Prioritizing COVID-19 interventions & individual donations

post by IanDavidMoss, catherio · 2020-05-06T21:29:12.249Z · EA · GW · 25 comments


  I. Executive Summary & Recommendations
  II. Big picture: What's the bad thing that's happening? What could cause less of it to happen?
    problem: a disease is spreading around, causing illness.
    levers can we pull to make direct impacts less bad?
    problem: disruptions to people's lives and livelihoods
      What levers can we pull to make indirect impacts less bad?
  III. Prioritization: Which levers are likely "most effective" to pull on?
    and other properties of the ecosystem & organizations.
  IV. Specific giving opportunities
    we plan to give to
    with some open questions/reservations
      Global poor
      Vaccines, diagnostics, and treatments
      Policy advice/knowledge/resources
      What about Johns Hopkins CHS?
    we wish we'd found more of
  V. Addendum: Should you prioritize COVID response over other EA priorities?
  Previous update log
        June 22:
        May 22:

UPDATE 7/23: Our group has concluded research activities for the time being. Previous updates have been moved to the bottom of the post. All information and recommendations below are current as of late June 2020. If you have questions or are considering a donation, feel free to reach out to one of the authors and we will help you if we can.

Authors: Catherine Olsson [EA · GW] and Ian David Moss, with contributions from the collective members of the "Funding Rational Actors Promptly" Pandemic Endowment (FRAPPE).

At the beginning of April, a group of about 20 friends pulled together a messenger chat to discuss how to most effectively spend personal donation funds towards mitigating global suffering caused by COVID-19. What started as an informal effort has since resulted in the distribution of at least $410,000 to charities on this list and indirectly influenced $16 million in additional capital, mostly via the decisions of a single large foundation.

A defining motivation of our group was to find time-sensitive and neglected bottlenecks to effective COVID response that could be eased with rapid funding or other supportive actions. Fast action can be an important source of philanthropic leverage in responses to the current pandemic, a factor that we did not see explored in depth in available analyses of COVID-related giving opportunities. Accordingly, we have summarized our research here in hopes that others can use it to inform their own giving.

This article is organized in two parts. The first shares our working framework for prioritizing interventions, which helped us get oriented in a fast-changing and otherwise confusing landscape. In the second part, we enumerate specific giving opportunities (jump to section [EA · GW]) we have found that currently rate highly on this framework as of right now (late June 2020).

We've written this post primarily for the benefit of donors who have already decided to focus on COVID-19 for their own reasons. We haven't made it a priority to weigh the relative value of COVID-related donations as compared to other issues or causes, although we address this briefly at the end.

Some disclaimers: this research is being done and our donations are being made in a purely personal capacity, and none of us is acting as an employee, representative, or spokesperson of our employer or any other organization. Furthermore, because we don't have complete information on many opportunities and the situation is changing so rapidly, none of what follows should be treated as the final word on COVID-related giving opportunities. With that said, we have tried hard to come to the best decisions we could in a short period of time using the resources we had, and are updating this post periodically as our perspective continues to evolve.

I. Executive Summary & Recommendations

When evaluating COVID-19 interventions for importance/scale, our intuition is to look for the following five "scale factors":

  1. Acting quickly, because widespread avoidable suffering is already taking place, because mitigation is more cost-effective when active case numbers are smaller, and because many potentially impactful interventions require lead time to set up.
  2. 🌍Concentrating benefits on the global poor, due to both disproportionate vulnerability and huge numbers.
  3. 😷Cheap mitigation strategies to limit or slow the spread of the disease, even in populations where full containment is not possible. We are particularly interested in interventions that are cost-effective relative to the burden they impose on society.
  4. 🔬Scientific research & development in support of any of the above facets of the problem, because a dollar spent on research can unlock orders of magnitude more benefit later. This includes vaccines to prevent contraction of the disease, therapeutic treatments that reduce severity for those who have it, diagnostics, and other areas.
  5. 📊Knowledge and advocacy to inform and motivate policy responses that are more likely to achieve desired outcomes from a global perspective.

For now, we have recommended the following donation opportunities, as we believe they meet many of these criteria and have room for more funding:

In addition, we have identified a number of other organizations doing promising work that have the potential to emerge as top recommendations as we learn more about them and/or as their work develops.

II. Big picture: What's the bad thing that's happening? What could cause less of it to happen?

In this section we lay out the basic moving parts of the current crisis that one could intervene on to produce a better outcome. Parts of this section might be obvious to some readers; however, what is "obvious" to some can be "surprising" to others, so we think it's worthwhile to restate the essential picture.

Two things are going on:

First-order problem: a disease is spreading around, causing illness.

The basic epidemiological picture is as follows:

1. Each person who has the disease infects some number of other people on average.

2. The disease at first spreads exponentially (R0 > 1) within populations of susceptible people who have contagious contact with each other.

3. If no measures are taken to bring R0 below 1 and there is no vaccine, the exponential spread begins to slow down in a population only when a large fraction of that population has been infected, such that the disease starts running out of susceptible hosts.

To get a feel for these dynamics, the simulator at is the best pedagogical resource we've seen so far.

Graphic by Kristen Tonga for FRAPPE

What levers can we pull to make direct impacts less bad?

1. Reduce the total number of people who get it. For example:

2. Reduce the amount of suffering per person who gets it. For example:

Second-order problem: disruptions to people's lives and livelihoods

In addition to the direct health impacts on people who get sick, there are indirect impacts. People who are sick or concerned about getting sick will not work, consume, travel, distribute goods, or participate in their communities at the same rate or in the same patterns as before. Additionally, mitigation strategies (such as lockdowns, test-and-trace programs, mandatory face coverings, or education campaigns) will further shape people's behaviors, as well as costing money. These altered patterns of activity and production, and direct and indirect financial costs, are already manifesting as job losses, food shortages, and other disruptions to people's lives and livelihoods. Particularly in poorer countries, the indirect effects of the disease could cause more harm than the disease itself, as they are not only harmful in their own right but worsen many existing social problems (other diseases, hunger, domestic violence, education, inequalities in access to essential services, etc.).

Some mitigation strategies are much more expensive than others, in terms of both money and disruption. In the case of a previous pandemic, for example, one analysis concluded that "[early] contact tracing was estimated to be 4,363 times more cost-effective than school closures ($2,260 vs. $9,860,000 per death prevented)." While we can't assume that these ratios will necessarily hold for COVID, a similarly wide differential among the cost-effectiveness of different strategies would not be surprising.

Furthermore, some mitigation strategies take much more "setup time" than others (e.g. a school closure can be done immediately, but contact tracing cannot be started until tracers are trained and hired), and yet mitigations are best done when case numbers are low (which is true early in the course of disease spread, or after a successful period of suppression). This means that wealthier places can deploy expensive and disruptive methods early on to buy time to set up cheaper methods later while keeping case numbers low throughout the mitigation process; lower-income areas, by contrast, cannot afford to do so as easily.

Finally, mitigation strategies exist in a policy and information environment that can either facilitate or hinder desirable outcomes. As one particularly high-profile example, the World Health Organization and United States Centers for Disease Control recommended that the general public avoid obtaining or wearing face masks in the initial months of the pandemic, only to eventually reverse those recommendations in the face of new evidence. The fact that these institutions made what was apparently the wrong call early on arguably made it more difficult for public officials to enforce mask-wearing now that it is broadly accepted practice.

What levers can we pull to make indirect impacts less bad?

III. Prioritization: Which levers are likely "most effective" to pull on?

When prioritizing interventions, the usual factors to consider from an effective altruist perspective are scale, neglectedness, and tractability. We think that time-sensitivity is another important factor in this case.


The above "napkin sketch" picture of what's going on yields some quick-and-dirty intuitions as to where the big "scale factors" are.

For one, exponential curves add orders of magnitude very quickly, so reducing the spread of the disease (especially in contexts where it can be done cheaply) is likely to be cost-effective. We emphasize that this is still the case even in communities that cannot avoid a high rate of infection. If a population has not been able to control the disease and cannot afford sustained lockdowns, and therefore may be on track to hit herd immunity before a vaccine is found, we originally entertained the hypothesis that it might not make a difference to the ultimate outcomes to slow the spread. However, we now understand that lowering R0 saves lives in all cases, because it both lowers the herd immunity saturation point and reduces "overshoot" in which excess infections occur above the herd immunity level. These both correspond with vast numbers of lives saved.

Some strategies are orders of magnitude more cost-effective than others. We believe these cheaper strategies may include wearing masks in public, handwashing, contact tracing when case numbers are low, disease surveillance (i.e. finding undetected cases), and personal protective equipment (PPE) for healthcare workers. (see Juneau et al. preprint). We're excited about interventions that make cheap mitigation strategies more available, affordable, and accessible.

We also expect orders of magnitude could be found in substantially reducing the severity of the disease, through developing, manufacturing, and distributing highly-effective treatments.

Existing thinking about the role of leverage in cost-effectiveness can be applied here too. Borrowing from the framework from Open Philanthropy Project's blog post "GiveWell's Top Charities Are Increasingly Hard to Beat," the following sources of leverage are ways to add multipliers to impact-per-dollar:

We boil this down to five "scale factors": ⏰Acting quickly, 🌍Focusing on the global poor, 😷Reducing the spread via cheaper strategies, 🔬Scientific research, and 📊Informing & coordinating policy.

Neglectedness, and other properties of the ecosystem & organizations.

We found that estimating neglectedness was critical to our understanding of opportunities, but more challenging than we expected because the landscape of other funders' attention is both difficult to track and evolving rapidly. For example, a simplistic view is that too much money is being spent on "coping with" the pandemic, as compared to "solving" it (see, e.g., the COVID-Zero messaging, and this tweet from Paul Romer). This lens might give the impression that vaccines are currently under-resourced; however, vaccines seem to have attracted a lot more attention compared to other treatments and have received billions of dollars in investment. The simplistic "coping" vs. "solving" lens also misses that many of the world's poorest people need support to literally survive pandemic-induced disruption, not just "cope" with it.

In addition to the usual ITN analysis, we came to realize that acting appropriately quickly is unusually important to an intervention's effectiveness on COVID-19 mitigation. This consideration is not usually called out explicitly in the ITN prioritization framework. In addition to the fact that exponential curves add orders of magnitude very quickly (as discussed above as a "scale factor"), there's the fact that fast-moving actors are rare; it's much more typical for decision-makers to respond slowly. This means that interventions that need to be undertaken quickly seem more likely to end up neglected, due to a lack of actors who can orient and act fast enough to do them. Slow-moving organizations might be appropriate to fund if the intervention is not especially time-sensitive, but if there is a narrow window of opportunity, and the opportunity passes, money spent on the attempt could be totally wasted. Finding an appropriate match between the time-sensitivity of interventions and the promptness of relevant actors is especially key. As a result, some donation opportunities that otherwise look good might not be effective due to a lack of urgency or readiness on the part of the specific potential recipients.

IV. Specific giving opportunities

We highlight first the top few overall giving opportunities we have found so far at this stage of our investigation, followed by other promising candidates by topic area. While we have had limited time to identify and evaluate organizations, we have now reached a point in our research where we feel quite good about most of the opportunities listed below.

Opportunities we plan to give to

Open Source Medical Supplies: 😷Cheap mitigation, 🌍Global poor, ⏰Acting quickly.

Fast Grants. 🔬Scientific research, ⏰Acting quickly.

COVID-END: 📊Informing & coordinating policy, 🌍Global poor, ⏰Acting quickly.

Promising, with some open questions/reservations

Global poor

Medecins Sans Frontieres. 😷Cheap mitigation, 🌍Global poor, ⏰Acting quickly.

GiveDirectly (International). 🌍Global poor, ⏰Acting quickly.

GiveIndia. 🌍Global poor, ⏰Acting quickly.

Development Media International. 😷Cheap mitigation, 🌍Global poor, ⏰Acting quickly.

Africa CDC. 😷Cheap mitigation, 📊Informing & coordinating policy, 🌍Global poor, ⏰Acting quickly.

Vaccines, diagnostics, and treatments

COVID-19 Early Treatment Fund: 🔬Scientific research, ⏰Acting quickly.

ACT Accelerator: 🔬Scientific research, 🌍Global poor, 📊Informing & coordinating policy, ⏰Acting quickly.

1 Day Sooner: 🔬Scientific research, ⏰Acting quickly.

Policy advice/knowledge/resources

IDinsight: 🌍Global poor, 📊Informing & coordinating policy, ⏰Acting quickly.

Center for Global Development: 🌍Global poor, 📊Informing & coordinating policy.

Rapid Reviews COVID-19 (no link): 🔬Scientific research.

What about Johns Hopkins CHS?

The Johns Hopkins Center for Health Security has been the most frequently cited top donation opportunity for COVID-19 so far in EA community writeups such as the Founders Pledge COVID-19 Response Fund and SoGive's post on EA Forum [EA · GW]. Pandemic preparedness is core to the center's mission and it has been quite active in the current crisis, having launched a widely followed coronavirus case tracking map/database; it also publishes numerous white papers addressing questions of interest to policymakers and its experts have been prominently featured in the media. There are a few reasons why we have not prioritized it in our own research. For one thing, the profile of the center has been raised considerably as a result of the pandemic and we are unsure what additional funding would make possible in the short term. In addition, the center's track record in providing high-quality advice does not appear to be unblemished; we noted that its experts explicitly recommended against wearing DIY masks in early March (a position reversed by the end of the month) and were not discouraging people from pressing ahead with travel plans as late as March 6, advice that may have led to costly decisions and missed opportunities during a period when infections were rapidly increasing.

Also considered

Other organizations we considered included Partners in Health, PATH, CARE, the Food and Agricultural Organization of the United Nations (FAO),, Y-RISE, the Center for Disaster Philanthropy, GiveDirectly (for its US-focused Project 100 campaign), the Emergent Fund's People's Bailout, National Domestic Workers Alliance, Meals on Wheels, America's Food Fund, United Way, Medical Credit Fund, ONE Campaign, Oxfam, Population Services International, and Give2Asia. While we have elected not to pursue these options at this time, we believe they are all doing relevant work and intend to track their activities periodically as bandwidth permits. Complete analysis of all organizations considered is available here.

Certain of these merit mention for donors with specific preferences or priorities that may be different from ours. For example, the Center for Disaster Philanthropy's COVID-19 Response Fund is a good option for donors who want to make a single donation to cover a wide range of interventions globally. For donors interested in helping vulnerable populations in the US, the Feeding America/World Central Kitchen partnership looks attractive on the basis of scale of impact and fast implementation. For US-focused donors with very strong social justice values, the Emergent Fund's People's Bailout could be an intriguing option.

If an organization doesn't appear anywhere in this blog post, it's possible we are not aware of it, or it's possible we were but decided not to investigate it in depth.

Opportunities we wish we'd found more of

Based on our analysis of the big picture, and the important levers we identified, we felt there were a number of gaps in the landscape that we wished we could support, but we could not quickly find as many strong organizations dedicated towards those efforts as we would've hoped to see. (Such organizations may exist, in which case we'd love to hear about them.)

V. Addendum: Should you prioritize COVID response over other EA priorities?

We've written this post primarily for the benefit of donors who have already decided to focus on COVID-19 for their own reasons. We have not made it a priority to analyze the relative value of COVID-related donations as compared to other issues or causes. This post should not be seen as taking any position for/against prioritizing COVID-19 over other issues or causes.

That said, we know this question is top of mind for many EAs, and we wanted to offer some brief thoughts on it here.

Evaluating the relative cost-effectiveness of "COVID-themed" vs. "non-COVID-themed" donations is more difficult than if these were wholly separable topics/areas. Instead, the effects of the pandemic itself are intertwined with both donors' actions and the work of the organizations they support in several ways. (This intertwinement seems less pronounced for cause areas such as AI x-risk, and more pronounced for cause areas such as global health and pandemic preparedness).

Some of these entwined interactions point against prioritizing COVID:

Some interactions point in favor of prioritizing COVID:

These factors point to a complicated picture that we have not undertaken to disentangle here. Overall, while we do not suggest that EAs redirect their giving away from effective charities they already support, especially in the global health arena, we do feel there are strong reasons for EAs to consider additional, COVID-specific giving. Moreover, the situation is so quickly evolving that there is not yet an established consensus about what is most effective to do, so we believe it is important that individual EAs take up the mantle of thinking carefully about what they think is best to do in the current unusual times, rather than exclusively deferring to the opinion of trusted voices in the EA world.

(For another EA Forum post which has a different take, see COVID-19 response as XRisk intervention [EA · GW])

Previous update log

October 7:

June 22:

May 22:


Comments sorted by top scores.

comment by Khorton · 2020-05-08T09:44:11.243Z · EA(p) · GW(p)

It's worth keeping in mind that if malaria services are disrupted the WHO expects malaria deaths could double (from about half a million to about a million). If you are currently a malaria donor, please think carefully before diverting your donations.

comment by HStencil · 2020-05-07T20:19:39.986Z · EA(p) · GW(p)

Thanks for this great post! I'm curious whether you've looked into any of the other developing world COVID-19 initiatives for which The Life You Can Save is currently raising money (beyond Development Media International and GiveDirectly). These include programs by TLYCS top charities D-Rev, Evidence Action, Living Goods, Population Services International, and Project Healthy Children, several of which are also, as you know, highly regarded by GiveWell.

Replies from: IanDavidMoss, catherio
comment by IanDavidMoss · 2020-05-22T07:24:56.468Z · EA(p) · GW(p)

Hi HStencil, we were able to look at all of these as part of the latest update! None besides DMI made into the main post, but we did write up Oxfam and PSI in our big spreadsheet and intend to monitor them going forward.

Replies from: HStencil
comment by HStencil · 2020-05-22T19:41:11.353Z · EA(p) · GW(p)

Great! Thanks so much for flagging that here! I assume this means that you consider Oxfam, PSI, DMI, and GiveDirectly to be more promising giving opportunities than the COVID-19 response programs of other TLYCS charities, like Living Goods, Project Healthy Children, etc. — is that right?

Replies from: IanDavidMoss
comment by IanDavidMoss · 2020-05-22T21:56:25.141Z · EA(p) · GW(p)

On the basis of our criteria, yes. Depending on a donor's personal priorities and preferences, that could look different of course. E.g., for annual donors to these organizations, I think there is a strong case to keep giving.

Replies from: HStencil
comment by HStencil · 2020-05-23T03:31:32.150Z · EA(p) · GW(p)

Thanks — that makes perfect sense!

comment by catherio · 2020-05-07T21:49:10.919Z · EA(p) · GW(p)

We didn't look into these specifically. We'd welcome additional research to investigate what their programs are and whether there's room for more funding!

Replies from: KathrynMecrow
comment by KathrynMecrow · 2020-05-08T18:02:00.407Z · EA(p) · GW(p)

( I should have combined my answers- I didn't see this until after I pressed send):

Hello there, you can see information on how The Life You Can Save's Recommended nonprofits are addressing the Covid-19 Pandemic over at < >. I urge anyone with questions to get in touch with our team! My contact details are Thanks so much.

comment by mss74 · 2020-05-09T09:47:51.927Z · EA(p) · GW(p)

Thank you for laying out your thinking on this topic! Was hoping to find something like this. Since you mentioned Southeast Asia I thought to link to something I've been working on - a compilation of Southeast Asian charities/organisations working on COVID Relief.

Some caveats: Not sure how interesting it would be, it's been quite a challenge to find these charities/orgs as is, and I have not had the bandwidth to evaluate them systematically. I've also only listed organisations working directly on PPE Provision or giving Supplies to the Vulnerable because a small 50person survey I did suggested that generally people are more likely to donate to short-term relief efforts than long-term capacity building. My main aim is to encourage richer Southeast Asians to give some money to parts of the region where the needs are clearly more pressing. I will be trying to analyse them the way you guys have done at a future point, but currently my aim is to just get more attention in places like Singapore/Malaysia directed towards Indonesia/Myanmar/Philippines through a digital donation campaign.

Replies from: IanDavidMoss
comment by IanDavidMoss · 2020-05-21T04:17:53.362Z · EA(p) · GW(p)

Super helpful resource, thank you!

Replies from: mss74
comment by mss74 · 2020-08-13T06:25:58.024Z · EA(p) · GW(p)

No worries, glad it was useful. Thought I would update that we've put all that information into a website with somewhat regularly updated summaries of the pandemic responses in the various Southeast Asian countries:

comment by KathrynMecrow · 2020-05-08T17:59:40.147Z · EA(p) · GW(p)

Hi All! In the proposals section you mention Development Media International (DMI). I work at The Life You Can Save and on the 19th May 6 PM (GMT) we will hold a Fundraiser where the CEO Roy Head of DMI will present on their work and take audience questions. We would welcome people considering donating to DMI who would like further information to get in touch with me over at Thank you.

comment by IanDavidMoss · 2020-05-22T07:22:01.003Z · EA(p) · GW(p)

Hi all, as promised, we've been monitoring the situation over the past couple of weeks and continuing to learn more about the original charities we investigated as well as new ones that have since come to our attention. We just published an update to this post and have two new top-recommended charities, COVID-END and Open Source Medical Supplies! In addition, we've added Development Media International (previously listed as Top), IDinsight, Rapid Reviews COVID-19, and the COVID-19 Early Treatment Fund as promising opportunities, and wrote up reviews for the above charities plus Medical Credit Fund, ONE Campaign, Oxfam, Population Services International, and Give2Asia in our full database of opportunities.

Our group has now distributed almost $120,000 to these charities and an additional $200,000+ has been pledged. Thanks to many of you in the comments who suggested charities for us to review and otherwise added to our understanding of what's going on. We hope these updates prove useful to those still considering donations or other ways to help.

comment by Suvita · 2020-05-11T14:11:24.277Z · EA(p) · GW(p)

Hi Catherine and Ian,

Thanks for your thoughtful work in this area.

Suvita are currently working with our state government partners on mass messaging (SMS and robocalls) in India to promote transmission-reducing behaviours, based on behavioural science evidence and expertise. We shared some details in our forum post [EA · GW] (which links to more info on our website) and would be happy to talk further if you'd like to know more. We have room for funding!

comment by RayTaylor · 2020-05-07T07:54:55.805Z · EA(p) · GW(p)

Thank you for this excellent post and analysis Ian - I've been working on the pandemic since January and still learned a lot.

1. This "crisis" seems to me a huge opportunity for changes in how we do education. I'd love to see posts on that, or does someone have links?

2. I think working on covid could more broadly help with preparedness for cascading risks, GCR and Xrisk. Sahil Shah at is learning and doing a lot on this, with FAO, WFP and others, but it would be great to see metta level work also, pulling out lessons learned from an actual response, which is a rare opportunity.

One useful thing could be to itemise and appreciate and learn from institutions, individuals and media that have done 1 or more really useful thing during the pandemic, because the chances are they would be good for the next pandemic, GCR or Xrisk event too?

3. I had great support here in India from Katriel Friedman and Fiona Conlon and team at Charity Science (Health). They are well-networked and could be worth funding in themselves, as could ALLFED (I'm biased!) and Indian animal charities (ask EA Aditya SK for suggestions) as could the Indian EA network itself: Varun Deshpande has been working up a competent proposal which I think is ready for funding: a small amount could make a. huge difference and be really encouraging and fertile. I also see a huge need for an Asian 80,000hours, and I'm supporting 2 universities who want a Foresight/Futures/Xrisk institute. The pandemic is making it very easy to see the need!

4. Lessons learned, but not implemented. For example, how come lots of countries including UK derived lessons learned from SARS-1, but only a few actually implemented those lessons (e.g. HK, Korea)?

In India, having 50kg of food vouchers ready and printed in every large city (+ some preparedness and training exercises) would have enabled a more subtle lockdown to happen without disrupting food supply (and causing lots of involuntary migration, with much suffering and death) and the cost would have been tiny.

Are there high leverage things we could do now, as we propose projects for funding, that could action the lessons learned more robustly and lastingly?
Should we be aiming more towards corporations and institutes, city regions and central banks than governments, who can "forget" or reverse or unfund preparedness when it becomes old news?
Is there a science of preparedness/recovery finance and preparedness nudge? Should it be part of the emerging fields of resilience and scaling/implementation science?
or should recovery be its own field, as it's always going to be the most neglected "last part" of any broader field such as resilience or DRR disaster risk reduction?

Obviously preparedness and recovery is core work for (interest: I cofounded). Sahil Shah is leading the work on cascading risks and financial mechanisms and direct support to Ethiopia and Tanzania, with support from myself, Sonia Cassidy (director of operations in London) and Prof David Denkenberger, EA and philanthropist.

5. At the moment it's very hard for any country to mount a humanitarian response to the next hurricane/cyclone - how can you put hundreds of people onto a ship or train and send. them into a disaster zone, where they could infect or be infected, and all the ICUs are flooded?

An obvious solution would be to do the safest possible Challenge Trial, and if I was a young Red Cross worker I would absolutely want to volunteer, for my own safety. The blockage is the wariness of doctors, who tend to consider only the narrow risk to the persons they treat, and not the broader consequences of no action (a variant on trolley problem, but with much. bigger consequences for no action). So I think there is an important legal/ethical issue around Challenge Trials, and probably a need for a new or adapted and faster ethical approval process, enabling proposals like those from Robin Hanson/Pete Singer/vaccinologists/C-TIG googlegroup to happen. At the moment there are too many restrictions/blocks which mean only high risk unofficial routes are available, and no competent research/tracking/publishing gets done, so we don't learn whether Challenge Trials have a safe protocol or not, and can't go to scale. Matthjis Maas in Copenhagen Law centre has worked on cascading scenarios (which he calls "boring apocalypse") so he might be a good collaborator, especially as neighbouring Sweden is, in effect, doing a wild and risky national Challenge Trial, with the virus itself. This is a bit dense and deserves a thread of it's own, with 3 authors - of someone is interested, please message Dr Aaron Stupple or Robin Hanson.

If anyone wants to reach me about any of this, WhatsApp +447765477305 while I'm in India and messages to are robust, otherwise via

I'd also love a volunteer or three to run a crowdfunder?

Replies from: IanDavidMoss
comment by IanDavidMoss · 2020-05-18T21:05:48.625Z · EA(p) · GW(p)

Hi Ray, thanks for these reflections and ideas. In response to your first question, I know someone working with EdTech Hub on this issue. You can find their COVID-19 response here.

comment by alana-UoEstudy2021 · 2021-02-15T15:32:01.957Z · EA(p) · GW(p)

Amazing read!

Just had a quick question on whether these 'scale factors' you mention are the elements you use to determine the effectiveness of charities?

comment by gavintaylor · 2020-07-06T13:08:01.845Z · EA(p) · GW(p)
We are seeking additional recommendations for charities that operate in Latin America and the Arabian Peninsula, particularly in the areas of direct aid (cash transfers) and strengthening health systems.

Doe direto was running a trial to give cash transfers to vulnerable families in Brazil. They seemed to have finished the trial now and I'm not sure if/when they will consider restarting it.

comment by HStencil · 2020-05-21T05:05:59.059Z · EA(p) · GW(p)

I'd also be curious about whether you've looked into the COVID-19 Early Treatment Fund's work sponsoring outpatient trials of promising anti-virals as early treatments for COVID-19. Marc Lipsitch spoke favorably of its work in his recent interview on the 80,000 Hours podcast, and in a number of respects, it strikes me as similarly promising to Fast Grants.

Replies from: IanDavidMoss
comment by IanDavidMoss · 2020-05-21T12:46:16.230Z · EA(p) · GW(p)

Yes, this one has been on our radar since last week and we are planning to include it in our upcoming update!

Replies from: HStencil
comment by HStencil · 2020-05-22T19:36:49.026Z · EA(p) · GW(p)

Thanks so much! This resource has been extremely useful.

comment by Sanjay · 2020-05-20T22:29:18.228Z · EA(p) · GW(p)

Thank you very much for writing this. I was very interested in your comments on Johns Hopkins CHS, and found your critiques very interesting. Those who found this interesting may wish to take a look at recent call notes from SoGive's recent call with them, which can be found here: [EA · GW]

I also copy and paste below the excerpt which specifically tackles the critiques raised here.

CHS explicitly recommended against wearing DIY masks in early March (a position reversed by the end of the month). When asked about this, CHS observed that there’s still not great data and evidence on masks. And that there’s a risk that using it without proper training could lead people to touch their face more. However on balance CHS has updated their opinions on this, and further acknowledges that masks are helpful for source control.

CHS were not discouraging people from pressing ahead with travel plans as late as 6th March. When asked about this, they observed that it was a change in emphasis between a commonly-held earlier view, which was that travel bans don’t achieve much because they ultimately don’t change the number of people infected, they only delay the inevitable. The change in view was because they had previously underestimated the value of delaying infections.

When discussing the items referred to in the previous two paragraphs, CHS referred to the already established received opinion or “dogma”, and how recent experience has been upturning that dogma.

comment by treeintheforest · 2020-08-27T00:37:30.643Z · EA(p) · GW(p)


I tried emailing Protege BR 2 days ago (I followed the instructions above and included Ian David Moss in the email) and later received an 'undeliverable' notification for Not sure whether they're still active or accepting donations (at least from international donors). I'd be grateful for any guidance regarding helping out the situation specifically in Brazil, but otherwise I'm considering donating to Open Source Medical Supplies instead. Any thoughts are appreciated.


Replies from: IanDavidMoss
comment by IanDavidMoss · 2020-09-08T20:53:50.358Z · EA(p) · GW(p)

Apologies that you had this experience, treesintheforest. I note that Protege BR has changed the email address that they've listed for contributions, and it's now (Olabi is the social enterprise that runs Protege BR.) You could try writing there instead. Otherwise, OSMS should be a good backup option, although I don't have any more up-to-date info on where their funding gaps are than what's in the post.

Replies from: treeintheforest
comment by treeintheforest · 2020-10-01T07:30:11.279Z · EA(p) · GW(p)

Thanks. I've just sent an email.