Assessing Risk as We Approach Post-Pandemic

One aspect of the pandemic that’s been frustrating to me is the continued inability for us to assess risk. What’s really dangerous for us to do, and what isn’t? Part of this came (for a long time) from the fact that we just didn’t understand that much about the virus. We assumed it was like other viruses, and so the emphasis at first was on washing hands and cleaning surfaces. Masks were dismissed as overkill. However, as time has gone by, the studies have continually identified that surface transmission just isn’t that likely. One of the few studies that actually tried to estimate it put it at less than 5 in 10,000.

But here’s the thing: I have no idea what that actually translates into when it comes to real world applications. 5 in 10,000. Does that mean if there are 10,000 interactions with a person touching a contaminated surface, then 5 of those will result in a new COVID case? Is that high? Is that low? I have no clue. Lab studies have been done to try and identify how long the virus lives on different surfaces, but those studies were almost all done in lab conditions, starting with a ton of the virus, and then checking to see how long that high concentration of the virus would live. They didn’t check to see what it was like when all sorts of variables are introduced.

But because scientists can’t guarantee the virus doesn’t get passed from person to person via infected surfaces, they’re not comfortable telling people they don’t need to worry about cleaning surfaces as vigorously. And so we live in a world where libraries continue to quarantine books for 3 days before they’re put back on the shelves. (Some libraries are quarantining for a week. I’ve heard others say they have no plans to ever stop quarantining books, since it “just makes sense” from a health perspective.) When I go to church, the pulpit is disinfected between every speaker. The pews are all wiped down after each meeting, even though there won’t be anyone else in there for another week. And that’s here in the hinterlands of Maine. (Well, hinterlands by most people’s standards. By Mainer standards, I’m just a bit of a ways off. Nowhere near hinterland status.)

I understand some of it. You want to feel safe, and so it’s important to feel like you’re doing something to make yourself safe. But the science has more and more indicated that air is much, much more dangerous than surfaces. Masks and ventilation are where to put the focus, and even when it comes to masks, it’s almost all on indoor mask usage. Outdoor transmission just really doesn’t happen. But my kids’ nordic teams have all been skiing all winter with masks on.

Then again, which is more important? That you ingrain in people the need to wear masks to be protected, so that they can remember to wear them indoors where it’s important, or a general loose approach to masks, which might lead to them being ignored indoors?

So much of dealing with the pandemic has come down (in my opinion) to a difficulty in assessing risk. As a relatively young, healthy person with none of the mitigating health factors to make my risk for serious COVID spike, my personal risk all along has been quite low, I’ve felt. I’d have to contract the disease (not a sure thing) and even if I did, the odds were strongly in my favor for coming through it just fine. Likewise, all my immediate family here in Maine also falls into the same low risk category. If my only concern were for protecting my family, I pretty much could have ignored the whole pandemic, gone about my regular life, and almost definitely been fine at the end of it. (This is, naturally, ignoring the restrictions placed on me by my work and my government, which I wouldn’t have done. But this is a thought experiment, folks. Work with me.)

I only took one philosophy class in college, but it was a good one, and I still remember Kant’s categorical imperative. Basically, it’s the thought that you should only act in a way that you would be comfortable with if it were made the universal law. How I’ve always understood it is that if what you did as an individual caused little relative harm, but if it were done by all people would cause a great deal of harm, you shouldn’t do that thing. COVID has been a perfect example of that, for me. Yes, I could have ignored it, but by doing so, if everyone else ignored it as well, a huge portion of the country would suffer. We’ve seen this played out time and time again across the world. It’s why I haven’t eaten in a restaurant in a year and a half. It’s why I haven’t gone on a vacation in the same time frame.

Except now we’re beginning to see the light at the end of the tunnel, and my thoughts are shifting away from how we needed to be acting to preserve everyone’s health. There’s all this discussion about what you can and can’t do once you’re vaccinated. And as I hear much of it, it seems to me the goal has shifted from “flatten the curve” to “make sure no one dies from COVID” and now to “make sure no one gets sick with COVID.”

It’s true that there are aspects to this disease that we still don’t understand, and I do worry that some of them may have longterm implications, especially long COVID. But one thing the vaccines do well is reduce the severity of the disease to the point that (as I understand it) no one gets a bad version of the disease after they’ve been properly vaccinated. If that’s true, then once I’m vaccinated, I’m really no longer concerned with getting the disease at all. Though I’m still uncertain what the odds are for unvaccinated children catching the disease, and how at risk they are. From what I’ve read, it’s very very low risk, but I’d love to have some concrete advice out there by doctors outlining what’s recommended.

But I don’t think the advice should be centered around “no one gets COVID.” If having COVID is no longer nearly as dangerous, I’d like to focus on reducing risk to an acceptable level. (You could say that’s what this has been about all along, with people having different views on what an “acceptable level of risk” is.)

In the end, I want guidelines that are more like “wear a mask” as opposed to “wash all surfaces.” I don’t need busywork to keep me feeling like I’m doing something, even when I’m doing nothing. There’s a whole lot of health theater happening right now. I realize some of it might be necessary, but that doesn’t mean I don’t roll my eyes a bit at it. (For the record, my library is still quarantining books for 3 days, mainly because it’s been an agreed upon standard for all libraries in the state, and I definitely want people feeling safe around our library books. I believe they are safe, but if it takes a 3 day quarantine to prove that to people, so be it.)

I don’t know. Today’s post has been all over the place, and I don’t have the time to go back and edit it down. If you want some further reading on the topic, I recommend this article in Nature that was pointed out to me today. I know the CDC’s supposed to be coming out with more recommendations on what vaccinated people can safely do. I hope that includes children in the mix somehow, because that’s an area I feel has really been ignored. If any of you have any good resources or articles you’ve come across that intersect this topic, please pass them my way. I’d love to check them out.

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