Reconsidering the Notion of Acceptable Risk

I found this opinion piece by David L. Katz provocative.  As I understand, the data so far show that mortality risk for people who test positive for Covid19 is low for people under 60, and then it rises, so that very senior citizens are at extreme risk, while those in their mid 60s like me are at risk, but it is still very likely that such people will survive the illness.  The piece argues that we should should target the at risk population for social distance practices.  The rest of the population should interact, let the disease spread, but acquire herd immunity as a consequence, which would ultimately defeat the disease.  This was a new argument for me and I'm still trying to process it, which is why I'm writing this post.

So, first, there is the question about the news we are hearing and other possible news we are not hearing. We seem to be overwhelmed with stories about those just tested who show infection.  When it is a public persona, that might be enough information.  But otherwise, is age of the person reported as well?  What of the prior health of the person?  Does that get reported too?  Conversely, we don't seem to be getting any news about people who were tested positive a month ago or even earlier than that who got sick, but then recovered and are more or less normal now.  Nor have we heard about when such a person is no longer contagious.  My conclusion, based on the availability heuristic, is that we are overplaying the risk from being infected, so most of us won't be able to entertain the argument in the Times opinion piece, as it goes against too much of what we believe to be true.

Then there is, how we as individuals as well as how we as members of organizations deal with risk, when the downside can be measured in money terms rather than in illness which might lead to death.  Here the perception of liability matters and that liability is tied to whether due precaution has been taken.  The decision making apparatus often drives to a solution that minimizes liability without caring about the potential upside risk, which conceivably could provide substantial benefit in the event it is realized. In other words, a full cost-benefit analysis might sometimes be consistent with absorbing liability, but organizations don't go that route out of fear of the downside risk.  In this, I'm thinking of my days as the main ed tech guy at Illinois, where the learning management system (we called it Illinois Compass) offered up the solution to risk of violations of copyright (an instructor using somebody else's materials without getting their permission first) and student privacy (a student's membership in a particular class is protected information that should not be made available to outsiders without the student's permission).  So closed container systems, which the lms exemplifies, became the vogue, irrespective of whether they encouraged deep learning by the students or not.  I have since come to view that what the lms does should be much more limited and that much of the online instruction should be done out in the open.  That better promotes learning.  But I feel like a voice in the wilderness on that one.

Finally, there is the issue of whether it is better to endure the downside risk rather than to try to avoid it, so as to lessen the fear of future such risks and make the person more resilient.  Here I'm thinking of pieces like What Straight-A Students Get Wrong by Adam Grant and The Overprotected Kid by Hanna Rosin. Getting bumps and bruises along the way is part of being a robust child.  Once in a while it will be worse than that.  Should parents protect the child against that downside risk?  Nowadays that seems the norm.  Yet we have a large fraction of college students who are having serious mental health issues.  Surely there is some linkage between the two.

Right now it seems to be younger people who are violating the restrictions of social distancing.  If they are living with older parent or their grandparents, that indeed might be problematic.  But if they are living on their own or with roommates their own age, maybe these violations will in the end be our salvation, as a species.

I'm no epidemiologist.  And I'm in the at-risk group.  But as an economist, seeing all these stories about how medical masks and virus testing are in very limited supply, I can make a reasonable case that in addition to hoping for dramatic increases in supply, we almost surely should be doing things to limit demand.  Yet I'm wondering whether our trying to be responsible precludes that.  It's something that needs to be thought through.