Risky business

Covid-19 risk calculation: 3 questions to ask before going out

"It's not going to be one size fits all."

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Six months into the Covid-19 pandemic, news reports and social media reflect a chaotic spectrum of behavior. While some people still stick close to home, others are venturing out: According to a recent Gallup poll, in June just 36 percent of U.S. adults said they socially distanced all the time, an eight-point decline from May.

Fluctuating case counts and conflicting geographic guidance drive this disparity in Covid-19 decision making, and make even the simplest of decisions feel challenging. How, exactly, do you wade through a torrent of mixed messages and make a choice?

Amesh Adalja, an infectious disease expert and senior scholar at the Johns Hopkins University Center for Health Security, tells Inverse that no activity during a pandemic is going to be without risk. However, Adalja says, people should still ask themselves these three questions as a way of guiding their decision making during this turbulent time:

  1. What is my individual risk tolerance? Am I somebody that's risk-averse or risk-tolerant?
  2. What are my risk factors for severe disease? Am I somebody that's more likely to have a severe case of Covid-19 or more likely to have a mild case? Factors to consider here include age and chronic health conditions.
  3. How important is what I want to do? Where does it fit in my hierarchy of values? Is the risk of the virus outweighed by the benefit that I get from this activity?

It's a careful balance: weighing personal and others' health risks with values and desires. Asking these questions and proceeding with caution is crucial because at this stage, there is no immediate end in sight.

"It's not going to be one size fits all," Adalja says. "Americans have, in general, taken for granted that everything they do is relatively risk-free because we haven't lived in an era where every time you step out the door, there's an infectious disease threat looming over your head."

Decision paralysis— Baruch Fischhoff, a professor at Carnegie Mellon and past president of the Society for Judgment and Decision Making and of the Society for Risk Analysis, has studied how humans make choices for over 40 years. Generally speaking, people are relatively good calculating risks, Fischoff says — when they're given "half a chance."

Our ability to choose depends on the information at hand and emotional cues.

"However, when you can't get a clear story from the people whose job it is to give you a clear story, then people will start looking else to less reliable sources," Fischhoff tells Inverse. People may overly rely on their emotions or turn to "fear-mongers online, sellers of quack cures, politicians, pundits and amateurs who pose as scientists."

Covid-19 has been a uniquely difficult situation to suss out, with more unknowns than knowns. In turn, the repeated failure of public health and government officials to send clear, coordinated messages around Covid-19 has created the perfect storm for widespread confusion, Fischhoff says.

"Where people have difficulty making decisions are typically situations where they haven't gotten good information, and they're forced to rely on their own imperfect intuitions," Fischhoff says.

Official communicators have done an "appalling, irresponsible job" through the pandemic, in Fischhoff's opinion. They haven't communicated clearly or used the research on effective communication. They haven't tested their message to find out how they would be interpreted.

"They have the temerity to blame the public for behaving irresponsibly," Fischoff argues. "That's blaming the victim of this official incompetence."

Some public health experts have taken to Twitter to break down the risks of common activities.

Other experts link waning motivation to take public health precautions to caution fatigue. People have become habituated to the threat of Covid-19, and tired of making personal sacrifices to curb its spread.

To make effective choices in this state of flux and fatigue, Fischhoff says, think like an epidemiologist.

"Ask: How much disease is out there? How fast is it being transmitted?" Then: "What can I do to protect myself? What can I do to protect other people?"

Each situation and community is different — because of this, Fischhoff and Adalja suggest consulting local public health agencies' guidance. Live Covid-19 case trackers like this one from the CDC can also help individuals pinpoint the rate of spread within their county or state.

Covid-19 risk levels by county, as of July 13. This interactive tool can help people determine their local risks of contracting Covid-19.

Harvard Global Health Institute

Ayesha Appa, a chief fellow of infectious diseases at the University of California, San Francisco, tells Inverse, that the way to preserve joy and fun while also minimizing the risk of Covid-19 acquisition is "kind of simple:"

"I consider which activities will set me and my loved ones up for success when it comes to maintaining safety."

That means considering another rule of three — this time, three actions you should always pair with any decision you make right now:

  • Wearing a mask (indoors and outdoors)
  • Watching your physical distance from others (at least 6 feet)
  • Washing hands frequently.

What are activities that naturally do not conflict with these principles? Appa suggests outdoor activities like fly fishing, surfing, camping with people in your household, or even hanging out in a hammock in the backyard. Covid-19 doesn't have to ruin all the things that make life fun — it just changes the way we do them.

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