Many docs might dig in, and if they don’t change their attitude and opinion when they should, you’ll just need to switch docs until you find a decent one. The doc I brought the print out to didn’t dig in and prescribed the med I requested after he read it. This had nothing to do with any study; it seemed that it was widely known among experts (the print out quoted expert opinion), but this doc just had the wrong opinion about it. I asked another doc about a combination of meds that’s usually not prescribed often (but probably should be) to younger age groups and the reasoning behind it without showing a print out (but I had one just in case) and he agreed even though it wasn’t standard of care. Sure, advocating for yourself could lead to an adversarial situation, but if you want to avoid mistakes and blind spots that can lead to your condition not improving or even worsening, I don’t see any other alternative.
Florin
You are definitely not supposed to have papers printed out for them. You might refer to a study you read, yes, but bringing print-outs is over the top even if you are a colleague of some sort.
This is the right advise for more unproven or controversial stuff like supplements or certain diets, but it’s the wrong advice for other stuff like medications. For instance, if your doc says that one med (which doesn’t work for you) is just as effective another med that you want to try but that he’s unwilling to prescribe, the only way to change your doc’s mind is to print out and highlight the exact text where his colleagues (especially if they know more about this med than he does) disagree with his opinion.
Here’s my take about docs and specialists based on personal experience:
Assume that they’re 75% wrong about everything, even about common medications that they should know like the back of their hand.
Yes, print out and highlight the text that shows that they’re wrong.
Usually, they’re not trained about nutrition (beyond what you’re mother told you to eat) and certainly not about supplements, so don’t ask.
Assume that you’re 75% wrong and your doc was right all along.
Yes, stress-test your doc’s opinions and your own research by using LLMs, the opinions of other docs, literature searches, standard-of-care guidelines, and patient forums.
If they continue to underperform or are assholes, change docs and explain why you switched docs to your new doc in order to avoid repeating the problems you had with your old doc.
Bottom line: they’re human; they make mistakes and have many blind spots just like any other professional, and for a sufficiently motivated and informed patient, it’s possible to discover at least some of those mistakes and blind spots and avoid them.
During a high-mortality (from 10% to 100% lethality) epidemic or pandemic, most people might not trust some of the pathogen-agnostic defenses that you mentioned such as far-UVC lamps, because it would be extremely difficult to verify that they were correctly installed (e.g., adequate amount of lamps per room), maintained (e.g., far-UVC emitter still works at adequate efficiency), and run (e.g., adequate air mixing which would depend on fans or HVAC systems). After decades of use, this trust issue might be resolved, but unfortunately, we may not have the luxury of time on our side.
The only things I’d trust today and for the near to medium-term future would be elastomeric respirators and powered air-purifying respirators (PAPRs) which can be verified to work by individuals (using fit tests) and orgs (like NIOSH) that test and certify respirators. And unlike massive infrastructure investments that will take decades to adequately implement if they ever get off the ground to begin with, stockpiling respirators would be cheaper, faster, and just as or more effective.
A better scenario would be that the problem of high-mortality pandemics will be solved automatically via complete automation which will enable the complete but relatively-comfortable physical isolation of every person as needed. This is now more likely to happen in the near future due to the rise of tech like LLMs and humanoid robots.
Targeting humans with bioweapons may have been genuinely difficult but will probably become much easier for several reasons like the following:
Indoor airborne aerosols are now known to be a significant (and likely dominant) vector of transmission in fast-spreading pandemics
Bioterrorist groups like Aum didn’t try hard enough (like using different types and variants of dangerous viruses and letting evolution do the rest)
LLMs, agents, and other digital tools might make some amount of rational design and digital evolution of viruses easier before release
Another reason to doubt the “noble lie” theory is that it was easy to make masks out of commonly available materials like cloth.
The real reason that requests to save PPE for health care workers were made was that these workers needed N95 respirators to protect themselves from procedures (like intubation) that were already know to aerosolize (and thus make airborne) any respiratory virus or bacteria, and surgical masks were needed for protection during medical procedures unrelated to Covid.
What disturbs me more than the fact that the transmission question hasn’t been settled yet is that public health policy still seems to assume, even after Covid, that fomite and droplet transmission are the only ways for the common cold (and other respiratory viral infections like the flu) to spread, entirely ignoring the possibility of airborne aerosol transmission.
Even without definitive evidence of how a particular strain of common cold virus is transmitted, we know that respiratory viruses can only spread through three possible routes: fomites, droplets, and aerosols. So, the missing piece of public health advice, besides washing hands (for fomite protection), is at least to wear a respirator (for droplet and aerosol protection) or isolate during a bad common cold (or flu) season. Eye protection can also considered, though transmission via the eyes is probably much less common.
Personally, I lean more toward airborne aerosol transmission, because it seems that a bunch of stuff needs to line up just right for fomite and droplet transmission to produce fast and significant spread. For instance, coughing or sneezing into someone else’s face doesn’t seem likely to be a common occurrence to me.
But would knowing the correct route of transmission make any significant difference for the public? Would most people start washing their hands more than they do today? Would they start wearing respirators or isolate at home for months? I doubt it; they’d probably only take extreme measures if the threat was perceived to be extreme, something at least as deadly and as transmissible as Covid. Still, some people (the elderly or people with compromised immune systems, for instance) might want to take some of these more extreme measures. It may also help the broader public get used to the idea of wearing respirators during a bad pandemic in order to avoid disruptions, such as lockdowns, that occurred during the Covid pandemic.
If you have the government LARPing a pandemic response, the fact that the government shouldn’t be trusted is the right learning. The key question you should ask if what you could do so that the next time the government isn’t LARPing but actually has a decent pandemic response.
I don’t blame politicians as much as the infectious disease experts they listened to. These experts were slow to recognize that aerosols were the primary mode of transmission and failed to drop support for stuff that was of dubious value such as surgical masks and lockdowns in favor of the widespread use of respirators. Some of the most prominent experts even badmouthed respirators just like they badmouthed regular masks earlier in the pandemic.The only defense against some of this kind of failure of expertise that I can think of is something I like to call a “thinking-things-through” form of analysis and is a retort to the “but you’re not an expert” argument. For some subjects like advanced math or physics, most people won’t be able to do this kind of analysis. But there are other kinds of expert claims that are much easier to evaluate such as the claim that masks could promote viral transmission due the potential for more “face-touching” or that masking could provide a false sense of security and lead to risky behavior or that masks offer decent protection (even though aerosols act like smoke and smoke can get past masks since they have huge gaps which well-fitted respirators don’t). In other words, if an expert tells someone to jump off a cliff to cure a headache, any rational person should be able to reason that that’s obviously bad advise. Of course, experts are still needed, but this can act as a check against at least some of their claims and perhaps weaken the groupthink that some experts can fall into.
Wouldn’t a respirator with a exhalation valve be more comfortable?
...EN argues that any sufficiently expressive cognitive system—such as the human brain—must generate internal propositions that are arithmetically undecidable. These undecidable structures function as evolutionarily advantageous analogues to Gödel sentences, inverted into the belief in raw subjective experience (qualia), despite being formally unprovable within the system itself.
Rather than explaining subjective illusions away in third-person terms, EN proposes that they arise as formal consequences of self-referential modeling, constrained by the expressive limits of second-order logic.
How could undecidability, unprovability, self-referential modeling, incompleteness, or any sort of logic generate the redness of red?Incomplete, self-referential modeling → ? → red
The brain does this by creating a symbol, which refers to a symbol, which refers to a symbol—an infinite regress with no grounding, no bottom. But evolution doesn’t need grounding; it needs action. So it skewed this looping process toward stability—toward a fixed point. That fixed point is the assertion: “I exist.” Not because the system proves it, but because the loop collapses into a self-reinforcing structure that feels true. This is not the discovery of a self—it’s the compression artifact of a system trying to model itself through unprovable means. The result is a symbol that mistakes itself for a subject.
The feeling part remains unexplained.
What justifies a formal system becoming experience?
Well, that’s the heart of the matter: ultimately, nothing.
Experience is not something we have, but something we enact. Your experience is barred from being “real” in any ontologically grounded sense because the universe cannot produce something like it directly. Yet it can still be consistent, much like a force—both can only be inferred from their effects.
We still seem to have experience. How can this “seeming” feel like something? If you boil everything down to math, how can math feel like anything?
One: Qualia are not illusions, they are fictions.
Why do people defend qualia so intensely if they’re illusions?
Because the illusion is evolutionarily entrenched and cognitively reinforced.
This seems contradictory.
A defendant guilty of homicide argues that, due to EN, the victim had no conscious experience and thus suffered no moral harm. The judge, also an EN advocate, counters that if consciousness is illusory, the defendant’s claim of injustice itself collapses. Ethical responsibility remains intact irrespective of qualia’s ontological status.
What about torturing animals?
We keep getting better at curing disease and preventing death, but this makes little difference in our fight against aging, due to its exponential nature.
Almost no age-related disease or condition can currently be prevented or cured. They can be somewhat slowed, but that’s about it. A rare exception is cataracts; it can be cured by replacing the eye’s lens.
This concept is inspired by established systems like Nordic civilian defense against nuclear threats or lifeboats on ships.
But those systems weren’t designed with the survival of humanity in mind, and so, they’re obviously going to be much less robust.I might not have emphasized this sufficiently in the post, but the aim is not to achieve near 100% robustness. Instead, the goal is to provide people with a fair chance of survival in a subset of crisis scenarios.
My initial intuition is that even if 70% of the units function effectively in a crisis, this would be a success.
You need to think about how much time these shelters could buy. 70% survival for how long? A few months is probably doable, but shelters and their associated infrastructure will not last forever.
If shelters buy a few months of survival, the crisis will need to be solved in a few months. That also means the shelters will need to be targeted to experts that might be able to provide a solution or allow enough time for a solution that already existed to disperse and kill off the mirror bacteria. If a solution will need to be developed, a lot of time will need to be spent in unprotected labs which will increase risk. Think about this: you’re stuck in a suit, you can’t eat, drink, peep, poop, or even type fast (because you have thick gloves), while at the same time you’re trying to do complicated experiments to save the world. These scenarios aren’t impossible to survive, but I expect they’ll have a high likelihood of failure. So you’d probably want to aim for a least a few years rather than months.
While rigorous testing will enhance confidence and could refine the design, the significant likelihood that the shelters will work as-is—supported by Los Alamos results and cleanroom precedent—suggests that they could prudently be deployed even without exhaustive testing if a crisis emerges and the above testing is not completed.
To stretch survival to years, you’d need to do a hell of a lot more real-world testing and design work. There’s no close-enough precedent for what you’re trying to do; I highly doubt that you can only rely on lessons from cleanrooms, labs, or nuclear bunkers. Has any cleanroom or lab demonstrated perfect containment for years? How about the mobile kind? Nuclear bunkers aren’t designed to be livable for years or be sterile. At best, lab testing and case studies can indicate that hardware may work, not that it will work in the real world.
And there’s a lot more to consider besides maintaining the mechanical and electrical system that supports the suit and shelter filtering system. You’d also need climate control systems; that’s one heat pump for the suit and one for the shelter. You’d need cooking devices and indoor air cleaners or an air recirculation system. And don’t forget about the VHP system. A comms system for the suit would also be nice. But things get complicated pretty fast. I suppose you can have two or three of each suit and shelter and alternate between them to add redundancy. But things get costly pretty fast.
The more you think about it, the more impractical (and less appealing to stakeholders) it seems to get. So, to convince anyone that this is anything other than a hail mary, extensive real-world testing must be done. And maybe you can mitigate the testing showstopper I mentioned earlier by periodically sterilizing and retesting used shelters and suits. Of course, ease of sterilization will need to be incorporated in the initial design.
Unless you seal most of industry inside shelters or risk being outdoors for long periods of time, decades of survival is probably close to impossible.
Your suggestion of using permanent bonds could indeed be a practical solution in such cases.
But you’d still have a gasket where the ductwork meets the membrane (and where it would be more exposed to temperature fluctuations), and a one-piece assembly would increase costs substantially and introduce space constraints due to the need to stockpile many assembly units.
I just thought of another showstopper that makes the other issues now seem insignificant: how could you ever determine whether or not the suits and shelters work to prevent bacterial contamination? The problem here is that humans are already “contaminated” and another problem is that the world isn’t contaminated with a unique kind of bacteria or bacteria-sized particle that you could test for. So, there’s actually nothing to test for. Even if you could test for something, how could you even detect one or a few bacteria that got through? I don’t see any way around this.
Air Supply Leaks
The below diagram illustrates the airflow dynamics. The air system is designed with a series of pressure gradients (P1 > P5 > P4 > P3 > P2), ensuring that any leak results in airflow from clean to dirty areas, not the reverse. This mechanism minimizes contamination risks, even in the event of small leaks. This principle is widely used in cleanroom and laboratory settings to maintain sterile environments.
This still doesn’t address gasket leaks (leaks between the filter’s gasket material and the filter tunnel). The potential for such leaks could be eliminated be permanently bonding the filter to the filter tunnel but that would mean that the filters couldn’t be replaced.
Cleanrooms and labs aren’t failure-proof, and failure would happen a lot more often in the messiness of the real world.
Membrane Integrity and Large Holes
You’re correct that larger holes or tears could compromise the shelter. To mitigate this, the material used for the shelter will be selected for its tear resistance and self-limiting properties. Existing materials for bubble hotels, for example, do not propagate tears. For DIY or lower-cost implementations, layering materials (e.g., plastic sheets reinforced with fabric) could provide additional durability. There is already extensive research on tear resistant fabrics, as well as substantial data from people actually living in such structures, such as bubble hotels. For mass production, it would be useful to carry out research on how to achieve tear resistance across a variety of materials and fabrication methods.
Even if tiny holes or material defects wouldn’t grow into large tears due to air pressure alone, what if something else impinged on the membrane? Couldn’t a large enough stressor conceivably cause a small hole to grow? After all, suits and shelters would often get banged up by normal use and the occasional red truck.
It’s probably safe to assume that small leaks couldn’t deflate these bubble hotels, but I doubt anyone has been motivated to look at whether some of these leaks could grow large enough to let in small amounts of particulates. Suit durability probably suffers from the same lack of research.
Component Failures
While no system is failure-proof, redundancy and robustness are central to the shelter’s design. Key measures include:
Longevity Testing: Components will undergo extensive real-world and simulated stress testing. Suppliers’ lifetime analyses will be leveraged to ensure reliability.
If you’re lucky, you might get away with testing thousands of shelters and suits, but if you want something really robust, you probably need to test hundreds of thousands and potentially millions. How will you get hundreds of thousands of people to isolate themselves for years at the minimum? Mars simulation theme parks? I’m only half joking; perhaps some sort of rotation system might work, but on the other hand, that might defeat (or at least minimize) the purpose of testing the practicality of continuously (without any breaks due to personnel changes) sealing out external contamination.
Redundant Systems: Critical systems like air supply will have manual overrides and backup power (e.g., a UPS to sustain operation during power transitions). Simple mechanical solutions will be emphasized to reduce dependence on complex electronics—in a crisis it can probably be assumed that one could rely on shelter inhabitants for at least some operation and maintenance.
How long could (and should) these redundant systems last? Years? Decades? What would be their failure rate? Spare batteries can fail if they’re not used, gaskets can become brittle or warped, metal can oxidize, and so on.
Redundancy might increase durability in the short term, but it also increases complexity, and complexity can create its own problems. Complexity might not be an issue when you can usually get all of the spare parts you need, but if industry no longer exists (because you want to minimize the time you spend outside), you’d need to stockpile a lot of parts and/or entire shelters and suits. That would increase costs. And how long would that stockpile actually last? How long would membrane material remain folded without degrading along the folds in a garage or warehouse that’s not climate controlled? There are likely to be many issues like this with long-term storage.
User Training: Shelters are designed for inhabitants to manage minor troubleshooting (e.g., switching power sources).
How will you train millions of people about how to live and survive in suits and shelters before a catastrophe happens? This goes way beyond simple maintenance procedures and troubleshooting.
It would be risky to wait for a catastrophe to happen due to the possible social disorder that might occur and logistical issues with distribution (e.g., trying to outrun simultaneous releases of mirror bacteria in all major population centers).
Mass Production Challenges
Scaling production to millions of units is indeed ambitious, but starting with smaller-scale production allows us to address these challenges iteratively. The simplicity of the design—based on off-the-shelf components—makes rapid scaling more feasible compared to more complex systems. Even producing tens of thousands of units could substantially reduce existential risk in high-priority scenarios.
Where will the incentive for mass producing millions of units come from? Or even tens of thousands?
Suit Usage and External Transfers
For outside missions, the focus is on minimizing exposure. Techniques used in gnotobiotic (germ-free) animal research, such as sterilized transfer tunnels filled with vaporized hydrogen peroxide (VHP), could be adapted for human use. Vehicles retrofitted with small shelters can serve as transfer units, reducing reliance on suits for complete protection.
What happens when the suit inevitably gets dirty? There’ll be a lot more mud and dirt in a world in which infrastructure isn’t maintained, and I doubt VHP will be adequate. So, there’ll probably need to be another elaborate decontamination procedure. More complexity, more points of failure, more cost.
Will those retrofitted vehicles be self-driving? If not, the cabin would need to be shelterified. Yeah, good luck with that. If it’s a self-driving truck with a shelter bolted on, you might also need a datacenter to go alone with that. But that means you’d need to maintain the datacenter and have more spare hardware and spend more time outside and maintain a power source for the datacenter, and so on. On the other hand, if self-driving will depend only on a local system, you’ll probably need an AGI for that. But if you have an AGI, you’d also probably have an ASI which should be able to make something way better like almost fail-proof suits and shelters, self-sufficient, impenetrable underground cities, or quickly eliminate the mirror bateria threat (e.g., by drexlerian nanobots, assuming they’re physically possible to construct).
-air supply leaks: the whole air supply is inside the shelter with a fan at the inside end. Thus, any leak goes from clean to dirty and is not an issue
I’m not sure what you’re describing here. Unless you’re talking about some sort of closed-loop system (like on a submarine or spacecraft), leaks are always a possibility. Can you share an illustration of what you’re trying to describe?-leaks through membrane (including airlock doors): not a major issue, the positive pressure will not let anything from the outside come inside
It might not be a major issue for a tiny pinhole but what about a larger hole or tear? What if that pinhole suddenly creates a larger rupture (helped out by a red truck perhaps?) in the membrane?
-shutdown due to failure of critical components is not foreseen to be an issue
Famous last words. Battery BMS fails → positive pressure is lost → bacteria gets in via tiny membrane hole(s) → everyone in the shelter dies
- all components should be possible to engineer for long continuous operation
These components will need to be mass-produced by the millions and continuously used under real world conditions to have any decent chance of being reliable. Even if certain components are already mass-produced for other uses, integrating them into a reliable system would still require integrating them into millions of shelters. But as I mentioned before, that’s not likely to happen.
The suits are indeed only 50k protection factor but it should be possible to use proven methods used to transfer germ free mice between facilities.
The leak problems that plague shelters would also apply to suits. And we are talking about using suits in the outside world, right? All facilities except shelters and perhaps food warehouses would not be protected and suits would be needed to access them.
I am happy to address this in more detail as we have spent quite a bit of time turning many stones. That said, a team of people can still make mistakes so I appreciate that you are helping me looking into this and this is part of the reason I posted—I would love to take a call to if that would be easier to hash this out.
If solutions to at least some of these issues are documented elsewhere, perhaps you can provide some links?
At least for now, public discussion seems more appropriate.
This shelter idea has many points of potential failure, possible showstoppers, and assuming a small population of shelters (hundreds or a few thousand), seems extremely unlikely to maintain an MVP for more than a few months.
Points of failure:
Leaks from the air and water filtration system (e.g., gasket leaks)
Leaks from the airlock
Leaks from the biohazard suits
Leaks from the shelter membrane
Shutdown of the filtration system due to mechanical or electrical failure
Showstoppers:
Food production or storage will require massive warehouses using the same extreme filtering as the suits and shelters. An alternative is to use some sort of disinfection tech like gamma ray sterilization, but I don’t know how practical that would be.
Producing all food indoors is currently not possible and seems unlikely be achieved anytime soon.
To mitigate the risk of these points of failure, millions of suits and shelters (along will massive amounts of supplies such as food and spare parts) will have to be manufactured and distributed, and millions of people will need to be trained in how to use them before any catastrophe occurred. Obviously, this is extremely unlikely to happen anytime soon, and I strongly suspect it won’t happen before mirror bacteria is created (due to the acceleration of biotech and AI progress) and released into the wild.
There would still be term limits: violent death, revolutions, invasions, and so on.
You might want to consider adding additional protection measures (like a respirator), as the effectiveness of some vaccines can be moderate to non-existent. The effectiveness of the flu vaccine in years when its well-matched to the circulating strains is between 40% and 60%, and when the vaccine is not well-matched, it’s protection against illness plummets, although it may still offer some protection against complications such as pneumonia. Vaccines don’t exist for bad colds and the stomach flu.
Reusable respirators will work well against any fast-spreading pandemic (assuming no ridiculously-long, asymptomatic incubation periods).
There seems to have been plenty of papers on airborne aerosol transmission of the flu and experiments with human subjects strongly suggested that the common cold is transmitted via aerosols. So, this makes it even more surprising that the experts got transmission so wrong and took forever to correct their mistake.
Brain transfers could get off the ground if they would be positioned as an almost full-proof (except for brain cancer) cancer cure. In a future in which almost everything else could be “cured” but cancer becomes the most common cause of death (a scenario which isn’t at all unlikely), a lot of pressure could build for using brain transfers. Brain cancer would still be a problem, but it would probably remain as rare as it is today. Metastasis of cancer to the brain would probably become just as rare due to improvements in early cancer diagnosis.
The continued degeneration of the brain might be at least partially solved by gradual replacement of the old brain itself. A big problem with this replacement strategy is that episodic memory would also be gradually destroyed by replacement cycles which would be designed to eventually replace the entire brain. Potential solutions range from constantly replaying all your memories in order to try to strengthen and preserve them in parts of the brain that won’t be replaced during a single replacement cycle or scanning and then 3D printing sections of brain tissue that would act as replacement tissue. If these solutions won’t work, the choice will be between certain death and gradual episodic memory loss. This situation won’t be ideal (and might somewhat decrease the enthusiasm for brain transfers), but I suspect that a lot of (or most?) people will choose gradual memory loss.