A waitress takes the temperature of customers as restaurants are permitted to offer al fresco dining as part of phase 2 reopening in New York City, June 27, 2020, photo by Andrew Kelly/Reuters

commentary

(Orange County Register)

Learning to Live in a Riskier World

A waitress takes the temperature of customers as restaurants are permitted to offer al fresco dining as part of phase 2 reopening in New York City, June 27, 2020

Photo by Andrew Kelly/Reuters

by Shanthi Nataraj and Sita Nataraj Slavov

July 2, 2020

Even as the public discussion about COVID-19 risk becomes increasingly polarized, many Americans are slowly and quietly balancing the threat of infection against valued daily activities, and learning to live in a riskier world.

On one hand, there are daily headlines expressing alarm about the dangers of reopening, citing rising cases and hospitalizations in early-opening states like Texas, Florida, and Arizona. The implication often seems to be not just that we should carefully consider how and when to reopen, but that returning to normalcy is not worth any increase in COVID-19 risk. On the other hand, some groups—such as the anti-mask activists who succeeded in temporarily getting mask requirements rescinded in Orange County—appear opposed to any restrictions or changes in their pre-COVID-19 lifestyles.

But what Americans need right now is not polarization. What is needed lies between the two extremes and involves accepting both a higher level of risk and sensible steps to mitigate that risk. Finding this middle ground can provide a path forward, allowing the nation to resume some valued activities—including work, school, social events, and travel—while putting up with some annoyances, like masks and temperature checks.

Everyone takes risks in life. For example, most people risk their lives—and the lives of friends, family, and strangers—on a daily basis by driving, taking that calculated risk because of the other important values at stake.

But COVID-19 is different in an important way: It presents a level of risk that most people have not experienced on a daily basis. In 2018, 37,991 Americans died in auto accidents. In just the first half of 2020, more than three times as many Americans died of COVID-19. In April, COVID-19 deaths exceeded average monthly car accident deaths even among those as young as 35-44.

On one side of the ledger, COVID-19 is clearly a major threat. On the other, isolation to stop its spread can do significant damage to economic security, social connection, and mental and physical health.

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That's scary.

That said, taking calculated risks can still be worth it for most, particularly when the alternative involves indefinitely curtailing a wide range of normal activity. COVID-19 changes the calculation, but it doesn't change the underlying logic. On one side of the ledger, COVID-19 is clearly a major threat. On the other side, isolation to stop its spread can do significant damage to economic security, social connection, and mental and physical health. Both sides of the ledger need to be taken seriously.

Americans have lived with higher levels of risk in the past. In recent years, young and middle-aged Americans—particularly those in the middle class—have faced a very low risk of death from any cause, and older Americans have tended to die of chronic or long-term illness.

But in earlier decades, people of all ages faced higher mortality risk, and infectious disease was much more of a threat. Even recently, before the pandemic began, people in many parts of the world were living with much higher levels of infectious disease risk than were typically seen in the United States.

Of course, part of learning to live with risk is mitigation. Just as people mitigate car accident risk with seatbelts, airbags, and speed limits, they also can mitigate COVID-19 risk by wearing masks, holding events outdoors, and physically distancing to the extent practical.

Policymakers can help by investing in testing capacity and encouraging everyone—symptomatic or not—to get tested regularly. When the benefits of certain mitigation measures are particularly large for society, they can also be enforced, just as traffic laws or liability insurance requirements for drivers are enforced.

And as it turns out—even as the loudest voices in the public discussion remain polarized—many Americans have already started to make the transition towards resuming daily life in a riskier world.

Just as people mitigate car accident risk, they also can mitigate COVID-19 risk by wearing masks, holding events outdoors, and physically distancing.

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Polls suggest that Americans are gradually becoming more comfortable resuming ordinary activities, like going to restaurants or shopping malls, and flying, while taking precautions like wearing masks in public.

A New York Times survey of epidemiologists shows that even members of this group are weighing the risks and benefits of the activities they value—from haircuts to dating—and choosing to take some calculated risks. And many policymakers have been listening: Even some of the states that were first to lock down are now balancing COVID-19 risk against other important priorities, while others that were first to reopen are reversing some of the more controversial steps, like reopening bars.

The CDC has released guidance on ways to reduce risk when going out—for both essential and non-essential activities—and the American Academy of Pediatrics has released a statement advocating the reopening of schools for in-person learning.

This shift to focus on harm reduction signals an acceptance of the fact that—even if a vaccine is developed at “warp speed”—people are going to be living with the COVID-19 pandemic for many months. Under more pessimistic scenarios, it could take years.

The only way to make this workable is to learn to live—with reasonable precautions—in a riskier world.


Shanthi Nataraj is director of the Labor and Workforce Development Program at the nonprofit, nonpartisan RAND Corporation, a senior economist at RAND, and a professor at the Pardee RAND Graduate School. Sita Nataraj Slavov is a professor at the Schar School of Policy and Government at George Mason University, and a visiting scholar at the American Enterprise Institute.

This commentary originally appeared on Orange County Register on July 2, 2020. Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis.