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The Denial of Death and Risk Assessment

I understand that it can be very difficult to enjoy life when you're dead. The reality of that situation seems to be why so many around the world are willing to give up "normal life" for a time so they have the option of returning to it as some point in the future. Fortunately, COVID-19 is not a virus that guarantees death if one contracts it. Apparently, many people that have the virus in their bloodstream show no symptoms. So COVID-19 isn't in the same class of things to avoid as, say, gunfire would be. But people do die from complications from the virus so treating it like a mild cold doesn't seem right either.

Yet, collectively, we’ve made a decision about how much at risk we are. And apparently it’s extremely high (seemingly closer to gunfire than to the cold).

As I write this, the threat of widespread death from COVID-19 has become so all consuming that we're willing to give up real community, finances, jobs, possibly a healthy mental life, and, perhaps worst of all, the ability to buy toilet paper at any local store. We’ve somehow decided that all the things we thought we apparently valued prior to the disease can be set aside because this one option—stopping the spread of COVID-19—is the only thing that matters.

We’ve done such a good job at buffering our psychology from being aware of death that when we’re confronted with it, it overwhelms us. So the news is filled with daily reports of those that have died and dire projections of those that will die if we don’t give up so many of the things that mattered to us. We’ve done this because our new awareness of widespread death, fueled by the media and health officials in lab coats, has brought the reality of death to our doorstep. And we’re terrified. We’re shown tragic photos of overrun hospitals and unfortunate souls on ventilators and dead bodies being loaded into vans. It all compounds the horror.

But we also seem to have minimized the reality that we're all at risk every day by a variety of threats. Simply by being the world we put ourselves and our fellow humans at risk. This is not to say we should embrace and amplify risk. It’s to acknowledge that we can’t entirely remove it. Our current task is to figure out how much risk actually exists, for whom, and how do we reasonably manage that risk. We seem to have forgotten that viruses are a part of our lives and, while we should take reasonable precautions to protect ourselves and others, the drive to eliminate risk at any cost reduces our options and will most likely put us at more risk.

The CDC estimates (Time magazine summary that links to actual CDC data) that in the annual flu season from 2018-2019, over an unusual period of 21 weeks, the flu variants infected upwards of 42.9 million, put 647,000 people in the hospital, and killed 61,200 in the United States alone. The same organization estimates that in the 2017-2018 season, in the United States, between 39 and 57 million people had the illness, between 600,000 and 1.3 million were hospitalized because of it, between 46,000 and 94,000 people died from it. And all this with a vaccines in the mix.

Ethically, much of the narrative surrounding the COVID-19 pandemic is about "saving lives." We're told that this trumps everything else because you "cannot put a value on a human life." If reducing mass mortality is something we should do at any cost, where was the outrage during the previous flu seasons where tens of thousands died and hundreds of thousands were put at risk? Where was the “shelter in place” order so that we could save so many? Where was the constant media barrage of all the people dying each week from this horrible disease? Where were the pictures of those in the hospitals gasping for breath, the tragic stories of the thousands who lost loved ones? The photo opportunities were available but we didn't see them. The stories could have been written. But they weren't.

This isn't an epidemiological claim. It's a ethical one. If we can't put a value on human life, shouldn't we be just as outraged at the deaths by seasonal flu such that we should shelter in place to prevent the loss of life that sheltering would provide? People argue that COVID-19 is novel and there are vaccines for the flu and the rate of transmission is higher for COVID-19 and . . . But these claims miss the ethical point entirely. If the argument that we should shelter in place, social distance, and decimate the economy is about saving hundreds of thousands of lives, then the argument should have applied to previous seasonal epidemics. Why hasn’t it?

Perhaps its because the flu is normal, it's expected, it's a part of the seasonal routine and the assessed risk is subconsciously calculated as a part of that norm. COVID-19 was introduced as a “novel” virus, as something unusual, something to be worried about. It's the unusual nature of this virus that caught the public (and political) attention and is causing widespread panic. It's possible that this alone is what drove behavioral changes early on and not a significant change in the epidemiology of this virus over others that we're exposed to every year. The psychology at play here is captured nicely in the Christopher Nolan film The Dark Knight. The character of The Joker describes why people accept norms, regardless of how risky they might be, but "freak out" over some situations even if they have equal or lesser risk and moral weight. Having just killed three of Gotham's officials, he explains to Harvey Dent,

Nobody panics when things go 'according to plan.' Even if the plan is horrifying! If, tomorrow, I tell the press that, like, a gang banger will get shot, or a truckload of soldiers will be blown up, nobody panics, because it's all 'part of the plan.' But when I say that one little old mayor will die, well then everyone loses their minds!

The "shelter in place" directive (and all the social media that judges anyone who questions it) can’t merely be driven by ethics. If it were, we should see similar restrictions for so much of "normal" human behavior to save those lives that are lost each and every day to the risks involved in being in the world. The issue isn’t whether every human life is valuable. That’s a given. We need to be mindful of the ethical impact (and I believe it will be significant) of biasing towards the elimination of one risk at the cost of amplifying others.

By flattening one curve, we’re creating a dozen more. The heath authorities that are telling us to flatten the COVID-19 curve will come to the rescue helping us to flatten curves related to depression and suicide from job and business loss, domestic abuse, homelessness, mental health issues, financial ruin, broken relationships, even death and injury related to a change in mode of transportation.

This virus is dangerous and shouldn't be ignored. But the media and political amplification can be equally as dangerous and shouldn't be ignored.

in the late 90s, stories surfaced about a little-known concern in some corners of computer science that a significant amount of computers around the world suffer some version of a class of problems related to the way computers store date information (known as the Y2K bug). By the end of 1999, the hype had far exceeded the science with many preparing for disaster (power grids shutting down, banking systems collapsing, and far worse)—all ostensibly based on good science. Many billions of dollars were spent just in Y2K “fixes” not including all the survival gear and preparatory equipment that were purchased by individuals and businesses. Even books were published predicting the end of civilization due to the bug and the rhetoric, fueled by the popular press, had permeated every aspect of Western society.

The new year came in with only minor problems (there are solid arguments that the billions spent had little to do with that) and the whole issue was regarded by many as a massive hype campaign even though the underlying science had identified some real issues that needed to be addressed. Granted, the Y2K scenario was about a future threat and COVID-19 is about an present and ostensibly measurable one. However, the role of the media and the subsequent social response is analogous.

On the edges, some people are starting to question the epidemiological claims common in the popular press and the governmental narrative. Sure, many of the “alternative” voices are conspiratorial and so their critical response gets diluted by the “Deep State” rhetoric so often present in these narratives. But the baby shouldn’t be thrown out with the bath water. So often truth can be found, at first, on the fringes and some of this commentary needs to be considered if for no other reason than to ensure the mainstream narrative is accurate.

History repeats itself. We're witnessing multiple "viruses" all playing their role in shaping the human condition. Pandora’s Box has been opened and politically and socially it can’t be closed. My hope is that reasonable people will step up and get us back on track. We should be careful but avoid paranoia. We need to be conscientious but resist the urge thoughtlessly to fall in line with the dominant narrative. More times than not, it proves to be wrong.

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