Risk averse?

A familiar figure popped up the other day in the news:

Ms [Mary] Kenny told RTÉ radio’s Today with Sarah McInerney show earlier on Monday that she did not intend to break the law, but wanted legal advice on the position of Irish citizens returning to the country. She described the Government’s quarantine regulations as “draconian” and said the response should be “proportionate.” Irish authorities require anyone coming into the State, apart from those travelling from Northern Ireland to self-isolate for 14 days.
Covid-19 was not the Black Death, she said. It killed “some” who were vulnerable, but for most the symptoms were flu-like and unpleasant and as such the Government’s response should be proportionate.
People should be sensible and take precautions, they should proceed with their lives. “There are risks in life,” she said.

Let’s look at risks. This is a fantastic overview of everyday risks. Pre-coronavirus!

Many of the things that cause people great distress—such as spiders, sharks, plane travel, and elevators—are considered “irrational” fears for a reason. That’s because the things that are most likely to off you are far more mundane, as the below infographic spotted by Bored Panda shows.

And:

Some of the statistics are a little surprising. For example, you’re far more likely to die while canoeing (the risk factor is 1 in 10,000) than while bungee jumping (1 in 500,000). Dance parties are slightly deadlier than skydiving—which is to say, these activities aren’t very dangerous at all. And you’ll probably be safe if you stick to video games, where the risk of death is 1 in 100 million.

Let’s take obvious risks.

Running and Jogging, 1 in a Million of dying.

Cycling, 1 in 140,845

Cars, 1 in 6,700

Aircraft, 1.27 deaths in 100,000 flight hours.

Dance parties, 1 in 100,000 dance parties.

Computer games, 1 in 100 Million.

Now consider the risks of catching coronavirus. First up activities and the risks of catching something.

These aren’t quantified numerically, but on a scale, but that’s alright.

Low Risk
Opening the mail
Getting restaurant takeout
Pumping gasoline
Playing tennis
Going camping

Low to moderate risk
Grocery shopping
Going for a walk, run, or bike ride with others
Playing golf
Staying at a hotel for two nights
Sitting in a doctor’s waiting room
Going to a library or museum
Eating in a restaurant (outside)
Walking in a busy downtown
Spending an hour at a playground

Moderate risk
Having dinner at someone else’s house
Attending a backyard barbecue
Going to a beach
Shopping at a mall
Sending kids to school, camp, or day care
Working a week in an office building
Swimming in a public pool
Visiting an elderly relative or friend in their home

Moderate to high risk
Going to a hair salon or barbershop
Eating in a restaurant (inside)
Attending a wedding or funeral
Traveling by plane
Playing basketball
Playing football
Hugging or shaking hands when greeting a friend

High risk
Eating at a buffet
Working out at a gym
Going to an amusement park
Going to a movie theater
Attending a large music concert
Going to a sports stadium
Attending a religious service with 500+ worshipers
Going to a bar

Now consider case fatality rates by age. This is a little opaque since CFRs aren’t necessarily covering all infected. Moreover there’s local issues too – CFRs appear different in different places. Spain for example has in younger to middle-aged cohorts a lower CFR than China or Italy. But this gives a sense of risk.

So how does it work? CFR is confirmed deaths due to Covid-19 divided by the number of confirmed cases.

Take my cohort – 50-59 years of age – I’m moving towards the middle part of that. In South Korea that is 0.5%, Spain 0.4%, China 1.3% and Italy 1%. Let’s look at this slightly different. If one catches Covid-19 (and is confirmed to have caught it) therefore in Spain one in 200 of those in the 50-59 year old age range would wind up dying. In China and Italy it is clearly double or a bit more than that. Compare and contrast with the mortality rate for flu. CNN noted in late March that in the US:

That coronavirus death rate, which is lower than earlier estimates, takes into account potentially milder cases that often go undiagnosed — but it’s still far higher than the 0.1% of people who are killed by the flu.

And worth bearing in mind that that 0.1% would be skewed towards the most vulnerable cohorts. Let’s consider that 0.1%. Amongst 20-29 year olds that is half of the rate affecting that cohort with regard to coronavirus (0.2%). For 30-39 years old it is a range between 0.11 and 0.3% for coronavirus. 40-49 year olds it is 0.08 and 0.4%. I’ve done 50-59 years olds. 60-69 years olds 1.8% to 3.5%. 70-79 years olds 4.8% to 12.8%. 80+ 13% to 20.2%.

Not that those in seemingly less vulnerable cohorts should be free of concerns. As this piece from The Atlantic notes:

No matter the cause, interpreting the “youth surge” as good news would be a mistake. Young people infected with COVID-19 still face extreme dangers—and present real danger to their close contacts and their community. “We see people in their 20s and 30s in our ICUs gasping for air because they have COVID-19,” James McDeavitt, the dean of clinical affairs at Baylor College of Medicine, told The Wall Street Journal. Young people who feel fine can still contract long-term organ damage, particularly to their lungs. They can pass the disease to more vulnerable people, who end up in the hospital; a youth surge could easily translate into a broader uptick some weeks from now. And the sheer breadth of the youth surge could force businesses to shut down, throwing millions more people into limbo or outright unemployment.

That last is key, and often forgotten in the debates about reopening.

Of course another point The Atlantic points to is that death rates may be declining somewhat – it makes sense, overcrowded hospitals are hospitals where more mistakes are likely to be made and treatment will be sub-optimal. But treatments are improving somewhat, and lower numbers of cases help. Even still the death rates are deeply concerning. And this brings us back to ‘risk’.

I harboured for many years a deep and profound fear of flying. No one would get on a commercial passenger aircraft where there was a 0.5 to 1 in 100% chance of it falling from the sky. Similarly with a 0.1% risk. Airlines would shut up shop tomorrow. Yet that .5% to 1% risk is precisely that which I would face at my age. I’d be fascinated if Mary Kenny could point to any activity she, or I, or you, indulge in day to day that carries the level of risk should one catch the coronavirus.

For Kenny the virus isn’t the Black Death. Though that’s not exactly a heartening comparison. At a time of no sanitation, no medical understanding worth the name, the Plague burned through global populations. In Europe alone it is thought it may have killed up to 60% of the population. Interestingly though the mortality rate from bubonic plague – where treated – is about 1-15%. That lower number is not a million miles away from Covid-19 mortality rates, as seen above. Perhaps Kenny hasn’t had flu, or pneumonia, but many of us have had one or other or both. And these are not particularly mild conditions. So perhaps Kenny doesn’t realise this, or is making an inapposite comparison.

Or could it be more broadly that her understanding of the term risk, and its meaning, and the level of risk she is exposed to day to day, is sadly flawed.