Astral Codex Ten

Will

82 min read

Will

Article

Will is a recurring person in the Astral Codex Ten archive, appearing 6 times across 6 issues between July 01, 2021 and June 18, 2025. The archive places it in contexts such as “From Will : A negative outlook for the South Asian foils (Thailand, Malaysia, Philippines)”; “Will (writes My Bookshelf Runneth Over) says”; “their son Will, for visiting me in the hospital”. It most often appears alongside Africa, China, New York.

Metadata

  • Category: People
  • Mention count: 6
  • Issue count: 6
  • First seen: July 01, 2021
  • Last seen: June 18, 2025

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Highlights From The Comments On "How Asia Works"
July 01, 2021 · Original source
Thirdly, he ignores that peasants will vote for land reform overwhelmingly in any democratic system. His focus on outside institutions is horribly misguided. From the CCP to 19th century Japan, peasant ability to make demands of the political system lead directly to land reform. If land reform is no longer viable in nations where the peasantry is still common, the question I'd ask is why that is. Are they all dictatorships? If so, it's a problem of democratization. Have they got other political goals? Then that's a separate issues.
Another thing: the importance of export markets. These countries need to have markets willing to purchase their goods. If they don't, export lead industrialization fails. Big imperial nations have options that modern nations don't. Where do these nations export their goods? To the US. Korea had special deals with the US. So did Japan, Taiwan, Hong Kong, Singapore. And even China got special deals (enough to cause Russian complaints). This may be changing, especially for big countries like China with internally developed markets. But this advocacy for ELI should mention the politics of finding places to sell their goods. Otherwise the idea of "protected at home competing abroad" fails.
Then we get the question on how widely his advice could be adopted. He briefly mentions in the Philippines section that, citing from memory, “Some people think they can do nothing, but condemning millions to poverty is no option at all” Well in some moral sense sure, but in a policy sense doing nothing is obviously an option. Elites have almost never pursued industrial policy for altruistic reasons: The success stories are all cases where elite interest lined up with the public interest. For example, South Korea was racially and ideologically homogeneous. Marshall Park in other words required industrialists to make SK rich and defended but didn’t care who they were. Studwell mentions that industrial policy failed in Malaysia in part because of affirmative action, and then ignores that point entirely. The East Asian countries that succeeded only did so because of their homogeneity allowing focus purely on industrialization, plus the fact that the US leaned heavily on them. It’s very unclear that a country could implement the Studwell program against the will of its elites. It isn’t the case that where there’s a will there’s a way. Finally, all of this requires a high quality bureaucracy, which East Asia has a long history of and the rest of the world lacks.
Highlights From The Comments On San Fransicko
June 29, 2022 · Original source
This doesn't address allegations that many of California's homeless are from elsewhere, but deliberately moved to a few metro areas due to nice weather and generous social services. (Or, I've heard stories that their local town put them on a bus to SF). If .2% of the population everywhere is basically OK with a lifestyle of camping on the street and doing drugs, and then they all cluster in one area- that area will likely end up a mecca of homelessness.
Said Chicoine, the permanent supportive housing provider for the Kushel study, “I don’t have a solution. I will acknowledge what you’re saying. I’m not going to be a bullshit advocate who says, ‘Oh you should just ignore that.’ It’s real. There’s so many stigmas and stereotypes that some of us in the industry were scared of telling the truth.”
“That will definitely happen,” said Berg. “And it’s not ‘What if,’ it’s ‘That will definitely happen.’ If you don’t deal with the reasons people are losing their housing then the system will never be able to keep up. Communities did really well getting people off the streets but they haven’t really thought about the inflow of people.”
My Left Kidney
October 27, 2023 · Original source
This isn’t controlling for selection bias - but neither was my uncle’s anecdotal observation. So although it does make me slightly nervous, I’m not going to treat it as actionable evidence. Still, my girlfriend ending up begging me not to donate, and I caved. But we broke up in 2019. The next few years were bumpy, but by 2022 my life was in a more stable place and I started thinking about kidneys again. By then I was married. I discussed the risks with my wife and she decided to let me go ahead. So in early November 2022, for the second time, I sent a form to the University of California San Francisco Medical Center saying I wanted to donate a kidney. IV. Something else happened that month. On November 11, FTX fell apart and was revealed as a giant scam. Suddenly everyone hated effective altruists. Publications that had been feting us a few months before pivoted to saying they knew we were evil all along. I practiced rehearsing the words “I have never donated to charity, and if I did, I certainly wouldn’t care whether it was effective or not”. But during the flurry of intakes, screenings, and evaluations that UCSF gave me that month, the doctors asked “so what made you want to donate?” And I hadn’t rehearsed an answer to this one, so I blurted out “Have you heard of effective altruism?” I expected the worst. But the usual response was “Oh! Those people! Great, no further explanation needed.” When everyone else abandoned us, the organ banks still thought of us as those nice people who were always giving them free kidneys. We were giving them a lot of free kidneys. When I talked to my family and non-EA friends about wanting to donate, the usual reaction was “You want to what?!” and then trying to convince me this was unfair to my wife or my potential future children or whatever. When I talked to my EA friends, the reaction was at least “Cool!”. But pretty often it was “Oh yeah, I donated two years ago, want to see my scar?” Most people don’t do interesting things unless they’re in a community where those things have been normalized. I was blessed with a community where this was so normal that I could read a Vox article about it and not vomit it back out. This is surprising, because kidney donation is only medium effective, as far as altruisms go4. The average donation buys the recipient about 5 - 7 extra years of life (beyond the counterfactual of dialysis). It also improves quality of life from about 70% of the healthy average to about 90%. Non-directed kidney donations can also help the organ bank solve allocation problems around matching donors and recipients of different blood types. Most sources say that an average donated kidney creates a “chain” of about five other donations, but most of these other donations would have happened anyway; the value over counterfactual is about 0.5 to 1 extra transplant completed before the intended recipient dies from waiting too long. So in total, a donation produces about 10 - 20 extra quality-adjusted life years. This is great - my grandfather died of kidney disease, and 10 - 20 more years with him would have meant a lot. But it only costs about $5,000 - $10,000 to produce this many QALYs through bog-standard effective altruist interventions, like buying mosquito nets for malarial regions in Africa. In a Philosophy 101 Thought Experiment sense, if you’re going to miss a lot of work recovering from your surgery, you might as well skip the surgery, do the work, and donate the extra money to Against Malaria Foundation instead5. Obviously this kind of thing is why everyone hates effective altruists. People got so mad at some British EAs who used donor money to “buy a castle”. I read the Brits’ arguments: they’d been running lots of conferences with policy-makers, researchers, etc; those conferences have gone really well and produced some of the systemic change everyone keeps wanting. But conference venues kept ripping them off, having a nice venue of their own would be cheaper in the long run, and after looking at many options, the “castle” was the cheapest. Their math checked out, and I believe them when they say this was the most effective use for that money. For their work, they got a million sneering thinkpieces on how “EA just takes people’s money to buy castles, then sit in them wearing crowns and waving scepters and laughing at poor people”. I respect the British organizers’ willingness to sacrifice their reputation on the altar of doing what was actually good instead of just good-looking. I worry that people use suffering as a heuristic for goodness. Mother Teresa becomes a hero because living with lepers in the Calcutta slums sounds horrible - so anyone who does it must be really charitable (regardless of whether or not the lepers get helped). Owning a castle is the opposite of suffering - it sounds great - therefore it is fake charity (no matter how much good you do with the castle). This heuristic isn’t terrible. If you’re suffering for your charity, then it must seem important to you, and you’re obviously not doing it for personal gain. If you do charity in a way that benefits you (like gets you a castle), then the personal gain aspect starts looking suspicious. The problem is the people who elevate it from a suspicion to an automatic condemnation. It seems like such a natural thing to do. And it encourages people to be masochists, sacrificing themselves pointlessly in photogenic ways, instead of thinking about what will actually help others. But getting back to the point: kidney donation has an unusually high ratio of photogenic suffering to altruistic gains. So why do EAs keep doing it? I can’t speak for anyone else, but I’ll speak for myself. It starts with wanting, just once, do a good thing that will make people like you more instead of less. It would be morally fraught to do this with money, since any money you spent on improving your self-image would be denied to the people in malarial regions of Africa who need it the most. But it’s not like there’s anything else you can do with that spare kidney. Still, it’s not just about that. All of this calculating and funging takes a psychic toll. Your brain uses the same emotional heuristics as everyone else’s. No matter how contrarian you pretend to be, deep down it’s hard to make your emotions track what you know is right and not what the rest of the world is telling you. The last Guardian opinion columnist who must be defeated is the Guardian opinion columnist inside your own heart. You want to do just one good thing that you’ll feel unreservedly good about, and where you know somebody’s going to be directly happy at the end of it in a way that doesn’t depend on a giant rickety tower of assumptions. Dylan Matthews wrote: As I’m no doubt the first person to notice, being an adult is hard. You are consistently faced with choices — about your career, about your friendships, about your romantic life, about your family — that have deep moral consequences, and even when you try the best you can, you’re going to get a lot of those choices wrong. And you more often than not won’t know if you got them wrong or right. Maybe you should’ve picked another job, where you could do more good. Maybe you should’ve gone to grad school. Maybe you shouldn’t have moved to a new city. So I was selfishly, deeply gratified to have made at least one choice in my life that I know beyond a shadow of a doubt was the right one. …and it really resonated. Everything else I try to do, there’s a little voice inside of me which says “Maybe the haters are right, maybe you’re stupid, maybe you’re just doing the easy things. Maybe you’re no good after all, maybe you’ll never be able to figure any of this out. Maybe you should just give up.” The Talmud is very clear: that voice is called the evil inclination, and it dwells in the left kidney. There is only one way to shut it off forever. I was ready. V. You might not be a masochist. But hospitals are sadists. They want to hear you beg. After I submitted the donation form, I was evaluated by a horde of indistinguishable women. They all had titles like “Transplant Coordinator”, “Financial Coordinator”, and “Patient Care Representative”. Several were social workers; one was a psychiatrist. They would see me through a buggy version of Zoom that caused various parts of their body to suddenly turn into the UCSF logo, and they all had questions like “Are you sure you want to do this?” and “Are you going to regret this later?” and “Is anyone pressuring you to do this?” and “Are you sure you want to do this?” After clearing that gauntlet came the tests. Blood tests - I think I must have given between 20 and 50 vials of blood throughout the screening process. Urine tests - both the normal kind where you pee in a cup, and a more involved kind where you have to store all your urine for 24 hours in a big jug, then take it to the lab. “Urinate into a jug” ought to be the easiest thing in the world, but some of the labs have overly complicated jugs that I, with my mere MD, couldn’t always get right - hence my experience accidentally pouring urine on myself in an Uber. Then came the big guns. Echocardiogram. MRI. One of my urine tests was slightly off, so I also got a nuclear kidney scan, where they injected radioactive liquid in me and monitored how long it took to come out the other end (I remember asking a friend “Can I use your bathroom? My urine might be slightly radioactive today, but it shouldn’t be enough to matter.”) Finally, five months after I originally applied, I got a phone call from the Transplant Coordinator. The test results were in, and . . . I had been rejected because I’d had mild childhood OCD. This was something I’d mentioned offhandedly during one of the psych evaluations. As a child, I used to touch objects in odd patterns that only made sense to me. I got diagnosed with OCD, put on SSRIs for a while, finally did therapy at age 15, hadn’t had any problems since. I still go back on SSRIs sometimes when I’m really stressed, and will grudgingly admit to the occasional odd-pattern-touching when no one’s looking. But it’s nothing anyone would know about if I didn’t tell them! It was mild even at age 15, and it’s been close-to-nonexistent for the past twenty years! Now I’m a successful psychiatrist who owns his own psychiatry practice and helps other people with the condition! I told them all this. They didn’t care. I asked them if there was anything I could do. They said maybe I could go to therapy for six months, then apply again. I asked them what kind of therapy was indicated for mild OCD that’s been in remission for twenty years. They sounded kind of surprised to learn there were different types of therapy and said whatever, just talk to someone or something. I asked them how frequent they thought the therapy needed to be. They sounded kind of surprised to learn that therapy could have different frequencies, and said, you know, therapy, the thing where you talk to someone. I asked them if they actually knew anything about OCD, psychotherapy, or mental health in general, or if they had just vaguely heard rumors that some people were bad and crazy and shouldn’t be allowed to make their own decisions, and that a ritual called “therapy” could absolve one of this impurity. They responded as politely as possible under the circumstances, but didn’t change their mind. I wasn’t going to waste an hour a week for six months, and spend thousands of dollars of my own extremely-not-reimbursed-by-UCSF money, to see a randomly-selected therapist for a condition I’d gotten over twenty years ago, just so I could apply again and get rejected a second time. This was one of the most infuriating and humiliating things that’s ever happened to me. We throw around a lot of terms like “stigma” and “paternalism”, and I’ve worked with patients who have dealt with all these issues (it’s UCSF in particular a surprising amount of the time!). But I was still surprised how much it hurt when it happened to me. Being denied the right to control your own body because of some meaningless diagnosis on a chart somewhere is surprisingly frustrating, even compared to things that should objectively be worse. I thought I was going to be able to do a good deed that I’d been fantasizing about for years, and some jerk administrator torpedoed my dreams because I had once, long ago, had mild mental health issues. So I gave up. I spent the next few weeks unleashing torrents of anti-UCSF abuse at anyone who would listen. This turned out to be very productive! When I was unleashing a torrent of anti-UCSF abuse to Josh Morrison of WaitlistZero, he asked if I’d tried other hospitals. I hadn’t. I’d assumed they were all in cahoots. But Josh said no, each hospital had their own evaluation process. Weill Cornell, a hospital in NYC, was one of the best transplant centers in the country, and had a reputation for fair and thoughtful pre-donor screening. Why didn’t I talk to them? NYC was far away, and I hate to travel, but I was just angry enough to accept. At this point I’d forgotten whatever good altruistic motivations I might have originally had and was fueled entirely by spite. Getting my kidney taken out somewhere else felt like it would be a sort of victory over UCSF. So I went for it. Cornell was lovely. They tried to do as much of the process as they could via Californian intermediaries, so that I only had to fly to New York twice. Their psychiatrist evaluated me, listened to me explain my weak history of OCD, then treated me like a reasonable adult who tells the truth and can handle his own medical decisions. They were concerned that I sometimes self-prescribed Lexapro to deal with anxiety. But we agreed on a compromise: I found another psychiatrist, let her give me the exact same prescription of Lexapro at a much higher cost to my insurance, and that resolved the problem. So in late September 2023 - ten months after I started the process - I finally got fully cleared to donate, surgery set for October 12. VI. I knew, in theory, that anaesthetics existed. Still, it’s weird. One moment you’re lying on a table in the OR, steeling yourself up for one of the big ordeals of your life. The next, you’re in a bed in the recovery room, feeling fine. The operation - this thing you’ve been thinking about and dreading for months - exists only as a lacuna in your memory. Not even some kind of fancy lacuna, where you remember the darkness closing in on you beforehand, or have to claw yourself back into consciousness afterwards. The most ordinary of lacunas, like a good night sleep. There was no pain, not at first. The painkillers and nerve blocks lasted about a day after the surgery. By the time they wore off, it was more of a dull ache. The hospital offered me Tylenol, and I wanted to protest - really? Tylenol? After major surgery? But the Tylenol worked. Some people will have small complications (I am a doctor, pretty jaded, and my definition of “small” may be different from yours). Dylan Matthews wrote about an issue where his scrotum briefly inflated like a balloon (probably this is one of the ones that doesn’t feel small when it’s happening to you). I missed out on that particular pleasure, but got others in exchange. I had an unusually hard time with the catheter - the nurse taking it out frowned and said the team that put it in had “gone too deep”, as if my urinary tract was the f@#king Mines of Moria - but that was fifteen seconds of intense pain. Then a week afterwards, just when I thought I’d recovered fully, I got bowled over by a UTI which knocked me out for a few days. But overall, I was surprised by the speed and ease of my recovery. A few hours after the surgery, I walked a few steps. After a day, I got the catheter out and could urinate normally again. After two days, I was eating “SmartGel”, a food substitute that has mysteriously failed to catch on outside of the immobilized-hospital-patient market. After three, I was out of the hospital. After four, I started easing myself back into (remote) work. After a week, I flew cross-country. . . . and then I got the UTI. If this section sounds schizophrenic, it’s because it’s a compromise between an original draft where I said nothing went wrong and it was amazing, and a later draft written after a haze of bladder pain. Just don’t develop complications, that’s my advice. Still, I recently heard from the surgeon that my recipient’s side of the surgery was a success, that my kidney was in them and going fine - and that put things back into perspective. To a first approximation, compared to the inherent gravity of taking an organ out of one person and putting it in a second person and saving their life - it was all easy and everything went well. When I look back on this in a decade, I’ll remember it as everything being easy and going well. Even now, with some lingering bladder pain, modern medicine still feels like a miracle. VII. In polls, 25 - 50% of Americans say they would donate a kidney to a stranger in need. This sentence fascinates me because of the hanging “would”. Would, if what? A natural reading is “would if someone needs it”. But there are 100,000 strangers on the waiting list for kidney transplants. Between 5,000 and 40,000 people die each year for lack of sufficient kidneys to transplant. Someone definitely needs it. Yet only about 200 people (0.0001%) donate kidneys to strangers per year. Why the gap between 25-50% and 0.0001%? Some of you will suspect respondents are lying to look good. But these are anonymous surveys. Lying to themselves to feel good, then? Maybe. But I think about myself at age 20, a young philosophy major studying utilitarianism. If someone had asked me a hypothetical about whether I would donate a kidney to a stranger in need, I probably would have said yes. Then I would have continued going about my business, never thinking of it as a thing real-life people could do. Part of this would have been logistics. I wouldn’t have known where to start. Do you need to have special contacts in the surgery industry? Seek out a would-be recipient on your own? Where would you find them? But more of it would have been psychological: it just wasn’t something that the people I knew did, and it would be weird and alienating for me to be the only one. This is going to be the preachy “and you should donate too!” section you were dreading all along, but I’m not going to make a lot of positive arguments. If 90% of the people who answer yes on those surveys are lying to feel good, then only 3 - 5% really want to donate. But bringing the donation rate from 0.0001% of people to 3 - 5% of people would solve the kidney shortage many times over. The point isn’t to drag anti-donation-extremists kicking and screaming to the operating table. The point is to reach the people who already want to do it, and make them feel comfortable starting the process. 20-year-old me was in that category. The process of making him feel comfortable involved fifteen years of meeting people who already done it. During residency, I met a fellow student doctor who had donated. Later, I got involved in effective altruism, and learned that movement leader Alexander Berger - a guy who can easily direct millions of dollars at whatever cause he wants - had donated his personal kidney as well. Some online friends. Some people I met at conferences. And Dylan Matthews, who I kept crossing paths with (most recently at the Manifest journalism panel). After enough of these people, it no longer felt like something that nobody does, and then I felt like I had psychological permission to do it. (obviously saints can do good things without needing psychological permission first, but not everyone has to be in that category, and I found it easier to get the psychological permission than to self-modify into a saint6.) So I’m mostly not going to argue besides saying: this is a thing I did, it’s a thing hundreds of other people do each year, getting started is as simple as filling out a form, and if it works for you, you should go for it7. When I woke up in the recovery room after surgery, I felt great. Amazing. Content, peaceful, proud of myself. Mostly this was because I was on enough opioids to supply a San Francisco homeless encampment for a month. But probably some of it was also the warm glow of having made a difference or something. That could be you! VIII. The ten of you who will listen to this and donate are great. That brings the kidney shortage down from 40,000 to 39,990/year. Everyone knows we need a systemic solution, and everyone knows what that solution will eventually have to be: financial compensation for kidney donors. But so far they haven’t been able to get together enough of a coalition to overcome the usual cabal of evil bioethicists who thwart every medical advance. My kidney donation “mentor”8 Ned Brooks is starting a new push - the Coalition To Modify NOTA - which proposes a $100,000 refundable tax credit - $10,000 per year for 10 years - for kidney donors. There would be a waiting period and you’d have to get evaluated first, so junkies couldn’t walk in off the street and get $100K to spend on fentanyl. No intermediate company would “profit” off the transaction, and rich people wouldn’t be able to pay directly to jump in line. It would be the same kidney donation system we have now, except the donors get $100,000 back after saving the government $1MM+. (the libertarian in me would normally prefer a free market, but “avoid taxes by selling your organs” also has a certain libertarian appeal) This came up often when I talked to other donors. They all had various motivations, but one of the things they cared about was being able to advocate for these kinds of systemic changes more effectively. I personally have been wanting to push this in an essay here for a while, but it seemed hypocritical to play up the desperate kidney shortage while I still had two kidneys. Now I can support NOTA modification whole-heartedly . . . full-throatedly? . . . it’s weird how many of these adverbs involve claims to still have all of your organs. This is also one of the answers to the question I asked in section IV: how do you balance acts of heroic altruism that everyone will love you for vs. acts of boring autistic altruism that will make everyone hate you, but which will accomplish more good in the end?) Coalition To Modify NOTA is full of previous living kidney donors, who are using the moral clout and recognition they’ve gotten to get attention and change the system in an unglamorous way. I find this an admirable way of squaring the circle: do the flashy heroic things to gain social capital, then spend the social capital on whatever’s ultimately most important. If you get one takeaway from this, let it be that those guys who bought the castle were good guys. Two takeaways, and it’s that plus modify NOTA. Three takeaways, and you should feel permission to (if you want) donate a kidney. You can sign up here.9 Feel free to email me at scott@slatestarcodex.com if you have questions about the process. 1Further perspective: I’m 38, which gives me a 2/million total chance of dying per day. So the likelihood that I would die during my kidney operation equals the likelihood that I would die during a randomly chosen two months of everyday life. 2Maybe, kind of. Our knowledge of how radiation causes cancer comes primarily from Hiroshima and Nagasaki; we can follow survivors who were one mile, two miles, etc, from the center of the blast, calculate how much radiation exposure they sustained, and see how much cancer they got years later. But by the time we’re dealing with CAT scan levels of radiation, cancer levels are so close to background that it’s hard to adjust for possible confounders. So the first scientists to study the problem just drew a line through their high-radiation data points and extended it to the low radiation levels - ie if 1 Sievert caused one thousand extra cancers, probably 1 milli-Sievert would cause one extra cancer. This is called the Linear Dose No Threshold (LDNT) model, and has become a subject of intense and acrimonious debate. Some people think that at some very small dose, radiation stops being bad for you at all. Other people think maybe at low enough doses radiation is good for you - see this claim that the atomic bomb “elongated lifespan” in survivors far enough away from the blast. If this were true, CTs probably wouldn’t increase cancer risk at all. I didn’t consider myself knowledgeable enough to take a firm position, and I noticed eminent scientists on both sides, so I am using the more cautious estimate here. 3I told them I had an aunt who died of radiation-induced cancer. It’s true, but I feel grubby for bringing her into this; I thought doctors would be more likely to listen to an emotional story than cold logic. 4EAs have been debating the exact effectiveness of kidney donations for a long time. You can find good skeptical arguments by Jeff Kaufman and Derek Shiller, and good arguments in favor by Alexander Berger and Tom Ash. 5Outside of Philosophy 101 thought experiments, there’s a nonprofit that will often reimburse you for lost wages from your donation. 6Self-modifying into a person who can act boldly without social permission is a more general solution and has many other advantages. But the long version involves living a full life of accumulating moral wisdom, and the short version starts with removing guardrails that are there for good reasons. 7But here are some practical points you might not already appreciate: You shouldn’t have to pay much money. If, like me, you need to travel (eg to New York), kidney related charities will reimburse your travel costs (in theory, I haven’t yet proven this, and a few costs were illegible and I decided not to submit them).
Inline links: bumpy, 4, 5 - 7 extra years of life, improves quality of life, creates a “chain”, $5,000 - $10,000, 5, sacrifice their reputation on the altar of doing what was actually good instead of just good-looking, WaitlistZero, https://substackcdn.com/image/fetch/$s_!7c71!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08cf5218-6398-4dfb-91a3-d5fc7989b754_765x642.png, polls, 5,000, 40,000, Manifest journalism panel, 6, filling out a form, 7, usual, 8, the, here, 9, 1, 2, Linear Dose No Threshold, this claim, 3, 4, Jeff Kaufman, Derek Shiller, Alexander Berger, Tom Ash, 5, 6, 7
So in late September 2023 - ten months after I started the process - I finally got fully cleared to donate, surgery set for October 12. VI. I knew, in theory, that anaesthetics existed. Still, it’s weird. One moment you’re lying on a table in the OR, steeling yourself up for one of the big ordeals of your life. The next, you’re in a bed in the recovery room, feeling fine. The operation - this thing you’ve been thinking about and dreading for months - exists only as a lacuna in your memory. Not even some kind of fancy lacuna, where you remember the darkness closing in on you beforehand, or have to claw yourself back into consciousness afterwards. The most ordinary of lacunas, like a good night sleep. There was no pain, not at first. The painkillers and nerve blocks lasted about a day after the surgery. By the time they wore off, it was more of a dull ache. The hospital offered me Tylenol, and I wanted to protest - really? Tylenol? After major surgery? But the Tylenol worked. Some people will have small complications (I am a doctor, pretty jaded, and my definition of “small” may be different from yours). Dylan Matthews wrote about an issue where his scrotum briefly inflated like a balloon (probably this is one of the ones that doesn’t feel small when it’s happening to you). I missed out on that particular pleasure, but got others in exchange. I had an unusually hard time with the catheter - the nurse taking it out frowned and said the team that put it in had “gone too deep”, as if my urinary tract was the f@#king Mines of Moria - but that was fifteen seconds of intense pain. Then a week afterwards, just when I thought I’d recovered fully, I got bowled over by a UTI which knocked me out for a few days. But overall, I was surprised by the speed and ease of my recovery. A few hours after the surgery, I walked a few steps. After a day, I got the catheter out and could urinate normally again. After two days, I was eating “SmartGel”, a food substitute that has mysteriously failed to catch on outside of the immobilized-hospital-patient market. After three, I was out of the hospital. After four, I started easing myself back into (remote) work. After a week, I flew cross-country. . . . and then I got the UTI. If this section sounds schizophrenic, it’s because it’s a compromise between an original draft where I said nothing went wrong and it was amazing, and a later draft written after a haze of bladder pain. Just don’t develop complications, that’s my advice. Still, I recently heard from the surgeon that my recipient’s side of the surgery was a success, that my kidney was in them and going fine - and that put things back into perspective. To a first approximation, compared to the inherent gravity of taking an organ out of one person and putting it in a second person and saving their life - it was all easy and everything went well. When I look back on this in a decade, I’ll remember it as everything being easy and going well. Even now, with some lingering bladder pain, modern medicine still feels like a miracle. VII. In polls, 25 - 50% of Americans say they would donate a kidney to a stranger in need. This sentence fascinates me because of the hanging “would”. Would, if what? A natural reading is “would if someone needs it”. But there are 100,000 strangers on the waiting list for kidney transplants. Between 5,000 and 40,000 people die each year for lack of sufficient kidneys to transplant. Someone definitely needs it. Yet only about 200 people (0.0001%) donate kidneys to strangers per year. Why the gap between 25-50% and 0.0001%? Some of you will suspect respondents are lying to look good. But these are anonymous surveys. Lying to themselves to feel good, then? Maybe. But I think about myself at age 20, a young philosophy major studying utilitarianism. If someone had asked me a hypothetical about whether I would donate a kidney to a stranger in need, I probably would have said yes. Then I would have continued going about my business, never thinking of it as a thing real-life people could do. Part of this would have been logistics. I wouldn’t have known where to start. Do you need to have special contacts in the surgery industry? Seek out a would-be recipient on your own? Where would you find them? But more of it would have been psychological: it just wasn’t something that the people I knew did, and it would be weird and alienating for me to be the only one. This is going to be the preachy “and you should donate too!” section you were dreading all along, but I’m not going to make a lot of positive arguments. If 90% of the people who answer yes on those surveys are lying to feel good, then only 3 - 5% really want to donate. But bringing the donation rate from 0.0001% of people to 3 - 5% of people would solve the kidney shortage many times over. The point isn’t to drag anti-donation-extremists kicking and screaming to the operating table. The point is to reach the people who already want to do it, and make them feel comfortable starting the process. 20-year-old me was in that category. The process of making him feel comfortable involved fifteen years of meeting people who already done it. During residency, I met a fellow student doctor who had donated. Later, I got involved in effective altruism, and learned that movement leader Alexander Berger - a guy who can easily direct millions of dollars at whatever cause he wants - had donated his personal kidney as well. Some online friends. Some people I met at conferences. And Dylan Matthews, who I kept crossing paths with (most recently at the Manifest journalism panel). After enough of these people, it no longer felt like something that nobody does, and then I felt like I had psychological permission to do it. (obviously saints can do good things without needing psychological permission first, but not everyone has to be in that category, and I found it easier to get the psychological permission than to self-modify into a saint6.) So I’m mostly not going to argue besides saying: this is a thing I did, it’s a thing hundreds of other people do each year, getting started is as simple as filling out a form, and if it works for you, you should go for it7. When I woke up in the recovery room after surgery, I felt great. Amazing. Content, peaceful, proud of myself. Mostly this was because I was on enough opioids to supply a San Francisco homeless encampment for a month. But probably some of it was also the warm glow of having made a difference or something. That could be you! VIII. The ten of you who will listen to this and donate are great. That brings the kidney shortage down from 40,000 to 39,990/year. Everyone knows we need a systemic solution, and everyone knows what that solution will eventually have to be: financial compensation for kidney donors. But so far they haven’t been able to get together enough of a coalition to overcome the usual cabal of evil bioethicists who thwart every medical advance. My kidney donation “mentor”8 Ned Brooks is starting a new push - the Coalition To Modify NOTA - which proposes a $100,000 refundable tax credit - $10,000 per year for 10 years - for kidney donors. There would be a waiting period and you’d have to get evaluated first, so junkies couldn’t walk in off the street and get $100K to spend on fentanyl. No intermediate company would “profit” off the transaction, and rich people wouldn’t be able to pay directly to jump in line. It would be the same kidney donation system we have now, except the donors get $100,000 back after saving the government $1MM+. (the libertarian in me would normally prefer a free market, but “avoid taxes by selling your organs” also has a certain libertarian appeal) This came up often when I talked to other donors. They all had various motivations, but one of the things they cared about was being able to advocate for these kinds of systemic changes more effectively. I personally have been wanting to push this in an essay here for a while, but it seemed hypocritical to play up the desperate kidney shortage while I still had two kidneys. Now I can support NOTA modification whole-heartedly . . . full-throatedly? . . . it’s weird how many of these adverbs involve claims to still have all of your organs. This is also one of the answers to the question I asked in section IV: how do you balance acts of heroic altruism that everyone will love you for vs. acts of boring autistic altruism that will make everyone hate you, but which will accomplish more good in the end?) Coalition To Modify NOTA is full of previous living kidney donors, who are using the moral clout and recognition they’ve gotten to get attention and change the system in an unglamorous way. I find this an admirable way of squaring the circle: do the flashy heroic things to gain social capital, then spend the social capital on whatever’s ultimately most important. If you get one takeaway from this, let it be that those guys who bought the castle were good guys. Two takeaways, and it’s that plus modify NOTA. Three takeaways, and you should feel permission to (if you want) donate a kidney. You can sign up here.9 Feel free to email me at scott@slatestarcodex.com if you have questions about the process. 1Further perspective: I’m 38, which gives me a 2/million total chance of dying per day. So the likelihood that I would die during my kidney operation equals the likelihood that I would die during a randomly chosen two months of everyday life. 2Maybe, kind of. Our knowledge of how radiation causes cancer comes primarily from Hiroshima and Nagasaki; we can follow survivors who were one mile, two miles, etc, from the center of the blast, calculate how much radiation exposure they sustained, and see how much cancer they got years later. But by the time we’re dealing with CAT scan levels of radiation, cancer levels are so close to background that it’s hard to adjust for possible confounders. So the first scientists to study the problem just drew a line through their high-radiation data points and extended it to the low radiation levels - ie if 1 Sievert caused one thousand extra cancers, probably 1 milli-Sievert would cause one extra cancer. This is called the Linear Dose No Threshold (LDNT) model, and has become a subject of intense and acrimonious debate. Some people think that at some very small dose, radiation stops being bad for you at all. Other people think maybe at low enough doses radiation is good for you - see this claim that the atomic bomb “elongated lifespan” in survivors far enough away from the blast. If this were true, CTs probably wouldn’t increase cancer risk at all. I didn’t consider myself knowledgeable enough to take a firm position, and I noticed eminent scientists on both sides, so I am using the more cautious estimate here. 3I told them I had an aunt who died of radiation-induced cancer. It’s true, but I feel grubby for bringing her into this; I thought doctors would be more likely to listen to an emotional story than cold logic. 4EAs have been debating the exact effectiveness of kidney donations for a long time. You can find good skeptical arguments by Jeff Kaufman and Derek Shiller, and good arguments in favor by Alexander Berger and Tom Ash. 5Outside of Philosophy 101 thought experiments, there’s a nonprofit that will often reimburse you for lost wages from your donation. 6Self-modifying into a person who can act boldly without social permission is a more general solution and has many other advantages. But the long version involves living a full life of accumulating moral wisdom, and the short version starts with removing guardrails that are there for good reasons. 7But here are some practical points you might not already appreciate: You shouldn’t have to pay much money. If, like me, you need to travel (eg to New York), kidney related charities will reimburse your travel costs (in theory, I haven’t yet proven this, and a few costs were illegible and I decided not to submit them).
Inline links: polls, 5,000, 40,000, Manifest journalism panel, 6, filling out a form, 7, usual, 8, the, here, 9, 1, 2, Linear Dose No Threshold, this claim, 3, 4, Jeff Kaufman, Derek Shiller, Alexander Berger, Tom Ash, 5, 6, 7
You shouldn’t have to pay much money. If, like me, you need to travel (eg to New York), kidney related charities will reimburse your travel costs (in theory, I haven’t yet proven this, and a few costs were illegible and I decided not to submit them).
Practically-A-Book Review: Rootclaim $100,000 Lab Leak Debate
March 28, 2024 · Original source
For example, does Putin have cancer? We start with the prior for Russian men ages 60-69 having cancer (14.32%, according to health data). We adjust for Putin’s healthy lifestyle (-30% cancer risk) and lack of family history (-5%). Putin hasn’t vanished from the world stage for long periods of time, which seems about 4x more likely to be true if he didn’t have cancer than if he did. About half of cancer patients lose their hair, and Putin hasn’t, so we’ll divide by two. On the other hand, Putin’s face has gotten more swollen recently, which happens about six times more often to cancer patients than to others, so we’ll multiply by six. And so on and so forth, until we end up with the final calculation: 86% chance Putin doesn’t have cancer, too bad. This is an unusual way to do things, but Saar claimed some early victories. For example, in a celebrity Israeli murder case, Saar used Rootclaim to determine that the main suspect was likely innocent, and a local mental patient had committed the crime; later, new DNA evidence seemed to back him up. One other important fact about Saar: he is very rich. In 2008, he sold his fraud detection startup to PayPal for $169 million. Since then he’s founded more companies, made more good investments, and won hundreds of thousands of dollars in professional poker. So, in the grand tradition of very rich people who think they have invented new forms of reasoning, Saar issued a monetary challenge. If you disagree with any of his Rootclaim analyses - you think Putin does have cancer, or whatever - he and the Rootclaim team will bet you $100,000 that they’re right. If the answer will come out eventually (eg wait to see when Putin dies), you can wait and see. Otherwise, he’ll accept all comers in video debates in front of a mutually-agreeable panel of judges. Since then, Saar and his $100,000 offer have been a fixture of Internet debates everywhere. When I argued that Vitamin D didn’t help fight COVID, people urged me to bet against Saar, and we had a good discussion before finally failing to agree on terms. When anti-vaccine multimillionaire Steve Kirsch made a similar offer, Saar took him up on it, although they’ve been bogged down in judge selection for the past year. Rootclaim also found in favor of the lab leak hypothesis of COVID. When Saar talked about this on an old ACX comment thread, fellow commenter tgof137 (Peter Miller) agreed to take him up on his $100K bet. At the time, I had no idea who Peter was. I kind of still don’t. He’s not Internet famous. He describes himself as a “physics student, programmer, and mountaineer” who “obsessively researches random topics”. After a family member got into lab leak a few years ago, he started investigating. Although he started somewhere between neutral and positive towards the hypothesis, he ended up “90%+” convinced it was false. He also ended up annoyed: contrarian bloggers were raking in Substack cash by promoting lab leak, but there seemed to be no incentive to defend zoonosis. Unlike Saar, Peter was not especially rich. $100K represented a big fraction of his net worth. But (he wrote me in an email): It was a moderately large financial risk for me ... I [expected] a smart and unbiased person would vote for zoonosis with, say, 80% odds after seeing all the evidence. If both judges voting for lab origin is uncorrelated, that's 20% squared, and it was pretty low odds of a catastrophic financial risk for me. I wasn't highly worried about losing the debate because I was wrong about the science. I put in enough effort to know I'm probably correct there. My biggest fear was that I'd choke at the debate for some reason, that I'd be too anxious and particularly that I'd be unable to sleep the night beforehand. I have zero prior debate experience to rely upon. If this seems like a weirdly blase attitude towards risk, Peter told blogger Philipp Markolin that he “is a mountain climber where sometimes there is a 5% chance to die, and the stakes are just not that high for a debate.” Unlike the eternally bogged-down Saar-Kirsch debate, here things moved quickly. The two contestants put out a call for judges on the ACX subreddit, and agreed on: Will van Treuren, a pharmaceutical entrepreneur with a PhD from Stanford and a background in bacteriology and immunology.
Inline links: does Putin have cancer, celebrity Israeli murder case, argued that Vitamin D didn’t help fight COVID, took him up on it, on an old ACX comment thread, told blogger Philipp Markolin, put out a call for judges
Will van Treuren, a pharmaceutical entrepreneur with a PhD from Stanford and a background in bacteriology and immunology.
Source: NPR. To be fair, we have only the scientist’s word that this is why he had the picture. But he definitely did have it. People say it would be a surprising coincidence if a zoonotic coronavirus pandemic just so happened to start in a city with a big coronavirus research lab, and this is true. But it would be an even more surprising coincidence if a lab-leak coronavirus pandemic just so happened to first get detected at a raccoon-dog stall in a wet market! Saar: It’s not clear that the first case was at the wet market; a certain Mr. Chen, with no connection to the market, seems to have fallen sick on December 8. An SCMP article suggested there were 92 previously-undetected cases suspicious for COVID as far back as November. And even if half of the first forty universally-agreed-upon cases had market connections that means another half didn’t. There was a bias towards detecting cases at the market: because authorities thought the market was the origin, and because everyone was thinking about zoonosis after SARS1, they only screened/diagnosed people with a market connection. One of the few non-market-connected COVID cases detected during this period was only detected because he was the relative of a hospital worker; the worker noticed the signs and insisted they go to the hospital despite the lack of a wet market connection. Although the map of positive samples and cases at the market was centered near the raccoon-dog stall, that could be because that area was sampled more; it’s also close to the mahjong room, where visitors and vendors at the market would go and unwind in a tight, poorly ventilated area. The next session will focus more on the WIV, but the short version is that they were doing lots of gain of function research. So one story compatible with the evidence is that a worker at WIV got infected with their modified coronavirus and passed it to his contacts. COVID started spreading quietly a few weeks to months before the first market-related case was detected. This accounts for the 92 earlier cases, Mr. Chen’s case, and the half of officially-detected cases with no wet market association. Then an infected person went to the market, causing a super-spreader event. Some of the infected market patrons went to the hospital, where doctors traced it back to the market and told other doctors to be on the lookout for wet market patrons coming in with weird viral pneumonias. They found some, declared victory, and the few anomalies - like the hospital worker’s relative - were forgotten, or assumed to have wet market connections that nobody could find. China quashed all evidence of the lab research (as was done in previous lab leak cases, eg the USSR) so all we have is the apparent wet market links that Peter found so convincing. Peter: The supposed pre-wet-market cases are confirmed fakes. Yes, the WHO did an investigation of whether there might have been COVID cases circulating before the wet market, and identified 92 unusual pneumonias that merited further review. But their final investigation, which included testing samples from these people after good tests became available, found that none of these people really had COVID. As for Mr. Chen, he said in an interview that he was hospitalized for dental issues on December 8, caught COVID in the hospital on December 16, and then was erroneously reported as “hospitalized for COVID on December 8”. The December 16 date is after the first wet market cases. Further, it seems epidemiologically impossible for COVID to have been circulating much before the first cases were officially detected December 11. The COVID pandemic doubles every 3.5 days. So if the first infection was much earlier - let’s say November 11 - we would expect 256x as much COVID as we actually saw. Even if the first couple of cases were missed because nobody was looking for them, the number of hospitalizations, deaths, etc, in January or whenever were all consistent with the number of people you’d expect if the pandemic started in early December - and not consistent with 256x that many people. So probably we should just accept that the first reported case - a wet market vendor, December 11 - was very early in the pandemic. She wasn’t literally the first case - that would most likely have been someone who worked at the raccoon-dog shop, whose case might (like 95% of COVID cases) have been mild enough not to come to medical attention. But she was certainly very early. Although authorities eventually decided COVID spread through a wet market and started deliberately looking for wet market connections, this only happened on December 30. So the earliest cases - including the 40 very earliest cases where half came from the wet market - weren’t biased (at least not through that particular route). So the claim that “the first case, and half of the first 40 cases, had wet market connections” stands as real and convincing evidence. Although the exact center of the map of positive COVID samples in the wet market was the mahjong room, the samples taken from the mahjong room were not, themselves, positive (cf: although a low-resolution population density map of New York might show Central Park in the exact center of the population density gradient, Central Park does not itself have population). There was no real “super-spreader event” at the wet market. There was a slow burn - one case the first day, a few more the next day, a few more the day after that. It’s hard to see how a single visit from an infected lab worker could do that. So the only way it could possibly be a lab leak is if the lab leaked sometime in late November, infected exactly one lab worker, that worker went straight to the wet market, infected a vendor, then went home, quarantined, recovered, and all other cases were downstream of that first infected wet market vendor. This is unparsimonious. Saar: The only source saying that Mr. Chen got sick early was an anonymous interview. And even if he was later than the first wet market cases, nobody was able to find any wet market connections. This means that whoever infected him was earlier than the index case and not linked to the wet market. Peter argued that COVID couldn’t have been more than a few weeks old when the first wet market cases were detected. But this was based on its known doubling rate. If pre-discovery COVID had a slower doubling time than known COVID, it could have been around longer. And post-lockdown serology suggested numbers that were larger than claimed at the time. So contra Peter’s claims, the infection could have been going on longer, which wouldn’t require the first lab worker to go straight to the market. It could have been weeks. Dr. Jesse Bloom’s investigation of the wet market samples, considered the final and most conclusive, failed to find a clear connection between COVID and raccoon-dogs or any other animals. Although the concentration of positive samples seemed highest near the raccoon dog stall, if you do a formal statistical analysis of which animals’ DNA was found near COVID samples most often, raccoon dogs are near the bottom. The top is wide-mouth bass, which can’t get COVID. This is obviously contamination, probably from infected humans touching wide-mouth bass tanks or something. Although the Chinese data included a negative sample from a mahjong table, it included a mention of poultry being sold nearby, which might mean this wasn’t the mahjong room itself, but some other mahjong table at a poultry shop elsewhere in the market, and (dry) mahjong tables might not hold the virus well anyway. Peter: Raccoon-dogs were sold in various cages at various stalls, separated by air gaps big enough to present a challenge for COVID transmission, and there’s no reason to think that one raccoon-dog would automatically pass it to all the others. The statistical analysis just proves there were many raccoon-dogs who didn’t have COVID. But you only need one. The raccoon dog shop and the drain leading out of the raccoon dog shop had some of the highest positive sample rates, which is more interesting than a statistical analysis which everyone agrees must be wrong (since it favors bass). It’s unclear why the negative mahjong sample says something about poultry, but based on the stated location, it’s definitely the one in the mahjong room. Session 1.5: Lineages This was technically part of Session 2, but formed enough of a discrete topic that I found it confusing to intermix it with all the other viral genetics points. I’m spinning it out into a separate summary, but the videos are all in the next session. Yuri: The coronavirus eventually mutated into many different strains. But the first big split, seen in some of the earliest samples, is between two different sub-strains called Lineage A and Lineage B, which differ by two mutations. In these two mutations, Lineage A is the same as BANAL-52, a bat virus which is the closest-known relative of COVID, but Lineage B is different. Since COVID probably evolved from something like BANAL-52, Lineage A must have come first, spread for a while, and then gotten two new mutations, turning it into Lineage B. All of the cases at the wet market, including the first detected case, were Lineage B. Lineage A wasn’t discovered until about a week later, and none of the Lineage A patients had been to the wet market. 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.
Inline links: NPR, found that, Mr. Chen, failed to find a clear connection between COVID and raccoon-dogs, https://substackcdn.com/image/fetch/$s_!8Led!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F85e46d3a-c19e-407b-88b7-1d8ea1489df7_1190x503.png, Pekar 2022, Pipes 2021, says, 3, here, this video, https://substackcdn.com/image/fetch/$s_!8aU2!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F815fe32d-d7ea-401b-b3a2-d8cd25b52ee8_490x780.png, https://substackcdn.com/image/fetch/$s_!0Tm_!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd0492f69-7b7e-4611-9d76-64ef8d7f59d5_511x511.png, Will, Eric, agreed, 4, put out a report on the lab leak hypothesis, https://substackcdn.com/image/fetch/$s_!g7k2!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F37f1b493-b556-41ec-925e-03f9d8bc26cb_1456x849.webp, surveyed experts, see here, https://substackcdn.com/image/fetch/$s_!Zejl!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe9c88e87-b6ca-4c6d-840e-24da726f50b7_975x365.png, https://substackcdn.com/image/fetch/$s_!T5rV!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4983e2cd-4151-42de-9685-08037ef7a8e8_635x788.png
Spring Meetups Everywhere 2024
March 30, 2024 · Original source
I’ll provisionally be attending the Berkeley meetup on June 5th. Skyler will provisionally be attending Northampton, Manhattan, Boston, Brooklyn, Baltimore, Burlington, and Berkeley.
HAIFA, ISRAEL Contact: Shai Contact Info: dizinteria[at]walla[dot]com Time: Tuesday, April 9th, 6:00 PM Location: We'll be in the zikaron garden next to the city hall, in a picnic blanket on the grass and I will be wearing a red shirt and carrying a sign with ACX MEETUP on it.If it rains we will meet up in a bookstore called 'goldmund' which is located at ekron street 6. Coordinates: https://plus.codes/8G4PRX7X+CQ
Inline links: https://plus.codes/8G4PRX7X+CQ
TEL AVIV, ISRAEL Contact: Inbar Contact Info: inbar192[at]gmail[dot]com Time: Thursday, April 25th, 5:00 PM Location: Sarona Park, grass area close to the Benedict restaurant, will have ACX sign and red balloons Coordinates: https://plus.codes/8G4P3QCP+MJ9 Group Link: https://www.facebook.com/groups/5389163051129361 Notes: Everyone is welcome! Feel free to bring snacks.
Inline links: https://plus.codes/8G4P3QCP+MJ9, https://www.facebook.com/groups/5389163051129361
ACX Grants 1-3 Year Updates
June 18, 2025 · Original source
We proposed an initiative to adopt "approval voting" for Seattle primaries. After the initiative qualified for the Nov 2022 ballot, the City Council added an alternative proposing "instant-runoff voting" (https://www.seattletimes.com/seattle-news/politics/competing-voting-reform-measures-make-seattles-november-ballot-after-city-council-oks-alternative/). While voting to do so, 3 councilmembers said that they hoped neither passed; one could see it as a way to prevent any election reform. Surprisingly, something did barely pass - the Council alternative (https://www.seattletimes.com/seattle-news/politics/will-seattle-move-to-ranked-choice-voting-margin-narrows-friday/). It will be used in 2027. Seattle uses "nonpartisan blanket primaries," where all candidates appear on 1 ballot and 2 winners advance to the general (to run for 1 seat). For that situation, it's hard to guess whether this is better or worse than the status quo, or even which objective metrics to monitor. One metric might be the November 2027 Seattle general elections: unusually close general election results might indicate that the primary advanced 2 competitive candidates (who had to work for marginal votes), and less-close general elections - a blowout - might indicate the opposite.
Since 2022, Alice has undertaken qualitative research in nine world regions: Mexico, Costa Rica, Brazil, Morocco, Italy, Spain, Britain, US, Poland, Turkey, India, Uzbekistan, South Korea and Hong Kong. Through this globally comparative analysis, she analyses the drivers and obstacles to gender equality. Gender interventions will be more impactful if they target locally binding constraints - in the Middle East, North Africa and South Asia, this is "the honour-income trade-off" (whereby male honour depends on female seclusion, and women tend to remain at home. Meanwhile, Latin America and the Caribbean face a different obstacle: pervasive violence elevates femicides. Over the past few years, she's held visiting appointments at Stanford, Chicago, and Yale, while providing policy advice to the World Bank, and sharing insights with a public audience via Substack (www.ggd.world). In April 2025, she gave a TedTalk on romantic love as an under-rated driver of gender equality.
We have two repurposed drugs that are clinical stage. The drug that's furthest along is boosted rapamycin, which we're using for chronic kidney disease in cats. We will have safety, stability, and pharmacokinetic data by July. Combined with the recent conditional approval of generic rapamycin for feline hypertrophic cardiomyopathy, this should put us in a good place to find a strategic partner.