Every Decision Is A Risk. Every Risk Is A Decision.

Maggie Koerth
fivethirtyeight.com
Originally posted 21 July 20

Here is an excerpt:

In general, research has shown that indoors is riskier than outside, long visits riskier than short ones, crowds riskier than individuals — and, look, just avoid situations where you’re being sneezed, yelled, coughed or sung at.

But the trouble with the muddy middle is that a general idea of what is riskier isn’t the same thing as a clear delineation between right and wrong. These charts — even the best ones — aren’t absolute arbiters of safety: They’re the result of surveying experts. In the case of Popescu’s chart, the risk categorizations were assigned based on discussions among herself, Emanuel and Dr. James P. Phillips, the chief of disaster medicine at George Washington University Emergency Medicine. They each independently assigned a risk level to each activity, and then hashed out the ones on which they disagreed.

Take golf. How safe is it to go out to the links? Initially, the three experts had different risk levels assigned to this activity because they were all making different assumptions about what a game of golf naturally involved, Popescu said. “Are people doing it alone? If not, how many people are in a cart? Are they wearing masks? Are they drinking? …. those little variables that can increase the risk,” she told me.

Golf isn’t just golf. It’s how you golf that matters.

Those variables and assumptions aren’t trivial to calculating risk. Nor are they static. There’s different muck under your boggy feet in different parts of the country, at different times. For instance, how safe is it to eat outdoors with friends? Popescu’s chart ranks “outdoor picnic or porch dining” with people outside your household as low risk — a very validating categorization, personally. But a chart produced by the Texas Medical Association, based on a survey of its 53,000 physician members, rates “attending a backyard barbeque” as a moderate risk, a 5 on a scale in which 9 is the stuff most of us have no problem eschewing.

The info is here.

San Quentin’s coronavirus outbreak shows why ‘herd immunity’ could mean disaster

Rong-Gong Lin II and Kim Christensen
The Los Angeles Times
Originally published 11 August 20

Here are two excerpts:

San Quentin is an imperfect setting to help understand when herd immunity might be achieved. Prisons are crowded settings that will promote coronavirus transmission more so than among people in other settings, like those who live in single-family homes.

But the San Quentin experience — as well as other data — does show that, in the absence of a vaccine, “in order to get to something that approaches herd immunity, we’re going to have to get something well on the far side of 50% of people infected,” Rutherford said. “Which comes with a resultant large cost in mortality and severe morbidity.

“If you believe the San Quentin stuff, you got to get up to way-up-there before you start seeing slowing of transmission,” Rutherford said.

Dr. Anthony Fauci, the U.S. government’s top infectious diseases expert, last week guessed it will probably require 50% to 75% of a population to be immune before achieving herd immunity — a goal that should be achieved not just through infected people recovering but also through vaccination.

California has a long way to go before the vast majority of residents have been infected.

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Sweden famously pursued a herd immunity strategy when it decided not to impose a severe lockdown.

But now, Sweden has among the highest mortality rates among European countries, and has a worse rate than that of the United States.

The info is here.

The Ethics of Quarantine

Ross Upshur
Virtual Mentor. 2003;5(11):393-395.


Here are two excerpts:

There are 2 independent ethical considerations to consider here: whether the concept of quarantine is justified ethically and whether it is effective. It is also important to make a clear distinction between quarantine and isolation. Quarantine refers to the separation of those exposed individuals who are not yet symptomatic for a period of time (usually the known incubation period of the suspected pathogen) to determine whether they will develop symptoms. Quarantine achieves 2 goals. First, it stops the chain of transmission because it is less possible to infect others if one is not in social circulation. Second, it allows the individuals under surveillance to be identified and directed toward appropriate care if they become symptomatic. This is more important in diseases where there is presymptomatic shedding of virus. Isolation, on the other hand, is keeping those who have symptoms from circulation in general populations.

Justification of quarantine and quarantine laws stems from a general moral obligation to prevent harm to (infection of) others if this can be done. Most democracies have public health laws that do permit quarantine. Even though quarantine is a curtailment of civil liberties, it can be broadly justified if several criteria can be met.

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Secondly, the proportionality, or least-restrictive-means, principle should be observed. This holds that public health authorities should use the least restrictive measures proportional to the goal of achieving disease control. This would indicate that quarantine be made voluntary before more restrictive means and sanctions such as mandatory orders or surveillance devices, home cameras, bracelets, or incarceration are contemplated. It is striking to note that in the Canadian SARS outbreak in the Greater Toronto area, approximately 30,000 persons were quarantined at some time. Toronto Public Health reports writing only 22 orders for mandatory detainment [3]. Even if the report is a tenfold underestimate, the remaining instances of voluntary quarantine constitute an impressive display of civic-mindedness.

Thirdly, reciprocity must be upheld. If society asks individuals to curtail their liberties for the good of others, society has a reciprocal obligation to assist them in the discharge of their obligations. That means providing individuals with adequate food and shelter and psychological support, accommodating them in their workplaces, and not discriminating against them. They should suffer no penalty on account of discharging their obligations to society.

The info is here.