Variolation May Cut Covid19 Deaths 3-30X

The article seems to be ignoring a critical aspect of Variolation. A quick Google on the topic indicates that it's more about being deliberately exposed to a less virulent strain of a virus, rather than being exposed to a lower initial viral load (which would also seem to make sense).

The term Variolation comes from the name of the Variola virus that caused Smallpox, but critically there are at least two strains of this virus: Variola Major and the less deadly Variola Minor. The Variolation practice, as I understand it, was to expose people to the Variola Minor strain, which apparently then resulted in at least some level of immunity to both strains.

Unfortunately, AFAIK, so far we don't yet have a less deadly strain of SARS-CV-2. Apparently there are currently ~8 strains so far, and all appear are about the same in terms of death rate.

https://www.cantonrep.com/news/20200330/8-strains-of-coronav...

Although there's clearly evidence that having a low initial dose is an important factor in the severity of many infections, probably including Covid-19, I'm not convinced that it's the dominant factor in instances where variolation was used successfully. In those cases, they deliberately used different infection pathways, such as drying out and grinding up scar tissue and applying it to a scrape on the skin with smallpox.

What would the options be for covid-19? The author seems to skip this train of thought, but I don't think you can reduce the death rate as much as he claims without at least considering it.

> This is because infections at home via close contacts tend to come with higher initial virus doses, in contrast to the smaller doses you might get from, say, a public door handle.

Unfortunately COVID-19 does not trigger a low dose response, which is why the virus spreads so quickly.

I'm not sure it's a foregone conclusion that variolation would work for covid-19, is it? There are theories that doctors have had more extreme cases due to infection dose, but I could see nothing approaching a dose vs. severity graph in this article.

It'd be worth it to try on a small scale with healthy volunteers, but it seems disingenuous to promote this strategy as a sure bet. What works for Smallpox might not for covid..

An interesting idea.

It might work in a world where the population has enough capability to coordinate something like a variolation village.

But then again, there are plenty of people out there who throw coronavirus parties, churches that hold service in direct defiance of social distancing orders, and individuals that spit on doorknobs: https://www.ibtimes.sg/are-these-people-trying-spread-deadly...

I think the author does not adequately understand the challenges associated with e.g. how the variolation village would be perceived and understood by others--its main flaw being that it would not contain the whole population. People don't like the idea of a ghetto.

For context, it's estimated that BEST case scenario (flatten the curve entirely, everybody gets medical attention) that 1.1 million Americans still die[1]. This is assuming a quarantine for > 6 months [1]. Vaccines are a year off [1].

Some may see this as risky, but given that containment is out of the question, the only risk with variolation experiments would be that one catches it earlier, currently 80% of people are expected to catch Covid [1].

Given that, but surely something akin to mixing the phlegm of the infected with hot water, or exposed to ultraviolet radiation for a certain interval, would be worth a shot and potentially mass-producible.

Unfortunately I imagine our slow and process-oriented healthcare system isn't going to be innovative or fast enough for this, and more like 2 million will die in US alone.

Maybe another country will give it a try.

[1] https://spiral.imperial.ac.uk/bitstream/10044/1/77482/5/Impe...

This has been looked at already by amateur researchers online (at places like /r/COVID19 and elsewhere). The problem with variolation is that you need to culture large amounts of the virus to make it scale, and once you're doing that you're basically 90%+ of the way to a vaccine already. Inactivating viruses, using viral material etc. (the extra step in vaccination, compared w/ variolation) is not hard.

Like said elsewhere -- we don't know what would be the "safe enough" method, on another side, desperate times...

https://en.wikipedia.org/wiki/Variolation

Still, there is a nice bit of history behind the concept, as an example, the story about how Britain learned about the method:

"It would not be until Italian physician Dr. Emmanuel Timoni of Constantinople promoted the practice that variolation began its spread through Western Europe. After coming across the practice in Constantinople, Timoni wrote a letter describing the method in detail which was later published in the Philosophical Transactions in early 1714.[6]:77 His account would become the first medical account of variolation to appear in Europe. Although the article did not gain widespread notoriety, it caught the attention of two important figures in the variolation movement, Bostonian preacher Cotton Mather and the wife of the British Ambassador to the Ottoman Empire, Lady Mary Wortley Montagu."

"No stranger to smallpox, Lady Mary had lost her brother to the devastating disease. Soon afterwards, she also contracted smallpox. Although she survived, she was left with severe facial scarring. While in Turkey she came across the process of variolation as it was practiced amongst the people of Constantinople. She first mentioned variolation in the famous letter to her friend, Sarah Chiswell, in April 1717.[7]:55 in which she enthusiastically recounted the process, which in Constantinople was most commonly administered by experienced elderly women. In 1718, she had the practice conducted on her five-year-old son, Edward Montagu. The procedure was supervised by the embassy doctor Charles Maitland. On her return to England, she had her four-year-old daughter inoculated in the presence of physicians of the royal court in 1721.[1]:90 Both variolations proved successful. Later on that year Maitland conducted an experimental inoculation of six prisoners within the Newgate Prison of London. In the experiment, six condemned prisoners were variolated and later exposed to smallpox with the promise of freedom if they survived.[2]:45 The experiment was a success, and soon variolation was drawing attention from the royal family, who helped promote the procedure throughout England. However, variolation caused the death of Prince Octavius of Great Britain, eighth son and thirteenth child of King George III in 1783."

https://www.nlm.nih.gov/exhibition/smallpox/sp_variolation.h...

"Variolation was never risk-free. Not only could the patient die from the procedure but the mild form of the disease which the patient contracted could spread, causing an epidemic."

Anti-Vaxxers, Anti-Hand Sanitisers, Anti-Masks and Anti-Variolation are all in the same boat.

This needs Gamification, Germany is doing this, bringing in certificates.

These people can get the country running again and go to the movies and restaurants.

I was going to infect myself but couldn't, then learned about load, so kinda glad I didn't jump in too early. I would have go hard to be infected since I figured it'd be quicker. Another reason to make it formal.

Quite possibly the dumbest thing I have ever read on this site.