarian Jew
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1
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December 02, 2021
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December 02, 2021
December 02, 2021 · Original source
Sinclair thinks self-evidently yes. He tells the story of his grandmother - a Hungarian Jew who fled to Australia to escape communist oppression. She was adventurous, “young at heart”, and “she did her damnedest to live life with the spirit and awe of a child”. Sinclair remembers her as a happy person and free spirit who was always there for him and his family during their childhood in the Australian outback.
Hungarian mathematicians

Hungarian mathematicians is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 13, 2022 and July 13, 2022. The archive places it in contexts such as "one of the half dozen most distinguished Hungarian mathematicians of the twentieth century". It most often appears alongside 1890s, Alan Turing, Albert Einstein.

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1
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July 13, 2022
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July 13, 2022
July 13, 2022 · Original source
At age 11, John went to high school at Budapest’s Fasori Gymnasium. This school has since attracted historical attention for the number of geniuses it produced; along with von Neumann and fellow Manhattan Project physicists Wigner and Teller, its alumni included Nobel-winning economist John Harsanyi and poet George Faludy. The faculty, too, were top-notch: young John’s math teacher was Laszlo Ratz, later to be memorialized by the Laszlo Ratz Prize given yearly for excellence in math education. But despite this enviable environment, it is unclear how much attention John ever paid in school. His brother writes about “frequent complaints of his high school teachers to the effect that when he was asked what the assignment was for today, he did not know; but he then participated in discussions with full competence and knowledge of the subject." Even Ratz was not fully confident in his ability to teach von Neumann, and eventually recommended a private tutor (according to MacRae, the tutor - Gabor Szego - would later become “one of the half dozen most distinguished Hungarian mathematicians of the twentieth century” and end up as chairman of the math department at Stanford).
Huntington's

Huntington's is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 20, 2021 and August 20, 2021. The archive places it in contexts such as "less amyloid, worse Huntington's". It most often appears alongside ACT/SSC, aducanumab, aducanumab.

Reference entry
Huntington's
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1
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1
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August 20, 2021
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August 20, 2021
August 20, 2021 · Original source
If this were the first time someone had tried amyloid-reduction as a therapy for amyloid diseases, I might be on your side. It's not. This has been tried a lot of times before with identical results - less amyloid, same Alzheimer's. Indeed, even outside Alzheimer's they tried this with Huntington's and got "less amyloid, worse Huntington's" for their trouble (the disease effects of Huntington's are from free huntingtin; the amyloid lumps are the brain's partially-successful attempt to sequester it).
Huntington's Clash Of Civilizations Thesis

Huntington's Clash Of Civilizations Thesis is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between February 26, 2021 and February 26, 2021. The archive places it in contexts such as "Is this what's happened to Huntington's Clash Of Civilizations Thesis in an increasingly consumerist world?". It most often appears alongside American Chinese food, Bay Area, BBQ pork rice.

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February 26, 2021
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February 26, 2021
February 26, 2021 · Original source
When I first learned about Crave, I thought Ike's had just changed its name for some reason. I googled to figure out why and learned that no, this is just sandwich plagiarism. I can't piece together the whole story, but it looks like Crave is owned by a Muslim family who wanted a sandwich place with more halal options. Is that enough to justify calling the Ike's/Crave rivalry a religious war? Is this what's happened to Huntington's Clash Of Civilizations Thesis in an increasingly consumerist world?
Huntington’s disease

Huntington’s disease is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 02, 2021 and March 02, 2021. The archive places it in contexts such as "permission to test DNP as a treatment for Huntington’s disease"; "DNP as a treatment for Huntington’s disease". It most often appears alongside 1938 FDA, 2,4-dinitrophenol, 2,4-dinitrophenol.

Reference entry
Huntington’s disease
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1
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1
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March 02, 2021
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March 02, 2021
March 02, 2021 · Original source
In 2019, the FDA gave Mitochon Pharmaceuticals permission to test DNP as a treatment for Huntington’s disease. Mitochondrial energy production generates various toxic byproducts which make neurological diseases worse, and making the mitochondria less efficient might produce fewer of them. They suggest they might have some way of giving it as a prodrug with fewer side effects, but pharma companies are always saying this sort of thing.
Hurricane Katrina

Hurricane Katrina is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 17, 2021 and August 17, 2021. The archive places it in contexts such as "“Given that the Hurricane Katrina study didn’t find this”". It most often appears alongside Arthur, Arthur Cleveland Harrison, Benezet experiment.

Reference entry
Hurricane Katrina
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August 17, 2021
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August 17, 2021
August 17, 2021 · Original source
After Hurricane Katrina, many New Orleans students had missed a year or two of school (because their school had been destroyed, or they’d had to evacuate the city and live with relatives, etc). After the hurricane, New Orleans switched to a charter-school-based system and test scores went up, with New Orleans students generally outperforming their peers. There’s a lot of discussion about whether this does or doesn’t mean that charter schools are great, but either way doesn’t seem like missing a year or two of school hurt the New Orleanians very much.
Another strain of literature focuses on big Third World disasters, like an earthquake in Pakistan. These disasters usually destroy schools and give students a few years’ gap in learning, and studies do find that the students do worse just after the disaster. But importantly, they are doing more worse than the schooling gap can account for - eg if they miss school for a year, they’re two or three years below grade level. Most studies I read attribute this to some combination of malnutrition and PTSD. The grade losses worsen even after the students are back in school (ie they might start two years behind, and after two more years of schooling they’re four years behind). The commentators attribute this to “being promoted too quickly”, but I interpret this as further evidence that something beyond just missing school is affecting this. Given that the Hurricane Katrina study didn’t find this, I suspect that in a First World environment where malnutrition is less of a risk, there’s less need to worry about this.
Hurricanes

Hurricanes is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 03, 2021 and March 03, 2021. The archive places it in contexts such as "a new study confirms that the rate at which hurricanes qualify as “major”". It most often appears alongside 9-11, Argentina, Austin Allred.

Reference entry
Hurricanes
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1
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1
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March 03, 2021
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March 03, 2021
March 03, 2021 · Original source
3: There’s been a lot of anecdotal evidence that hurricanes have gotten stronger in recent years; a new study confirms that the rate at which hurricanes qualify as “major” (winds above 100 knots) goes up by about 8% per decade.
Hussite faith

Hussite faith is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 01, 2025 and August 01, 2025. The archive places it in contexts such as "or the Hussite faith". It most often appears alongside Africa, Agamemnon, Age of Empires II.

Reference entry
Hussite faith
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1
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August 01, 2025
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August 01, 2025
August 01, 2025 · Original source
Basilica: For something they believe in. In this period, that's the Catholic faith. Or the Muslim faith, or the Cathar faith, or the Hussite faith. They don't die for nothing.
Hussite sect

Hussite sect is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 20, 2024 and November 20, 2024. The archive places it in contexts such as "depicts a meeting of the Hussite sect". It most often appears alongside /r/ImaginaryWarhammer, 19th Century, Abstract/Modern.

Reference entry
Hussite sect
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1
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1
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November 20, 2024
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November 20, 2024
November 20, 2024 · Original source
Human. This is “Meeting At Krizky” by Alphonse Mucha (1916). It is part of his Slav Epic, a series of paintings on the history of Eastern Europe, and depicts a meeting of the Hussite sect, whose attempts to found a sort of proto-Protestantism would spark the 15th-century Hussite Wars.
Hussite Wars

Hussite Wars is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 20, 2024 and November 20, 2024. The archive places it in contexts such as "attempts to found a sort of proto-Protestantism would spark the 15th-century Hussite Wars". It most often appears alongside /r/ImaginaryWarhammer, 19th Century, Abstract/Modern.

Reference entry
Hussite Wars
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1
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1
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November 20, 2024
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November 20, 2024
November 20, 2024 · Original source
Human. This is “Meeting At Krizky” by Alphonse Mucha (1916). It is part of his Slav Epic, a series of paintings on the history of Eastern Europe, and depicts a meeting of the Hussite sect, whose attempts to found a sort of proto-Protestantism would spark the 15th-century Hussite Wars.
Hutchinson-Gilford progeria

Hutchinson-Gilford progeria is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 01, 2021 and June 01, 2021. The archive places it in contexts such as "lamin A whose constitutive activation causes [Hutchinson-Gilford progeria]". It most often appears alongside Alzheimers, beta amyloid plaques, FDA.

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June 01, 2021
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June 01, 2021
June 01, 2021 · Original source
That's great for the 300 or so children worldwide with Hutchinson-Gilford progeria (it's a really rare disease). But none of the discussion about this answered the question I wanted to know: can lornafarnib also prevent normal aging?
Hutchinson-Gilford progeria (I'll just say "progeria" from here on, even though that's kind of inaccurate) is what's called a laminopathy. It's a disease of the nuclear lamina, a weblike structure that helps support and give shape to the cell nucleus. The lamina is partly made of a protein called lamin A. Children with progeria have a mutation in the relevant gene; instead of producing lamin A, they produce a defective mutant protein called progerin. The cell tries to build the nuclear lamina out of defective progerin instead of normal lamin A, and as a result the cell nucleus is screwed up and can't maintain a normal shape.
Age-related nuclear defects are caused by sporadic use, in healthy individuals, of the same cryptic splice site in lamin A whose constitutive activation causes [Hutchinson-Gilford progeria]. Inhibition of this splice site reverses the nuclear defects associated with aging. These observations implicate lamin A in physiological aging.
Hutchinson-Gilford Syndrome

Hutchinson-Gilford Syndrome is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 01, 2021 and June 01, 2021. The archive places it in contexts such as "There's been a lot of research on one important form - Hutchinson-Gilford Syndrome". It most often appears alongside Alzheimers, beta amyloid plaques, FDA.

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1
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June 01, 2021 · Original source
That's great for the 300 or so children worldwide with Hutchinson-Gilford progeria (it's a really rare disease). But none of the discussion about this answered the question I wanted to know: can lornafarnib also prevent normal aging?
Hutchinson-Gilford progeria (I'll just say "progeria" from here on, even though that's kind of inaccurate) is what's called a laminopathy. It's a disease of the nuclear lamina, a weblike structure that helps support and give shape to the cell nucleus. The lamina is partly made of a protein called lamin A. Children with progeria have a mutation in the relevant gene; instead of producing lamin A, they produce a defective mutant protein called progerin. The cell tries to build the nuclear lamina out of defective progerin instead of normal lamin A, and as a result the cell nucleus is screwed up and can't maintain a normal shape.
Age-related nuclear defects are caused by sporadic use, in healthy individuals, of the same cryptic splice site in lamin A whose constitutive activation causes [Hutchinson-Gilford progeria]. Inhibition of this splice site reverses the nuclear defects associated with aging. These observations implicate lamin A in physiological aging.
Hutterites

Hutterites is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 12, 2025 and August 12, 2025. The archive places it in contexts such as "Other suggestions for groups I forgot include Mennonites and Hutterites (similar to Amish)". It most often appears alongside All Who Go Not Return, Amica Terra, Amish.

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Hutterites
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August 12, 2025
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August 12, 2025 · Original source
He’s right. I added them in, along with the Mormons. Other suggestions for groups I forgot include Mennonites and Hutterites (similar to Amish), online gamers, the military, and the Long Now Foundation.
Huxleys

Huxleys is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 21, 2021 and November 21, 2021. The archive places it in contexts such as "enough to explain Darwins and Huxleys?". It most often appears alongside ACX Grant, Andrés Gomez Emilsson, Bobby Fischer.

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Huxleys
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November 21, 2021
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November 21, 2021 · Original source
3: Still a lot of pushback on the Great Families posts (one of the most common comments on the ivermectin post was “this is so much more evidence-based than that family stuff”). I’m wondering if I’ve been blogging so long and cast such a wide net that I’ve collected readers who aren’t familiar with The Nurture Assumption (book full of evidence that parenting styles and effects of early home environment don’t matter for most outcomes later in life, within normal bounds) - anyone know of a good refresher I can link people to? But maybe some of you want to argue they matter for the top 0.01% - small enough that nobody will ever notice in a study, but enough to explain Darwins and Huxleys?
Hyde

Hyde is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 15, 2025 and August 15, 2025. The archive places it in contexts such as "the Hyde to their Jekyll, a rabid animal". It most often appears alongside Amazon, Burning Man, Forbes 30 Under 30.

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Hyde
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August 15, 2025
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August 15, 2025
August 15, 2025 · Original source
This would be demanding a reward for meeting the bare minimum requirements, and that would make you gross and entitled. This is the new guidance we’re tossing at young men. It’s the equivalent of taking away GPS from a driver and handing them a map scrawled by a half-blind cartographer tripping on acid. The obvious result is getting disastrously lost; the only question is which type of lostness will impact a man. III. Patterns Within the Pain Over the years, I’ve developed mental categories for the varieties of lostness men are faced with. Each one comes with its own unique troubles that stymie the health of men and the success of their relationships. There is no science behind my categories; they are merely my attempt to find patterns within the misery of others. Their boundaries are fuzzy, so men may belong to multiple categories, or may transition from one to another. I find it impossible to review dating in the Bay Area without utilizing these categories. My experiences with each category are wildly different; some cause me to walk away from a date feeling sad, some scared, some hopeful. Below, I offer a description of five of the most common categories I’ve encountered, the paths that lead to these particular forms of lostness, and what happens to men who fall into these categories. I also offer my review of dating men from each category and discuss how their lostness impacts relationships. I hope my experiences can be enlightening to individuals who may find themselves trapped in these categories; sometimes a third-party viewpoint can be helpful for finding yourself. I also hope to provide some insight for how women navigate dating and what red and green flags we may be picking up on. (This, of course, is merely anecdata and should be taken with a massive grain of salt.) But more importantly, I hope this framework can help people to have more empathy for men who fall into these categories. The public commons are filled with lamenting about “floundering,” “immature,” “selfish,” “hateful” men who are “toxic to society.” While much of the concern is deserved, channeling it into spite and disgust toward individuals is a waste of energy. These men did not wake up one day and intentionally decide to be filled with anger, anxiety, and apathy toward society; society failed them, and when they tried to point this out, their concerns were shrugged off. Our broken system for raising young men deserves spite and disgust; the individuals trapped in that system deserve empathy and help. I hope this framework can help to shift conversations about these lost men toward finding solutions, rather than blaming young men for their troubles. So without further ado, I present my categories of lostness. IV. The Categories of Lostness THE MAN WHO IS NOT The Man Who Is Not isn’t the sort of person you’d expect to get lost, at least not if you knew him when he was young. He was a pretty normal kid with a pretty normal childhood. Good friends, decent family, stable home life. Yeah, there were a few rough spots, but who didn’t have those? He’s not exactly a stand-out success, but he gets good enough grades that get him into a good enough college. He’s reluctant to go; he doesn’t enjoy school all that much. But his parents push him to get a degree, and after he arrives, he decides college life isn’t half bad–he makes some friends, dates a couple girls casually, and enjoys plenty of parties. The worst stressor seems to be the nagging question of his degree concentration and what career he’s going to pursue. He’s changed his mind three times already, unsure what he really wants from his life, and his guidance counselor and parents are starting to lose their patience. He finally settles on Economics. It’s certainly not his passion, but he’s always been good at math, and this seems like a decent way to make money from that talent. He still has no idea what he wants from life, but at least now he’ll have time and resources to figure it out. He graduates with his bachelors and takes a job as a data analyst at a big bank in the city. He’s excited; he’s been promised by mentors and Hollywood and Instagram that this is going to be a magical time of his life, full of new adventures and self-discovery. What he finds isn’t nearly so exciting. Work is boring and draining, consisting of the same tasks every day with a workload that grows ever larger, and he has zero emotional attachment to the end product. He quickly starts to suspect he chose the wrong major, or maybe the wrong job, although mentors shrug off his concerns. Work isn’t supposed to be fun, they say. Get used to it. It’s not uplifting advice, to say the least. He tries to distract himself from his miserable job with his social life, but it’s not as easy as he expected. All his college friends moved to different cities, and their texts grow increasingly rare. The city is huge, filled with hundreds of thousands of people, but it feels like they're a swarm of NPCs. Few people talk to him unless he approaches first, and the dialogue is always transactional. He would like to buy a cup of coffee. They would like to know where the bus stop is. He wants to sign up for a gym membership. Sometimes he tries to steer the conversations to more personal topics, and he manages to get a few phone numbers and promises to hang out sometime. But when he texts them, they never reply. He’s lonely. He doesn’t like admitting it, not even to himself, because it feels pathetic. After all, there’s nothing wrong with him. He’s a perfectly pleasant individual, and people have said he’s smart and funny, and he’s never struggled to make friends in the past. Yet the thousands and thousands of people who surround him couldn’t care less about his existence, and their apathy begins to grow a heavy lump of despair within him. He consults the internet, and Reddit tells him to find a community. This seems like solid advice, so he tries to form stronger relationships with his coworkers. After all, work is the closest replacement he has to the structured community he had at college. Back in school, being trapped on campus together just naturally led to friendships and relationships, and he assumes the same will happen at work. He’s wrong. People don't have time to chat during the day, and they don’t want to hang out after work. They have partners and families and hobbies to get to, and besides, what happens if they have a falling out? That would make office interactions weird. The office is a place for friendliness, but not friends, and certainly not romantic relationships. The rejection stings, but he’s not about to give up. He joins a running club and a book club and starts attending group classes at his local gym. He’s not really sure if he enjoys any of these activities, but they seem like good ways to meet people and join new communities. As the weeks tick past, people start to remember his name, and he gets added to some group chats for scheduling activities. Suddenly, his calendar is full of events, and his evenings are no longer an endless churn of YouTube and video game binges. He feels better. Still not great, exactly, but the despair has begun to recede, and he can breathe without feeling the primal fear of being alone and isolated. There’s still something missing; he still goes to work wondering why the hell he’s there and leaves wondering what the hell he’s achieved, and he has no idea what he’s trying to do with his life. But he knows he’s still young and is pretty sure there’s still time to figure it out. A life crisis occurs. It's small, but something he’d appreciate some support through. He reaches out to a few of his new friends, and they offer condolences, but none of them have time to meet up. He gets one friend to agree to a phone call, but he’s barely done explaining the issue before she insists she’s “not really sure she can help” and suggests he maybe talks to a therapist. The dismissal comes as a shock. His old friends would have made time for him and carefully listened and offered advice. It’s not like he’s asking a huge favor; this is basic friendship stuff. What kind of friends refuse to give such basic forms of help? A cold, creeping reality dawns on him: friends wouldn’t do that. Those “communities” he’s joined are just loose groups of acquaintances who enjoy the same activities. He’s never had the opportunity to have deep, emotionally-bonding discussions with any members, and that’s how they like it. After all, true communities come with effort and commitment, and who has time for that these days? His new “friends” are nothing of the sort. For them to be friends, they'd have to actually know him. And they don't. They know Running Club Him and Book Club Him and Gym Him, but none of them understands the whole of him. He starts to question whether that version of himself even exists. After all, humans are social creatures, and if you don’t have a community or a partner or a purpose, can you even call yourself a whole person? Logically, he knows he is, but it doesn’t feel like it. There’s a growing void in his soul, an absence that chokes the breath from his chest. It’s odd that a void could weigh anything, but it seems to be a black hole sucking in his emotions, condensing them in a pit of gravity until his limbs struggle to carry the weight. During a soulless work icebreaker, someone asks him how he’d describe himself. He stutters out a short answer that sounds decent enough, but he realizes he’s not sure what the honest answer is. He’s smart, he supposes, although his recent performance at work doesn’t prove it. He used to consider himself funny, but jokes don’t come easily these days. He’d never dare to say it out-loud, but the truth is he’d describe himself as sad and lost and alone and frankly rather scared, like some sort of abandoned child. It’s pathetic, and he knows it. After all, he’s not a child; he’s a grown man. Or is he? He doesn’t fit the old-fashioned definition of manhood offered by the right, nor does he fit the modern definition offered by polite society, which is basically just a stereotypical woman with a beard and muscle. He doesn’t feel like a grown man, but he doesn't feel like anything at all. He feels empty, devoid of a core identity, and uncertain how to plug that hole. He may not know what he is, but he knows what he is not: not happy. Not whole. Not satisfied. Not purposeful. Not connected. Not loved. There seems to be an obvious solution to at least the last problem: he can get another girlfriend. He hasn’t had one since college, and that was a few years ago, but he’s certain he can find another one. A girlfriend is guaranteed to offer him love and support. That’s the entire point of having a romantic relationship, after all. But dating isn’t easy in the Bay Area. The apps are soul-crushing, his jadedness and bitterness growing with each swipe and conversation with a bot. He manages to land a few dates, but they all seem to focus on the same set of questions: what are your passions? What are your friends like? What do you want from your future? It feels like a stomach-churning interview, and the judgemental frowns from the women make it clear he didn’t pass. He starts to dread dates when he lands them, and begins to cancel them last-minute, unable to face the anxiety and rejection they lead to. He feels increasingly desperate with each day that passes. Desperation isn’t attractive, and he knows it, but he’s not sure how to tamp down the emotion. The void is consuming him; every day he can feel it crushing more of his soul. Yet no one seems even the slightest bit interested in helping him free himself from its grip. As soon as he tries to express his feelings to anyone, they react as if he’s diseased, immediately losing interest in him. Men are supposed to be strong and uplift others, not complain and demand attention for themselves. Maybe he is diseased. He’s pretty sure he’s suffering from depression at this point, and the stomach-churning anxiety and dread that frequently fill him don’t seem normal. He brings it up with his doctor and gets referred to a therapist. He’s reluctant to go—it seems to be an admission of his weakness. But he’s desperate for someone to listen to him, so he decides to give it a try. It turns out the therapist doesn’t have any interest in listening to him, either. She seems preoccupied with reminding him of his “luck” and “privilege” and insisting that he needs to use it to better his life. He knows she has a valid point; he’s a straight, educated male. He has privileges in society that others would risk their life for. Logically, it would make sense to be happy and grateful, not sad and upset. Yet the void has no respect for logic; rather than tempering his pain, the rationality merely adds a layer of self-disgust onto the despair. There are so many who suffer more than him, yet he can barely shoulder this burden. He tries repeatedly to explain the pitiful truth to the therapist: he can’t help himself. He can’t. He’s tried over and over again, and it doesn’t work. He remains lost, and society continues to not care. The therapist insists he’s not trying hard enough. Her advice is baffling. Exactly what is he supposed to be trying to do? What steps does he need to take to feel whole again? What actions are needed so he can know who he is, and what his purpose is, and convince people that he matters? The therapist explains that only he can answer those questions. The whole thing feels like a cruel joke. His performance continues to slip at work, until one day he’s let go. A couple coworkers send a farewell email, but most don’t seem to even notice his departure. He knows he should start applying to other jobs, but he’s too tired. Tired of the loneliness, of the existential dread, of the rejection, of being reminded how “privileged” he is to exist as this broken shadow of a human being. The void has consumed him alive, and there seems to be no escape. He lets himself go–doesn’t shower as much, stops going to the gym and running club and book club. Some small part of him hopes this will trigger sympathy and cause people to reach out. Instead, it has the opposite effect. He transforms from barely noticeable to completely invisible. He is a ghost now, a haunted remnant of a human, yet the only person who cares is himself. And, increasingly, even that isn't true. He doesn’t want to be invisible anymore. He doesn’t want to be ignored and rejected. He doesn’t want to be tired and scared and lonely and bitter and lost. He doesn’t want to be. And the world doesn't give a single fuck. Dating a Man Who Is Not: It’s rare to actually go on a date with a man in this category. More often I find them glancing at me, only to abruptly look away when I try to meet their eyes. Attempts at conversing with them are usually met with hollow replies and an exhausted sense of suspicion. On the rare instances I’ve ended up on dates with these men, it seems they’ve already used up all their hope and energy to schedule and arrive to the date. By the time we actually sit down for coffee, they’ve shriveled back into a ghost, providing half-hearted answers to questions about themselves. When they do talk freely, it’s usually a rant. Most of them seem to realize ranting isn’t ideal behavior on a first date, but they’re clearly desperate for someone, anyone, to listen to their pain. Yeah, it’s going to scare away the woman, but she’s not going to stick around, anyway. No one ever does. At least that’s what the void tells them, and there’s nothing I could say to sway this opinion. Hypothetically, there might be something I could do–I could enter into a relationship with him and provide the love and support he desperately craves, giving him the strength he needs to discover his purpose in life. Yet realistically, this is a fantasy. A single person can rarely solve issues this severe; it requires the combined strength of an entire community to drag a soul back from such extreme depths. Any attempt at a romantic relationship would crumble under the weight of the void, and only leave the man feeling more hopeless. The best I can do for these men is recommend they join communities where genuine emotional bonds can be forged. These still exist, although they’re frighteningly hard to find in modern society. I’ve been lucky enough to join several, and it’s startling how many people have the same story: feeling depressed and isolated and purposeless, and suddenly feeling like they’re alive for the first time in years once they’ve been embraced into the community. Therapy and guided self-improvement are also helpful, of course. But it has to be the right therapist, and those seem surprisingly rare. I’ve heard some truly jaw-dropping stories about experiences with therapists, and I feel concern for the men who haven’t heard of “therapist shopping” and don’t realize it can take trial and error to find compatible and competent help. Dates with these men leave me worried. Not for myself, but for these sullen ghosts who seem on the verge of giving up. There’s so much obvious potential within them, yet society offers them so few ladders to climb back from the pit of depression they’ve fallen into. When those ladders do exist, they're often missing rungs or spontaneously snap when men put their full weight on them. We need more resources for these men, and even more importantly, we need better maps for them, so they don’t lose themselves to depression in the first place. THE MAN WITH A PLAN The Man With a Plan is the inverted twin of the Man Who Is Not. Rather than struggling to figure out what he wants, he knows exactly what his goals are: he’s going to get good grades, which get him into a good school, which earns him a good job, which finances a good house in a good neighborhood and attracts a good spouse who provides good kids. He knows this is what he wants, because it is the creed that has been repeated to him since he was in elementary school. He does not know who he should be; his copy of the map is just as butchered as any other. But he knows what he needs to do, and that is what matters. After all, we’re merely the sum of our actions, right? Life is smooth sailing for him. His mentors are right–hard work pays off, and once he graduates with that valuable degree, he lands an excellent job in exactly the field his parents always encouraged him to pursue. The money is great, and soon so is his apartment and his car. Everything seems to be falling into place. He downloads a dating app and gets a fair amount of matches, one of whom turns into his girlfriend. She’s pretty, and successful, and shares his goals of settling down in a good neighborhood to have some kids. His parents are thrilled. All their hard work has paid off, just as they expected. He knows he should also be thrilled, too, but he’s not. There’s a vague sense of unease within him. It’s haunted him since he was young, sometimes dragging his thoughts to depressed and anxious places, although he always assumed it was because he just hadn’t completed all the steps in the plan. His work was unfinished, and thus so was he. Yet as he checks off more and more boxes on the list of tasks to attain a good life, that feeling seems to be growing in strength, not decreasing. He shrugs it off, reassuring himself that it’s just work stress that’s making him overthink things. Everything in his life is good. There’s no reasonable cause for despair, so he just needs to let those thoughts go. Years pass, and he works hard to juggle work and his romantic relationship and his friends, although his friends seem to take less time these days. They’re getting married, having kids, and becoming too busy to hang out. When they do get together, it’s usually for an activity–an escape room, a movie night, karaoke. Once the event completes, people scurry off to other obligations, leaving little time for deep conversations. But he has his girlfriend, at least. She’s just as pretty and smart and ambitious as ever. She’s also getting increasingly anxious for a ring, dropping hints that eventually start to sound more like demands. This should excite him, but instead it just stirs the formless dread within him. He chastises himself for it–he needs to grow up and learn to commit. He’s too old to be yearning for the life of a bachelor. As they say, the grass is always greener on the other side. One night, as they lay in bed, his girlfriend asks him how many kids he wants. He realizes that he doesn’t know. And actually, now that he thinks about it, he’s not even sure if he wants kids. They scream a lot, and they make all sorts of noxious odors and messes, and saddling himself to a dependent for eighteen years seems rather terrifying. The thoughts come to him unbidden, and he doesn’t dare to voice them. Two kids. That’s what he tells his girlfriend, and she seems pleased enough with this answer. Yet he can’t shake the dread from his mind. The part of his mind that those fears escaped from seems to have been a pandora’s box. Now that it’s open, he can’t close it, and the dread continues to grow. He doesn't want to move to the suburbs; he knows there are better homes and schools there, but he enjoys the city. He’s not sure he wants his upcoming promotion to manager; yeah, his salary will increase, but he hates corporate politics. He doesn’t actually like doing escape rooms; he desperately misses the days of hanging out with his friends and getting tipsy and maybe a little high, and talking endlessly until the sun begins to rise. And his girlfriend… when he really thinks about it, there’s little in common between them except the same checklist of goals. She’s a wonderful partner, but is she a wonderful partner for him? He doesn’t know. For so long, he’s convinced himself that people are just a sum of their actions, and if he just has a solid plan, he’s going to be a good person with a good life. Now he realizes that’s a lie. Yes, actions matter, but so do feelings. And he’s spent his entire adult life actively repressing his feelings, tamping them down in a desperate attempt to follow the plan and gain happiness. But it’s been a fool’s errand; he’s followed the plan, and it’s only led to existential dread. He wants to discuss these things with his friends, but he realizes they hardly know him anymore, because he hardly knows himself. He lost himself somewhere in the endless march of the plan, and he begins to wonder if he’s ever fully existed at all. He’s followed his parent’s biddings ever since he was a young child, and chastised himself for any desire he’s ever had that doesn’t fit into the cookie-cutter ideal of capitalistic success. His girlfriend says he’s been acting odd lately, cold and distant. He apologizes, and then he tells her that he likes painting. She probably doesn’t know that, because she’s never seen him do it, because the last time he painted was during art class in high school. He was good at it, and he loved it. It made him feel alive. His teacher suggested he could become a professional someday, but he’d immediately rejected the idea, knowing the life of a starving artist wasn’t a good plan. Maybe he was wrong. Maybe he should have embraced that life. Maybe he’d be happier, and wouldn’t wake up every morning with crushing dread at the thought of going to work. His girlfriend says they should sign up for some wine-and-paint nights. He says they should break up. He quits his job, too. He hates it; it consumes his time and sucks at his soul, leaving behind a robotic husk. He’s done with that bullshit. Done. His friends suggest he’s having a mental breakdown and needs help. It confirms his suspicions: they don’t know him at all. If they did, they would see that he is helping himself. He’s finally taking the time to find and understand himself, to discover his purpose. For a few weeks, he’s elated and excited to be on this new journey. But then the existential dread begins to creep back in. He’s never really done anything without a plan. And he’s still not entirely sure what he’s trying to accomplish; he knows he wants to “find himself,” but he’s unclear on what that requires, and the self-help books he consumes seem to have muddled and contradictory answers. He starts painting again, taking up classes at a local studio, but his skill level is that of a fourteen-year-old with potential. He hasn’t practiced in two decades, and his work is weak compared to most other artists his age. He’s not used to being the least skilled person in the room. His prior plan never allowed that as a possibility, and the sense of failure is disorientating. He also has no idea what he’s going to do with his art. He wants to make a plan, but also balks at the idea of trapping himself in yet another series of checkboxes. He signs up to see a therapist, and she assures him that he just needs to find his happiness, but this feels like picking out a gift for someone he’s never met. How is he supposed to know what makes him happy, if he’s never been given the chance to figure out who he even is? He doom scrolls on social media, wincing at the posts about people’s deep passion for their jobs and blazing love for their significant other. Part of him feels disgusted by what he perceives as disingenuity; after all, he was making similar posts just a year ago, and it was all a facade. But another part of him feels a cold wave of fear. What if all those other people aren’t faking it? What if he’s just broken, and unable to feel the same happiness and fulfillment that others experience? He feels empty. His unknown future starts to feel like a crushing concern, rather than an exciting adventure. His few remaining friends suggest that maybe he should try to get back together with his girlfriend, maybe try to piece together his old life. It’s not too late, they assure him. But he doesn’t want that. He misses sex and cuddling and having someone to tell about his day, but he doesn’t miss her. It’s probably because he’s fundamentally broken, and she deserves better than him. And as for his job, he can’t bring himself to possibly go back, despite his rapidly dwindling bank account. He turns to the dating world, hoping maybe finding a solid partner will help him solve his brokenness. Yet he seems to keep attracting women with similar forms of emptiness within them, and a void that joins with a void is still just as empty. But he’s not going to give up. He has to find someone, something to give him purpose. Otherwise, his whole life and all his work and all his pain has been pointless. And he’s not sure he could deal with that outcome. Dating a Man With a Plan: In my experience, Men with Plans are the most common form of lost men in the Bay Area. I feel like half the men I go on dates with fit into this category to some degree. These men also tend to be intensely attracted to me, or rather, to my lack of a conventional plan. I’ve stumbled through a highly unusual path, somehow getting lucky enough to gain a solid understanding of myself, pursue my passions, earn a solid living, and enjoy a happy life along the way. My story is like crack to them. They tell me they want to be more like me; they insist they want to see more of me. There seems to be a mistaken belief that they can absorb my personality through osmosis if they date me, absolving themselves of the requirement to figure out their own path and personality. It’s a sad misunderstanding of how it all works. My unconventional life isn’t the result of zany choices and the advice contained in self-help books; it’s the result of an intensely rocky childhood I almost didn’t survive. I don’t have a “cure” for these men and their lack of self-identity. I’ve figured out myself, found my community, and discovered my path, but I can’t do the same for them. Once they figure this out, they almost immediately lose interest in me. Which is for the best, as I struggle to feel romantic attraction toward men in this category. It’s hard to love someone if they don’t even understand themselves well enough to know what’s lovable. The good news is that this category seems to be the easiest for men to break free from. If they’re determined not to give up, and willing to realize that the right woman isn’t going to fix their issues, they can create a happy life of their own. They’ll often stumble around for a while–sometimes months, sometimes years–but they’ll eventually find a solid community and a purpose within it. Their brain is already programmed to follow plans and good habits, so as soon as they figure out a new map for themselves, the rest becomes easy. The process of figuring out a new plan can be rocky, though. I won’t sugar-coat that bit. The reality is that a good community is hard to find, and purpose often comes from a certain amount of suffering. Some men never manage to climb out of this category and adopt the hopeless lostness of a Man Who Is Not. But with the right support, most can escape to a bright future. THE MAN WHO PROVIDES Meet a Man Who Provides in person, and he’s often interesting and intellectually stimulating, an immediate “yes” when he asks for a date. His online profile features photos from international adventures, flashy job titles like “CEO” and “Senior Director,” and loving moments caught with his friends at Burning Man. The Man who Provides kept hold of one tattered remnant of the old map to manhood: the part that states men must provide resources. This is a vital piece, one that has guided men for thousands of years, and it has survived the great purge of manhood. Sure, people are more likely to point out that it is flawed and unfair, but the reality is that men are still expected to be breadwinners. (If you doubt this, just ask any “stay at home dad” about the hostility they’ve received for their role.) The Man who Provides takes this single piece of the map and makes it his entire identity. Much like the Man With a Plan, he takes his education and career seriously. But he doesn’t strive for a good education and career; he wants the best. In order to provide the most resources, he needs to earn as much success as possible, and he’s willing to put in the work to do it. Tiger parents are excellent at creating Men Who Provide. From a young age, the message is clear: your worth is equivalent to your ability to provide, and providing requires consistent success. Other Men Who Provide stumble into the obsession with success by themselves. Often these men are neurodivergent to some degree–ADHD, autistic, hyper-intelligent, or just otherwise “different.” They exasperate and confuse others, and are the subject of bullying by both peers and authority figures. Success is an escape valve for these men; it earns them praise their personality never receives. Before long, it becomes a costume, a mask slipped over their personality to ward off apathy or disdain. The Man Who Provides graduates at the top of his class and lands a job at a top company, which doesn’t come as a surprise to anyone who knows him. It’s also not a surprise when he leaves the job to found his own company, which is sure to be a success. Despite his insane work hours, the Man Who Provides somehow manages to accomplish a vast amount of extra-curricular activities as well. He travels the world, speaking of it the same way most people speak of triathlons. The globe is not a tantalizing opportunity, but rather a challenge meant to be vanquished; he knows precisely how many countries he’s been to and how many he “has left.” He’s fond of drugs and brags of the enlightenment he’s found in acid and mushrooms. The amount of ketamine he consumes makes some question exactly why he’s so hell bent on dissociating from his enlightened world, but most are simply impressed by the variety of substances he’s sampled. Those “friends” in his Burning Man photos were from his startup incubator, and he hasn’t spoken to any of them in ten months. He misses speaking with them, if he’s honest with himself, but he worries they’d drag him down. Their startups haven’t been as successful as his, and he’s convinced it’s because of their attitudes and lack of work ethic. As for dating? Well, a partner is yet another thing to be optimized, of course. They must match or exceed his quality level, and a woman’s quality revolves around their job title and academic degrees. His dating life is tumultuous, to say the least. He goes through periods of casually dating many women, proving his desirability to those around him. Then he’ll enter a serious relationship, with emphasis on serious. His time is valuable, so this relationship had better not waste it. The relationship will seem perfect at first–two successful, powerful, passionate people combining forces! What could possibly stand in their way? The answer: themselves. Their relationship quickly implodes, as it turns out two individuals hyper-focused on their personal success tend to be terrible at a group activity such as dating. Back to the carousel of casual dating he goes, carrying stories of his ex who just “couldn’t match his intensity” and “resented his success.” Then into another serious relationship, this time with someone with a bit less self-esteem and a determination to prove her worth to this intimidatingly accomplished man. The relationship lasts longer this time around, a year, maybe two. Then it implodes just as violently, with the woman insisting he was a manipulative and neglectful partner. He’s baffled by the claims; she’s the one who was always offering to support his success! It’s not like he made her do anything. And besides, everything he did was for the both of them. He just wanted to provide. Back to the carousel of casual dating he goes, still carrying the hope of finding The One, a woman to complete him, to prove to the world that he’s an attractive, successful man. All the while, a void grows in his chest. Every day, he seems to wake up with less energy and more dread. A friend hints that he’s burning out, and this insinuation panics him, so he runs off to the Amazon to do some ayahuasca about it. But the travel and drugs no longer invigorates him in the same way, and it’s beginning to truly worry him. He refuses to focus on these emotions, though. Emotions make him illogical and weak, and he needs to be strong and decisive. He’ll keep his focus on his company’s success, making sure that he can continue to provide and prove his worth. And in the meantime, he’ll keep searching for his perfect match to reap the rewards of his success and reassure him that he’s truly an excellent provider. It’s a small pool of women who meet his quality bar, but he’ll eventually find The One. He knows it. After all, when he puts his mind to something, he always succeeds. Dating a Man Who Provides: Two words sum up dates with these men: pity and frustration. These dates generally begin with these men stating that their time is quite limited, hinting that they’ve made quite the sacrifice to offer some of it to you. Things only go downhill from there, with the entire affair feeling like an intense job interview. I have zero interest in passing these interviews, which creates frustration in these men. I’ve wasted their precious time, and they’ve wasted mine. They generally end the date quite quickly, convinced that I have no hope of clearing their quality bar. Yet they have no hope of clearing mine. A strong sense of self-identity is a requirement for anyone I date, and these men have never been given the chance to develop one outside of “founder” or “Ivy Leaguer” or “Forbes 30 Under 30.” This leaves their identity hopelessly precarious and revolving around their immediate success. A bad day at work or a failed business deal can spell weeks of brooding and self-loathing. You never quite know what version of the man may appear; he could be euphoric from his latest product launch, or despondent and moody from a meeting that went wrong. There’s little I can do to address the issues faced by Men Who Provide. Try to talk them out of focusing so much on standard capitalistic forms of achievement, and they’ll often accuse you of being jealous and sabotaging their success. Point out their clear misery, and they’ll insist “there’s no gain without pain,” and if they can just achieve a constantly moving goalpost, they’ll finally be happy. These men generally only shake off this mentality after burning themselves out and facing a bout of depression so severe it kills their ability to succeed in a traditional capacity. This forces them to find other ways to derive satisfaction and finally grow a self-identity that doesn’t revolve around money and success. It’s saddening that these men have to go through this burnout process to learn these lessons; I hope to see less of these men in the future, as more people come forward to describe this toxic form of living. In the meantime, I try to catch young men before they fall into these self-destructive patterns. I lecture my young interns about the hazards of a success-obsessed lifestyle, and encourage them to find senses of worth that don’t revolve around gaining power and providing money. I’ll be honest, they don’t seem to listen to me much. But I hope my words remain in the back of their mind, ready to help guide them away from misery when they’re ready to make that change. THE MAN WHO OPTS OUT The Man Who Opts Out is a growing contingent of the male population, but a rare sight in the dating world. These are men who have given up on dating, or never even attempted it in the first place. Some of these men have serious, obvious flaws that keep them locked out of the dating world, such as personality disorders, issues with violence, or severe trauma that’s gone unaddressed. The majority don’t fit this description, though. In fact, in the Bay Area, a large number of these men are very high-functioning members of society who are smart, respectful, and financially successful. Often the Man Who Opts Out is the victim of bullying or neglect as a young adult. People accuse him of being awkward, or short, or shy, or overweight, or an “undesirable” ethnicity. Or maybe no one ever directly vocalizes it, but the messages in the media are enough to convince him of his low self-worth, and his interactions with girls seem to confirm it. Most treat him as if he’s invisible, and his few female friends are quick to emphasize that they’re just friends. Dating feels impossible. After all, the goal of dating is to make someone fall in love with you, and how could someone love him when he’s so terribly unattractive? He decides to shove aside dating and focus on the other things society tells him are important: his schooling, his career, his social circle. He can actively work to improve and succeed in these areas, whereas being attractive feels miserably out of his control. When he’s a teenager, this mentality doesn’t cause much alarm. In fact, some mentors even mistake his avoidance of dating as a sign of maturity. He “has his priorities straight,” they say. Yeah, some of his peers might mock him for not having a girlfriend, but did they get into MIT? Nope. But he did. That helps to ease the pain of not having a date for senior prom. When he’s in his early-twenties, his aversion to dating starts to feel like a problem. Friends and family comment on it, voicing concern. He decides, reluctantly, to give dating a shot. Loneliness is beginning to eat at him, and he decides it’s worth facing his fears to have a girlfriend who infuses his life with warmth and affection. He’s still terribly self-conscious about his attractiveness, but his friends insist he’s “perfect boyfriend material,” so he gives it a chance. His attempts don’t go well. In fact, you might say they’re a bit of a disaster. Women have come to expect a certain level of romantic competence from a twenty-two-year-old, and he just doesn’t meet the bar. It’s a painful shock. He’d started to gain his confidence back, proving through his successful schooling and his burgeoning career that he’s really worth something, even if he doesn’t quite meet the traditional model of a hot young bachelor. At this point, he’s accustomed to succeeding at most things in life. But every attempt to flirt and date paints an entirely different picture of himself: he’s practically trembling with nerves, unsure what to talk about, prone to rambling about his niche interests until their eyes glaze over, terrified of accidentally being a creep, yet overly eager for the romantic affection that he desperately craves. He’s a bit of an anxious, awkward mess, and most women don’t enjoy the vibes. One even starts a rumor that he’s a creep. The accusation brings back an aching self-consciousness he hasn’t felt in years. He vows to stop even trying. After all, what’s the point? It’s hopeless. Years pass. He settles into his career, becomes more successful and more mature. He’s not exactly a social butterfly, but he has some good friends and enough love and connection in his life to keep him tumbling down the path of a Man Who Is Not. Yet something is missing. He tries not to think about it, but there’s a growing emptiness inside him that makes life increasingly hollow. It’s not just a missing girlfriend; it’s a lack of someone, anyone, finding him attractive. More and more friends are finding committed relationships. At the end of the day, they go home to cuddles and laughter and sex and long, deep conversations. He returns home to his silent apartment and plays video games. That’s it, he decides. He’s done feeling miserable and lesser. He’s not some hapless twenty-two-year-old anymore. He’s a good, mature man with good friends who insist he can find someone, if he just tries. He’s no longer in college, so meeting women isn’t as easy as it was when he was twenty-two and still living on a campus. He downloads a dating app, and almost immediately regrets it. He gets maybe one match a month, and it’s almost always a bot. When he does match, he carries the conversation, and the woman usually ghosts at a certain point. He spends hours and hours swiping on profiles, growing more bitter with each swipe. When he goes on dates, he feels like he’s being interviewed, and usually the woman ghosts him afterward. He takes another break from dating. More years pass, and his friends who are coupled feel increasingly alien. They’re having weddings, honeymoons, kids; buying houses and saving for college; attending recitals and soccer practices. He’s still playing Call of Duty and Dota with his dwindling group of single friends. Occasionally, some of his coupled friends will join them on Discord, playing a couple hurried rounds before having to log off to cook dinner or tuck the kids into bed. Damn, I miss being single, they’ll say, laughing. You have all the time, all the hobbies, all the peace you could ever want. They don’t address the elephant in the room–that at any time, they could dump their partner and be single again. Yet they don’t. Because being alone sucks. As he nears his mid-thirties, an interesting development occurs: women start to actively become interested in him. Those superficial characteristics that kept them at bay when he was younger no longer seem so important. So what if he’s only five-foot-six and a bit heavier than average? He has an amazing job, a stellar reputation, a gorgeous apartment, and a great sense of humor. He’s a catch. Yet once they discover he’s never been in a long-term relationship, they once more seem to recoil. He enters into a series of short-term flings, trying to make up for the lost experience. At first it’s exhilarating to have women actually show interest in him. They like him. They want him. Quickly, it becomes exhausting. Even when women initially approach him, he’s the one who must invest the most effort. The women know what they’re doing; he’s constantly trying to keep up. Some of them get tired of waiting for him to learn and walk away, opening up old wounds in his self-confidence. He considers trying to make one of the connections more serious, but it becomes obvious that she’d expect him to change so much. His hobbies, his sleeping patterns, his work habits, his furniture, his friendships… all of it would require modification to keep a girl around. And history has taught him that he’ll just end up getting rejected anyway, so what’s even the point? It all feels so futile and so unfair. All around him, he sees women who settled with crappy men who don’t treat them properly. He wouldn’t do that; he’s a good person. Maybe a bit socially awkward, maybe not the handsomest, maybe a little clueless about some aspects of relationships, but he can learn to be a good partner, if he’s just given a chance. Some of his single friends have officially given up on ever finding a woman, and they encourage him to do the same. It’s peaceful, they insist. No more pointless pining, no more painful daydreams that never come true. They’re right, he decides. He’s done. It’s over. Yet one evening, as he lays in bed, the loneliness chews at his soul as he stares at the empty spot beside him. He reaches for his phone and downloads a dating app. He’ll go on just one more date, he tells himself. Just to remind himself of why he doesn’t date anymore. Just to remind himself of why it’s futile to even try. Dating a Man Who Opts Out: A date with a Man Who Opts Out is a losing battle. They arrive defeated and suspicious, certain they’re wasting their time, and it’s a self-fulfilling prophecy. Some awkwardly avoid any topic that could reveal their lack of dating experience, while others throw it in your face, wanting to get the reveal over with. I’m often surprised by the men who fall into this category; society paints them all as grungy, awkward trolls who live in their mothers’ basements, but many are not only high-functioning members of society, but also highly desirable individuals–attractive, wealthy, successful. Yet their self-confidence doesn’t reflect this success; they’re mentally trapped as the awkward, bullied teenager, convinced no one could ever truly love them. For some, this causes bitterness or apathy to spoil interactions with women; dates with these men are uncomfortable events for everyone involved. Every question is met with suspicion, with the man assuming his responses will be used to negatively judge him. For others, their lack of self-confidence causes a painful shyness and refusal to open up. They’re convinced that at any second, the woman will find something about them to reject, so they hide as much of themselves as possible. These are some of the most painful dates I’ve experienced. The nurturing side of me wants to pull the man into a hug, to assure him he’s enough, to promise I won’t judge. Yet the logical side of me knows I need to judge–ultimately, it’s a necessary part of dating. And a crippling lack of self-esteem is a death blow for the stability of any relationship. If I want a healthy relationship, I simply cannot date someone with that trait. It’s a vicious cycle–a man’s confidence in his dating ability is crushed, he finally works up the nerve to show up to a date, gets rejected, and his self-esteem lowers even more. He limps off to nurse his wounds, vowing to avoid the “pointless” exercise of dating. It might be another year before he attempts to go on another date, or two years, or perhaps he just gives up altogether. I absolutely hate being a participant in this cycle. It’s the dating equivalent of kicking a puppy and always leaves me feeling a dull ache of empathy for the men involved. I also hate the standard advice given to these men: that it’s “just a numbers game” and they need to “just keep putting themselves out there.” The truth isn’t nearly so easy. A man with severe self-esteem issues is not likely to find a healthy relationship, no matter how many times he flings himself at the dating world. The core issue of self-esteem must be addressed. For some, this means structured therapy or psychiatric treatment, for others, it means growing their social life until it’s vibrant enough to soothe the part of their soul that insists they’re not enough. Or maybe it’s a combo of all three or something else entirely. But action needs to be taken to address the lack of self-esteem; the man can’t just half-heartedly daydream about a woman who might swoop in to “love him just the way he is” and solve all his confidence problems. Also, relationships take practice. If a man is past the age of twenty-five and has never been in a committed relationship, most women will view this as a red flag. They’ve spent their teens and early-twenties doing the hard work of learning how to be in a relationship, and they don’t want to partner with someone who hasn’t even begun that journey yet. The good news is that there are ways to compensate for this. I would happily date a thirty-year-old who has never been in a romantic relationship, if he has other social relationships to prove his viability as a partner. Close ties to his friends, family, and community can prove he’s well-versed in all the vital elements of a relationship: communication, trust, empathy, honesty, etc. Yet the fact remains that the longer someone opts out of the dating world, the harder it becomes to opt back in. So my advice to men who fall into this category is to rip off the bandaid. If they want a partner, they need to start working toward it now. Overcoming insecurities and past traumas takes time and effort. The good news is that men who fall into this category seem to be pleasantly surprised at how quickly their social and romantic prospects improve, once they identify and address the root issues. Many of them happily “graduate” out of this category and go on to have wonderful relationships. I have a feeling the man I end up partnered with will be someone who graduated out of this category. After all, both my previous serious partners fell into this category earlier in their life. I seem to have a soft-spot for people who overcome insecurities; they tend to be delightfully empathetic and dynamic individuals. In the meantime, I’ll continue to try to encourage men who fall into this category not to give up. There’s a path to healthy, happy relationships. It may not be simple, but as the tired but true saying goes, nothing important ever is easy. THE MAN WHO BECOMES A BEAST The Man Who Becomes a Beast often begins as a Man Who Is Not. He is lost, and depressed, and anxious to find himself, yet unsure how to even begin. He drudges through his job, hating every moment, yet sometimes he hates being away from work even more. At work, he’s at least acknowledged as a person. As soon as he leaves, the lonely silence of his existence threatens to suffocate him. He doesn’t know what he wants from life, but he knows it’s not this. The city is filled with young, attractive women that inspire wistful daydreams. Maybe he’ll ask one out, and they’ll hit it off, and then his apartment will no longer be empty. Then maybe she can introduce him to her friends, and the empty abyss of his social calendar will suddenly be filled with dinners, and trips, and concerts, and— No. He doesn’t dare. He’s far from an Adonis–his physique pales in comparison to most men. Chances are, any girl he asks out will say no, and she’ll think he’s a creep for approaching her. Then she might tell the other women that he’s a creep, and the whole thing would be a disaster. It’s better not to directly approach women. He can find a girlfriend on the apps. Except that certainly hasn’t been going well. He rarely gets matches, let alone dates. On the rare instances they occur, the women seem bored by the conversation and pepper him with questions about his intentions and future that he can’t answer. His performance at work slips, and he’s placed on a performance improvement plan. He knows he’ll probably be fired next quarter, but he can’t bring himself to care. His doctor tells him he’s depressed and tosses some pills at him, but it only serves to anger him. The anger is a surprise. He’s not an angry person, or at least he’s never been in the past. Yet the emotion keeps flaring to life in his chest, poisoning his mind with spite. Spite toward his idiot manager who doesn’t give a shit about him. Spite toward the women who judge him without truly knowing him. Spite at the asshole doctor who mindlessly writes a prescription without bothering to understand the real problem. There’s nothing wrong with his head; it’s the rest of the world that’s the problem. He doesn’t do anything wrong, yet the world treats him like he’s less than worthless. He doesn’t need pills, he just needs someone to give a shit. He struggles to focus and turns to social media to distract his churning mind. YouTube, Instagram, and TikTok indulge him with a steady stream of entertainment, numbing his frustration and anger with an unceasing shower of fitness routines and video game hacks and soccer highlights. Gradually, the algorithms drift toward new content. A buff dude sneers into the camera, pointing an accusing finger as he rants about “betas” and their pathetic video games and tiny dicks. It’s not the first time this influencer has crossed his feed, but it is the first time he actually watches a full video. He’s not sure whether to be offended or amused. The video is so over-the-top that he wants to laugh it off, but it also hits some painful insecurities. He is wasting his life at his shitty job. He would attract more women if he worked out more. He hates feeling awkward and uncertain and invisible. He watches several more videos. The influencer sure isn’t a philosopher, but he at least has the balls to discuss the way society has neglected men. High school graduation rates are plummeting, college enrollment has taken a nosedive, addiction is spreading like wildfire, incarceration is creeping upwards, suicide rates are rocketing to the sky. Where’s the public dismay? Where’s the outrage and the activism? Nowhere, says the influencer. All those activists are too busy accusing men of being dangerous monsters to bother caring about them. Fuck those people and all they stand for, says the influencer. If you want anyone to care about you, you have to make them care. And this influencer knows exactly how to accomplish that. And then he gives it: a map for manhood. One that’s entirely different from the vague, confusing, dismissive directions that polite society has offered. One whose guidance loudly insists that being a man is a good thing, something to be proud of and use to his advantage. The manosphere map promises power, success, sex, money, belonging, and confidence if it’s followed. In contrast, the map offered by polite society offers a vague promise to not be considered a failure or a danger. The choice seems obvious. If he looked hard at the manosphere map, its contradictions are obvious. It promises the respect and adoration of women, but insists this is to be gained through mistreating them. It promises power and money, yet discourages higher education, despite this being the most sure-fire way to climb the class ladder. It insists women are less intelligent and logical beings, yet also insists they have taken over control of the world. Yet it’s hard to think critically about these contradictions; life has left him exhausted and angry, and the manosphere map insists that success and payback are just a few easy steps away. And those steps are deliciously concrete and specific. The manosphere offers millions of hours of video tutorials on the single subject of how to get a woman “out of your league” to like you. Meanwhile, polite society balks at the mere question, droning on about how romantic “leagues” are an inherently patriarchal and harmful concept. Sure, some of the advice seems off. Insulting women goes against how he was raised, and some of the money advice seems like it's using people. Yet how he was raised led him to be anxious and invisible. And the rest of society seems to be using him, so why shouldn’t he turn the tables? And besides, the map works. He knows it does. There are a hundred comments on each popular video balking at their morals, but a thousand more from men reporting the success of the techniques. He decides to give it a try. He goes out and uses the techniques at a bar, and it works. He brings a woman home for the first time in years. Yeah, she seems kind of unstable and uncertain, but that’s to be expected. She’s a woman, after all. She just needs an alpha male to give her guidance and purpose; he’s actually doing her a favor. He’s hooked. On the clear directions, on the sex, on the feeling of power. And although he doesn’t like to admit it, he’s hooked on the attention. His actions and opinions upset the people he’s determined to be his enemies; he likes their outrage, and the way he’s able to control their emotions with merely a few words. They hate him, but that’s okay, because he hates them too. The influencers were right: fuck society and their weak, pathetic norms. If you want something, you have to be a real man and take it. Dating a Man Who Becomes a Beast: There’s a unique aura that surrounds Men Who Become Beasts. Some are fit, and cocky, and smooth, exuding the hyper-masculine air that the Tate brothers exemplify. However, most remain awkward and abrasive, juggling self-consciousness with a sneering confidence that they’re more enlightened than the “sheep” who refuse to see the “truth.” Both types share a noxious mixture of arrogance and frustration, and they’re all too eager to prove their disdain for the world. I rarely end up on dates with these men; I’ve gotten good at detecting them over the years, both in-person and on dating apps. Still, occasionally they slip past my radar, and I find myself grabbing coffee with someone whose presence raises my hackles. I will always end the date as soon as possible and update my detection heuristics. Yet it seems impossible to truly avoid these men. I punched one a few months back. He tried to dance with my friend at a concert, refused to take her clear “no” for an answer, forcefully shoved himself against her, and did not appreciate me shoving him back. He grabbed my arm and yanked me toward him; I landed a jab to his throat. (Apparently, the manosphere doesn’t teach men to tuck their chins during a fight. Quite the oversight.) My jab shocked him enough to loosen his grip, and I yanked free. Three strangers from the crowd grabbed him, restraining him as he tried to lunge at me. His face twisted in a snarl as he hurled insults over the booming bass. Cunt, crazy bitch, low value whore. It was the latter insult that gave it away: he was yet another young man drugged by the toxic ideology of the manosphere. There was something darkly poetic about the scene: three strangers, all men, throwing themselves in harm’s way to stop a two-hundred-pound brick of muscle from pulverizing me. Struggling against their grasp was the Hyde to their Jekyll, a rabid animal who used his natural strength to attack rather than to protect. I pity that young man. He was well-dressed, handsome, and fit, clearly doing something right to have made it to an expensive concert in a popular city. Yet his mind has been tainted by a creed that turned him into a predator. The preachers of this creed promise success and respect, yet in reality, they doom their adherents to be unfit for society, forcibly outcast from any loving community. That young man walks the world as a predator, destined to be deprived of the love and respect he yearns for. He’ll likely gain some twisted semblance of a relationship; there are plenty of women out there who won’t recognize the warning signs. But it will be a relationship rooted in fear and manipulation, devoid of the warmth of love. He will feel that coldness. It will haunt him, and stoke his anger, and some poor woman will probably be the victim when his rage boils over. I don’t know what to do about these men. I worry it’s too late for most of them; so many have been steeping in the manosphere ideology for years, and converting them away will be as hard as swaying a religious fanatic. So I avoid them. I fear them. And I sure as hell don’t date them. V. The Man Who Is Whole Don’t let my categories of lostness convince you that all men are bumbling through life without purpose. Many men have beaten the odds and become Men Who Are Whole, and these men deserve an entire section devoted to them. A Man Who Is Whole rarely begins whole. Occasionally they do, but these are rare and frankly baffling anomalies. Most begin within another category, and through a combination of sheer will, some luck, and the support of a community, they forge themselves into remarkably solid individuals. A Man Who Is Whole has created his own map to manhood. Often, he’s been blessed with close mentors, and usually it’s coupled with an intense passion for something. Maybe he’s passionate about teaching, or building a business, or becoming a father, or creating music, or writing long-winded essays about the dangers of AI. Whatever it is, it’s a purpose he can use as his true north when piecing together his personal map. His passions lend themselves to goals, but after some trial and error, it becomes clear that obsessing over his personal goals doesn’t feel quite right. He needs to find some way to benefit his community through his goals. But what is his community exactly? He’s not sure, but he’s determined to find out. It’s not easy, and he screws up several times, burning and getting burned by various relationships. But eventually he manages to find a solid community, a real one with deep, emotional bonds and a mutual desire to provide love and support. His passion gives him motivation; his goals give him intention; his community gives him purpose. Combined, they provide a scaffolding for him to build himself into the best version of himself. He continues to flesh out his map, creating a unique path with the help of his community. Mentors guide him, peers critique him, friends and partners encourage him. The map is a messy thing, with lots of erased sections and some meandering parts, but after several years, it finally feels finished. He knows how to be a man, because he knows how to be himself, and there is no doubt in his mind that he is a man. Some of the traits are exactly what he expected when he was a boy dreaming about manhood: his confidence, his strength, his protectiveness. But others were surprise discoveries: his empathy, his restraint, his soft spot for kids and desire to mentor them. The map is his, and his alone, a hard-won victory personalized to his wants and needs. It should be celebrated and cherished, and whenever he gets the chance, shared with other young men who might benefit from its contents. Dating A Man Who Is Whole: Dating a Man Who Is Whole is a rare and precious experience. Their presence has a solidness that’s infinitely alluring and soothing, and it makes me want to nuzzle into their chest and listen to their heart, to marvel that such mundane biological pieces could somehow have produced such a magnetic presence. There’s a stereotype that Men Who Are Whole are always overtly confident and highly masculine, but I haven’t found this to be true. In fact, many of them carry a subtle sort of masculinity that lends itself to gentleness and empathy. They have little to prove to the world, because they know who they are, and so does their community, and they are respected for it. They have overcome a lot to achieve this frame of mind. They’ve bumbled through confusing directions and dead ends, but never given up, and the persistence has paid off. It makes them invaluable partners through difficult times; they know how to handle themselves in tough situations, and they’re eager to share their strength with others. They’re not perfect. No human ever is. But they know that, and they have the humility to discuss issues in an open and empathetic way, while still standing their ground when necessary. It’s an honor to be loved by a Man Who Is Whole, and it’s always a surprising delight when they choose you as the focus of their affection. But there is also an inevitable sadness that clings to the edges of their presence. After all, it’s only when you interact with them that you realize how lost all those other men are. They usually are aware of how different their existence is to many other men, and they carry the weight of friends and loved ones who have been permanently lost to other categories. I believe that most young men have the potential to become Men Who Are Whole, if they’re given the right support and guidance. I think the rarity of these men is one of the greatest indictments on our current culture and our methods of raising boys. Yet I’m hopeful that someday they’ll be the rule rather than the exception. I’m deeply lucky to have several of these men in my life. If you do as well, don’t forget to remind them how grateful you are for them and how proud you are of who they’ve become. Oftentimes, they don’t understand just how impressive and important they are. So tell them, and treasure them, and maintain hope that someday there will be more of them. VI. Crafting a New Map The sheer number of lost men make it obvious that polite society has failed to deliver an effective map to manhood. Men are miserable, and their pain is reflected in the rising rate of suicide, depression, anxiety, joblessness, and crime. The numbers don’t lie: the current map doesn’t work. Society owes it to young men to draft a new map for them, one with more positivity and concrete steps that can help them avoid getting lost. I have many ideas about potential fixes and additions to the Modern Map to Manhood, but there are five that I feel are most important: Encourage positive male role models to provide detailed directions on how to “become a man.”
Hydra

Hydra is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between March 23, 2021 and March 23, 2021. The archive places it in contexts such as "Taleb's first (and cutest) example is the Hydra, which grows more and more heads the more a hero tries to harm it". It most often appears alongside 2008 crisis, A Failure, But Not Of Prediction, Ancient Phoenicia.

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Hydra
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March 23, 2021
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March 23, 2021
March 23, 2021 · Original source
The glass is fragile: the less you disrupt it, the better it does. A rock is “robust” - neither fragile nor antifragile - it will do about equally well whether you disrupt it or not. What about antifragile? Taleb's first (and cutest) example is the Hydra, which grows more and more heads the more a hero tries to harm it. What else is like this?
Hydraulic Despotism

Hydraulic Despotism is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 13, 2022 and August 13, 2022. The archive places it in contexts such as "The book likens this to Hydraulic Despotism". It most often appears alongside ACX, AI, ancient Greeks.

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Hydraulic Despotism
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1
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August 13, 2022
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August 13, 2022
August 13, 2022 · Original source
It’s a book that meditates on the loneliness of true superiority, of the ennui of true invulnerability. It is a book that ponders humanity as brought to heel at the side of a benevolent and less-than-human mind with greater-than-human capabilities. Hydraulic Despotism As was the case in the nearly two-Christianities-ago day of Leto’s father, control of the spice resources of the planet Arakis amounts to de facto control of the universe; it’s the unobtainium does-everything-you-need resource the dune universe runs off. The book likens this to Hydraulic Despotism, where control of an all-important resource (generally water) allows for control of everything downstream of and reliant on that resource.
As was the case in the nearly two-Christianities-ago day of Leto’s father, control of the spice resources of the planet Arakis amounts to de facto control of the universe; it’s the unobtainium does-everything-you-need resource the dune universe runs off. The book likens this to Hydraulic Despotism, where control of an all-important resource (generally water) allows for control of everything downstream of and reliant on that resource.
hydrogen

hydrogen is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 09, 2021 and September 09, 2021. The archive places it in contexts such as "The hydrogen in water is a combination of normal hydrogen". It most often appears alongside Amazon, American, Castro.

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hydrogen
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September 09, 2021
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September 09, 2021
September 09, 2021 · Original source
The hydrogen in water is a combination of normal hydrogen (only a proton in the nucleus) and deuterium (a proton and neutron in the nucleus). These have slightly different chemical properties, so you can do various types of distillation to enrich for one or the other, including repeated freezing (realistically freezing works very slowly; our hypothetical spy would need an unrealistic amount of time, water, and patience). Normal water is about 99.9% H2O, 0.1% HDO, and negligible amounts of D2O. Water with more D2O than normal is called heavy water, water with more HDO than normal is called semiheavy water, and water with more H2O than normal (ie not even the usual tiny amounts of the other two constituents) is called light water.
Move on to the molecular biology argument. The basis of cellular energy generation is the proton pump in the mitochondria, which moves hydrogen nuclei around to create a charge gradient. If the hydrogen nuclei have unexpected neutrons, that could jam the pump or change how the gradient works. I'm not entirely able to follow this, but maybe then there is some kind of cellular signaling cascade? Basov, Fedulova, Baryshev, and Dzhimak:
hydrogen bomb

hydrogen bomb is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 13, 2022 and July 13, 2022. The archive places it in contexts such as "instrumental in the development of the hydrogen bomb and much of modern statistics"; "instrumental in the development of the hydrogen bomb". It most often appears alongside 1890s, Alan Turing, Albert Einstein.

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hydrogen bomb
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July 13, 2022
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July 13, 2022
July 13, 2022 · Original source
John von Neumann invented the digital computer. The fields of game theory and cellular automata. Important pieces of modern economics, set theory, and particle physics. A substantial part of the technology behind the atom and hydrogen bombs. Several whole fields of mathematics I hadn’t previously heard of, like “operator algebras”, “continuous geometry”, and “ergodic theory”.
Granting that von Neumann was not a nerd, was he a psychopath? This has been a matter of more debate. His detractors called him “cold”, “calculating”, and “ruthless”, and pointed out that his game theory work, while brilliant, tended to focus on the most cutthroat scenarios (it was he who invented the term “zero-sum game”). While some of his Manhattan Project collaborators came to regret or at least agonize over their role in inventing the Bomb, von Neumann was disinclined to waste time questioning past decisions. Instead, he goaded the government to get to work building bigger, deadlier hydrogen bombs before the Russians managed the same.
The book actually has a story that touches on this point in a kind of hilarious way. Von Neumann’s friend, fellow European Jewish emigre, and fellow Manhattan Project physicist Stanislaw Ulam contracted a case of viral encephalitis, an inflammation of the brain. His doctors told him that he should “rest his brain”, ie avoid thinking too hard. A desperate Ulam tried to distract himself by playing solitaire, but couldn’t help wondering about the probabilities of winning. Failing to solve the problem with any statistical trick then known, he was unable to prevent himself from developing what is now called the Monte Carlo method, which proved instrumental in the development of the hydrogen bomb and much of modern statistics.
hyoid

hyoid is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 19, 2024 and July 19, 2024. The archive places it in contexts such as "Part of the reason for erectus ’s probably mushy speech is that they lacked a modern hyoid (Greek for ‘U-shaped’) bone". It most often appears alongside Alan Turing, Amazon, Amazon jungle.

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hyoid
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1
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July 19, 2024
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July 19, 2024
July 19, 2024 · Original source
Erectus speech perhaps sounded more garbled relative to that of sapiens, making it harder to hear the differences between words. … Part of the reason for erectus’s probably mushy speech is that they lacked a modern hyoid (Greek for ‘U-shaped’) bone, the small bone in the pharynx that anchors the larynx. The muscles that connect the hyoid to the larynx use their hyoid anchor to raise and lower the larynx and produce a wider variety of speech sounds. The hyoid bone of erectus was shaped more like the hyoid bones of the other great apes and had not yet taken on the shape of sapiens’ and neanderthalensis’ hyoids (these two being virtually identical).
hyperbolic discounting

hyperbolic discounting is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between April 15, 2025 and April 15, 2025. The archive places it in contexts such as "a clearer understanding of the circuitry involved (in this case, hyperbolic discounting )". It most often appears alongside Affordable Housing Bureau, Ajb, Alienation of labor.

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hyperbolic discounting
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April 15, 2025
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April 15, 2025
April 15, 2025 · Original source
Homeowners want to preserve or increase the value of their houses. Of these, I think 6 is one of the less important ones - if this were the dominating factor, people would support upzoning, since it usually raises the value of properties in the upzone (if developers can build skyscrapers on your land, then your land value goes up relative to the profitability of skyscrapers). But part of the problem is that people don’t support upzoning. So 6 can’t be the dominating factor. Without POSIWID, people could think about all of these possibilities and come to their own conclusions. POSIWID tries to ban thinking about 1-5 by fiat, insisting that 6 is the only possible explanation and anyone considering the others is naive. I think this makes it a bad heuristic. But there are two more concerning things about how Negating is using POSIWID. First, he’s picking out one particularly salient thing the system does (raise house prices) and claim that’s “the” purpose. He could equally well pick any of the other results - preserve neighborhood character, protect the environment, help Chinese people escape currency controls. Like I said in the original post, in practice POSIWID serves as justification for paranoia - whatever effect you like least, whatever possibility would be most sinister - that’s the one that the system is intentionally aiming for. Second, he’s saying it’s the purpose of “the” system. Which system? I bet whatever government he’s talking about has some organization called the Affordable Housing Bureau, or whatever. And I bet that the Affordable Housing Bureau really does make housing slightly more affordable, relative to the counterfactual where it doesn’t exist. It’s just that lots of other government, market, and social forces conspire to make it much less affordable. If Negating were to claim “The purpose of the Affordable Housing Bureau is to make housing less affordable”, this would be false even if the overall picture (the government is deliberately raising real estate prices) were true. Brad writes: I have to toss in Pournelle's Iron Law. The purpose of a system - when it is first established - may be dramatically different from the purpose it assumes after a few years. Consider: You establish a system to solve a problem. That could be homelessness, or asylum, or drug abuse, or any of a number of other things. This system employs people, who then have an automatic interest - not in solving the problem - but in prolonging it, even in making it worse. After all, without the problem, the organization would not need to exist. And hwold writes: I see it used as "if you have a complex system/bureaucracy to solve X, then the incentives inside it is for X to get worse, and incentives will not have 0 influence on outcomes" For example : https://x.com/Devon_Eriksen_/status/1906042672499864034 I think this sounds profound on first glance, and it’s probably true in some cases. But it’s not nearly true enough to be an Iron Law. Try to think about it in specific Near Mode cases: If you eliminated police, would crime go down, because the police have an incentive to preserve crime? If you eliminated the fire department, would fires go down, because the fire department has an incentive to preserve fire? If you eliminated doctors, would cancer deaths go down, because doctors have an incentive to preserve cancer deaths? If you eliminated the FDA, would dangerous drug side effects go down, because the FDA has an incentive to preserve dangerous drug side effects? If you eliminated the Federal Reserve, would bank runs go down, because the Federal Reserve has an incentive to preserve bank runs? Brad’s original comment mentions homelessness and drug abuse, but I know some drug abuse doctors, and they’re (mostly) good people who do their best in a tough situation. Drug abuse doesn’t continue because drug abuse doctors are secretly ensuring it continues to help their bottom line. Drug abuse continues because fentanyl is really, really addictive. Even good conspiracy theories don’t work like this. Was there a conspiracy among pain pill manufacturers to addict people? Yeah, kinda, although I think the degree to which this caused the opioid crisis is pretty overblown. But the pain pill manufacturers weren’t a system dedicated to preventing addiction. They did their job (reduce pain) fine, then ran an unrelated evil conspiracy on the side! Breb writes: This way of thinking may result from taking a strategy for predicting the motives of individuals, and using it to predict the motives of organisations. "Cui bono?" works when you're considering a single action carried out by a single person at a single moment in time, but it doesn't really work when you're considering the behaviour of hundreds of people who are incentivised to somewhat-but-not-perfectly cooperate over a long period to somewhat-but-not-perfectly implement a goal that was established by someone who somewhat-but-not-perfectly understands that that goal is just an instrument to attain a larger, more complex goal set by somebody else. I’m against this for individuals too! There are a million self-help gurus who try to convince you that that if you procrastinate - let’s say you always do term papers the night before and get terrible grades and it’s threatening your ability to complete college - then it must be because this secretly benefits you in some way. Maybe your overly-strict father wants you to complete college, and you’re deliberately trying to fail as a secret act of rebellion against him hidden even from yourself. Although something like this might sometimes be true, more often a clearer understanding of the circuitry involved (in this case, hyperbolic discounting) saves you from these labyrinths and lets you think about things straightforwardly again. Tom J writes: In the original Stafford Beer sense, the slogan POSIWID means that you can't tell from outside the system whether any given behaviour was *intended* or not. For the purposes of objective analysis, you have to treat your system as a black box that *does* whatever it's observed to do, as opposed to what people *claim* the point of the system is. This may be true in cybernetics. Or it may be an interesting methodological commitment, in the same way that the behaviorists’ “assume there is no such thing as human interiority” was an interesting methodological commitment. But I don’t think it’s common or valuable in normal-life analysis of social systems. When Biden bans NVIDIA from sending advanced chips to China, black box analysis would have to be ambivalent between explanations like: Biden personally hates Jensen Huang and wants his company to suffer
hyperforin

hyperforin is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 25, 2021 and May 25, 2021. The archive places it in contexts such as "The most important active chemical, hyperforin, might be a weak reuptake inhibitor". It most often appears alongside 2002 meta-analysis by Cochrane Collaboration, 5-HTP, 5-HTP.

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hyperforin
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May 25, 2021
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May 25, 2021
May 25, 2021 · Original source
St. John’s Wort is a plant which has been used in herbal medicine for centuries (its name may come from the Knights of St. John, who used it to treat wounds while crusading). The most important active chemical, hyperforin, might be a weak reuptake inhibitor of various chemicals, including serotonin (which would technically make it an SSRI), but as far as I can tell this is too weak to really explain its effects. A meta-analysis of 35 studies including 6993 patients suggests it works, but other studies show no benefit. German studies tend to do the best and American studies the worst, which might either reveal something about those countries’ cultural biases, or about the different strains and extracts of the plant used in the two countries. This herb is infamous for interacting with various medications, and if you’re taking anything else you should talk to your doctor before starting it. This seems like a reasonable brand, but I’m open to suggestions for better ones.
hypergamy hypothesis

hypergamy hypothesis is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 24, 2023 and May 24, 2023. The archive places it in contexts such as "Wouldn’t the hypergamy hypothesis pronounce this a good deal for both of them?". It most often appears alongside Almas, American study, AttractiveWorld.

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hypergamy hypothesis
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1
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May 24, 2023
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May 24, 2023
May 24, 2023 · Original source
If both men and women care about their partners’ looks and status, but men care proportionally more about looks, then women must care proportionally more about status. So one form of the hypergamy hypothesis goes: since men seem to care more about looks than women, women probably marry up.
Maybe this isn’t as common-sensically wrong as it seems. I know many rich male Google programmers, but I have never seen any of them marry a stunning black girl from the ghetto. Why not? Wouldn’t the hypergamy hypothesis pronounce this a good deal for both of them? He gets a beautiful wife, she gets a rich husband? And it’s not just a race thing, I’ve also never seen them marry a beautiful hillbilly from West Virginia, or a beautiful farmer’s daughter from Modesto. I don’t even really see them marry a beautiful girl from the suburbs with a community college degree.
“Female hypergamy” (from now on, just “hypergamy”) is a supposed tendency for women to seek husbands who are higher-status than themselves. Arguing about educational hypergamy (women seeking husbands who are more educated than themselves) is especially popular, because women are now (on average) more educated than men - if every woman wants a more-educated husband, most won’t get them, and there will be some kind of crisis.
Hyperinfection syndrome

Hyperinfection syndrome is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between November 23, 2021 and November 23, 2021. The archive places it in contexts such as "Hyperinfection syndrome is pretty rare". It most often appears alongside 1/6 insurrectionists, Ahmed, Alabama.

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1
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November 23, 2021
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November 23, 2021
November 23, 2021 · Original source
Hyperinfection syndrome is pretty rare. For it to make even the slightest dent in the numbers, you would have to assume very very high prevalence of Strongyloides and also far higher incidence of hyperinfection syndrome than what has been described.
"The host innate and adaptive immune response plays a critical role in the maintenance of chronic strongyloidiasis and the prevention of hyperinfection syndrome and dissemination. Similar to other helminth infections, strongyloidiasis elicits a Th-2 lymphocyte predominant immune response with production of cytokines, IgE antibodies, eosinophils, and mast cells which participate in expulsion and killing of the helminth [3, 7, 11]. Strongyloides antigens activate eosinophils via the innate immune response [12]. Activated eosinophils act as antigen presenting cells to stimulate antigen-specific Th-2 cytokine production including IL-4 and IL-5 [8•, 12]. IL-4 induces activated B lymphocytes to class-switch for production of IgE and IgG4 antibodies and additional cytokines (IL-8) attract granulocytes such as neutrophils to aid in larvae killing [7, 11, 12]. IgE production allows for mast cell degranulation and enhances further eosinophil migration [8•]. IL-5 acts as an eosinophil colony stimulating factor promoting further eosinophil growth and activation [8•, 11, 12]. Approximately 75 % of patients with chronic strongyloidiasis have peripheral eosinophilia or elevated total IgE levels [4, 12]. Protective immunity to infective larvae has been found to involve specific Strongyloides antibodies, complement activation and neutrophils in antibody-dependent, cell-mediated cyotoxicity type responses [11]. Patients with severe disease have been shown to have a significant decrease in antibody levels and a decrease in eosinophil level compared to asymptomatic infected individuals, suggesting that both antibodies and granulocytes play a significant role in protection from infection [11]. The sophisticated interaction between strongyloidiasis and the host immune system allows for long-term survival of the pathogen in the host gastrointestinal tract."
hyperlinks

hyperlinks is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 19, 2025 and September 19, 2025. The archive places it in contexts such as "Nelson understood them, would need to contain the targets in themselves". It most often appears alongside 1987, 1988, Adleman.

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hyperlinks
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September 19, 2025
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September 19, 2025
September 19, 2025 · Original source
compilable "Command Meta Language" Live on stage, in the year 1968, Engelbart started up the NLS, opened a document, and typed some words into it. The words, he said, constituted a statement. And statements made up a file. Engelbart copied, manipulated, saved, and loaded his words and statements and files, zipping around with his newly-invented mouse. He demonstrated his ability to embed documents in one another—images with links to statements, words nested and categorized by one another, files filled with metadata. And then he paused, and the screen went blank. He explained that he and his colleagues at the ARC had been using this system to do their daily work for the last six months. He mentioned that they had, now, six consoles up and running. He showed the crowd a real document, then navigated to a statement within it. “This presentation is devoted to the AHIRC.” “What is the AHIRC?” he asked. Engelbart “froze” the initial statement, clicked on the acronym, and below the words “Augmented-Human-Intellect Research Center” appeared. He kept clicking and freezing, and a trail of nested and related information appeared—a list of funders, a graph of staffing over time, a mission statement. This was hypermedia. These were hyperlinks, he explained. NLS was a hypertext system. The presentation went on for 90 minutes longer, and became known as The Mother of All Demos.2 At around the 75-minute mark, Engelbart shows that two different NLS users could edit a single document simultaneously. While this was extremely impressive functionality, it was achieved with time-sharing—computation was done on a single machine, switching rapidly between tasks—and became infeasible the very next year, when ARPANET was released and the number of machines you could connect to one system grew rapidly. Engelbart’s hypertext system was impressive in its own right, even without collaborativity. And still, little came of it—Andy van Dam, an attendee and revolutionary computer scientist himself, would reflect decades later: “Everybody was blown away … and nothing else happened. There was almost no further impact.” Engelbart’s ideas were just a little too out there. ARC quickly faded into obscurity. In 1972, Engelbart joined an organization called Erhard Seminars Training. EST, or “est” as it was marketed, offered a 60-hour self-improvement course for tech entrepreneurs modeled loosely on Zen Buddhism. Critics suggested that the est course was a mind-control method aimed at raising an authoritarian army. It was quite credibly branded a cult. The founder of est, Werner Erhard, was accused of tax fraud (he fought the claims and won $200,000 from the IRS) and incest (by his daughter, who later recanted). Engelbart served, for many years, on est’s board of directors. His researchers all left for greener, less cult-y pastures, and ARC died with hardly a whimper. No one really wanted to associate with Engelbart. His crackpot theories about an internet modeled after the memex fell into disrepute, and, if he was remembered at all, it was for the invention of the mouse. No one cared anymore about the memex, or hypertext. 3. Hyper-dreams of Hyper-everything Well, one man cared. Ted Nelson was born in 1937 to two twenty-year-olds, Ralph Nelson and Celeste Holm. His parents divorced in 1939, leaving him to be raised by his grandparents. Both Nelson (the elder) and Holm would go on to extremely-successful film careers: the former became an Emmy-winning director; the latter an Oscar-winning actress. And, at first, Ted seemed to be following in their footsteps. As a philosophy major at Swarthmore College, he produced a film called The Epiphany of Slocum Furlow, which he described as “a short comedy about loneliness at college and the meaning of life.”3 Nelson also claims to have “[d]irected [and written] book and lyrics for what was apparently the first rock musical” in his junior year at Swarthmore. Thankfully, his interest in a career as an entertainer soon waned, and Nelson went off to study sociology in grad school—first at the University of Chicago, then at Harvard. Nelson took a computer class at Harvard, in 1960, and “[his] world exploded.”4 He realized the incredible power of computing, quickly intuited that these new machines could be generally applied to everything, and founded Project Xanadu.5 Initially, Xanadu’s scope was pretty limited. Word processors weren’t around yet, but Nelson wanted to build something strikingly similar: he wanted to write a program that could store and display documents, with version histories and edits all stored and displayed at the same time too. Later, Nelson would call this version-history feature “intercomparison.” (Strange coinages will be a… theme; I’m just trying to get you ready.) Nelson began working on an implementation, but his feature wishlist grew quickly, and he didn’t really know what he was doing, so in 1965, he sought help. He prepared a talk for the Association for Computing Machinery, and dropped, quite frankly, a bomb on the audience: The kinds of file structures required if we are to use the computer for personal files and as an adjunct to creativity are wholly different in character from those customary in business and scientific data processing. They need to provide the capacity for intricate and idiosyncratic arrangements, total modifiability, undecided alternatives, and thorough internal documentation. The original idea was to make a file for writers and scientists, much like the personal side of Bush's Memex, that would do the things such people need with the richness they would want. But there are so many possible specific functions that the mind reels. These uses and considerations become so complex that the only answer is a simple and generalized building-block structure, user-oriented and wholly general-purpose. The resulting file structure is explained and examples of its use are given. Ted Nelson was building the memex. Of course, he wasn’t a very technical guy, and so his talk mostly focused on the philosophy of Xanadu, not its implementation. He commented (emphasis mine): There are three false or inadequate theories of how writing is properly done. The first is that writing is a matter of inspiration. While inspiration is useful, it is rarely enough in itself. “Writing is 10% inspiration, 90% perspiration,” is a common saying. But this leads us to the second false theory, that “writing consists of applying the seat of the pants to the seat of the chair.” Insofar as sitting facilitates work, this view seems reasonable, but it also suggests that what is done while sitting is a matter of comparative indifference; probably not. The third false theory is that all you really need is a good outline, created on prior consideration, and that if the outline is correctly followed the required text will be produced. For most good writers this theory is quite wrong. Rarely does the original outline predict well what headings and sequence will create the effects desired: the balance of emphasis, sequence of interrelating points, texture of insight, rhythm, etc. We may better call the outlining process inductive: certain interrelations appear to the author in the material itself, some at the outset and some as he works. He can only decide which to emphasize, which to use as unifying ideas and principles, and which to slight or delete, by trying. Outlines in general are spurious, made up after the fact by examining the segmentation of a finished work. If a finished work clearly follows an outline, that outline probably has been hammered out of many inspirations, comparisons and tests. Between the inspirations, then, and during the sitting, the task of writing is one of rearrangement and reprocessing, and the real outline develops slowly. The original crude or fragmentary texts created at the outset generally undergo many revision processes before they are finished. Intellectually they are pondered, juxtaposed, compared, adapted, transposed, and judged; mechanically they are copied, overwritten with revision markings, rearranged and copied again. This cycle may be repeated many times. The whole grows by trial and error in the processes of arrangement, comparison and retrenchment. Nelson recognized that the creation of knowledge is cyclical, recursive, self-referential. And he figured that our computer systems should accept and reflect that process: If a writer is really to be helped by an automated system, it ought to do more than retype and transpose: it should stand by him during the early periods of muddled confusion, when his ideas are scraps, fragments, phrases, and contradictory overall designs. And it must help him through to the final draft with every feasible mechanical aid—making the fragments easy to find, and making easier the tentative sequencing and juxtaposing and comparing. How do you design such a system? To navigate intuitively within complex file systems, between document versions, and across source materials—to access all the scraps and fragments writers need to write—you would need to establish what Vannevar Bush called “tracks.” You would need to connect and save different ideas, linking them together. That was it—you needed links. Nelson went further, though—it wouldn’t do to simply have links to all the other files, a writer needed to see the other files before him, needed them to be brought up and displayed alongside his current work on demand. The links needed to contain their targets within themselves—so Nelson called them hyperlinks. And he called text embedded with hyperlinks hypertext, and movies embedded in his structure became hyperfilms, and so on. Nelson wanted us using computers to write and create self-referential, intricately-interconnected (“intertwingled,” as he’d later put it), eminently-accessible hypermedia. And recall, in 1965, state-of-the-art computing looked like this. Ted Nelson was thinking far, far ahead. Maybe too far ahead. Conference attendees were initially excited about his idea, but when he revealed himself to know very little about the technical task of building Xanadu—or even whether it was possible at all—interest evaporated. 4. Failing to Develop Xanadu But Nelson was all in. He would later write, “This is not a technical issue, but rather moral, aesthetic and conceptual.” Nelson loved knowledge and connection and abstraction—mere technical details wouldn’t stop him from building the best possible computer system for producing and consuming information. He met Doug Engelbart in the mid 60s, forming a friendship with the only other man taking hypertext seriously at the time, and hopped around unhappily between various academic and scientific appointments. At one point, he and Andy van Dam worked together and produced the Hypertext Editing System—released in 1967, just before Engelbart’s NLS. It was the first computer application to ever have an “undo” button—Nelson claims to this day that he invented it (and the “back” button). Shortly thereafter, Nelson’s wife left him. In his 2010 autobiography, he writes, “She, reasonably, wanted a Nice Life; women want that sort of thing.” They had a son, whom Nelson continued to visit regularly. “Debbie has been a friend and great support all these years,” Nelson adds. “[S]he believed in me.” Nelson gave a talk at Union Theological Seminary in 1968 that included this slide, which Nelson considers “the first depiction of what the personal computer turned out to be.” “About six years later they started building computers like this at Xerox PARC.” Around the same time, Nelson claims to have called Vannevar Bush and told him about Project Xanadu. Bush “wanted very much to discuss it with” Nelson, but Nelson “hated him instantly [because] he sounded like a sports coach” and never contacted him again. This, of course, proved to be extremely self-destructive (though I can’t honestly say I would’ve done otherwise). Because Xanadu was as good as dead. No one would give him the money he needed to work on it, especially not after Doug Engelbart poisoned the idea of hypertext. Nelson went where there was funding, working briefly on an early word processor called Juggler of Text (JOT). …And then he lost investment, stopped working on the project, and moved to Chicago, where he’d been offered a job teaching at the University of Illinois, to start work on a book. He would call it Computer Lib. In fact, he started work on another book at the same time, called Dream Machines. By the time he completed each of them, in 1974, ARPANET had been released, and his vision for Project Xanadu had evolved. He published the two works together—Computer Lib was his lamentation over the industry’s disdain for hypertext, and Dream Machines was Xanadu’s manifesto. Nelson designed and printed the book himself. Its pages mostly look like this: Self-referential, multimedia, creative, and fun—they were a blueprint for the internet he was building. In the Dream Machines half, Nelson writes, “The real dream is for ‘everything’ to be in the hypertext. Everything you read, you read from the screen (and can always get back to right away; everything you write, you write at the screen (and can cross-link to whatever you read).” In one section Nelson asks himself, “Can It Be Done?” His answer: “I dunno.” Remember, Xanadu wouldn’t only involve links between works—it required hyperlinks, which as Nelson understood them, would need to contain the targets in themselves. (Eventually, Nelson would give these embeddings a new name—“transclusions”—and hyperlink came to simply mean “link between hypertext files.”) Every link would run both ways, each hypertext file would know exactly which other files were linked to it and how. This introduced a few problems, in the new interconnected ARPANET age: How do you keep track? Where’s the metadata stored? Can you afford enough space for it all?
Self-referential, multimedia, creative, and fun—they were a blueprint for the internet he was building. In the Dream Machines half, Nelson writes, “The real dream is for ‘everything’ to be in the hypertext. Everything you read, you read from the screen (and can always get back to right away; everything you write, you write at the screen (and can cross-link to whatever you read).” In one section Nelson asks himself, “Can It Be Done?” His answer: “I dunno.” Remember, Xanadu wouldn’t only involve links between works—it required hyperlinks, which as Nelson understood them, would need to contain the targets in themselves. (Eventually, Nelson would give these embeddings a new name—“transclusions”—and hyperlink came to simply mean “link between hypertext files.”) Every link would run both ways, each hypertext file would know exactly which other files were linked to it and how. This introduced a few problems, in the new interconnected ARPANET age: How do you keep track? Where’s the metadata stored? Can you afford enough space for it all?
hyperloops

hyperloops is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between August 08, 2022 and August 08, 2022. The archive places it in contexts such as "big investors in hyperloops, and a working hyperloop". It most often appears alongside AI, CFTC, Connor Leahy.

Reference entry
hyperloops
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1
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1
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August 08, 2022
Last seen
August 08, 2022
August 08, 2022 · Original source
2: Comments of the week: John Schilling tries to calculate the cost of building Neom, and comes up with an optimistic estimate of $4 trillion (compared to its $0.5-1 trillion budget). But he uses the cost of WTC1 as a base; this is unfair because it’s one of the costliest skyscrapers ever. If we use the similarly-sized Princess Tower in Dubai, one of the cheapest, we get a base cost of $2 trillion before applying economies of scale, and ??? afterwards (potentially much less because they can mass produce, or potentially much more because they exhaust the global concrete market). But the $1 trillion Neom budget also has to cover the Floating Octagon Of Clean Industry, the giant ski resort, etc, so it’s still a long shot. Also, Reader talks about his experience working in one of the companies that designed Neom. And Honourary notes that the Saudis are big investors in hyperloops, and a working hyperloop could make good on Neom’s otherwise-hyperbolic transportation claims. Maybe one way to think about Neom is as the first city designed from the ground up around hyperloops, in the same way that Levittown was the first city designed from the ground up around cars. This makes me update very slightly towards plausibility - but it’s still based around combining ~5 things that have never been tried before, and hoping none of them goes wrong or exceeds projected costs.
hypermedia

hypermedia is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 19, 2025 and September 19, 2025. The archive places it in contexts such as "This was hypermedia. These were hyperlinks, he explained. NLS was a hypertext system". It most often appears alongside 1987, 1988, Adleman.

Reference entry
hypermedia
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1
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1
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September 19, 2025
Last seen
September 19, 2025
September 19, 2025 · Original source
hypermedia
integrated hypermedia email
hypermedia publishing
hyperstitional cascade

hyperstitional cascade is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between January 16, 2024 and January 16, 2024. The archive places it in contexts such as "Or you can think of it as producing a hyperstitional cascade". It most often appears alongside #MeToo, 9-11, common knowledge problem.

Reference entry
hyperstitional cascade
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1
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1
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January 16, 2024
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January 16, 2024
January 16, 2024 · Original source
Obviously there are some things that aren’t really distributions, but just things where you learn how the world works. If your spouse cheats on you the first chance that they get, you should make a big update about their chance of doing so in the future too. But I think the most fundamental counterargument is that dramatic events are unimportant from an epistemic point of view, but very important from a coordination point of view. Harvey Weinstein abusing people in Hollywood didn’t cause / shouldn’t have caused much of an epistemic update. All the insiders knew there was lots of abuse in Hollywood (many of them even knew that Harvey Weinstein specifically was involved!) #MeToo didn’t happen because people learned the new fact that there was at least one abuser in Hollywood. It happened because it served as a Schelling point for coordination. Everyone who wanted to get tough on sexual assault suddenly felt that everyone else who wanted to get tough on sexual assault would be energized enough to support them. You can think of this as a common knowledge problem. Everyone knew that there were sexual abusers in Hollywood. Maybe everyone even knew that everyone knew this. But everyone didn’t know that everyone knew that everyone knew […] that everyone knew, until the Weinstein allegations made it common knowledge. Or you can think of it as producing a hyperstitional cascade. A campaign against sexual abuse will only work if people believe that it will. That is, people will only want to join an anti-sexual-abuse campaign if they’ll be on the winning side - both because they don’t want to waste their time, and because they don’t want sexual abusers to retaliate against them. And their campaign will only win if many people support it. Most of the time, no individual anti-abuse crusader is sure enough of winning to start a campaign and get momentum behind it. But the Weinstein allegations produced a mood where everyone felt like “it was time” for an anti-sexual-assault campaign, so everyone believed such a campaign would work, so everyone was willing to support it, so it did work. I think same mechanism is true of terrorist attacks, mass shootings by the outgroup, and lab leak pandemics. There are people who are against all of these things. But they have trouble coordinating. Also, they would benefit from the support of the “stupid people” demographic, and stupid people only remember that something is possible for a space of a few days immediately after it happens, otherwise it’s “science fiction”. So crusaders build on the sudden uptick of stupid-person-support to bootstrap a movement and a “moment” and shift to a new equilibrium in which they’re coordinated and respectable and their opponents aren’t. And sometimes this blossoms into some giant coordinated push like #MeToo or the Global War On Terror. All of this is true, and if you’re an activist you should take advantage of it. Certainly the balance of the world depends on who can leverage sudden shifts in the mood of stupid people most effectively. I’m just saying, don’t be a stupid person yourself. Even if you opportunistically use the time just after a lab leak pandemic or a sex scandal to push the biosecurity agenda or feminist agenda you had all along, don’t be the kind of person who doesn’t care about biosecurity or feminism except in the few-week period around a pandemic or sex scandal, but demands an immediate and overwhelming response as soon as some extremely predictable dramatic thing happens. Dramatic events are a good time to agitate for a coalition, but this is a necessary evil. In a perfect world, people would predict distributions beforehand, update a few percent on a dramatic event, but otherwise continue pursuing the policy they had agreed upon long before. 1Assume that before COVID, you were considering two theories: Lab Leaks Common: There is a 33% chance of a lab-leak-caused pandemic per decade.
HyperTalk

HyperTalk is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between June 11, 2021 and June 11, 2021. The archive places it in contexts such as "At home I was teaching myself to code in HyperTalk". It most often appears alongside AOL, AOL, Ben.

Reference entry
HyperTalk
Mention count
1
Issue count
1
First seen
June 11, 2021
Last seen
June 11, 2021
June 11, 2021 · Original source
More than thirty years after those students were frustrating Holt, I was the dolt in another small, private school. At home I was teaching myself to code in HyperTalk. At school I was exactly this kid from a Holt memo:
hypertext

hypertext is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 19, 2025 and September 19, 2025. The archive places it in contexts such as "NLS was a hypertext system"; "Computer Lib was his lamentation over the industry’s disdain for hypertext"; "Every link would run both ways, each hypertext file would know exactly which other files were linked". It most often appears alongside 1987, 1988, Adleman.

Reference entry
hypertext
Mention count
1
Issue count
1
First seen
September 19, 2025
Last seen
September 19, 2025
September 19, 2025 · Original source
compilable "Command Meta Language" Live on stage, in the year 1968, Engelbart started up the NLS, opened a document, and typed some words into it. The words, he said, constituted a statement. And statements made up a file. Engelbart copied, manipulated, saved, and loaded his words and statements and files, zipping around with his newly-invented mouse. He demonstrated his ability to embed documents in one another—images with links to statements, words nested and categorized by one another, files filled with metadata. And then he paused, and the screen went blank. He explained that he and his colleagues at the ARC had been using this system to do their daily work for the last six months. He mentioned that they had, now, six consoles up and running. He showed the crowd a real document, then navigated to a statement within it. “This presentation is devoted to the AHIRC.” “What is the AHIRC?” he asked. Engelbart “froze” the initial statement, clicked on the acronym, and below the words “Augmented-Human-Intellect Research Center” appeared. He kept clicking and freezing, and a trail of nested and related information appeared—a list of funders, a graph of staffing over time, a mission statement. This was hypermedia. These were hyperlinks, he explained. NLS was a hypertext system. The presentation went on for 90 minutes longer, and became known as The Mother of All Demos.2 At around the 75-minute mark, Engelbart shows that two different NLS users could edit a single document simultaneously. While this was extremely impressive functionality, it was achieved with time-sharing—computation was done on a single machine, switching rapidly between tasks—and became infeasible the very next year, when ARPANET was released and the number of machines you could connect to one system grew rapidly. Engelbart’s hypertext system was impressive in its own right, even without collaborativity. And still, little came of it—Andy van Dam, an attendee and revolutionary computer scientist himself, would reflect decades later: “Everybody was blown away … and nothing else happened. There was almost no further impact.” Engelbart’s ideas were just a little too out there. ARC quickly faded into obscurity. In 1972, Engelbart joined an organization called Erhard Seminars Training. EST, or “est” as it was marketed, offered a 60-hour self-improvement course for tech entrepreneurs modeled loosely on Zen Buddhism. Critics suggested that the est course was a mind-control method aimed at raising an authoritarian army. It was quite credibly branded a cult. The founder of est, Werner Erhard, was accused of tax fraud (he fought the claims and won $200,000 from the IRS) and incest (by his daughter, who later recanted). Engelbart served, for many years, on est’s board of directors. His researchers all left for greener, less cult-y pastures, and ARC died with hardly a whimper. No one really wanted to associate with Engelbart. His crackpot theories about an internet modeled after the memex fell into disrepute, and, if he was remembered at all, it was for the invention of the mouse. No one cared anymore about the memex, or hypertext. 3. Hyper-dreams of Hyper-everything Well, one man cared. Ted Nelson was born in 1937 to two twenty-year-olds, Ralph Nelson and Celeste Holm. His parents divorced in 1939, leaving him to be raised by his grandparents. Both Nelson (the elder) and Holm would go on to extremely-successful film careers: the former became an Emmy-winning director; the latter an Oscar-winning actress. And, at first, Ted seemed to be following in their footsteps. As a philosophy major at Swarthmore College, he produced a film called The Epiphany of Slocum Furlow, which he described as “a short comedy about loneliness at college and the meaning of life.”3 Nelson also claims to have “[d]irected [and written] book and lyrics for what was apparently the first rock musical” in his junior year at Swarthmore. Thankfully, his interest in a career as an entertainer soon waned, and Nelson went off to study sociology in grad school—first at the University of Chicago, then at Harvard. Nelson took a computer class at Harvard, in 1960, and “[his] world exploded.”4 He realized the incredible power of computing, quickly intuited that these new machines could be generally applied to everything, and founded Project Xanadu.5 Initially, Xanadu’s scope was pretty limited. Word processors weren’t around yet, but Nelson wanted to build something strikingly similar: he wanted to write a program that could store and display documents, with version histories and edits all stored and displayed at the same time too. Later, Nelson would call this version-history feature “intercomparison.” (Strange coinages will be a… theme; I’m just trying to get you ready.) Nelson began working on an implementation, but his feature wishlist grew quickly, and he didn’t really know what he was doing, so in 1965, he sought help. He prepared a talk for the Association for Computing Machinery, and dropped, quite frankly, a bomb on the audience: The kinds of file structures required if we are to use the computer for personal files and as an adjunct to creativity are wholly different in character from those customary in business and scientific data processing. They need to provide the capacity for intricate and idiosyncratic arrangements, total modifiability, undecided alternatives, and thorough internal documentation. The original idea was to make a file for writers and scientists, much like the personal side of Bush's Memex, that would do the things such people need with the richness they would want. But there are so many possible specific functions that the mind reels. These uses and considerations become so complex that the only answer is a simple and generalized building-block structure, user-oriented and wholly general-purpose. The resulting file structure is explained and examples of its use are given. Ted Nelson was building the memex. Of course, he wasn’t a very technical guy, and so his talk mostly focused on the philosophy of Xanadu, not its implementation. He commented (emphasis mine): There are three false or inadequate theories of how writing is properly done. The first is that writing is a matter of inspiration. While inspiration is useful, it is rarely enough in itself. “Writing is 10% inspiration, 90% perspiration,” is a common saying. But this leads us to the second false theory, that “writing consists of applying the seat of the pants to the seat of the chair.” Insofar as sitting facilitates work, this view seems reasonable, but it also suggests that what is done while sitting is a matter of comparative indifference; probably not. The third false theory is that all you really need is a good outline, created on prior consideration, and that if the outline is correctly followed the required text will be produced. For most good writers this theory is quite wrong. Rarely does the original outline predict well what headings and sequence will create the effects desired: the balance of emphasis, sequence of interrelating points, texture of insight, rhythm, etc. We may better call the outlining process inductive: certain interrelations appear to the author in the material itself, some at the outset and some as he works. He can only decide which to emphasize, which to use as unifying ideas and principles, and which to slight or delete, by trying. Outlines in general are spurious, made up after the fact by examining the segmentation of a finished work. If a finished work clearly follows an outline, that outline probably has been hammered out of many inspirations, comparisons and tests. Between the inspirations, then, and during the sitting, the task of writing is one of rearrangement and reprocessing, and the real outline develops slowly. The original crude or fragmentary texts created at the outset generally undergo many revision processes before they are finished. Intellectually they are pondered, juxtaposed, compared, adapted, transposed, and judged; mechanically they are copied, overwritten with revision markings, rearranged and copied again. This cycle may be repeated many times. The whole grows by trial and error in the processes of arrangement, comparison and retrenchment. Nelson recognized that the creation of knowledge is cyclical, recursive, self-referential. And he figured that our computer systems should accept and reflect that process: If a writer is really to be helped by an automated system, it ought to do more than retype and transpose: it should stand by him during the early periods of muddled confusion, when his ideas are scraps, fragments, phrases, and contradictory overall designs. And it must help him through to the final draft with every feasible mechanical aid—making the fragments easy to find, and making easier the tentative sequencing and juxtaposing and comparing. How do you design such a system? To navigate intuitively within complex file systems, between document versions, and across source materials—to access all the scraps and fragments writers need to write—you would need to establish what Vannevar Bush called “tracks.” You would need to connect and save different ideas, linking them together. That was it—you needed links. Nelson went further, though—it wouldn’t do to simply have links to all the other files, a writer needed to see the other files before him, needed them to be brought up and displayed alongside his current work on demand. The links needed to contain their targets within themselves—so Nelson called them hyperlinks. And he called text embedded with hyperlinks hypertext, and movies embedded in his structure became hyperfilms, and so on. Nelson wanted us using computers to write and create self-referential, intricately-interconnected (“intertwingled,” as he’d later put it), eminently-accessible hypermedia. And recall, in 1965, state-of-the-art computing looked like this. Ted Nelson was thinking far, far ahead. Maybe too far ahead. Conference attendees were initially excited about his idea, but when he revealed himself to know very little about the technical task of building Xanadu—or even whether it was possible at all—interest evaporated. 4. Failing to Develop Xanadu But Nelson was all in. He would later write, “This is not a technical issue, but rather moral, aesthetic and conceptual.” Nelson loved knowledge and connection and abstraction—mere technical details wouldn’t stop him from building the best possible computer system for producing and consuming information. He met Doug Engelbart in the mid 60s, forming a friendship with the only other man taking hypertext seriously at the time, and hopped around unhappily between various academic and scientific appointments. At one point, he and Andy van Dam worked together and produced the Hypertext Editing System—released in 1967, just before Engelbart’s NLS. It was the first computer application to ever have an “undo” button—Nelson claims to this day that he invented it (and the “back” button). Shortly thereafter, Nelson’s wife left him. In his 2010 autobiography, he writes, “She, reasonably, wanted a Nice Life; women want that sort of thing.” They had a son, whom Nelson continued to visit regularly. “Debbie has been a friend and great support all these years,” Nelson adds. “[S]he believed in me.” Nelson gave a talk at Union Theological Seminary in 1968 that included this slide, which Nelson considers “the first depiction of what the personal computer turned out to be.” “About six years later they started building computers like this at Xerox PARC.” Around the same time, Nelson claims to have called Vannevar Bush and told him about Project Xanadu. Bush “wanted very much to discuss it with” Nelson, but Nelson “hated him instantly [because] he sounded like a sports coach” and never contacted him again. This, of course, proved to be extremely self-destructive (though I can’t honestly say I would’ve done otherwise). Because Xanadu was as good as dead. No one would give him the money he needed to work on it, especially not after Doug Engelbart poisoned the idea of hypertext. Nelson went where there was funding, working briefly on an early word processor called Juggler of Text (JOT). …And then he lost investment, stopped working on the project, and moved to Chicago, where he’d been offered a job teaching at the University of Illinois, to start work on a book. He would call it Computer Lib. In fact, he started work on another book at the same time, called Dream Machines. By the time he completed each of them, in 1974, ARPANET had been released, and his vision for Project Xanadu had evolved. He published the two works together—Computer Lib was his lamentation over the industry’s disdain for hypertext, and Dream Machines was Xanadu’s manifesto. Nelson designed and printed the book himself. Its pages mostly look like this: Self-referential, multimedia, creative, and fun—they were a blueprint for the internet he was building. In the Dream Machines half, Nelson writes, “The real dream is for ‘everything’ to be in the hypertext. Everything you read, you read from the screen (and can always get back to right away; everything you write, you write at the screen (and can cross-link to whatever you read).” In one section Nelson asks himself, “Can It Be Done?” His answer: “I dunno.” Remember, Xanadu wouldn’t only involve links between works—it required hyperlinks, which as Nelson understood them, would need to contain the targets in themselves. (Eventually, Nelson would give these embeddings a new name—“transclusions”—and hyperlink came to simply mean “link between hypertext files.”) Every link would run both ways, each hypertext file would know exactly which other files were linked to it and how. This introduced a few problems, in the new interconnected ARPANET age: How do you keep track? Where’s the metadata stored? Can you afford enough space for it all?
Ted Nelson was thinking far, far ahead. Maybe too far ahead. Conference attendees were initially excited about his idea, but when he revealed himself to know very little about the technical task of building Xanadu—or even whether it was possible at all—interest evaporated. 4. Failing to Develop Xanadu But Nelson was all in. He would later write, “This is not a technical issue, but rather moral, aesthetic and conceptual.” Nelson loved knowledge and connection and abstraction—mere technical details wouldn’t stop him from building the best possible computer system for producing and consuming information. He met Doug Engelbart in the mid 60s, forming a friendship with the only other man taking hypertext seriously at the time, and hopped around unhappily between various academic and scientific appointments. At one point, he and Andy van Dam worked together and produced the Hypertext Editing System—released in 1967, just before Engelbart’s NLS. It was the first computer application to ever have an “undo” button—Nelson claims to this day that he invented it (and the “back” button). Shortly thereafter, Nelson’s wife left him. In his 2010 autobiography, he writes, “She, reasonably, wanted a Nice Life; women want that sort of thing.” They had a son, whom Nelson continued to visit regularly. “Debbie has been a friend and great support all these years,” Nelson adds. “[S]he believed in me.” Nelson gave a talk at Union Theological Seminary in 1968 that included this slide, which Nelson considers “the first depiction of what the personal computer turned out to be.” “About six years later they started building computers like this at Xerox PARC.” Around the same time, Nelson claims to have called Vannevar Bush and told him about Project Xanadu. Bush “wanted very much to discuss it with” Nelson, but Nelson “hated him instantly [because] he sounded like a sports coach” and never contacted him again. This, of course, proved to be extremely self-destructive (though I can’t honestly say I would’ve done otherwise). Because Xanadu was as good as dead. No one would give him the money he needed to work on it, especially not after Doug Engelbart poisoned the idea of hypertext. Nelson went where there was funding, working briefly on an early word processor called Juggler of Text (JOT). …And then he lost investment, stopped working on the project, and moved to Chicago, where he’d been offered a job teaching at the University of Illinois, to start work on a book. He would call it Computer Lib. In fact, he started work on another book at the same time, called Dream Machines. By the time he completed each of them, in 1974, ARPANET had been released, and his vision for Project Xanadu had evolved. He published the two works together—Computer Lib was his lamentation over the industry’s disdain for hypertext, and Dream Machines was Xanadu’s manifesto. Nelson designed and printed the book himself. Its pages mostly look like this: Self-referential, multimedia, creative, and fun—they were a blueprint for the internet he was building. In the Dream Machines half, Nelson writes, “The real dream is for ‘everything’ to be in the hypertext. Everything you read, you read from the screen (and can always get back to right away; everything you write, you write at the screen (and can cross-link to whatever you read).” In one section Nelson asks himself, “Can It Be Done?” His answer: “I dunno.” Remember, Xanadu wouldn’t only involve links between works—it required hyperlinks, which as Nelson understood them, would need to contain the targets in themselves. (Eventually, Nelson would give these embeddings a new name—“transclusions”—and hyperlink came to simply mean “link between hypertext files.”) Every link would run both ways, each hypertext file would know exactly which other files were linked to it and how. This introduced a few problems, in the new interconnected ARPANET age: How do you keep track? Where’s the metadata stored? Can you afford enough space for it all?
“About six years later they started building computers like this at Xerox PARC.” Around the same time, Nelson claims to have called Vannevar Bush and told him about Project Xanadu. Bush “wanted very much to discuss it with” Nelson, but Nelson “hated him instantly [because] he sounded like a sports coach” and never contacted him again. This, of course, proved to be extremely self-destructive (though I can’t honestly say I would’ve done otherwise). Because Xanadu was as good as dead. No one would give him the money he needed to work on it, especially not after Doug Engelbart poisoned the idea of hypertext. Nelson went where there was funding, working briefly on an early word processor called Juggler of Text (JOT). …And then he lost investment, stopped working on the project, and moved to Chicago, where he’d been offered a job teaching at the University of Illinois, to start work on a book. He would call it Computer Lib. In fact, he started work on another book at the same time, called Dream Machines. By the time he completed each of them, in 1974, ARPANET had been released, and his vision for Project Xanadu had evolved. He published the two works together—Computer Lib was his lamentation over the industry’s disdain for hypertext, and Dream Machines was Xanadu’s manifesto. Nelson designed and printed the book himself. Its pages mostly look like this: Self-referential, multimedia, creative, and fun—they were a blueprint for the internet he was building. In the Dream Machines half, Nelson writes, “The real dream is for ‘everything’ to be in the hypertext. Everything you read, you read from the screen (and can always get back to right away; everything you write, you write at the screen (and can cross-link to whatever you read).” In one section Nelson asks himself, “Can It Be Done?” His answer: “I dunno.” Remember, Xanadu wouldn’t only involve links between works—it required hyperlinks, which as Nelson understood them, would need to contain the targets in themselves. (Eventually, Nelson would give these embeddings a new name—“transclusions”—and hyperlink came to simply mean “link between hypertext files.”) Every link would run both ways, each hypertext file would know exactly which other files were linked to it and how. This introduced a few problems, in the new interconnected ARPANET age: How do you keep track? Where’s the metadata stored? Can you afford enough space for it all?
Hypertext Editing System

Hypertext Editing System is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 19, 2025 and September 19, 2025. The archive places it in contexts such as "produced the Hypertext Editing System—released in 1967". It most often appears alongside 1987, 1988, Adleman.

Mention count
1
Issue count
1
First seen
September 19, 2025
Last seen
September 19, 2025
September 19, 2025 · Original source
Ted Nelson was thinking far, far ahead. Maybe too far ahead. Conference attendees were initially excited about his idea, but when he revealed himself to know very little about the technical task of building Xanadu—or even whether it was possible at all—interest evaporated. 4. Failing to Develop Xanadu But Nelson was all in. He would later write, “This is not a technical issue, but rather moral, aesthetic and conceptual.” Nelson loved knowledge and connection and abstraction—mere technical details wouldn’t stop him from building the best possible computer system for producing and consuming information. He met Doug Engelbart in the mid 60s, forming a friendship with the only other man taking hypertext seriously at the time, and hopped around unhappily between various academic and scientific appointments. At one point, he and Andy van Dam worked together and produced the Hypertext Editing System—released in 1967, just before Engelbart’s NLS. It was the first computer application to ever have an “undo” button—Nelson claims to this day that he invented it (and the “back” button). Shortly thereafter, Nelson’s wife left him. In his 2010 autobiography, he writes, “She, reasonably, wanted a Nice Life; women want that sort of thing.” They had a son, whom Nelson continued to visit regularly. “Debbie has been a friend and great support all these years,” Nelson adds. “[S]he believed in me.” Nelson gave a talk at Union Theological Seminary in 1968 that included this slide, which Nelson considers “the first depiction of what the personal computer turned out to be.” “About six years later they started building computers like this at Xerox PARC.” Around the same time, Nelson claims to have called Vannevar Bush and told him about Project Xanadu. Bush “wanted very much to discuss it with” Nelson, but Nelson “hated him instantly [because] he sounded like a sports coach” and never contacted him again. This, of course, proved to be extremely self-destructive (though I can’t honestly say I would’ve done otherwise). Because Xanadu was as good as dead. No one would give him the money he needed to work on it, especially not after Doug Engelbart poisoned the idea of hypertext. Nelson went where there was funding, working briefly on an early word processor called Juggler of Text (JOT). …And then he lost investment, stopped working on the project, and moved to Chicago, where he’d been offered a job teaching at the University of Illinois, to start work on a book. He would call it Computer Lib. In fact, he started work on another book at the same time, called Dream Machines. By the time he completed each of them, in 1974, ARPANET had been released, and his vision for Project Xanadu had evolved. He published the two works together—Computer Lib was his lamentation over the industry’s disdain for hypertext, and Dream Machines was Xanadu’s manifesto. Nelson designed and printed the book himself. Its pages mostly look like this: Self-referential, multimedia, creative, and fun—they were a blueprint for the internet he was building. In the Dream Machines half, Nelson writes, “The real dream is for ‘everything’ to be in the hypertext. Everything you read, you read from the screen (and can always get back to right away; everything you write, you write at the screen (and can cross-link to whatever you read).” In one section Nelson asks himself, “Can It Be Done?” His answer: “I dunno.” Remember, Xanadu wouldn’t only involve links between works—it required hyperlinks, which as Nelson understood them, would need to contain the targets in themselves. (Eventually, Nelson would give these embeddings a new name—“transclusions”—and hyperlink came to simply mean “link between hypertext files.”) Every link would run both ways, each hypertext file would know exactly which other files were linked to it and how. This introduced a few problems, in the new interconnected ARPANET age: How do you keep track? Where’s the metadata stored? Can you afford enough space for it all?
hyperthymic temperament

hyperthymic temperament is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 18, 2023 and September 18, 2023. The archive places it in contexts such as "Musk’s intensity and energy sound more like hyperthymic temperament". It most often appears alongside 787, adderallposting, ADL.

Mention count
1
Issue count
1
First seen
September 18, 2023
Last seen
September 18, 2023
September 18, 2023 · Original source
Musk’s intensity and energy sound more like hyperthymic temperament, a technical term for “kind of like hypomania but that’s just how you are”. Wikipedia describes the following features:
hypnosis

hypnosis is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between September 03, 2024 and September 03, 2024. The archive places it in contexts such as "Imagine that under hypnosis, an investigator is commanding you to remember". It most often appears alongside 1980s, Air Force One, anal probing.

Reference entry
hypnosis
Mention count
1
Issue count
1
First seen
September 03, 2024
Last seen
September 03, 2024
September 03, 2024 · Original source
“So in the typical case, someone who may or may not have seen a UFO gets hypnotized and asked to ‘remember’ what happened. They usually ‘remember’ some sort of weird entities with big eyes and no mouths paralyzing them and inserting a probe into their rectum. Well, colonoscopies are usually done under ‘twilight anaesthesia’, which doesn’t really produce full unconsciousness. It just sort of scrambles your brain so you can’t figure out what’s going on and don’t form memories. Imagine that under hypnosis, an investigator is commanding you to remember. You look deep inside your brain for repressed memories that you can’t consciously access, and - there it is! - some weird half-forgotten shards of a memory you can’t quite put together. When you stare at it really hard, it resolves into an image of some people in surgical gowns, goggles, and masks, probing your rectum. Except it’s not clear enough to place the surgical dress, so you just describe them as having strangely-textured skin, big eyes, and no mouths.”
hypnotherapy

hypnotherapy is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between May 21, 2024 and May 21, 2024. The archive places it in contexts such as "In hypnotherapy the strategy is hypnosis". It most often appears alongside Bay Area, Bessel van der Kolk, Bob.

Reference entry
hypnotherapy
Mention count
1
Issue count
1
First seen
May 21, 2024
Last seen
May 21, 2024
May 21, 2024 · Original source
Dr. William Baldwin started out as a dentist, learned hypnotherapy for pain control, but his patients said such weird things during their trances that he retrained as a therapist and invented a mixed psychology-exorcism practice called Spirit Releasement Therapy - now its own therapy school with journal articles and conferences and everything.
Dr. Charles Tramont started out as a surgeon, also learned hypnotherapy for pain control, and followed basically the same path as Dr. Baldwin. Falconer quotes him approvingly as saying that “there are three basic varieties of foreign energies [in a person]: dark forces who never were human, earthbounds who are the souls of dead humans, and extraterrestrials . . . when asked if he believed in this stuff, he said absolutely because it has cured so many people.”
That just leaves the apparently-successful exorcisms. Part of the story must be placebo effects. Our culture’s scientific materialist paradigm helps us get effectively placebo-ed by medicine (even medications that work have associated placebo effects stronger than the real chemical effect). Cultures with a spiritual paradigm can probably be effectively placebo-ed by exorcism. But I know that I, with my medication experience, can’t match some of the cures that Falconer claims to have effected, so something else must be going on. Here I can only say that most good trauma therapies seem to be telling the person that the trauma and its associated compensatory behavior are no longer adaptive, plus some strategy to really dig into the traumatized part of the brain and make it sink in on an emotional level. In hypnotherapy the strategy is hypnosis. In EMDR it’s eye movements. In coherence therapy it’s visualizing the contradictory beliefs really hard. In IFS, it’s interacting with symbolic Parts of yourself in a lucid-dream-like trance state. Seems like a potentially good strategy! In all the exorcisms Falconer describes, I’m struck by his careful preparatory work where he tries to find the beliefs and experiences associated with the demon and unwind the associated emotions. Do that in a hypnosis-like state and add the wow factor of a dramatic exorcism, and maybe something good happens.4
hypothyroidism

hypothyroidism is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 31, 2025 and July 31, 2025. The archive places it in contexts such as "two bright orange squares (gallstones vs. hypertension and hypothyroidism)". It most often appears alongside 23andMe, 23andme, Alex Young.

Reference entry
hypothyroidism
Mention count
1
Issue count
1
First seen
July 31, 2025
Last seen
July 31, 2025
July 31, 2025 · Original source
Aside from two bright orange squares (gallstones vs. hypertension and hypothyroidism - I don’t know what’s up with this and it doesn’t seem to be a widely-appreciated result) we see that most correlations are zero or positive - that is, selecting against one disease selects against another or at worst does nothing. In this ocean of blue, worrying about those few orange squares feels a bit motivated. Hans Jonas-ism says that no medical intervention may ever cause any harm, no matter how much benefit it produces. By this standard, perhaps slightly raising the risk of gallstones in the process of preventing various cancers and psychoses and other forms of human misery is unacceptable. To anyone with the more normal perspective where something with large benefits and tiny downsides is still pretty good, I don’t think the antagonistic pleiotropy argument carries much weight. Ethical Objection: Cost No way around this one: if these products work, they mean that rich people can have healthier/smarter/taller/prettier kids than poor people. One might object that at least they’re in good company: other products which help rich kids get healthier/smarter/taller/prettier than poor kids include private tutors, gyms, hair salons, health insurance, clothing, books, and food. Is this really the time to declare ourselves against this kind of thing? But maybe we should fight against expanding this already-bloated category. Or maybe there’s something more final about a genetic advantage. Maybe a stronger argument is that rich people get first crack at every new technology, but poor people usually follow close behind. The first cellphone, in 1982, cost $12,000 in today’s dollars. Now you can get something a thousand times better for $50, and Kenyan pastoralists use cell phones to call up the local shaman. The trajectory of genetics has been even more striking: sequencing a single genome cost about $100 million in 2000 and is somewhere around $100 today. Polygenic embryo selection has the potential to follow a similar path. There are two associated costs - sequencing the embryos, and running the analysis. Sequencing costs are decreasing and may eventually be comparable to the sorts of genetic screening (for e.g. Down Syndrome) that most families get anyway. Analysis costs are mostly the one-time expense of inventing the predictor; we might expect these to follow the same pattern as generic medications, where cutting-edge technology is jealously guarded and expensive, but last decade’s technology has made its way off patent and is cheap-to-free. A few groups have already created free open-source predictors; so far these are much worse than the private companies’ versions, but one of last year’s ACX Grantees is working on a better one. Also, it would be crazy for any forward-thinking government not to cover this; it could save hundreds of thousands of dollars in future health care expenses. In countries with public health care, this comes directly out of the government treasury; even in the US, it’s covered by Medicare after age 65. The government should be begging people to select embryos. The most persistent cost barrier is likely to be in vitro fertilization itself, a necessary precursor. In the US, 2-3% of babies are born through IVF. For those kids, this is a no-brainer - even if the cost never comes down, the cheaper products are only a fraction of total IVF expense. What about the other 98%? If those parents feel like they have to get embryo selection (and therefore IVF) to keep up, this could be a significant burden. IVF isn’t fun - it requires pumping a woman full of mind-altering hormones for weeks, extracting eggs in a minor surgery, and then implanting embryos in another minor surgery, all with a decent chance that some step will fail and you’ll have to do it all again. It also costs $15,000 in the US (less in poorer countries), and unlike the genetics, the cost has barely gone down in the past twenty-five years. Some countries, including Israel, offer free IVF for anybody who wants it. And universal basic IVF is surprisingly popular even in the usually government-phobic United States - Donald Trump made it part of his campaign platform. So there’s a plausible path to embryo selection for everyone who wants it. But it’s still going to take a while, it will hit different people at different times, and so far11 there’s no way around the month or two of various miserable medical procedures for women. Ethical Objection: Personhood Is it really correct to say that you have reduced someone’s risk of breast cancer by 46%, if what you’ve really done is closer to replacing them with a different person who is 46% less likely to have breast cancer? I cover this one in more depth here. Ethical Objection: Race This one is awkward: right now the technology works best for white people. Most genetic data available for research/commercial use comes from the UK, US, and Europe - areas which are mostly white. Asian biobanks, and those serving US minority communities, have been more reluctant to share data. So we know a lot about the genetics of white people, and only a limited amount about the genetics of anyone else. Companies are suitably embarrassed about this, and researchers in the field are working hard to wring every ounce of information out of the minority data they have. But for now, white people are the clear winner. Here’s data from Herasight: A European family with five embryos and no family history can cut their diabetes risk by 47%, and an African family 29%, with everyone else in between. As usual, all companies say that they adjust their scores based on the couple’s genetic ancestry. As usual, Herasight challenges them to publicly release data on exactly how they performed the adjustments and how well they work. All companies say they are working as hard as they can to improve cross-ancestry portability, but that progress will remain limited until governments collect/release better genetic data on non-white populations. Ethical Objection: Selection At some point, you’ve got to choose. Genomic Prediction and Herasight offer scores that aggregate overall health risks. Some people will follow them slavishly. Other people will try to second-guess them - would you prefer your child have lower cancer risk, or less chance of heart attacks? And this is the best case scenario! Herasight offers predictors for IQ, height and BMI; Nucleus offers those plus eye color and hair color12. A parent might encounter a situation where the embryo with their favorite eye color also has the highest cancer and schizophrenia risk, and choose to doom their child to cancer and schizophrenia because they really want pretty eyes. On average, even if everyone in the world selected for eye color, it wouldn’t raise cancer and schizophrenia risk. No not-deliberately-perverse polygenic selection choice can make your child worse off in expectation. Still, suppose you got cancer, and your mom admitted that she selected you for pretty eyes and didn’t even check the cancer column of the embryo selection report. How would you feel? And would you feel better or worse than someone whose parents didn’t do embryo selection at all, and spent the money on a Caribbean vacation? What if they selected your brother for everything great, then had you naturally? What if they selected you for IQ, but actually you are very stupid, and you were one of the 20% of cases where a predictor that’s right 80% of the time gets it wrong? Mark my words, one day there will be entire subfields of therapy dedicated to these issues. Going Nuclear Even as outsiders criticize the whole field, Herasight has launched a full-scale attack on competitor Nucleus. Herasight’s white paper compares its own predictors (favorably) to those of Orchid and Genomic Prediction… …but refuses to acknowledge Nucleus at all. In a supplementary note, the authors explain why: they accuse Nucleus of being so bad that it would “not yield a reliable or meaningful addition to our analysis”. They say Nucleus has inflated the accuracy of their scores. This is most dramatic for a few conditions like ADHD, where the leading published polygenic score is based on 2,300,000 variants but explains only ~1% of variance in the condition. Nucleus’ score is based on 12 variants13 and (implicitly) claims to explain 3-6%. This doesn’t make sense. Some of Nucleus’ other scores do use millions of variants. But many of these are 5-10 year old scores downloaded from open-source catalogs, whose accuracy statistics are easily available and far less than Nucleus claims. Here is what Herasight finds when they double-check Nucleus’ numbers: On their Substack, Herasight also criticizes Nucleus’ monogenic screening product. They point out cases where it fails to properly screen for the conditions it claims. For example, the Nucleus website advertises screening for spinal muscular atrophy: But on their gene list… …they don’t screen for SMN, which causes 95% of spinal muscular atrophy cases. They only screen for UBA1, which causes a distinct and much rarer condition called x-linked infantile spinal muscular atrophy. Professional organizations publish guidelines for what genes need to be screened in a screening product, and Nucleus does not appear to be following them. In further discussion, Herasight continued with exhaustive criticism of essentially everything Nucleus had ever done down to the smallest detail. Nucleus reports list the same baseline disease risk regardless of patient ancestry, but different ancestry groups should have different risks14. Nucleus’ physician reports sometimes list lower-than-average risk for patients with positive polygenic scores15. Nucleus’ age-based risk tables don’t distinguish between age and cohort effects (is this bad? see footnote16). My favorite critique is that Nucleus wrote a blog post criticizing competing company Orchid… …which included a section on how Orchid is a polygenic selection company, and polygenic selection companies are inherently “sketchy” and “honestly should be illegal”. But Nucleus is also a polygenic selection company! This is like Marlboro attacking Camel on the grounds that cigarettes are addictive and should be banned! Obviously something went wrong here - my guess is AI - and it’s a really bad look, especially when these scientific issues are so hard to litigate, and so many of us will have to go off gestalt impressions of corporate culture. Nucleus states that they validate their models internally and intend to make their results public soon. A Foothill Of The Future It’s hard not to love this technology. Lots of people (and the aforementioned professional organizations) manage anyway, but it’s hard. If this were a single-use medical treatment, delivered by a doctor after someone got the relevant condition, it would be one of the biggest advances of the decade - imagine a drug that cures 10 - 40%17 of breast cancers with no side effects! But in fact, it works for breast cancer, and schizophrenia, and heart attacks, and approximately everything else. The only things comparable are antibiotics and GLP-1RAs. And then there’s the IQ effects. Even after studying the literature, people have wildly different opinions about the importance of IQ. One of the most important debates is to what degree IQ differences are a cause of poverty, a consequence of poverty, or both. I lean towards both - a country with limited access to schools and medical care will have low average IQ, but as a consequence it probably won’t become the next big semiconductor hub. This technology could close half the IQ gap between poor and middle-income countries, or between middle-income and rich. Or it could give rich countries average IQs that have never been seen before, and let us see what kind of O-ring technologies (and new forms of social cooperation) lie just beyond the frontier. (this is the nice quantifiable argument in favor of IQ enhancement, but I find myself more convinced by fuzzier things - how much is it worth to be able to enjoy great art and literature? To fully comprehend what we know of nature, and be able to fully appreciate the mystery of the rest? To have a sense of why society works the way it does, instead of feeling like you’re being blown back and forth by institutions you don’t really understand? Amateur psychoanalysts like to say that the only people who care about IQ are those looking for an excuse to boast about how high their own is, but my experience is the opposite: I care about IQ because I bang up against the limits of my own a thousand times a day, and I hate it. I fantasize about ways to make my children smarter than I am for the same reason a dog confined in a tiny crate might fantasize about getting her puppies adopted out to a nice house with a big grassy yard.) My biggest qualm is that it might not matter. This is such a tiny foothill, flanking such a vast and foreboding range of mountains, that it might be a mistake to care about it at all. Selecting the best of five or ten embryos is not a very effective way to get the genes you want. There are things in the pipeline that will make this look like Hippocrates draining black bile. By the time the first polygenically selected children are adults, they’ll be old news. And then there’s AI. The average age at diagnosis for Type II diabetes is 45 years. Will there still be people growing gradually older and getting Type II diabetes and taking insulin injections in 2070? If not, what are we even doing here? Many people in the transhumanist community are still bullish on this technology. They think - well, there’s still an outside chance that something comes up and AGI takes another few decades. If we can enhance humans to be smarter, healthier, and more determined by the time it arrives, maybe we’ll have a better chance. Or maybe, if there’s a positive optimistic vision of a human-based high-tech future, people will be more willing to delay AI in the first place. I like this argument, but I also think it’s worth stepping back. What’s the point of anything? Why have kids at all in a world that’s changing this fast? Why save for the future? At some point your answer has to be romantic and aesthetic - it’s never been clear whether anything you do matters in any ultimate sense, but you’ve got to act as if it does and hope for the best. From that perspective, this is the most romantic technology of all. You’re not just giving a better life to your kids. Genes travel from generation to generation; you’re giving a better life your grandkids, your great-grandkids and so on to the point 1.77*log₂(population) generations from now when you are the ancestor of everybody and nobody. Somebody in Macaronesia in 3525 AD will avoid getting breast cancer because of you (if there is still cancer; if there are still breasts). Some combination of reasonable cost-benefit analysis and romantic/aesthetic commitments makes me want to have children despite the uncertainty, and the same combination made me sign up to use this technology despite the same. More later on how that’s going. 1I’m slightly mixing up two different things here - Down Syndrome can be detected with an aneuploidy test, but cystic fibrosis takes a more involved PGT-M test. 2There are two separate questions here. First, how much would diabetes risk decline if you selected the embryo with the lowest risk for diabetes - something you have no reason to do, since you have no reason to privilege diabetes risk over risk of any other disease? Second, how much would diabetes risk go down if you selected the embryo with the lowest health risk overall? Genomic Prediction’s their risk calculator calculator shows, seemingly paradoxically, that you get -38% relative risk by selecting against diabetes alone, but -41% relative risk by selecting against everything at once. Over email, they stand by this surprising result, saying that “for a couple of diseases (type II diabetes and CAD), the EHS actually accomplishes a larger risk reduction than the individual predictors. The explanation is that the EHS takes into account multiple PRS of diseases with high comorbidity”. See eg Figure 3 here: …and the section of the post called “Antagonistic Pleiotropy” for more. However, this paradoxical benefit is only true for a few conditions like diabetes - for everything else, selecting on health index does better than you would naively think, but still does not decrease the risk of a given condition as much as selecting against that condition directly. 3That is, new mutations in that particular baby, as opposed to older mutations already present in the parents. 4Conflicts of interest: I have used Orchid’s and Herasight’s products on my own embryos (not the ones used to conceive my existing kids, but for a potential third child), employees of Genomic Prediction and Herasight have been extremely helpful in contributing expertise to ACX posts on genetics, and I might invest in this field at some point (though haven’t done so yet). This post started as Herasight asking me to write about their white paper, then spiraled out of control. There were some unexpected time pressures and the result is that I didn’t get a chance to run everything in Herasight’s white paper by their competitors as thoroughly as I would like. Although I talked to representatives of all four companies profiled here, I feel like this probably reflects Herasight’s perspective better than other companies’, and that this is a major flaw. If other companies have responses, I’ll publish them. Thanks to all companies involved for their assistance on this article. Finally, I am favorably disposed toward Herasight because of how I learned about them: a professor named Jonathan Anomaly got cancelled from Penn for being too gung-ho about genetic enhancement, and used his newfound freedom to join a very-early-stage Herasight, raise their ambitions, and sell everyone (including me) on the idea. I grew up on a diet of books and movies about mad scientists, and I’m a sucker for a story about a guy named Doctor Anomaly pursuing revenge against the small-minded fools who destroyed his career by creating a race of superbabies. 5The version of the tool I looked at said 5.9 points for five embryos, up to 9 points for twenty embryos. The version of the tool on their current said says 5.3 - 9, so they might have recalculated after I finalized this article. 6Used in quotation marks because these scores were fine for the predictive tasks they were applied for - they just weren’t finding genes that directly caused the outcome of interest. 7Conflict of interest notice: this table was originally unadjusted. A representative of Herasight claimed that this was unfair, because each company used slightly different reporting conventions, and offered to correct for this in a neutral way. I retraced their reasoning, confirmed that the correction did not especially benefit Herasight at the expense of other companies, and accepted the correction. The original unadjusted table is below: Herasight was insufficiently comfortable with Nucleus’ methodology to even be willing to posit a corrected value, so I left their self-reported value in gray. 8Zagorsky (2007) says an extra IQ point means $234-$616/year in higher salary. The midpoint of $425 equals $670 in today’s dollars; assuming a forty-year career, Nucleus’ +1 point estimate is worth $26,800 (vs. $9,249 Nucleus cost) and Herasight’s +6 point estimate is worth $160,800 (vs. $53,250 Herasight cost). 9As part of researching this article, I asked all four major companies about their within-family validation strategies. Here are some details: Genomic Prediction discusses their strategy in this paper. The results are complicated to interpret - the within-family numbers often have such wide error bars that they overlap with both the across-family numbers and with zero - but looking qualitatively it seems like most scores on average lose about 25% of their risk reduction ability (though averages might not be the right way to do this, and some might be much more affected than others). Their website reports unadjusted, not within-family validated numbers; GP says they say this clearly on their site (which is true), Herasight counters that they still present their numbers as applicable to embryo selection (which is also true). To get the most applicable-to-embryo-selection numbers, you might want to adjust GP’s stated numbers down somewhat; it’s hard to say exactly how much, but maybe 20 - 25%?
hysteria

hysteria is a recurring concept in the Astral Codex Ten archive, appearing 1 times across 1 issues between July 15, 2021 and July 15, 2021. The archive places it in contexts such as "fully-generic late-1800s diagnoses like hysteria". It most often appears alongside 1902, 1903, 1906 Japanese neurology journal.

Reference entry
hysteria
Mention count
1
Issue count
1
First seen
July 15, 2021
Last seen
July 15, 2021
July 15, 2021 · Original source
Weirdly enough, all of this had happened before. According Watters, pre-industrial Europe had the same pattern of anorexia as Hong Kong - rare, extremely scattered cases, mostly for stress reasons unrelated to beauty standards (plus or minus a couple of weird nuns). At the dawn of scientific psychiatry in the 19th century, most neurotic illnesses among women were classified under the general heading of "hysteria". Common hysterical symptoms were nervous tics, sudden inexplicable paralysis of the limbs, on-and-off blindness, convulsions, amnesia, and inability to walk (none of which are typical symptoms of depression/anxiety today!) Around the 1850s, some hysterics started also having something like anorexia. Psychiatrists found this fascinating, wrote a bunch of well-received papers about it, and it became a common topic of discussion in Victorian salons. As interest in the disease spread, so did the disease itself, with anorexia going from one of the rarest hysterical symptoms to one of the most common. Incidence peaked around 1900, after which it slowly trailed off, until around 1940 it was vanishingly rare again. Watters quotes medical historians who attribute this to decreasing interest: once it became so dirt-common that doctors stopped writing papers about it and high-society types stopped talking about it in hushed voices, it became boring and gradually died out. The disorder came back in the 1970s and 80s, for a bunch of reasons. First, a famous singer, Karen Carpenter, collapsed on stage from anorexia, making the news in the same way as the Hong Kong schoolgirl case. Second, terrible 1970s feminists learned about it and started romanticizing it as some sort of brave hunger strike against the patriarchy. Third, and probably most important, US obesity rates went like this:
Much more fun was the history of Japanese mental illness, which focused on neurasthensia. This was another one of those fully-generic late-1800s diagnoses like hysteria (I assume late-1800s psychiatrists just sort of flipped a coin: heads you were neurasthenic, tails you were hysteric). Around the Meiji Restoration, when everyone was obsessed with how great foreign stuff was, Japanese medical students went to Germany, learned psychiatry, came back to Japan, and told everyone they were neurasthenic. Being neurasthenic became first a fashion, then a class marker. The idea was that neurasthenics were people who were working too hard (good, admirable), and who were so smart and doing so much furious intellectual activity that it was straining their nerves (impressive). Also, they were probably sensitive souls too pure for this world. The most embarrassing extreme of this happened in 1903, when some photogenic Japanese youth carved a poem in a tree, went to a beautiful waterfall, and leapt to his death. Everyone praised him for how sensitive and artistic and neurasthenic this was, and turned him into a posthumous national hero. Meanwhile, “in 1902 an article reported that fully one-third of patients visiting hospitals for consultations were suffering from the new disease.”
I was more interested in a sort of sub-thesis that kept recurring under the surface: does naming and pointing to a mental health problem make it worse? This was clearest in Hong Kong, where a seemingly very low base rate of anorexia exploded as soon as people started launching mental health awareness campaigns saying that it was a common and important disease (as had apparently happened before in Victorian Europe and 70s/80s America). But it also showed up in the section on how increasing awareness of PTSD seems to be associated with more PTSD, and how debriefing trauma victims about how they might get PTSD makes them more likely to get it. And it was clearest in the short aside about the epidemic of neurasthenia in Japan after experts suggested that having neurasthenia might be cool, which remitted once those experts said it was actually cringe. A full treatment of this theory would go through the bizarre history of conversion disorder, multiple personality disorder, and various mass hysterias, tying it into some of the fad diagnoses of our own day. I might write this at some point.