People are reaching full-fledged panic mode about the coronavirus.
The likelihood is that many people walking around a city like New York have been exposed to the virus or may even have it, but are asymptomatic.
In an article in The Atlantic on who should avoid crowds, Olga Khazan explores the question of whether we should be avoiding crowds.
“There are people who are walking around who must have it, or have had it very recently, or are about to have it,” according to Helen Chu, an infectious-disease professor at the University of Washington.
But does that mean you should cancel events and lock yourself inside for a few weeks? It may depend on your specific health situation.
Khazan reports that,
A surprising number of people with a wide array of health conditions—including diagnoses as common as asthma—should be more cautious than usual. But most Americans shouldn’t necessarily be avoiding crowds and airplanes at this point, experts say. Instead, some risk assessment, both on an individual level and a societal level, is going to be required..
Your Personal Risk Preference
The decision on whether to avoid conferences, public transportation, and other crowded places depends on what Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, calls personal “risk preference.”
That is, how worried are you about catching COVID–19? If you’re relatively young, healthy, and traveling to a place other than the five restricted countries relatively soon, you might decide that the risk of catching the disease is worth whatever it is you’re doing.
Assessing personal risk preference is something I help my clients through in many contexts. Whether you’re investing in a home or evaluating a new job offer or any other big move, there is always risk.
Even small moves carry risk. Walking outside your home, taking public transportation, eating in a restaurant — all activities you do often, and all involve risk. What makes these activities feel more risky now? The potential consequence.
Risk vs Consequence
The distinction between risk and consequence is one of my favorite frames. I first heard this distinction from legendary rock climber Alex Honnold. Honnold is known for climbing certain routes “free solo” – without ropes or a partner. His free solo ascent of El Capitan in Yosemite National Park was the subject of the Oscar-award-winning documentary Free Solo.
As Honnold explains it in the context of climbing, the risk of a climb is determined by how hard the climb is and how prepared the climber is. The consequence is what would happen if he fell during a climb.
Before he free solos a route, he climbs it many times with ropes and rehearses every step. Through preparation, he mitigates the risk that he will fall. The consequence of a potential fall are as high as they come: death, or at least severe injury.
Here’s how he puts it:
People always see me give a slide show or they see videos and they’re like “that’s super risky because you’re so high off the ground.” And I’m like, “it’s a super high consequence, because if I fall I’m gonna fall like 2,000 feet. Obviously that would be a horrible thing.”
Honnold is the king of the understatement. You really need to watch the video to hear his tone on this.
Risk vs Consequence in Your Decisions
Back to the coronavirus. Khazan reports that
People with asthma are not more likely to catch COVID–19, but they are more likely to fare poorly if they do.
This is a perfect example of risk vs consequence. The risk of contracting the coronavirus is not higher for people with asthma than for others. But for those with asthma, as well as others with prior respiratory issues or compromised immune systems, the consequence of contracting the virus is high.
Assessing your tolerance for risk and consequences
So when Amesh Adalja speaks about assessing your personal risk preference, it’s not just the risk you need to analyze, but also the consequence.
What’s the risk of exposure?
If you live in a densely populated area like New York City, i’t’s likely high.
What’s the risk of getting the virus, if exposed?
This is unknown, although likely high. Some experts expect that most of us will contract the virus at some point. But not everyone who is exposed gets the virus. It doctors tested everyone in a known group who was exposed to the virus, we might be able to extrapolate patterns when looking at who developed the virus after exposure and who didn’t. In the absence of that information, we don’t know.
What are the consequences of getting the virus?
This is the real question you want to ask. If you have an underlying respiratory condition, the consequences can be life-threatening. For a healthy child or adult the consequences likely aren’t severe, and there may be no consequences.
The more we can parse the risks vs the consequences in any situation, the better decisions we can make.
There’s still a lot we don’t know, but one thing is certain: panicking is not an effective strategy for mitigating risk or minimizing the consequences.
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