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Estimating Our Coronavirus Risk

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I am not an epidemiologist, nor am I a medical person. I am, however, experienced with risk assessment and analyzing risks from my days as the Deputy Director of Safety and Health, and the Systems Safety Program Manager, at the Air Force Astronautics (nee Rocket Propulsion) Laboratory at Edwards AFB, California.

In the field of rocketry, dealing with toxic propellants of various kinds as well as massive amounts of flammable and explosive materials, risk assessment is serious business. We strove to understand the risks associated with our operations and to mitigate them as much as possible.

In the years since I left the Rocket Lab — I will always think of it as the Rocket Lab, “the Rock,” no matter how many times they change the name — I’ve had ample opportunities to analyze risk in other contexts. Today, let’s consider the SARS-CoV-2 virus, frequently called the “coronavirus” even though it’s really one of many such viruses.

Risk, in general, may be thought of as a combination of the potential for a bad thing happening and how bad the results are expected to be. In rocketry, we characterized it as probability times severity. For instance, an event that would damage an expensive piece of equipment would generally be considered less severe than an event that would injure a person, but the overall risk to the project might be similar if the first, damaging event was much more likely to happen compared to the second, injurious event. In each case, we analyzed the risks in order to figure out where we might apply physical and procedural measures to reduce it.

The risk presented by the SARS-CoV-2 virus is a little different because the severity of the COVID-19 disease is a given. Still, it seems to me we can conceptualize the risk in useful ways by assessing the probability of developing the disease and even that of catching the virus.

First, using reports that mortality associated with COVID-19 seems to be related to patients’ ages and whether they suffered from ill health, I took a stab at a matrix showing the risk of dying from COVID-19. Assuming one has actually been infected with the SARS-CoV-2 virus, it seems reasonable to say the risk of dying from COVID-19 rises with age and the number of complicating factors, as shown:


(Estimated risk of dying from COVID-19, having contracted the SARS-CoV-2 virus.)

Thus, as the doctors and epidemiologists have said, the older we are and the more health problems we have, the higher our risk and the more diligent we should be in protecting ourselves. Makes sense to me.

But what’s the risk of actually contracting the SARS-CoV-2 virus?

That’s a more complicated issue. Certainly one must be exposed to the virus, but every exposure does not result in infection. And every exposure is not the same.

For instance, the emphasis on Proximity Avoidance (my preferred term for “social distancing”) neglects how long we are in close proximity to one another. I have seen people step off the sidewalk into a thoroughfare in order to avoid spending a second or two within the recommended six-foot distance, because they apparently believe that the briefest encounter will result in infection. I’ve also read complaints about the practice of holding doors open, for the same reason.

Realistically, however, the risk is not just a function of distance but also of time. Spending a few seconds passing someone on the sidewalk is not as risky as standing shoulder-to-shoulder with them for several minutes. So if we assume someone near us is carrying SARS-CoV-2 and neither of us is wearing a mask, the risk of contracting the virus from them based on both distance and time probably looks something like this:


(Estimated risk of contracting the SARS-CoV-2 virus from encountering a single carrier.)

Other factors could come into play, of course. Passing in a tight hallway is likely a bit more risky than passing on a greenway. And if at least one of us is wearing a decent (i.e., fluid resistant) mask, most of those blocks marked “high” probably fall to “moderate” risk levels.

As we move away from one-on-one encounters to the possibility of encountering groups of people, the risk picture becomes more complicated and harder to illustrate in a simple matrix format. Both time and distance remain factors in how risky it is to be around people, and if we add to them the numbers of people and whether they are masked, we need to simplify things a bit in order to account for so many factors. The assumptions remain:

  • The closer we are to a carrier, the higher the probability of transmission
  • The longer we spend in the vicinity of a carrier, the higher the probability of transmission
  • The more people nearby, the higher the probability that one is a carrier
  • Masks that catch droplets reduce the risk but do not eliminate it

We can combine time and distance by dividing the duration by the amount of separation. Thus, the longer we spend in close proximity with someone, the higher the value. As shown in the matrix above, spending a full minute six feet away from someone is probably about the same risk as spending ten seconds only one foot away from them.

We can also combine the group size and masks (or “barriers”) factors. In this case, we can divide the number of carriers (or presumed carriers) we encounter by how many are wearing masks — and whether we are wearing one. So if we are masked and encounter a single person wearing a mask, the “carrier/barrier” factor would be one presumed carrier divided by two barriers: 1/2, or 0.5. Likewise, if we encounter four presumed carriers at once and only one of them (plus us) are masked, the factor would be 4/2, or 2.0. The higher the value, the higher the probability of exposure.

Putting those factors together gives a risk estimation that looks something like this:


(Expanded estimation of risk of contracting the SARS-CoV-2 virus.)

Folks may quibble about the values I chose for each axis, or whether a particular intersection should be rated differently (e.g., as “moderate” instead of “low”), but the real question after all of this is, how much risk are you willing to accept?

And the question after that is, should you force anyone else to accept a higher or lower risk than they are willing to accept?

In my last blog post, “Home of the Scared,” I noted that the fears associated with the SARS-CoV-2 virus are not new. “Fear was already rampant in our risk-averse society, albeit at something of a maintenance level, in terms of how tentative many people have become in their day-to-day lives. But people with vested interests applied the scary virus as if it were gasoline to more general fears that have smoldered for years.” It’s been all too easy to inflame those fears, because neither the media nor the recognized experts have presented this in risk management terms. Rather, many commentators and observers have emphasized the dangers of COVID-19 — i.e., its severity — rather than the probability of contracting it, to the point that “… a moderate danger like SARS-CoV-2 has brought some people to the point of near panic.”

Now, even though it’s been shown that moderate risk-taking results in greater satisfaction with life, neither fearlessness nor recklessness are especial virtues. Fear in itself is not a bad thing, nor is it a negative trait: It’s a natural reaction to extant threats. But while the inability to sense a threat is a deficit, and refusing to acknowledge a threat is foolish, it’s better to consider threats realistically and to take reasonable steps to reduce their risk — all the while accepting the simple fact that life without risk is impossible.

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P.S. Don’t forget to order your Proximity Avoidance T-Shirt….

(Proximity Avoidance logo, designed by Christopher Rinehart.)

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Home of the Scared

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If I had a magic wand, I would make you less afraid. Not foolhardy, just less apprehensive of the world and the people around you.

I grew up learning that fear was a thing to be conquered, not a thing to which we should capitulate. FDR, for all his faults, famously said, “The only thing we have to fear, is fear itself.” Frank Herbert gave us the “Litany Against Fear” in his novel, Dune: “Fear is the mind-killer…. I will face my fear.” Yet, somehow, instead of learning courage in the face of fear, many people today seem to have become paralyzed by fear.

Some claim to be tolerant of others but demonstrate fear of opposing ideas when they shout down anyone who disagrees with them. Some claim to “speak truth to power,” but cower in “safe spaces.” And now, many not only hide away in fear of the SARS-CoV-2 virus but they demand that others sequester themselves as well. Fear has led some of us to become subjects of the state moreso than citizens of it: subject to the state, happy to trade our freedom for a little security … or the illusion of security.

Leaving off for the moment the unfortunate fact that some people regard the entire song as problematic, have we reached the point where these United States need to replace the last line of “The Star-Spangled Banner”?

In some respects, we reached that point a long time ago.

fear
(Image: “fear,” by Sean MacEntee, on Flickr under Creative Commons.)

This diatribe against fear, for instance, has been percolating in my brain for over a decade as I observed us, as a society, growing more and more fearful.

A dozen years ago, I read a book review entitled “Mill is a dead white male with something to say” in which Tessa Mayes interviewed Richard Reeves, a biographer of philosopher John Stuart Mill. The review began,

‘Harm’ is a political buzzword of our age. The spectre of harm is used to justify smoking bans in public places (to protect people from the harm of smoke), ‘anti-stalking’ measures against people who get involved in shouting matches with their partner or a workmate (in the name of protecting individuals from ‘emotional harm’), censorship (offensive words are said to ‘harm’ our self-esteem) and opposition to consumerism (apparently it ‘harms’ the environment).

All sorts of activities, from boozing to gambling to sexual relationships, are now said to involve harm – either to the person carrying them out or to people caught up in these whirlwinds of harmful behaviour. And thus, it is argued, government intervention into these intimate areas of our lives is not only justifiable, it is necessary.

To that list, we may now add such things as trading in non-state-approved items, traveling to non-state-approved places, congregating with non-state-approved people, and so forth.

The review pointed out that Mill

had a view of men as capable and energetic, who, when given the chance, could progress to become serious and even ‘heroic’ individuals. Thus, he had a quite narrow view of harm: in his view, it would take quite a lot to harm individuals who were possessed of free will and very often grit, and therefore he argued that only clear cases of harm could justify restrictions.

Today, by contrast, individuals are viewed as weak and vulnerable. The term ‘the vulnerable’ is used to refer to whole swathes of society. We are considered to be easily damaged and fragile creatures who must be mollycoddled by political leaders, social workers and health practitioners in order to keep our self-esteem intact. So almost everything is seen as ‘harmful’ to us today.

And how much more so when faced with something like SARS-CoV-2 that is demonstrably harmful? Something that mathematics predicted would harm millions, most especially “the vulnerable”?

It was not deemed sufficient to erect barriers to protect the “easily damaged and fragile” among us — the elderly, the infirm — when it seemed that medical facilities would be overrun with patients. Instead, political leaders and especially the media turned to a suasion tool that has proven far too useful: fear. Not that the fears associated with the SARS-CoV-2 virus were especially new. Fear was already rampant in our risk-averse society, albeit at something of a maintenance level, in terms of how tentative many people have become in their day-to-day lives. But people with vested interests applied the scary virus as if it were gasoline to more general fears that have smoldered for years. Carefully constructed and almost constantly negative reporting about the virus magnified those fears into quiet terror.

And people who are frequently (if not constantly) afraid are not likely to object to limitations on their liberties.

The difference between Mill’s view of harm and the popular view of harm today is the difference between a view of mankind as generally good and capable of freedom, and a view of mankind as weak and degraded. So where Mill emphasised the necessity of liberty, today many officials and commentators talk about the ‘dangers of unadulterated liberty’.

For Mill, any half-decent conception of the state had to be considered in line with individual liberty and social progress. As he writes in On Liberty: ‘A State which dwarfs its men, in order that they may be more docile instruments in its hands even for beneficial purposes, will find that with small men no great thing can really be accomplished.’

But why are we so afraid?

I submit that many of us are afraid because we abandoned faith. By abandoning faith, we abandoned hope in an afterlife, and by abandoning hope in an afterlife, we have come to fear death itself as the ultimate evil. Not to have a healthy respect for death, not to disdain it and to seek to postpone it because life itself is grand and glorious, but to fear it above all things.**

In his book The War of Art, Steven Pressfield noted that the Spartan King, Leonidas, said the highest virtue of a warrior was “contempt for death.” To count death as nothing, as unworthy of notice even though it is inevitable. Why is that important? Because if you don’t fear death, you won’t fear much of anything; in contrast, if you fear death too much, you will fear practically everything.

You may not admit it. But every fear stems from the fear of death. Believing in an afterlife is the surest way to overcome that fear, and such belief was the root of the fearlessness of mankind throughout history. But when more and more people began to disbelieve in an afterlife, once they came to fear death and to dread the very idea of it, they naturally began to shy away from anything too risky.

And those who deeply fear death do not understand those with contempt for it.

Not everyone can muster true contempt for death, can master that ultimate fear, but that ability in the face of predatory threats made relationships and status and roles much clearer in the past. We lack that kind of tangible threat these days. The SARS-CoV-2 virus, as dangerous as it is, does not pose such a threat — if for no other reason than that we cannot sense it directly.

When predators lurked outside, when their eyes shone in the dark beyond the firelight, when the dawn revealed the blood and mutilated corpses of the unwary, the weak and fearful naturally appreciated the strong and brave. We have been so long without a real existential threat that the weak have become less fearful, and the strong seem to have become less necessary. Some of the strong and good still protect the tribe, and we ought to be thankful for them. But we seem to have reached the point that the weak have grown comfortable enough that they feel justified in mocking the strong. That, I suppose, they may consider enlightenment.

Many years ago a popular brand of clothing featured the words “No fear.” That sentiment is lacking these days. Not only does almost everyone seem to be afraid, but many of us express our fears quite openly and surround ourselves (virtually) with those who share or at least bolster our fears. In some respects we appear to be a generation steeped in fear — and whereas our society used to wrestle with tangible fears like those of nuclear annihilation, we have given free rein to so many ephemeral fears that now a moderate danger like SARS-CoV-2 has brought some people to the point of near panic.***

Previous generations cultivated what the British called the “stiff upper lip,” but today we might well be a culture of quivering lips. Perhaps rather than the age of information, what we live in is the age of angst. Enemies need not bother terrorizing us anymore. We are already afraid. Not all of us, necessarily, but enough of us.

And, as I said at the start, if I had a magic wand to wave, I would use it to decrease our collective fear so we might once again lay claim to being the “land of the free, and the home of the brave.”

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*It is probably prudent to note that some people have been laying claim to rights without any emphasis on assuming the responsibilities that go with those rights. But, that’s a topic for another post.
**I recognize some degree of irony in my talking so blithely about death and having contempt for it, while still subject to deep and sometimes soul-wrenching grief.
***In a future post, I hope to look at the SARS-CoV-2 virus through the lens of risk management, in hopes of showing that there is less need for panic than some people think.

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P.S. While on the subject of the virus, don’t forget to order your Proximity Avoidance T-Shirt….

(Proximity Avoidance logo, designed by Christopher Rinehart.)

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