Claims

Safe injection sites solve one problem, create another

Safe injection/consumption sites reduce overdose deaths and the spread of disease in the short run but may create a worse long-run problem by fostering a culture of enablement that implicitly says there is nothing wrong with people wasting their lives in addiction until they die; because the key question is the impact on others, distributing needles and paraphernalia without an intervention toward a healthier path risks massive public spillover effects.

Supports mandatory holds and mandated detox

Mahan supports mandatory psychiatric holds and court-mandated treatment with oversight and checks and balances, arguing the bar for involuntary intervention has been set so high—requiring someone to state they want to kill themselves or others—that it is nearly impossible to hold someone even 72 hours, so requiring a few weeks of detox given today's addictive substances may be the most compassionate thing possible.

Secure DNA offers a cheap universal screening upgrade

Secure DNA — built by three Turing Prize winners and a Nobel laureate, run by a Swiss foundation on a $500,000 annual budget — is a fully encrypted screening tool designed to catch split orders, lets whitelisted parties anonymously submit new sequences of concern, is free to adopt in about an afternoon, but must be made mandatory and universal to work against split orders.

Pandemic-proof PPE is engineering-feasible and cheap

Pandemic-proof personal protective equipment (P4E) is within our engineering capabilities — as proven by high job-safety records in BSL4 labs — and a not-for-profit group believes it can be developed for well under a billion dollars, then domestically manufactured and stockpiled so that, given early biosurveillance warning, frontline workers can operate in full confidence during even a grim pandemic.

Deep VISION's three escalating bad ideas

Deep VISION planned three escalating dangerous activities: virus hunting (extracting ~10,000 undiscovered viruses from remote locations into leaky labs), characterization (experiments to determine which are pandemic-grade), and publication of the list and full genomes of the most dangerous viruses to the entire world.

All labs leak at unknown rates

Every category of laboratory, up to the highest biosecurity level, demonstrably leaks pathogens, and we do not know the rate at which they leak because there is no uniform reporting system, making an isolated bat cave a safer place for a pandemic-grade pathogen than a human-staffed lab.

Traditional public health monitoring is sufficient

Monitoring the interfaces between human populations and where dangerous viruses live can be done very robustly with traditional public health methods, without extracting viruses into leak-prone labs.

COVID was a failed dress rehearsal

COVID was remarkably benign — super infectious but not super lethal — and functioned as a dress rehearsal for something far worse, which humanity appears to have failed in a variety of ways.

Multiple simultaneous engineered pandemics could topple civilization

Whereas COVID emerged from a single point and spread at roughly 4.5 miles per hour giving two months of warning, a malevolent actor releasing seven engineered pandemics simultaneously from 20 airports could overwhelm diagnosis, cause combined fatality rates far beyond COVID, and collapse society when frontline workers refuse to risk their lives, shutting down food, law enforcement, and electricity.

USAID's PREDICT found 1,200 novel viruses

USAID previously funded a virus-hunting program called PREDICT that discovered roughly 1,200 novel mammalian viruses, and the Wuhan Institute of Virology has long collected coronaviruses, though no virus-hunting program approached Deep VISION's scale.

1918 flu killed one in thirty and remains dangerous

The 1918 Spanish flu killed almost one out of every thirty people on earth, and although widespread exposure to its descendants offers some hope, there is no guarantee it would not cause another pandemic if reanimated today.

CDC published 1918 flu genome after reverse genetics existed

The CDC published the 1918 flu genome to the internet in 2005 — at least five or six years after reverse genetics was pioneered for influenza — when an estimated hundred people could already reanimate the virus, a number that has since grown by two orders of magnitude, and no vaccine improvements have been attributed to the publication in the 20 years since.

Esvelt ordered 1918 flu fragments and nearly all providers fulfilled

In an FBI-authorized study, Kevin Esvelt ordered 1918 flu as 500-nucleotide fragments from about 38 providers, and all but two fulfilled the orders — several IGSC members among them — because US regulations cover full DNA sequences but not fragments, proving anyone with a credit card can assemble the genome despite thinly disguised orders.

Biosurveillance can catch stealth pandemics early

Wastewater biosurveillance that detects sudden explosions of never-before-seen DNA sequences via deep metagenomic sequencing can catch even a 'stealth pandemic' with a long asymptomatic incubation period; the Nucleic Acid Observatory's proposed $15 million system sampling eight major international airports could detect a pathogen well before 1% population prevalence, and budgets scale roughly linearly with sensitivity.

Germicidal UV light offers rapid infection payback

Upper-room germicidal ultraviolet light already reduces infections via rapid air exchange, and a Canadian respiratory advocacy group estimates that broadly deploying it in a new 20-year-life hospital under a single-payer system yields a payback period of roughly 18 days — a figure that, even if off by 1,000x, would be a clarion call for global public health.

Voluntary DNA screening equals no screening

The International Gene Synthesis Consortium screens dangerous sequences but is voluntary and no longer represents the claimed 80% of the world's synthetic DNA supply; a world where screening is optional is a world with no screening, because bad actors simply route orders to cheaper non-screening companies — like an airport where security is optional and opt-outs get a discount.

Airport Security Analogy for Bio-Defense

Just as the US went from dozens of hijackings per year in the late 1960s (when airlines resisted metal detectors) to zero hijackings in 25 years — not by making hijacking impossible but by making it hard enough that plotters become vulnerable to interception — implementing mandatory DNA screening would greatly lower ambient bio-risk without making attacks impossible.

Deep VISION could have canceled civilization

Deep VISION, a USAID program with a $125 million five-year budget, had in its worst case the potential to 'cancel civilization' despite being designed with the best of intentions.

We've had multiple non-COVID pandemics per century

Beyond COVID, the world has experienced roughly four pandemics over the past century or so, meaning zoonotic risk will likely deal humanity these cards again regardless of engineered threats, and the proposed defenses are transferable to natural pandemics.

You Cannot Make a Verified Vaccine Preemptively

Even if you discover and confirm a deadly virus, you cannot make a useful vaccine for it because vaccine efficacy is only established during an actual outbreak by comparing inoculated versus uninoculated people; you would only have an unvalidated vaccine candidate of unknown safety and efficacy.

To escape decadence, society should take much more risk; in biotech specifically, there has been essentially zero progress on dementia and Alzheimer's in 40-50 years because researchers are stuck on the beta amyloid hypothesis, which is obviously not working and amounts to a self-reinforcing racket.

A multi-center Stanford study on complex diagnoses found physicians alone were 73% accurate, AI alone was 88% accurate, but when AI was given to doctors the doctors only improved to 76% while the AI degraded from 88% to 76% — illustrating that human involvement can drag down AI performance.

Symptom-based medicine will disappear: instead of detecting disease from symptoms, we will detect disease 10 years before symptoms manifest based on what's happening in the body, and providing far more up-front care reduces downstream disease burden and expensive interventions like heart surgery and ER visits.

The capitated/Medicare Advantage segment of healthcare will be transformed by AI far more effectively than fee-for-service, because for a hospital system reducing cost means reducing revenue, whereas in a capitated system providers benefit from AI-driven cost reduction since they get paid a fixed amount per patient.

Everyone on the planet will be able to get a free AI primary-care/multi-specialty physician for less than a dollar a month, but the hard problem is regulatory — the AMA won't let the AI write a prescription, so human physicians must approve the diagnosis and prescription.

Medicine breaks roughly into quarters — medical expertise/physicians (~25%, going toward zero cost), pharmaceuticals (~25%, transformed by AI drug design where the key gain is raising the <5% probability of FDA approval from a lead candidate), diagnostics/imaging (~25%, where the cost is the technician not the machine, addressable by 'self-driving' MRI/ultrasound), and in-hospital care (~25%).

Within the next 5-10 years biological intervention will approach computer programming in precision — designing molecules and even drugs for one patient at a time targeting a single genetic anomaly — and single-shot genetic treatments for diseases like sickle cell will arrive within ~10 years.

Drug companies like Vertex argue that price controls limit innovation in isolated, hard-to-treat areas (e.g. cystic fibrosis) where research is most needed, which is the policy rationale behind exempting orphan drugs from price controls.

Zipline now serves 5,000 hospitals and health facilities globally, delivers about 75% of Rwanda's national blood supply outside the capital, and delivered 20 million doses of vaccine in the last 18 months.

In dying, hearing is the last sense to go—so talking to or singing to someone even in a coma is productive—and playing a song a person loved as a child can soothe anxiety in their final moments, allowing them to cross over peacefully.

Entanglement-based imaging cameras are being used to detect tiny details in breast cancer tumor biopsies, picking up far more detail than infrared cameras alone because the visible-light photon provides much sharper images while the entangled infrared photon probes the object.

Francis Collins promised in the 1990s/2001 that within 10 years human genome sequencing would yield 'previously unimaginable insights' and 'rational strategies for minimizing and preventing the disease phenotypes altogether.'

The central dogma of molecular biology (Crick, 1958), that information flows DNA→RNA→protein and cannot be reversed, is correct as a chemical sequence statement, but it does not prevent organisms from controlling their genomes — as shown when immune systems mutate only the antigen-grabbing region of immunoglobulin genes via chance changes, then select and proliferate the cells that successfully grab the pathogen and kill the rest.

Genome sequencing has largely failed to deliver promised medical treatments for common complex diseases: a UCL team published in the BMJ in October last year showed that polygenic scores, built using the same techniques as a clinical drug trial, simply do not work for cardiovascular disease and cancer — which together account for 60% of fatalities — though monogenic (rare single-gene) diseases remain a valid target for genetic cures.

South Sudan entered the COVID pandemic with only three ventilators, illustrating the formal-resilience disadvantage of poor countries.

Nearly all major historical pandemics—diphtheria, Ebola, HIV/AIDS, the Black Death—are the result of zoonotic spillover, and the increasingly rapacious relationship of capitalist economies to nature is driving more frequent spillover events, as evidenced by three novel coronaviruses in roughly 25 years.

Climate change and ecological disruption will return pathogens to the West—tropical diseases migrating to temperate zones, archaic pathogens released from melting permafrost, and antibiotic resistance—and these challenges will not be solvable simply by expanding the health care budget; cash-strapped Western states facing rising defence commitments will be unable to provide the kind of financial assistance they did during COVID-19.

Increased health care spending yields diminishing returns: after 2020 the UK substantially increased health care spending yet outcomes did not improve much, refuting the post-war left/center-left assumption that more health spending is always straightforwardly better.

A 19th-century French doctor observed that his noble and bourgeois patients had more illnesses than peasants, who were more resilient because living closer to nature exposed them regularly to pathogens and built stronger immune systems.

Lipopolysaccharide (LPS) can accumulate during peptide manufacturing and causes an immune response; while a tiny amount may not cause a massive response, repeated exposures accumulate and become problematic, which is why properly cleaned (LPS-removed) peptides from pharma or compounding pharmacies are safer than gray/black-market sources.

Applied therapeutic peptides fall into three categories: prescription FDA-approved peptides from board-certified physicians (the safest), gray-market peptides purchasable online with questionable safety/efficacy, and black-market peptides which are often contaminated and not what they claim to be; the safest path is prescription peptides because they are cleaned of lipopolysaccharide (LPS).

Taking growth hormone directly carries common risks including carpal tunnel syndrome, cartilage overgrowth, structural changes to the head, face and body (brow thickening), a lean-but-distended gut, and unusual skin texture; growth-hormone-promoting peptides produce less dramatic structural changes than direct growth hormone.

Growth hormone secretagogue peptides should be taken about 20-30 minutes before sleep, at least an hour and a half (preferably two hours) after eating and with no food for at least 30 minutes afterward, because elevated blood sugar or food in the gut blunts their growth-hormone- and IGF-1-raising effect, and bedtime timing augments the natural early-night growth hormone pulse.

People tend to wrongly assume peptides are inherently safe or free of side effects because they are not hormone therapies like testosterone or estrogen therapy; in fact peptides are very potent compounds with many pleiotropic effects, peptide therapeutics are in early stages, and they carry real risks requiring physician oversight, clean sourcing, regular blood testing, and tumor monitoring.

BPC-157 has a very high safety profile in terms of lethal dosing, with an LD50 as high as 2 grams (2,000 mg) per kilogram of body weight; typical therapeutic doses are far lower, around 300-500 micrograms subcutaneously two to three times per week for about 8 weeks, followed by cycling off for 8-10 weeks.

The melanotan peptides (1 through 5) all mimic melanocyte-stimulating hormone and cause skin darkening, but melanotan 1 does not cross the blood-brain barrier (only tanning), whereas melanotan 2-5 cross it and additionally increase mood and libido and decrease appetite; PT-141 (the FDA-approved drug Vyleesi) targets this system and is approved for premenopausal hypoactive sexual desire in women but is used off-label in men.

Type-two secretagogues like GHRP-3 and MK-677 (an oral, non-injectable GHRP) can potently increase growth hormone but also more than double circulating cortisol and elevate prolactin; because cortisol should be high in the morning and very low at night, and these peptides are taken before bed, the cortisol elevation can be problematic.

BPC-157 poses a potential tumor growth risk because it upregulates growth hormone receptors and increases VEGF (vascular endothelial growth factor) to drive angiogenesis; tumors thrive on increased blood flow and growth factors, so BPC-157 may maintain or accelerate tumor growth — notably it does the exact opposite of the cancer drug Avastin, which is a VEGF inhibitor.

Kisspeptin is a recently discovered peptide made in the brain that sits at the top of the reproductive hormone cascade — it turns on GnRH, which triggers LH and FSH release from the pituitary, which in turn stimulate the gonads to produce testosterone and estrogen and drive sperm/follicle development; synthetic kisspeptin is prescribed for hypothalamic amenorrhea and used off-label to boost vitality and libido, while kisspeptin antagonists treat menopausal vasomotor symptoms.

Hexarelin is the strongest stimulator of growth hormone release (pulses 2-3x larger than other secretagogues) but can dramatically increase prolactin (suppressing libido), cause fluid retention and malaise, and most problematically desensitize the growth-hormone-releasing-hormone receptors, potentially permanently turning off the system's response to any peptide or endogenous signal.