Driving drunk in Coronavirus World

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Whenever I get into my car, even on a nice day while wide awake and sober, I am taking on the risk of death. And very late every snowy winter’s night in Minnesota, some guy is out on the road driving fast and drunk. Which one of these risks is most like the “Coronavirus World” in which we currently live?

The answer to that will tell you the future of the U.S. economy. What level of perceived risk will entice you and me out to restaurants, airports and concerts? And how does your perception match up with reality?

Let me suggest that you can view the risks of living in this new world of potentially-lethal virus contagion in the same terms and “gut feel” that you use to decide whether to go out for a drive in your car. For each of the last few years in the U.S. we have logged over 40,000 traffic-related deaths, plus over 2 million injuries annually. Almost all of these traffic accidents have one or more identifiable contributing factors, mostly alcohol, weather or speed.

We have blown past that traffic fatality number in Covid-19 deaths this year, and Covid deaths are still growing exponentially, but we are still in the same order of magnitude (number of zeroes behind the number) as the traffic accident risk and death rate at the moment. That is important.

Now, most of those drunk drivers will get home safely tonight. But they live in a very different “risk world” from me, and likely you. In contrast to the risk-taking driver, the probability of you dying in a traffic accident on a nice day where everyone is sober and obeying the speed limit is very tiny. In terms of order of magnitude, this is much closer to the odds of someone winning a big lottery prize this year. It happens, but probably not to you.

It is exactly this “gut feel” of very low risk that allows most of us get in the car without fear. If you cannot handle even that low level of risk, you probably will not drive at all, but most rational people will take multiple measures to “mitigate their risk” of unsafe driving. They live in the lower-right bubble of the chart below:

Covid risk of harm

With this coronavirus crisis we are, risk-wise, currently in the upper-left portion of that graph. There are hundreds of thousands of “drunk drivers” on the streets in the form of virus carriers, most of them asymptomatic. However, like my Minnesota winter beer-loving driver from the opening scenario above, lots of people are just fine taking on this risk. Now, that may be because they have rationally reconciled their risk tolerance to the situation, or they are desperate to get to work, or they listen to bad information on their favorite TV network, or they don’t know the math. But there are plenty of “bet takers” out there. As for me, I do not drive on New Year’s Eve.

The same risk behavior will happen as economies “open up” economically. Some people are just exercising as many mitigation measures as they can because they need to get back to work. Or perhaps more frivolously “testing the road” because they want that new tattoo. Or worse, some people are just in the habit of “driving drunk” and don’t care who knows it. Their defiance to the “social contract” actually becomes their identity.

As for me and my family, we are not “re-entering the economy” until we can get more of the “drunk drivers” off the road or until someone builds us a Sherman Tank in which to drive around, in the likely form of an effective vaccine. I know that we cannot eliminate all of the risk of death from coronavirus, but I do assert that most rational people will “come back” only when their “gut check” feels like the risk of a nice Sunday drive.

What I fear most here is that, like drunk driving itself, the “Party of Life” Republicans will become accepting of an unnecessary level of deaths in order to keep the “bar economy” earning money. There is a huge ethical difference between the tragedy of unpreventable deaths, as we experienced in the early stages of this pandemic, versus the intentional maintenance and acceptance of deaths that could have been prevented. We are currently at the latter phase of this crisis.

Going for a “Six Sigma” testing and risk-reduction matrix

While there is a lot of concern in the press about the accuracy of some of the available virus or antibody tests, these efforts will always be on a continuum. [1] Some tests will be cheap and fast, but relatively inaccurate. On the other extreme will be slow, expensive, and highly accurate tests. As more data gets gathered, there is no reason why these tests cannot exist in the same world.

As I have previously written, much of business and science lives on appropriately administered random sampling regimens to catch problems and defects. “Six Sigma” quality programs are common throughout manufacturing for getting defects down to less than one per 3.4 per million products. That comes out to about 100 undetected cases of Covid-19 in the U.S. at any given time. If this is good enough for the General Electric jet engines powering the airplanes I used to fly in regularly (in “normal” times), it would be good enough to get me out of my house.

The state of Indiana has been running one of the most impressive data collection efforts so far. They randomly selected, at last report, 4600 people to be voluntarily tested at 63 sites state-wide. The result is one of the best databases so far telling us both how virulent and how fatal this coronavirus is. This kind of testing also provides early warning on future “hot spots” by catching asymptomatic spreaders.

Wuhan, China, the origin of this crisis, has announced a plan to test all 11 million residents in the next few weeks. This is statistically excessive, but it indicates how serious some other countries are in stamping out this virus. In most places in the U.S., an asymptomatic carrier will still likely be refused being given a test.

The reality is that we will never “ride the curve” down to the “safe driving zone” without identifying more of the asymptomatic spreaders of the virus. In order to catch them, to use an old cliché, you need to play like Wayne Gretzky and skate where the puck is going to be, not where it’s been. Some governors are still stuck testing “where it has been,” and not even doing that well. Contact tracing, a critical component of any mitigation strategy, simply does not work if you are only catching in your tests thousands of people who actually caught the virus weeks ago.

But we are going in the wrong direction

The sad fact is that we are not doing well at all here. Courts and legislatures in places with big virus “hot spots” like Wisconsin are doing everything they can to destroy science-based mitigation programs, and President Trump praises them.

I have to admit that I am deeply skeptical that the current government and their supporters have the desire, the morality, or the common sense to do anything except make this problem much worse. Over 50 million Americans are at heightened risk of death from this virus. We have the ability to run a “Six Sigma” country and make these people safe. We do it every day in American business to make your country normally a very safe place in which to live. Your elected government is failing right now to make your family safe.

Vote.


Notes:

  1. This is a basic statistics problem as much as anything. If you are hunting for needles in haystacks, “false positives” can really skew your results. It is simply one more factor to consider in a multi-pronged testing approach.

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