## Coronavirus: the second-weirdest solution?

Many people have suggested coating handles, doorknobs and so forth with virus-killing copper tape. It’s a shame that this isn’t being tried on a wider scale. In the meantime, though, here’s a related but different idea that I had last night.

Imagine we could coat every doorknob, every light switch, every railing, every other surface that people might touch in public buildings, with some long-lasting disgusting, sticky, slimy substance. For a variety of reasons, one probably wouldn’t use actual excrement, although it wouldn’t hurt if the substance looked like that. Or it could be a sickly neon green or red, to make it impossible to conceal when you’d gotten the substance on your hands.

What would be the result? Of course, people would avoid touching these surfaces. If they had to, they’d do so with a napkin or glove whenever possible. If they had to touch them bare-handedly, they’d rush to wash their hands with soap as soon as possible afterwards. Certainly they wouldn’t touch their faces before having washed their hands.

In short, they’d show exactly the behaviors that experts agree are among the most helpful, if our goal is to slow the spread of the coronavirus. In effect, we’d be plugging an unfortunate gap in our evolutionary programming—namely, that the surfaces where viruses can thrive aren’t intuitively disgusting to us, as (say) vomit or putrid meat are—by making those surfaces disgusting, as they ought to be in the middle of a pandemic.

Note that, even if it somehow turns out to be infeasible to coat all the touchable surfaces in public buildings with disgusting goo, you might still derive great personal benefit from imagining them so covered. If you manage to pull that off, it will yield just the right heuristic for when and how often you should now be washing your hands (and avoiding touching your face), without no need for additional conscious reflection.

Mostly, having the above thoughts made me grateful for my friend Robin Hanson. For as long Robin is around, tweeting and blogging from his unique corner of mindspace, no one will ever be able to say that my ideas for how to control the coronavirus were the world’s weirdest or most politically tone-deaf.

### 46 Responses to “Coronavirus: the second-weirdest solution?”

1. David Appell Says:

Back in the days of payphones, one trick to steal change was to crack an egg and pour the contents into the change slot. When someone’s dime fell through they’d put their finger into the slot and, not enjoying what they felt, abandon their money in there. The thief would come around to collect the coins later.

2. Austin Says:

Reminds me of a Tullock airbag.

3. Scott Says:

Austin #2: In the age of Twitter-shaming, I’ve learned that one needs to apply careful ethical review even to thought experiments.

People getting gross slime on their hands: probably fine

Spikes in steering wheels, to increase the fatality of accidents and thereby incentivize people to drive more carefully: yeah, today I’d probably search for a less grisly proposal that made the same point!

4. Peter S. Shenkin Says:

“even if it somehow turns out to be infeasible to coat all the touchable surfaces in public buildings with disgusting goo, you might still derive great personal benefit from imagining them so covered”

Great! Let’s write an augmented reality app that creates the appropriate visualization, so that we don’t have to leave quite as much to the imagination.

5. Douglas Fort Says:

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

6. Marnie Dunsmore Says:

Strange as it may seem, last fall, my cat Charlie was diagnosed with FIP, a lethal cat specific coronavirus.

Not wanting our adorable Charlie to start pushing up daisy’s, I found out about Niels Petersen’s paper:

https://journals.sagepub.com/doi/full/10.1177/1098612X19825701

I bought GS-441524 and injected Charlie at the dose recommended in the paper. Results were dramatic and he is now fully recovered from FIP (which, without GS-441524, is almost always lethal in cats).

Gilead pioneered this drug (commercial name is remdesivir). They are now conducting trials on this drug to see if it blocks Covid-19. The drug seems to work broadly against class 1 coronavirus in humans and cats.

My bet is on Gilead. Gilead should have a drug that works against covid-19 by the summer.

7. Ralf Says:

So, what do I do if there is a door between the sink and my office? The kind where I need to use the doorknob to open it? Looks like I’ll just have to spread goo all over my keyboard as it is impossible for me to wash my hands without getting goo on it again afterwards? 😉

I have yet to see an office restroom where this would not apply. I feel we need to upgrade our buildings before applying your solution.

8. Yoni Says:

Yes, but by that measure we should cover / imagine covered everyone in this goo too! Not the nicest world to live in.

9. Scott Says:

Ralf #7: Bring a paper towel with you and use it to open the door. Seriously, it wouldn’t be the worst idea for us to get into the habit of doing that.

10. Luca Says:

This is how a complexity theorist approaches a public policy problem. Our problem is that we want people to wash their hands and not touch their face after touching a doorknob. There is a situation in which this problem is solved, so let’s reduce to that situation.

11. bion a howard Says:

dude, just take the von clauswitz approach to molecular biology. attack the virus directly at its center of gravity. one way around weird societal interventions and drug development B.S. is to develop platforms which apply to a range of diseases. why reinvent some fancy shape of atoms for each disease? it’s entirely possible to develop something which works on cancer and coronavirus. just look at CRISPR, or RNAi … master delivery and you can simply re-target the therapy toward different sequences.

Here (https://github.com/bionicles/coronavirus) is code to design CRISPR-Cas13 CARVER (https://www.sciencedirect.com/science/article/pii/S109727651…) 30mer guides against regions of Coronavirus conserved between SARS, MERS, HKU1, and SARS-nCoV-2 (Covid-19 Virus) and not found in highly expressed Lung protein-coding RNA. Uses BioPython, Redis SADD/SISMEMBER, and tools from EMBL (Emboss Consensus and Clustal Omega Alignment) and data from NCBI. The good news is, it’s probably possible to delete Coronavirus genome directly inside the lungs, without vaccines; just deliver nanoparticles or adenovirus (doesn’t replicate) with an inhaler and express CRISPR-Cas13 and the gRNA using the Surfactant promoter sequence for lung-only expression of the therapy

disclaimer: I need to work on the readme and write a blog post, but the data is there and the general core works. There’s ~30k guides possible and 226 target 13 longest conserved regions across 4 different outbreaks spanning 17 years of virus evolution (provides reasonable confidence these regions are necessary for the virus to function)

If anyone knows some folks in the Pharma / Biotech industry I could use help to run the tests on this, tell em to email bion at bitpharma.com

12. Scott Says:

Luca #10:

This is how a complexity theorist approaches a public policy problem. Our problem is that we want people to wash their hands and not touch their face after touching a doorknob. There is a situation in which this problem is solved, so let’s reduce to that situation.

Yes! Although my path was slightly different:

(1) Our problem would be solved if only coronaviruses were easily visible, like little glowing disgusting insects.
(2) So let’s reduce to that situation, or to something similar to it.

13. Marnie Dunsmore Says:

“A closer look at the Ebola drug that’s become the top hope for a coronavirus treatment”

“Gilead has taken pains to emphasize, when announcing new plans for remdesivir, that it lacks human data on whether the drug actually works to treat COVID-19.

“What it does have is preclinical data showing the drug to be active against the MERS and SARS viruses, which share enough genetic similarities to SARS-COV-2 that researchers and the company think remdesvir could work against it too.

“Testing by National Institutes of Health researchers, published in January, demonstrated remdesivir prevented MERS from developing in monkeys, and helped improve the condition of those animals that were already infected.

“”Our results, together with replication inhibition by remdesivir of a wide range of coronaviruses in vitro and in vivo, may further indicate utility of remdesivir against the novel coronavirus […] emerging from Wuhan, China,” they wrote.

14. Robert Michaels Says:

Coronavirus: the third-weirdest solution?

Class Action Lawyers Take Note !

Who will be the first to sue the Chinese Communist Party in the International Court of Justice (and any other relevant courts) for their culpability in the COVID2019 coronavirus outbreak, dissemination, and misinformation campaign throughout the world ?

1) Failure to prevent the immoral, unethical, and illegal destruction, smuggling of wildlife, failure to police and enforce against animal “wet markets”, for decades, even centuries – – – leading to the emergence of many diseases in China, (SARS, H1N1, etc.) and now COVID 2019 costing the world $trillions of dollars loss in death, sickness, time lost, economic disasters, etc. 2) Spreading misinformation and failure to accurately and timely report the dates, progression, and statistics of the COVID 2019 infection, hindering other countries understanding, planning, treatment, etc. of this disease. It is widely known that the Chinese are world public enemy #1 in the illegal and immoral consumption of rhino, elephant, tiger, pangolian, and many other, animal tusks, body parts, etc. which has resulted in the extinction or near extinction of many species. It is also known the Chinese have failed to accept the United Nations Convention on the Law of the Sea (UNCLOS) ruling regarding the nine dash line, and it would likely be expected they refuse to accept any “Western” court ruling regarding their overwhelming culpability in wildlife extinction and infectious disease spread. However, a legal precedent has been established against authoritative and despotic regimes who refuse to cooperate with the world community: For example, when North Korea tortured and destroyed a perfectly healthy American Otto Warmbier, whose life ended shortly after he was repatriated back to the US as a vegetable, his parents filed suit in US Federal court and received a$500 million dollar judgement against N. Korea.

Thereafter, a N. Korean cargo ship was seized by US Coast Guard in American Samoa and auctioned off for $1.7 to$2 million to begin to compensate the Warmbier’s. Therefore, following any serious court judgement against the Chinese, Chinese vessels and assets all around the world suddenly become fair game, are seized and auctioned off to pay the judgement. The Chinese navy doesn’t have anywhere near the capability to police all the oceans of the world. Game over for the Chinese Communist Party.

15. Scott Says:

Douglas Fort #5: Right, when you read for example about ancient Israel, it’s hard for the modern mind even to grasp just how seriously ritual purification was taken (practically half the Torah is about such topics). Alas, archeological excavations have taught us that in (e.g.) the case of the Essenes, the sect that wrote the Dead Sea Scrolls, the obsessive purity rituals not only didn’t help prevent the spread of disease, they almost certainly made things much worse. But it’s interesting to imagine a future wherein pandemics have so ravaged humanity that the only communities still able to thrive are cults that incorporate the discoveries of modern microbiology and epidemiology into their cultic rituals.

16. Scott Says:

Marnie Dunsmore: Given the almost-total failure to develop effective drugs against the common cold and flu despite a century of efforts, is there some a-priori reason why we’d expect drugs against the new coronavirus to have a better chance? Isn’t there much more reason for optimism regarding vaccines?

17. Marnie Dunsmore Says:

Mechanism of action revealed for remdesivir, potential coronavirus drug

https://www.drugtargetreview.com/news/56798/mechanism-of-action-revealed-for-remdesivir-potential-coronavirus-drug/

18. Marnie Dunsmore Says:

Mechanism of Inhibition of Ebola Virus RNA-Dependent RNA Polymerase by Remdesivir.

Abstract

Remdesivir (GS-5734) is a 1′-cyano-substituted adenosine nucleotide analogue prodrug that shows broad-spectrum antiviral activity against several RNA viruses. This compound is currently under clinical development for the treatment of Ebola virus disease (EVD). While antiviral effects have been demonstrated in cell culture and in non-human primates, the mechanism of action of Ebola virus (EBOV) inhibition for remdesivir remains to be fully elucidated. The EBOV RNA-dependent RNA polymerase (RdRp) complex was recently expressed and purified, enabling biochemical studies with the relevant triphosphate (TP) form of remdesivir and its presumptive target. In this study, we confirmed that remdesivir-TP is able to compete for incorporation with adenosine triphosphate (ATP). Enzyme kinetics revealed that EBOV RdRp and respiratory syncytial virus (RSV) RdRp incorporate ATP and remdesivir-TP with similar efficiencies. The selectivity of ATP against remdesivir-TP is ~4 for EBOV RdRp and ~3 for RSV RdRp. In contrast, purified human mitochondrial RNA polymerase (h-mtRNAP) effectively discriminates against remdesivir-TP with a selectivity value of ~500-fold. For EBOV RdRp, the incorporated inhibitor at position i does not affect the ensuing nucleotide incorporation event at position i+1. For RSV RdRp, we measured a ~6-fold inhibition at position i+1 although RNA synthesis was not terminated. Chain termination was in both cases delayed and was seen predominantly at position i+5. This pattern is specific to remdesivir-TP and its 1′-cyano modification. Compounds with modifications at the 2′-position show different patterns of inhibition. While 2′-C-methyl-ATP is not incorporated, ara-ATP acts as a non-obligate chain terminator and prevents nucleotide incorporation at position i+1. Taken together, our biochemical data indicate that the major contribution to EBOV RNA synthesis inhibition by remdesivir can be ascribed to delayed chain termination. The long distance of five residues between the incorporated nucleotide analogue and its inhibitory effect warrant further investigation.

https://www.ncbi.nlm.nih.gov/pubmed/30987343

19. Marnie Dunsmore Says:

The antiviral compound remdesivir potently inhibits RNA-dependent RNA polymerase from Middle East respiratory syndrome coronavirus.

Abstract

Antiviral drugs for managing infections with human coronaviruses are not yet approved, posing a serious challenge to current global efforts aimed at containing the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Remdesivir (RDV) is an investigational compound with a broad spectrum of antiviral activities against RNA viruses, including SARS-CoV and Middle East respiratory syndrome (MERS-CoV). RDV is a nucleotide analog inhibitor of RNA-dependent RNA polymerases (RdRps). Here, we co-expressed the MERS-CoV nonstructural proteins nsp5, nsp7, nsp8, and nsp12 (RdRp) in insect cells as a part a polyprotein to study the mechanism of inhibition of MERS-CoV RdRp by RDV. We initially demonstrated that nsp8 and nsp12 form an active complex. The triphosphate form of the inhibitor (RDV-TP) competes with its natural counterpart ATP. Of note, the selectivity value for RDV-TP obtained here with a steady-state approach suggests that it is more efficiently incorporated than ATP and two other nucleotide analogues. Once incorporated at position i, the inhibitor caused RNA synthesis arrest at position i+3. Hence, the likely mechanism of action is delayed RNA chain termination. The additional three nucleotides may protect the inhibitor from excision by the viral 3′-5′ exonuclease activity. Together, these results help to explain the high potency of RDV against RNA viruses in cell-based assays.

https://www.ncbi.nlm.nih.gov/pubmed/32094225

20. Scott Says:

Marnie Dunsmore: Thanks for sharing. Please, no further comments on antiviral drugs.

21. Rahul Says:

But most of these surfaces are there for a reason?

Eg handrails and doorknobs.

How does disincentivizing touching them solve the problem?

Maybe we get more broken necks?

22. Rahul Says:

Scott #9

If all of us used a paper towel Everytime we touched a doorknob how many more dead trees would that be each year?

23. Scott Says:

Rahul #21: In all the cases I mentioned, you want to allow the surface to be touched if needed, but you also want to force people to wash their hands right afterwards. Coating in disgusting slime achieves precisely that behavior.

24. Scott Says:

Rahul #22:

Theorem: There’s a moral balance that needs to be struck between saving the planet’s future and saving the specific humans alive right now—we can’t go 100% for the former.

Proof: If we could put all value on the future of the planet, we’d say to let the coronavirus run its course, let the response be so world-historically incompetent that the medical system (which can’t handle the influx) basically collapses, civilization basically collapses along with it, the human population drops by 30% or more and emissions fall even much more. But that would be self-evidently morally abhorrent, QED.

25. Tim Makarios Says:

Rahul #22:

What about this?: If you wear shirts that have buttons at the wrists, take a handkerchief and make one buttonhole near a corner, and another some way along an adjacent side, so that you can button the handkerchief around your wrist, and let it dangle loosely around your hand when your arm is down, like a kind of open sleeve extension. (If you don’t wear sleeves with buttons at the wrists, maybe replace one of the buttonholes in the handkerchief with a button.)

Teach yourself to keep the handkerchief between your hand and things you touch like doorknobs and hand rails. Since it’s buttoned around your wrist, one side of the handkerchief should always touch the doorknobs and handrails, and the other side should always touch your hand.

Open questions: Would this actually keep germs off your hand, and, consequently, your face, if you absentmindedly touch your face? If not, would a second handkerchief help? (If the outer handkerchief absorbs some germs, it should almost always be only loosely draped against the inner handkerchief; would this prevent the absorption of germs into the handkerchief that your hand actually touches?)

Disclaimer: I haven’t actually tried this, so maybe not even the construction works, let alone the germ-protection.

26. The floor is lava ! Says:

Everything else is lava too. You’d think that germophobic OCD types would feel vindicated but nooooo, apparently you need to have been washing hands for 20 seconds after every contact with a surface rather than a mere 5-10 for that.

27. A. Karhukainen Says:

For about five years now, I have traveled all my train trips that do not take longer than say, half an hour, by standing, and NOT holding with my hand from any rail or such. I started this as an exercise for increasing my “body position awareness” after meditation sessions, and nowadays it’s almost automatic, also my reaction to any sudden swerves: I very very rarely lose my balance even then. You have to just “read” and anticipate the train’s movements with your legs. Interestingly, it’s also the skill most kids have, it’s only their parents who incessantly tell them in metros and trains to “take hold of somewhere, otherwise you will fall”, and so spoil another natural ability.

As what comes to doors, in many cases you can just kick them open, not using your hands. Of course toilets are exceptions. Do this: after you have zipped up and washed your hands lightly, open the door a little (use a towel paper for knob if there is available), and then wash your hands again, with soap. Then open the door more with your foot when you leave.

28. Charles X. Says:

Do you have any similar ideas for interventions to nudge people into staying at least a few feet apart from each other?

29. Nick Says:

Scott, you’ve been posting unusually frequently the past few days. Are you trying to kill time in a quarantine??? If so, I recommend Zelda Breath of the Wild.

30. Scott Says:

Charles X #28: Yes, I do have a suggestion for social distancing. Everyone should eat lots of fresh garlic constantly; indeed it should be set out in bowls at social gatherings. Additional advantages of this solution are that

(1) garlic is delicious, and
(2) it provides protection in case the coronavirus mutates and starts turning us into vampires.

31. fred Says:

I’ve been saying this crisis could be a real boon for VR technology.

Now is the time to start questioning the need for large scale travel, daily commute. Time for a rethink of tourism as well.

Your idea would be very easy to implement with AR: we would overlay a glowing red layer on various surfaces, based on risk, and as soon as you touch them, the system would track it and show it on your hands and on subsequent surfaces you touch. Within a week you’d be “trained”.
Good AR tech is still 5 – 10 years away.

32. Scott Says:

Nick #29: No, I haven’t quarantined myself, but
(1) I’ve refused to commit to any additional travel beyond what’s already been booked (and even the booked travel might be cancelled depending on how things evolve), and
(2) I’ve found it difficult to concentrate on anything besides news and analysis about the looming pandemic.
In such circumstances, blogging is a perfect form of “work”!

Incidentally, I did introduce my 7-year-old daughter a few days ago to two of the classics of Western civilization: namely, Super Mario World and Street Fighter II. I hadn’t played either in nearly 30 years. No Zelda yet, but if we do go into lockdown there will be plenty of time for that!

33. fred Says:

Refresher on “exponential growth”!

34. anon Says:

Have you considered going to Israel during this pandemic? Given how badly Trump has dealt with this situation, maybe in Israel it will be hopefully safer. At least they take it seriously here.

35. Scott Says:

anon #34: It’s not the worst idea! Although if we were to do that, we ought to leave soon. Or maybe we should quarantine ourselves in some remote part of the Texas hill country.

36. fred Says:

anon #34
Israel just announced that all arrivals are subjected to a mandatory 14 days quarantine.

37. Deepa Ramani Says:

After the pandemic, I’d be unable to stop thinking of light switches that way, a cost I’m ok with :).

Seth Stephens-Davidowitz (nytimes) says:

It seems the smartest response to coronavirus would be: 1) A massive federal investment in making ventilators/temp hospitals asap 2) A complete quarantine of elderly/sick. If we did this, maybe we could actually defeat disease with little economic or human cost.

38. fred Says:

This may sound crazy, but considering some experts predict 75% of the world will catch this, you’d probably be better off catching it asap.
For one thing there is still plenty of hospital capacity in case you have a bad reaction.
But I also wonder if having your immune system get acquainted with the virus now may keep you more protected if/when more aggressive waves of the virus come along (in the case of the Spanish Flu of 1918, the second wave was especially lethal, after the virus mutated).

39. Tim Makarios Says:

fred #33:

Interesting video (as always from 3Blue1Brown). I notice, though that he used infections outside China, which is useful for explaining exponential functions, but is only part of the picture if you’re explaining covid-19. If you take into account cases inside China, as well as the fact that many people have recovered, and some have died, the total number of active cases, according to official statistics, fell every day for 16 days. It’s rising again, true, but if the official statistics are to be believed, then there’s already more going on than simply exponential growth.

40. Tim Makarios Says:

41. fred Says:

Washing hands is necessary for sure.
But one elephant in the room in the US is the lack of face masks.
Authorities tell us that they’re not necessary, which is convenient because you can’t buy any!
In the countries that have managed to control the infection (for sure, like HK and Singapore) everyone is wearing a face mask.

If you look at some research on the Flu, it’s clear that propagation doesn’t happen just with coughing and sneezing – “normal” breathing and speaking is enough to spread the virus through the air.

For example: https://www.pnas.org/content/115/5/1081

“This suggests that exhaled droplets, generated by mechanisms other than cough, are responsible for a portion of the viral load observed in the fine-aerosol fraction. Several researchers have recently shown that exhaled aerosol particles are frequently generated from normal healthy lungs by small airway closure and reopening. It has been hypothesized that during respiratory infections, airway closure and reopening frequency would be increased due to inflammation with a commensurate increase in aerosol generation and contagiousness”

42. Rainer Says:

scott #24:
“… the human population drops by 30% or more..”
How did you get or derive that unrealistically high number?

I fear the virus is beginning to mentally affect scientific rationality 🙁

43. Cindy Easton Says:

For Marnie Dunsmore: re- your cat. Just wondering – the investigative number for the Gilead antiviral drug that they originally were developing for Ebola was GS-5734 which is remdesivir. I am wondering if the drug you injected your cat with is the same drug with a differ investigational number since it was being investigated as a veterinary drug. Or is it a completely different antiviral? How did you procure it? Very curious. I am a researcher and pharmacist with a broad scientific background.
As a side note: Apparently there are some issues with remdesivir in that they have not yet been able to attribute improvement in respiration, reduction in fever etc. temporally with the administration of the drug. Subjects have experienced some severe GI side effects and elevated liver enzymes. If enzymes return to baseline after stopping the drug, that should not be a problem, but it depends on how long you have to take the drug before it is determined that you are “cured.” Nausea and vomiting can be decreased with any number of drugs – we have some good ones used in chemotherapy, but that would be a whole other trial to make sure that they did not interact with the remdesivir.

44. Marnie Dunsmore Says:

@Cindy Easton

I injected my cat with GS-441524. Remdesivir is a prodrug that metabolizes into its active form, which is GS-441524.

For some reason, Dr. Niels Pedersen at UC Davis chose GS-441524, and not GS-5734 (Remdesivir), when he did his study on FIP.

GS-441524 can easily be procured online. Most of it is being produced in China, from what i can tell. It is not FDA approved and definitely should not be used in humans.

When my cat was on GS-441524, he did have some GI issues. But he already had severe GI issues anyway, because the FIP had caused lesions in his small and large intestine. I don’t know if it affected his liver.

45. Marnie Dunsmore Says:

@Cindy Easton

Regarding GI symptoms in our cat:

He had already been vomiting for three months before I treated him with GS-441524. This was due to the FIP, which had caused a lesion in his small intestine. We know he had a lesion there prior to the GS-441524 treatment because we had a diagnostic ultrasound run on him. He actually stopped vomiting while being treated with GS-441524. I suspect this was because the GS-441524 gradually caused the lesion to subside. Anyway, I can’t say that the GS-441524 caused pronounced GI symptoms in our cat. He was injected daily for 30 days at the recommnended dosage, which is 4.0 mg/kg.

https://www.ncbi.nlm.nih.gov/pubmed/30755068

He has been off of GS-441524 for 27 days. He appears to be a completely norma cat now. His nose is wet and cold. No temperature. He’s playful and naughty. We are counting out the weeks and hoping he doesn’t go into remission.

46. Michele Amoretti Says:

I think the slime coating approach would not work with spring breakers.

https://www.washingtonpost.com/nation/2020/03/19/coronavirus-spring-break-party/

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