There is nothing more galling than learning that you had been exposed to the coronavirus weeks ago and nobody bothered to tell you (my experience today). Oh, yeah, there is, which is being exposed to this virus every day on the front lines for healthcare and customer service workers, yet being unable to get tested unless you are deathly ill.
This debate over “What next?” in our battle with the coronavirus exposes the confusion over two simple words – risk and hazard. Understanding the difference between these two words, and better understanding a third word, mitigation, can give us insight as to “the way out” of this public health and economic mess that we are in.
I have been writing a lot about the risks of the novel coronavirus lately, most recently in talking about how this risk is different in rural communities as opposed to urban areas. Risk is primarily a statistical concept, or perhaps a “gut feel.” It is often portrayed as the impersonal “dice roll” that, in this case, you may get sick or even die from this virus.
Hazard, on the other hand, is very tangible. It is an object or a person that can potentially cause harm. Rat poison is the classic hazard. But how risky it is to have in your house depends on where and how you keep it. If stored safely and securely, the poison’s risk can be quite low. If sitting underneath your bathroom sink with a toddler in the house, however, that creates a criminal-level hazard that magnifies the risk to that child’s health.
To use another familiar example, a golf course sand trap is a hazard. The mathematical odds of placing your ball into that sand trap is the risk. But there is also mitigation available for that risk. If you choose wisely from your bag of clubs (and I never could) you can literally change the odds, or even change the future if a green jacket is riding on it.
My several charts over the last two months demonstrate the cold statistical risks of this virus, how many people test positive, and what percentage of them die. Hazards, especially in this case, are often people behaving badly. Because of our abysmal testing and case follow-up in this country, hundreds of thousands of people have no idea that they are carriers of the virus, especially if they are asymptomatic. More troubling are the thousands of sick people who, perhaps out of economic desperation, or convinced by pundits that this was “just the flu,” pass the coronavirus on to God-knows-how-many people daily.
As a society, we often adjudge both the moral culpability and legal liability of “hazardous people” based on their level of ignorance, although sometimes we say that “ignorance is no excuse.” We have quickly reached that point with this virus. There are now at least two “news networks” that keep millions of their watchers intentionally ignorant about the potential ravages of COVID-19 in order to protect their favored political players.
Two kinds of risk
Let’s get back to that “seasonal flu” analogy. The seasonal flu exhibits a “risk profile” that I call “coal mining risk.” Our reliance on fossil fuels, especially coal, has clearly polluted this planet, and caused the premature deaths of millions of people through respiratory illnesses, plus perhaps thousands of men worldwide who die directly in coal mining accidents due to unsafe working conditions.
But this particular environmental risk results in a fairly steady number of deaths annually. Those people who are concerned continue to work political and scientific channels to mitigate that risk and to forestall its worst effects. Most people have become inured to “coal risk,” however, and they don’t lose any sleep over it.
The novel coronavirus, on the other hand, presents what I call “nuclear energy risk.” Relatively speaking, very few people die in uranium mines or nuclear power plant accidents annually. There is normally very little short-term and visible environmental pollution from a nuclear power plant. But then you get a “Fukushima” and we see a very different form of risk. The potential for loss of life in a short amount of time in these rare incidents could potentially be huge, and the long-term environmental damage is massive. Importantly, the “fear factor” of nuclear energy risk far exceeds that of “coal mining risk,” perhaps even beyond their rational differences. It is the fear of the “unknown” versus a fear of the “known.”
In short, we should be more concerned and proactive about the continuing risks of the seasonal flu than we are, and we should continue to push against the known hazards who spread these viruses annually. And at the same time, we need to get ourselves much more educated about “novel” viruses so that fear and ignorance do not reign, but rather science does.
Mitigating coronavirus hazards
You mitigate the hazards in your life by first identifying them and then minimizing their risk potential. Let me use as an example a case where Americans do not confront this reality very well.
In Sweden, the risk of you dying because of a drunk driver is far lower than in the United States. This is because the normally socially liberal Swedes are very heavy-handed at mitigating this hazard. The blood-alcohol content level that will get you arrested in Sweden is 0.02%, versus usually 0.08% in the U.S. Punishment is heavy, and fines are assessed based on the level of your income. In the U.S. we have basically decided to accept thousands of drunk-driving fatalities yearly because “some good people drive while impaired” and we don’t like prosecuting them.
And, sadly, we are leaning toward this same attitude regarding coronavirus hazards. We could vigorously ramp up testing, especially for public-facing workers. We could at least station people with fever-detecting thermometers outside every grocery store, as has been done in some countries. Or hire thousands of “contact tracers” to track down potentially infected people. These are effective hazard mitigation strategies.
We could enforce more strict quarantines on virus-positive people, for example housing them separately from their families in some of the near-empty hotels. Instead, we have chosen to effectively quarantine our highest-risk and older citizens until a vaccine comes out. As long as this “rat poison” is everywhere on the street, it will remain too risky for millions of Americans to leave their homes.
Of course, that “lock up the immune-compromised” strategy won’t really work, and indeed it is backfiring badly. Nursing homes and correctional facilities are the perfect breeding grounds for this virus, and people die as a result of this unmitigated hazard staring us in the face.
And so, it turns out that the biggest hazards walking the streets are the politicians who refuse to act with the power invested in them to massively expand mitigation strategies, or those who favor giveaways to billionaires over protecting their citizens.
Perhaps it is time to pull out that pitching wedge in order to whack where it will hurt the most.
WaPo put together an interesting graphic illustrating the scale of the COVID-19 deaths in the US, comparing the average number of deaths for a given week for a 5-year period ending in 2018, to the number of confirmed COVID-19 deaths in the same week this year. I would add that the COVID-19 deaths are under-reported for a variety of reasons, including reporting delays, reporting omissions, and lack of consistency in reporting (i.e. was COVID-19 the primary COD, or a contributing cause). The article provides a link to the historical data set, and user-defined reports can be customized using a browser-based query builder.
This situation has been disgracefully mismanaged, certainly at the federal level, and to varying degrees at the state level, depending on the state. My undergraduate degree is in biology, and can’t help but wonder if the past four months has been a perverse exercise in “natural selection”, on many fronts. Perhaps we should call it “unnatural selection”, in those instances where the impact on human lives has been almost uniformly and devastatingly negative, and was almost certainly preventable if stronger actions and better communication had happened; in December in China, and in January in the US. Unfortunately, it’s obvious that things are as chaotic as ever, with multiple points of failure in leadership, management, manufacturing, supply chains, resource management and coordination, revealing the critical weaknesses in the US response and in this Administration in general.
So, if there is a political version of natural selection, then I’m hoping that the politicians who are only concerned with their re-election campaigns, bank accounts, and approval from Dear Leader and the media talking heads will be defeated in November (along with the perp of course) so that responsible, informed adults can save our country from four more years of this damaging, pathological incompetence and government malpractice.
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