Assessing Risk and Restarting School

OK, as the nation wrestles with when and how to open schools back up, I feel it is again time to make one of my lengthy posts on this crisis. I had kind of hoped by now we would be on our way to controlling the virus and getting things back to new normal, but I really should have known better. As I think about it, I am probably going to meander in this post, as I have a couple of points to make before sliding back to the question of addressing the opening of schools.

(Side note: If you want to get into a debate on whether this crisis is actually real or whether most of the scientists are lying please do it on another of my posts. I have to discuss that somewhat because it is integral to discussing risk assessment, but it's not the point of this post. And I am freaking tired of having that argument come up no matter what the post is about.)

Human beings are, in general, amazingly bad at analyzing risk rationally. There are a lot of reasons for this and a lot of different biases that come into play. (I have included a couple of links below.) Right now, it means that across the political spectrum and across the spectrum of the seriousness with which we take COVID-19 (sadly our president's actions have largely dictated that these two spectra are close to the same) this leads to issues. But the idea that people "on both sides" are assessing risk inaccurately has lead to a narrative that people on both sides are making equally rational decisions. That is the idea I want to take apart in this post.

I am going to start with the critique of what I view as people broadly "on my side" of the argument, to the extant that there are two sides. On the average, humans tend to be overly optimistic about risk. But once we tip over into pessimism/fear we tend to be overly pessimistic and fearful. This leads us to overestimate risk. Witness the woman this morning who freaked out when, as I approached her on the bike path and moved about seven or eight feet off the path, maybe ten feet or so from her, started yelling at me that I was poisoning the environment by not wearing a mask. When I run I don't wear a mask because it becomes a sweaty, wet mess really quickly. I do carry it so that if I have to stop near someone to cross a street I can slip it on quickly. All of the available evidence suggests that even two people without masks passing closely by each other outside are at very little risk. At the ten feet we were apart her screaming at me (with her face pointed toward me) probably put me at more risk than my running by her put her. And neither of us was in much danger from C-19. I also know people who have said they won't even have a conversation outside sitting 8 or 10 feet apart with our without masks. Unless these people have seriously health risks, they are over estimating their risk. The evidence is pretty clear that outdoor activities that don't involve a significant amount of time in close contact are pretty low risk. On the other hand, people in this category are making, in my view, a more rational decision than many people on the other side. They are prioritizing avoiding potentially catastrophic consequences. Do I think that if some of them had a better grasp of the actual risk they might change behavior somewhat? Absolutely. But it is not, at heart, irrational.

On the other side are all the people who started out in the "this is a hoax" or "this is no worse than the flu" camp. These are the people who were loudly crying "the cure is worse than the disease" in March. They are people who, to put it simply, do not understand infection models in a pandemic and relied on the expertise of people who largely do not understand infection models in a pandemic and/or experts who didn't really understand all of the data before making their initial predictions and have ever since been trying to slowly hedge their way out of that initial mistake without having to say "I was wrong" or even "I made my best estimate based on the data at hand but now we have more data." People in this camp underestimate risk in two fundamental areas.

First, they think that low percentages are the same thing as almost no danger. People tend to think of danger in terms of "will this happen to me" or to any one person. When they conclude very likely no, they then think there is no danger. This lets them dismiss COVID-19 as nothing worse than the flu when in fact it is far worse than any flue in at least the last 50 years and more likely the last 100 years. Over 150,000 Americans have died from COVID-19 (actually it is VERY likely this is a fairly significant undercount by 10% or more). People in this group seem to think that knowing some math and basic statistics lets them analyze information and find "the data" that proves their position. Also in this category is focusing only on deaths and not on the much larger number of long term health problems associated with C-19.

The second underestimation is that they adhere to their optimism in the face of evidence that suggests it is unwarranted. So they consistently say things like "studies show kids can't pass the virus" when that is simply not a reasonable position to hold any more. Or they say "death rates are declining" for weeks, trying to argue that because the ration of deaths to confirmed cases the virus is killing fewer people. When in fact it was starting to kill more people (and the rate of increase was increasing) and the ratio was only declining because the number of cases was skyrocketing. This position is, at its heart, irrational. Which makes it much harder to combat.

Some people who think low danger means no danger will stop and think if you can talk about the implications of their own numbers. I had a parent I know (I have taught a coached a couple of her kids) who told me she didn't think that more than a third of Dublin teachers would get infected if we went back to in person schools. And no more than half of the kids. And then she told me her (optimistic side) beliefs about death and hospitalization percentages. She told me "You know the chance that I die from this is very small. When I asked her if she was OK with 2-4 teachers dying and 30-60 being hospitalized she said of course not. She had never stopped to think about the implications of her own numbers.

The people in the second category are much harder to convince. So far the only thing I have seen change many minds is when they know someone who dies or when they or someone close to them gets seriously ill. Which is odd in and of itself because that really doesn't change the overall risk.

So this brings us to school opening back up and whether it should be in person. There is a small but very vocal group in the I will deny all the evidence and argue that there is no danger, or that the danger to kids psyches is greater, or that the danger to the economy is greater, or that teachers are just lazy or even that we are not going to be able to eradicate COVID-19 so we should just go ahead and let everyone get infected now. Anything they can think of to argue that schools should be open. Teachers, at least those who believe it is too dangerous to go to face to face instruction now, are really focused on this group and I think it is largely fruitless. We shouldn't ignore them, as their disinformation needs to be countered, but we are not going to convince them of any other position. It is people in the group who are conflating low danger with no danger that can be won over. When they stop seeing a low chance for their kid or their kids' teacher to be harmed as the same as no one will be harmed they may change their minds.



Links:

Humans and risk, covid specific: https://www.nytimes.com/2020/06/30/smarter-living/why-youre-probably-not-so-great-at-risk-assessment.html

Humans and risk, general: https://www.psychologytoday.com/us/blog/the-inertia-trap/201303/why-are-people-bad-evaluating-risks

Substantial Undercount likely: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767980

Kids 10-19 do spread the virus like adults: https://wwwnc.cdc.gov/eid/article/26/10/20-1315_article