(I funded Marcus with my own money to look into this).
Some quick takes:
As we’ve also observed for mid-2020 covid, Rt for sufficiently concerning diseases trends toward 1 by default because of control systems.
it makes a lot of rational selfish sense for people to take precautions up to the point where marginal risk equals marginal cost of additionally mitigating risk.
This is a pretty shitty failure of coordination (it sucks that people are taking precautions to avoid getting sick when they’ll wound up getting sick anyway) but it doesn’t rationally make sense for any individual to deviate
I disagree with “If you are a sexually active gay man , it is likely wise to limit your number of sexual partners as you are at a large risk.” as an important takeaway.
As mentioned in the above point, MSM folks are already rationally incorporating personal risk into account so additional advice to be conservative here isn’t very useful.
I also think almost all of the current spread happens at a relatively small number of sex parties.
The only things we can do to curb realistic spread is by taking actions that are large enough to push Rt<<1 hard.
One plausible method is pushing for monkeypox vaccines, I think current guesses are that it reduces additional spread by 85%, which I think is enough to cut Rt <<1 even after behavioral changes (since R0~=2?).
I think for gay men who a) have sex regularly with many people and b) I personally know well enough to offer unsolicited advice and regularly (so, like, 3 people) “try to get vaccinated” might be my main advice
To be clear this advice is not without significant costs, the smallpox vaccines do have nontrivial side effects.
If we had a more sane public health system, offering regular and free monkeypox testing, and recommending that sex parties require them (the way they currently require covid tests) would also be a mainline intervention.
I think there is still a plausible case that EAs should try hard to curb monkeypox in at least one area, for epistemic reasons and as a way to get legible wins.
I really think monkeypox is “easy mode” as public health interventions go, much slower serial interval than covid, fairly identifiable contact tracing, a vaccine already out, etc.
However I’m not personally super excited about working on this and this type of thing requires a fair amount of effort to be mobilized
The main takeaway I’ve had in the last few years is that prevention and (very) early-stage response is the most important thing for any emerging epidemic that you care enough to stop, ideally you want to cut spread while it’s still in the exponential growth stage (and every doubling time approximately doubles the cost of trying to stop growth then).
(I funded Marcus with my own money to look into this).
Some quick takes:
As we’ve also observed for mid-2020 covid, Rt for sufficiently concerning diseases trends toward 1 by default because of control systems.
it makes a lot of rational selfish sense for people to take precautions up to the point where marginal risk equals marginal cost of additionally mitigating risk.
This is a pretty shitty failure of coordination (it sucks that people are taking precautions to avoid getting sick when they’ll wound up getting sick anyway) but it doesn’t rationally make sense for any individual to deviate
I disagree with “If you are a sexually active gay man , it is likely wise to limit your number of sexual partners as you are at a large risk.” as an important takeaway.
As mentioned in the above point, MSM folks are already rationally incorporating personal risk into account so additional advice to be conservative here isn’t very useful.
I also think almost all of the current spread happens at a relatively small number of sex parties.
The only things we can do to curb realistic spread is by taking actions that are large enough to push Rt<<1 hard.
One plausible method is pushing for monkeypox vaccines, I think current guesses are that it reduces additional spread by 85%, which I think is enough to cut Rt <<1 even after behavioral changes (since R0~=2?).
I think for gay men who a) have sex regularly with many people and b) I personally know well enough to offer unsolicited advice and regularly (so, like, 3 people) “try to get vaccinated” might be my main advice
To be clear this advice is not without significant costs, the smallpox vaccines do have nontrivial side effects.
If we had a more sane public health system, offering regular and free monkeypox testing, and recommending that sex parties require them (the way they currently require covid tests) would also be a mainline intervention.
I think there is still a plausible case that EAs should try hard to curb monkeypox in at least one area, for epistemic reasons and as a way to get legible wins.
I really think monkeypox is “easy mode” as public health interventions go, much slower serial interval than covid, fairly identifiable contact tracing, a vaccine already out, etc.
However I’m not personally super excited about working on this and this type of thing requires a fair amount of effort to be mobilized
The main takeaway I’ve had in the last few years is that prevention and (very) early-stage response is the most important thing for any emerging epidemic that you care enough to stop, ideally you want to cut spread while it’s still in the exponential growth stage (and every doubling time approximately doubles the cost of trying to stop growth then).