Is it Safe?
Risk is in the eye of the beholder and that’s a big problem
Just a Checkup
Fans of true horror will know the cryptic line from the 1976 movie Marathon Man: Is it safe?
It was calmly repeated over and over in a terrifying scene between Dustin Hoffman and Laurence Olivier, the former bound to a dental chair by the latter, a Nazi war criminal turned US spy agency informant.
Hoffman’s character Babe can make no sense of the question at all, even with the extreme prompt of an anesthesia-free dental exam. He does understand immediately, however, that he is not safe in any way and that his very life is at risk.
The current social panic, triggered by a pathogen that we can neither taste nor see, and carried by virtually anyone, friend or foe, is reminiscent of this movie.
We still know very little about the corona virus and its spread, leading to confusing safety advice about wearing masks or getting too close to others in the great outdoors.
We are exposed to a regular tally of cases and associated death toll, but unless we know someone personally, millions of cases and hundreds of thousands of deaths are honestly as relevant as the daily carnage on the world’s motorways.
The vast majority of us have limited our social interactions to healthy people, have not been to a hospital recently, and likely do not even have the virus (given 3 million plus positive cases found so far in a global population of almost 8 billion). So, our personal knowledge of the disease is about nil.
And yet, I am sure that you are like me and have thought more than once recently that sniffles or a scratchy throat in the morning mean that the dreaded virus has finally arrived pour moi.
I am even more certain that you have encountered people literally jumping out of your way in supermarket aisles or park trails, reacting like skeeter bugs to a hot pond.
Their disapproval of others is first seen in a dark glance from a distance, followed by a scowl and tensed body, and only when the holy six foot force field is approached, do they then loudly and presumptuously spring away.
I assume such people, like me, have no direct personal knowledge of the virus and yet, like Dustin Hoffman, they have concluded that their life is imminently at risk and other people must be avoided at all costs.
Concern begets anxiety, and that in turn produces fear and dislike of others. It is a nasty — and truly unnecessary — mix.
Be Kind
This is the social downside of this health emergency: how we perceive risk in the world and how we then treat others in light of that perception.
Here in Vancouver, where I live, we are urged by the public health authorities to “be kind”. That is great advice in even normal times, but sadly seems to be ignored by many in today’s environment.
I have never seen such consistent public rudeness from strangers as in the past month or two. A day does not go by without someone acting out their personal wish for control over other people’s actions and movements.
And this is in repressed Canada, where sorry is a form of social greeting. What must it be like in more exciting and outspoken places?
Of course, things are exponentially worse on the internet, where anonymity and distance between people allow for much more expressive communication.
There, readers of social media and commentary are treated to frequent accusations of selfishness and ignorance by people who simply have contrasting opinions. I won’t even provide a link to these conversations, as they are so ubiquitous.
Do you support opening the economy a crack? Well, then, you must want to trade lives for lucre. Want to take a walk in the park? Some see that as a betrayal of heroic health care workers. No mask in the grocery store? Watch out, you are the pathogen.
There is a “judgy” feel to this discourse and its aim is not to enhance the social good.
Rather, there is a deep seated desire to insult, shame and condemn others, to force them to comport with a self-defined mode of acceptable behavior. These scolds demand that all of us follow only their interpretation of the currently evolving social rules of the road.
I could almost understand such venom if someone had coughed without covering next to me, or if groups of people were touching each other without regard to possible viral transmission.
I say almost because I actually have yet to see anyone behave in such an inappropriate way. Almost without exception (and those exceptions tend to be in places with little contagion risk or where small bands of low risk youth congregate), people are quite sensibly and politely staying away from each other.
Further, my observation is that the noisy social confrontations almost always take place at a reasonable distance and seem to be both premeditated and compulsive. It’s almost as if (and probably is true that) people are looking to fault others.
So, the infraction is not really about getting too close, but rather the grossly exaggerated perceptions of the person taking offense. It is not the virus in our bodies that is the problem, it is the warped ideas in certain dark clouded minds.
Risk is All
These social hall monitors are not wrong in thinking that there is risk out there. Their mistake is rather in thinking that it is dangerous everywhere.
To take that point, it is obvious that this pandemic is harming and killing millions of people and it is doing it in a very compressed time frame.
There are hot spots that have emerged, like Wuhan, northern Italy and New York City, where contagion is especially intense and the health system is under stress.
There are also specific places, notably long term care homes and densely packed places like hospitals, prisons and factories, where vulnerable populations are at risk or too many people come into close personal contact.
The mistake of the fearful is extrapolating those conditions to every other place on the planet, including all interior spaces and any outdoor location.
The mere fact of coming close to another individual is not dangerous per se.
The actual risk is the probability of contracting the virus and becoming ill. Those odds in turn depend on the physics of transmission, the health of the individual, and, most importantly, the likelihood that a person or contaminated surfaces are spreading the virus.
Fear and anxiety arise in some people because that last factor, unlike the first two, can never be known, given asymptomatic transmission and a visibly undetectable pathogen. That is the ultimate motivation for those who scold: we cannot truly know our enemy and so everyone is a potential combatant on a field of battle that is literally everywhere.
This risk-is-all thinking has a certain logic, but it is also terribly flawed.
For example, we do not know who among us is mentally unstable, who has murderous intent, or who plots to undermine us through gossip or other actions. We do not trust everyone, but we also do not distrust everyone because there are some bad apples. Instead, we typically trust most people based on experience and common sense. It’s never all or nothing.
Likewise, we do not really know what food is safe to consume, what places hold dangers, what happenstance can occur in our daily lives. Nevertheless, we go out into the world and consciously engage with others and with things, knowing that potential dangers are not set to zero in every place.
On a day to day basis, then, we cope with risk in the world by being wary and by judging it according to circumstances. Risk assessment is targeted and detailed, not some general presumption of grave danger. It is a spectrum of possibilities, not an on-off button labelled safe or deadly. And it is certainly not a blame game, where we think we are pristine clean and virus-free and all others are suspect.
Scale it Up
So let’s take that sensible approach to risk assessment — targeted, measured, and matched against reality — and scale it up from the personal level to the societal level.
Many governments in this crisis have taken the approach of “no life left unsaved” in what is truly a vain attempt to thwart the Grim Reaper. It is not that we cannot prevent or ameliorate pain and suffering through our actions and technologies, but rather that we must consider the cost of those interventions, whether intended or not.
Most policy measures to fight the pandemic have been one-size-fits-all: everyone washes their hands, everyone stays away from strangers, everyone but those essential stop working, everyone stays at home. We have quarantined the entire healthy population, a complete inversion of the normal policy of quarantining the sick alone. The missing nuance here would be laughable if this was not such a serious matter.
This lack of targeting fails our first test of sensible risk assessment. Aiming every measure at everyone everywhere is an overly blunt response, especially when the pandemic is local in the most fundamental way, spreading physically from one person to another in serial order.
As an important aside, it is honestly a wonder that politicians are so surprised at the terrible economic and fiscal consequences when they decided to take this all-encompassing stop-motion approach to human interactions on the planet. What else could possibly occur? And what should now be expected in terms of health outcomes from tens of millions of people without jobs or companies, in a health system also running at half capacity? There truly is little imagination in the upper reaches of our policy making elite.
On our second test, the public health orders have not been measured either. Most governments put in place their most stringent restrictions right when the peak level of contagion was occurring or, for some, when there was little contagion in their countries at all. That speaks to some sort of panic that was finally triggered in mid-March, after dragging their feet through the first two months of known contagion. Too little policy at first and far too much later fails our second test of sensible risk assessment.
The third and final strike against most governments’ actions is how well the policies match reality. This is at least a partial fail because there is little correlation between what was done against the pandemic and what then occurred. The partial success is that policies were at least totally focused on the health aspects of the crisis, though ignoring adverse effects in other areas.
For example, places like Sweden, Japan, and Taiwan are famous for mostly not locking down their citizens and workplaces, and yet their viral mortality rates vary widely. Other places like New Zealand, Italy, and India were very strict and see the same meaningless correlation to outcomes.
By contrast, what does seem to be a common thread is that those countries that acted quickly and boldly were generally able to keep the contagion, and hence deaths, to a low level. Places on the geopolitical periphery of China like Hong Kong, Singapore, South Korea and Vietnam met this standard. Most other states did not and so this is a massive failure of risk assessment, since it shows little forward thinking and preventive policy action.
Now that we are at full public health policy tightness in most places around the world, can we see better risk assessment going forward?
In a word: no. Governments tend to be married to their past decisions and so a very gradual opening of restrictions is the best we can expect. The pandemic is likely to continue of its own accord and only fade slowly over time, and so politicians will keep the brakes on to avoid taking blame for coming deaths. A highly integrated society and economy like our own can only remain in limbo given these conditions. This means that the overall pain of this unnormal time will only continue.
The Real Solution
There is a way out of this mess, though, and it is completely a function of our state of mind. We simply have to accept the risk of the pandemic, in the same way that we accept other public health risks (like illness, suicides, and car accidents), and then go about our daily business as usual.
By doing so, we acknowledge that risk will remain and it will be made tangible in terms of further hospitalizations and deaths. We will collectively decide how to reduce the risk through social distancing and other measures, in the same way that car design, speed limits, and seat belt use prevent — but do not eliminate — suffering on our roads.
Taking this perspective means that limits on our mobility and the economy must be lifted. There is little reason to delay that process, since we already know that our restrictive policies took effect after the peak in the contagion and have done little to affect the trajectory since then.
It also means that masks, limited social interaction, no physical touching, and barriers at work and play are probably not part of our far future, as all of these things are abnormal and do not fit with our natural inclinations as sociable creatures. Those changes which cannot be aligned with our human nature are unlikely to continue over time. We just will not be able to force ourselves to do them.
Finally, it means that we need to have the strength to hold the course on the pandemic, even as the death toll rises to its ultimate end. There will be formidable political pressures against accepting pandemic risk but yielding to these pressures will only extend the adjustment period, thus continuing to deform our standard of living and quality of life.
So, will any of these arguments for sensible risk assessment sway the fearful few, including the social scolds and so many of our leaders? Of course not, since they are simply publicly displaying their immutable personalities. There are also too many incentives for them to not change course.
It is rather up to us, the reasonable silent majority, to make our voices heard and push governments (and all other organizations) to act in ways that are consistent with our open societies and good old common sense.
In answer to the question: Is it safe?
No, it is never safe … but we go on with our lives anyway.
