Matthew B fulfilled my fervent wish (as did Michael R, whose comment will be going up later today) by dealing with the risk assessment issue authoritatively and clearly so I wouldn’t have to.
Here is his Comment of the Day on the post, “The Pandemic Creates A Classic And Difficult Ethics Conflict, But The Resolution Is Clear, Part I: Stipulations”:
We’re seeing the problem with the vast majority of people’s inability to grasp statistics, and in particular the statistics of risk. That’s the problem here – with the Wuhan flu, we’re talking about something that – at most – could kill 1 in 100 people. We’re seeing higher numbers for death rates in many places, but they’re talking about case fatality rate. 1% in the US means 3 million people die, and we’re at 70K dead as of this morning in the US, 3.2 million short in 1% of American’s dying. Yes, I get many haven’t been infected and many more will die, but we’re absolutely on a trajectory far short of a 1% fatality rate.
As soon as you’re talking about numbers that low, far too many people’s brains stop being logical and emotion takes over. The tell for this is the saying “if it just saves one life.” People say that, but they’re turn a blind eye to so many things that kill people an no one addresses. Because there is no critical thought being applied, they remain illogical and darn near impossible to considering any position other than those formed by emotion.
We take risks every day that we don’t think about and we ignore things that people die from because of normalization of that risk. If you’re under 45, your odds of suicide, homicide and accidents killing you outweighs your risk of dying of health complications. If you’re under 25, that risk is three to one that it’s something other than a health condition that kills you. Even amongst the health conditions, there are many that are swayed by our own conduct and we ignore that.
Through most of the existence of the automobile, it’s ranked as the number one cause of premature death in the United States. Only in the last decade has the rise of the opioid epidemic managed to surpass the death rate of automobile fatalities. The opioid epidemic is a harder one to discuss, so I’ll start with the automobile. Automobile deaths are ignored, few people are afraid to get into a car because it might kill them. There are marginal improvements in automobile safety, but many of the key contributors have had little improvement. Mass use of air travel has had about 1/2 the time of the mass use of the automobile, but air travel has had massive improvements. At first there were many crashes because airplanes broke and directly or indirectly through the distractions they caused resulted in mass fatalities. That got fixed first. Then aviation regulators figured out that a growing fraction of accidents were pilots flying perfectly good airplanes into the ground or each other. They borrowed ideas from the nuclear industry, and instituted many policies that have resulted in a remarkable fall in airline fatalities. Do you realize the last time an passenger aircraft went down in the United States was November, 2001? 19 years. The only other crash was a 777 in San Francisco that stalled on approach, and most of the passengers came out with no or minor injuries. That’s truly remarkable.
The medical community has noticed, and has adopted the same philosophies. You can see this in examples like surgical checklists that every instrument and disposable is counted before and after surgery with checklists to stop sowing patents closed with those items left in them. Or every person asking a patient over and over again, what’s your full name and date of birth and what they’re in for so they stop giving the wrong medication or taking out the wrong kidney and those other simple but devastating mistakes. Have we seen the same in automobiles? No. Why? Because the public won’t accept many of them. We’ve pushed on drunk driving some but not really. Certainly not in proportion to the risks. We’ve made cars smaller and lighter to save fuel, citing the limited resource it is and the environmental costs of emissions. But that comes at a real cost in maimed and killed. Bigger cars save lives, but we’re pushed into smaller and lighter cars by governmental regulations. Few were willing to drive Jimmy Carter’s 55 MPH. Heck, I’m sure not, I hated it and pretty much ignored it. We have an enforcement focus on aggressive and fast driving, but don’t put a focus on the other bad behaviours drivers had. A good example is slow left lane drivers. That conduct is bad both because it is indicative in inattentive driving and it disrupts the flow of traffic. Smooth flow is vastly safer, it is the mixing of some people trying to weave by them that causes accidents. In many cases don’t do infrastructure improvements based on risk. A good example is crossover accidents – ones where a vehicle loses control and crosses into oncoming traffic. They’re brutal, being high speed crashes with a high incidence of fatalities. Getting every divided highway in the US outfitted with barriers will save more lives than any other infrastructure, but most of the miles are still not protected.
Going back to the irrationality aspect of these discussions, I face this professionally as I am the design leader for a product line that carries considerable risks. We manage them, but there is inherent risk. So many of these accidental injuries and deaths are about the unintentional release of energy. Falling from a height is releasing your gravitational potential energy. Crashing a car is releasing the kinetic energy of you and the car. Ditto for electrical arcs burning people or electricity shocking people, hydraulic fluid, compress air or other fluids exploding something, a spring exploding something, a machine coming apart and so on. It’s all about tradeoff of risk vs utility. We’re not going to stop using electricity, we’re not going to get rid of farm and factory machinery. There is risk, and there is the need to manage it but it’s going to be there unless we forgo technology. The greater the energy the greater the risks. The irrational statement that I get and struggle against is “Isn’t it safer if we just….” Yes, you’re correct, it is safer. It is also ignoring the level of ‘accepted’ risk. “Isn’t it safer” far too often ignores the unintended consequences. The guard that gets in the way of the operator too much is the guard that is more likely to be removed. A “less safe” guard that is left in place is far more safe than the guard that’s sitting in the corner of the room not doing it’s job.
That’s rather long winded way to make the point that the reaction to Covid won’t be rational and is only the last installment of the mass public failure to apply critical thinking to the area. What’s to be done? I’m not sure. Of course this is the appeal of the communist ideal where the “experts” are put in charge. It’s a great appeal to the university professor crowd where they think they’re smarter and more knowledgeable than the public. It’s also failed utterly every time it’s tried because who is an “expert” remains a political decision, the more centralized the power the more it corrupts, and it considers dissent heretical where any dissent must be stamped out. “Experts” can’t remain experts where an open and free dialog is suppressed. While you and I don’t always agree on all of the politics Jack, we’re both ardent supporters of representative democracy and individual liberty. I too reject “experts” as being the go to leaders here.
I’m all for “urging” and “imploring” but the moment it treads into where the government is placing restrictions on personal liberty, that’s where I’m going to draw my line. Legal restriction on the health in the name of public health is a new growth of government power, and we’re already seeing some of the government officials behaving power drunk. We need to nip that behavior before it grows.