I’m having trouble parsing but I think the first point is about the mutation rate in humans? I don’t expect that to be informative about flu virus except as a floor.
Elizabeth
Karma: 17,948
This post was hard for me to read. A few months after I wrote it I developed medical issues that are still ongoing and really sapped my ability to work. Right now I feel on the precipice of developing Large Scale Ambitions, and that I’d probably have taken the plunge to something bigger if I’d hadn’t gotten so sick for so long.
On the other hand, I spent the past 2 years trying to dramatically reform Effective Altruism. I expected to quit in May but got sucked back in via my work with Timothy TL. I didn’t think of this as ambitious, but looking back I do find it ridiculous that I thought I would succeed, which is kind of like ambition except I’m not having any fun with it.
I remain really happy with the “dear self” format. Most advice is advice to your past self anyway, and it’s nice to be straightforward about it. It avoids friction with people very different from me, because they can’t argue that that they know better for me personally.
I like the balance I struck between treating social motivations as real and important, and encouraging people to look beyond them.
You might also enjoy my twitter thread on Frying Pan Agency, where you start with small actions like fixing a wobbly frying pan handle and work your way up.
Still no answer to “how do you tell when to release subpar work and when to keep improving?”. I have a sense I should be working on my ceiling and not my floor right now, but don’t know how.
Thank you for the explanation.
Is there a reason you deflected when I originally asked about AI assistance? To me that’s a much bigger deal than the AI assistance itself.
I think this is a useful concept that I use several times a year. I don’t use the term Dark Forest I’m not sure how much that can be attributed to this post, but this post is the only relevant thing in the review so we’ll go with that.
I also appreciate how easy to read and concise this post is. It gives me a vision of how my own writing could be shorter without losing impact.
I didn’t keep good track of them, but this post led to me receiving many DMs that it had motivated someone to get tested. I also occasionally indirectly hear about people who got tested, so I think the total impact might be up to 100 people, of which maybe 1⁄3 had a deficiency (wide confidence intervals on both numbers). I’m very happy with that impact.
I do wish I’d created a better title. The current one is very generic, and breaks LW’s “aim to inform not persuade” guideline.
My ultimate goal with this post was to use vegan advocacy as an especially legible example of a deepseated problem in effective altruism, which we could use to understand and eventually remove the problem at the root. As far as I know, the only person who has tried to use it as an example is me, and that work didn’t have much visible effect either. I haven’t seen anyone else reference this post while discussing a different problem. It’s possible this happens out of sight (Lincoln Quirk implies this here), but if I’d achieved my goal it would be clearly visible.
I suggest putting your proposed dress code at the top. Right now it’s only kind of described, somewhere in the middle with no way to jump to it.
This sounds like a problem with the transcript itself, not placing it in the post vs. a separate link? Which is fair enough, just want to make sure I understand.
I stand by what I said here: this post asks an important question but badly mangles the discussion. I don’t believe this fictional person weighed the evidence and came to a conclusion she is advocating for as best she can: she’s clearly suffering from distorted thoughts and applying post-hoc justifications.
The conflation of “Duncan’s ideal” and “the perfect ideal everyone has agreed to” is what I’m complaining about.
If Duncan had, e.g., included guidelines that were LW consensus but he disagreed with, then it would feel more like an attempt to codify the site’s collective preferences rather than his in particular.
I’m very grateful I found Tristan and we were able to have this discussion.
My series on vegan nutrition epistemics generated a lot of friction and hostility. Tristan was one of very few vegan advocates I felt I learned things from, and the things I learned were valuable and beautiful. The frame of impractical reverence continues to come up and I’m glad I can recognize it now. I am also happy this primed me to recognize what I don’t like about reverence as a frame, and refine my articulation of my own values.
I wish this had been called “Duncan’s Guidelines for Discourse” or something like that. I like most of the guidelines given, but they’re not consensus. And while I support Duncan’s right to block people from his posts (and agree with him far on discourse norms far more than with the people he blocked), it means that people who disagree with him on the rules can’t make their case in the comments. That feels like an unbalanced playing field to me.
This is outside the reference class I intended (needed at least one human case), but since I didn’t specify that I’ll award a token $10. Please let me know what your paypal is.
How sure are you that flu is generally spread through fluids? It seems like the medical system is ~prejudiced against the concept of airborne transmission.
The use case is a lesswrong post people use to make decisions (which could be written by me, or you, but it’s looking like @DirectedEvolution).
Is this partially AI written? The reference to further clinical study seems weird.
I love this detailed list. I’ve responded in-line to every one, but feel free to ask more questions, here or over email.
Livestock vs. Wild Birds
The distinction between livestock and wild birds is significant. Livestock are in much closer contact with humans and are biologically closer as well. How granular of an analysis are you interested in here?
I care about wild birds to the extent they’re spreading disease to livestock or serve as reservoirs.
I’ve also heard a wide number of mammals have been infected. I care about this to the extent it affects humans and livestock. E.g. does this suggest it’s airborne after all, or say something about the mutation rate?
US-specific H5N1 Trends
It’s peculiar that H5N1 seems so prevalent in the US. Could this be due to measurement bias, or does the US simply have more factory farming? How interested are you in exploring the reasons behind this trend?
I’m interested in quantifying the quality of US surveillance, but otherwise deprioritize this.
Citations and Depth
While most points aren’t cited (which is fine), it might be valuable to compile both a list of key aspects and resources for further reading. Are you looking for a more polished, thoroughly cited document?
Citations are important to the extent they let people check and build on your work. But if it’s a widely known consensus such that it’s easy to look up but complicated to cite, it’s not important to add a citation. E.g. my fact about RNA segments is very easy to check but would have been annoying to find a citation for because I learned it 20 years ago.
Overall citations for the current state of things (e.g. how many human infections of unknown providence) are more important than citations for basic science.
Biological Factors of Severity
Binding to human receptors is just one factor controlling the severity and infectiousness of a virus. Would you like a deeper dive into the biology of respiratory infections and what makes them dangerous?
Low priority. Pass on resources if you find them but don’t bother with synthesis.
Tamiflu and Xofluza
Wikipedia notes that Tamiflu has limited evidence of being worth the side effects. Are you interested in a detailed evaluation of its effectiveness? Similarly, how interested are you in assessing the likelihood of shortages and efficacy of Tamiflu/Xofluza during an H5N1 pandemic?
I’m very interested in tamiflu’s efficacy. Some specific important questions:
is tamiflu more effective when taken very early? when did the people in the studies that found low efficacy take tamiflu? My understanding is it is effective for prophylactic use, which suggests earlier is better.
how does the math change if the flu is more dangerous or virulent?
Not interested in assessing likelihood of shortages.
Over-the-counter Tests
Is the issue a lack of over-the-counter tests specifically for H5N1, or for flu in general? General flu PCR testing is likely available—should we investigate this?
My assumption is the European OTC tests will catch H5N1, but if that’s wrong I’d like to know.
I don’t care much about non-home tests, except I am interested in the national flu surveillance program and how much we can trust it.
Trajectory of Illness
For past H5N1 cases, is there a treatable “window of opportunity” before the infection becomes severe? How critical is it to determine whether mild cases might escalate and require aggressive intervention?
Very interested in this.
Historical Epidemics
I could pull together a list of relevant modern epidemics (human-to-human airborne transmission without an animal vector). Are there any specific criteria you’d like to prioritize?
The reference class is “things that got at least as far as H5N1 did this year”- widespread in livestock and with some humans infected.
Cross Immunity
While cross immunity seems important, determining decision-relevant information may be challenging. Would you like a summary of existing knowledge or only actionable insights?
Medium priority for a summary of existing knowledge, bonus points for a quantitative model even if it’s low confidence.
Respiratory Infection Dynamics
Epidemiologists suggest that respiratory infections are deadlier lower in the lungs but more infectious higher in the system. Is this a fundamental tradeoff? Would a “both-and” virus be possible? What evolutionary advantages might viruses have in infecting the lower lungs?
If you happen to stumble on relevant information I’d like to hear it, but I don’t want synthesis.
Government Stockpiles and Interventions
What stockpiles of H5N1 vaccines exist? What options are available for increasing testing and vaccination of livestock? How are governments incentivizing medication, vaccine, and PPE production?
Yes to stockpiles, yes to shallow investigation of options for livestock.
Political Considerations
Should we examine how a Trump presidency or similar political scenarios might influence the interaction between local and federal health agencies?
No.
Species-to-Species Spread
The rapid spread of H5N1 to multiple bird and mammal species raises the question of whether humans will inevitably be affected. Is this worth exploring in-depth?
Yes.
Mortality and Long-term Effects
What demographics do other flu strains tend to affect most? Are there long-term side effects comparable to “long COVID”?
We know who normally gets hit hardest by diseases, I’m only interested in deviation from that.
No to “long flu”, because I am already convinced it exists but the data on it is bad.
Mutation and Vaccine Efficacy
How quickly do flu strains, especially H5N1, tend to mutate? What implications does this have for vaccine efficacy and cross-reactivity? How much asymptomatic spread occurs with flu, and how long does it remain airborne?
Yes to mutation rate, especially if you can quantify what’s needed to allow human-to-human transfer.
Yes to general flu knowledge like asymptomatic period and time airborne.
No Deaths Yet
How should we update based on the fact that, contrary to past occurrences of H5N1 that had a ~50% CFR, none of the 58 confirmed cases have died?
This paper says there has been one death from the current clade. I’m very interested in knowing if that’s correct. It also says tamiflu was found to reduce mortality in earlier, more deadly forms of H5N1.
That’s a lot, so here are my top three priorities: vaccine efficacy (wide confidence intervals are fine), treatment efficacy, and likelihood of human-to-human transmission.
The current h5n1 strain already has one death https://academic.oup.com/jid/article/230/3/533/7758741
short answer: no. Possibly because of hepcidin.