Promoting the global eradication of COVID-19 through mail-in testing of mild and asymptomatic cases

The SANE Approach to a Vaccine

SANE stands for “Search for an Attenuated Natural [Strain] via Epidemiology.”

Essentially, yes. We are following a tried and tested approach to solving a vaccine problem – the polio, measles, rubella, mumps, and chickenpox vaccines all use live attenuated (weakened) viruses, which is what The SANE Project aims to find. Our approach adds in modern genetic sequencing technology that has become available since these older vaccines were developed.

Public Answer:

Our goal is to:

  1. Test people with mild or asymptomatic cases of COVID-19 via easy mail-in kits
  2. Get genetic data from the sampled virus, in order to detect mutations caused by nature
  3. Detect and track down a weakened form of the virus. The oral polio vaccine was also created from a natural virus mutation that made it weak enough to use in a vaccine. Please see our detailed approach here.

Scientific Answer:

  • There are natural strains of SARS-CoV-2 in the world that have mutated to be non-pathogenic (asymptomatic or mild), but which are still infective and will provide immunity to the more pathogenic (deadly) strains.
  • One of these natural attenuated strains could be used as a live vaccine and its safety demonstrated using epidemiology via its natural transmission.
  • Please see our detailed approach here.

Eventually, we would like to sample many people from global hotspots but would first start locally in the United States. Please see our high-level approach here.

Another approach is to routinely test people in long-term care facilities or other isolated communities such as meatpacking plants that do not already have active cases of infection. If we detect the virus in an infected community where its people are only mildly sick or completely asymptomatic, we may have found clues pointing us towards a weakened or “attenuated” version of the virus that could then be used for a vaccine.

We certainly hope other vaccine efforts succeed! However, a diversified approach to the many challenges of a global pandemic is critical, not to mention any future pandemics that may arise.

  • Apart from the time it will take to develop, trial, and mass produce one of the “designer” vaccines (12-18 months), it is unlikely that most current vaccine efforts will be able to produce long-lasting protection with a single dose.
  • This is because immunity to respiratory viruses (like the novel coronavirus) doesn’t usually last longer than 6 months to 2 years with a single vaccine.
  • We would need to keep vaccinating everyone in the world every year (or maybe every few months if we are unlucky).
  • This just isn’t going to work in the real world (especially poor countries or conflict zones) and is one of the reasons why we don’t have a vaccine for the coronavirus strains that cause the common cold.
  • Unless we can drive the current dangerous SARS-CoV-2 strains to extinction we are going to have a problem with this disease indefinitely.

Our approach could lead to global eradication much more quickly and cost-effectively.

  • Giving a natural attenuated viral strain to a population as a vaccine would change the ecosystem for the dangerous strains of the virus.
  • The dangerous strains would find it difficult to spread through the community as many (most) people would have already been infected (and hence immune) with the attenuated strain (i.e. have herd immunity).
  • Over time the dangerous strains would become rarer, and the attenuated strains more common, until eventually the dangerous strains would become extinct and we would just be left with the mild version floating around.
  • While we would not be able to get rid of this mild strain, it would just be another of the hundreds of viruses out there causing common colds, including other coronaviruses that cause common colds.
  • This proposal at its base is really one of replacing the dangerous strains with a less dangerous strain that we can live with, similar to the common cold.

It is the ecology aspect of this proposal that makes it different from other attenuated vaccine proposals. Currently, all attenuated vaccines developed in the lab are designed to just protect the person receiving the vaccine. An attenuated strain identified by screening infected people (epidemiology) will identify a strain that can still be transmitted from individual to individual. This makes the use of such a strain radically different from a conventional lab-created attenuated viral vaccine.

The SANE Approach Infographic

The Sane Approach

A Possible Solution to COVID-19

There may be a less harmful or “attenuated” strain of the virus (SARS-CoV-2) that causes COVID-19, but the only way to know is to go out and look. It is in fact unethical not to look.

We are promoting the search for a weakened, mutated form (i.e. an “attenuated” form) of the novel coronavirus (SARS-CoV-2) which causes COVID-19. 

We can maximize our chances of finding an attenuated virus by harnessing modern sequencing technology, which allows scientists to decipher reliably the genome of hundreds of thousands of variants at relatively low cost and effort. 

If we find such a strain, there are many possible implications, from a faster and less costly path to a vaccine to improving the outcomes and ethics of vaccine trials.

Samples have so far been collected primarily from sick patients, who are unlikely to be infected with an attenuated variant. We need to start gathering samples from asymptomatic or mildly sick individuals. This approach is becoming increasingly plausible as sequencing capacity expands. 

Patient outcome data must be paired with viral genome sequences in databases. We ought to pair clinical outcomes with viral genomic data. Right now, “do you have COVID-19?” is the only data we are collecting. We should be collecting data about how sick people are or become, and pair that with the genetics of the virus that infected them.

Despite the routine use of live-attenuated vaccines against polio, measles, mumps, rubella, and chickenpox, modern “designer” vaccines have gained favor over live ones. In view of the size of the crisis, diversification of efforts to obtain a vaccine is key.

How You Can Help

Here are some things you can do right now:

  • Read about the SANE approach to better understand it.
  • Try to answer your questions and objections through our FAQs.
  • If you are able to help fund or sponsor our project, please contact us.
  • If you would like to volunteer, please contact us.
  • If you have specialized knowledge in regulation, sequencing, virology, or immunology, please contact us.
  • If you can help us execute our testing program, please contact us.


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