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Stay Safe? - The Illusion of Safety

OP-ED

A true understanding of the intersection of risk and human nature entails disseminating accurate information regarding actual risk levels and letting people make their own decisions.

It's a sign of the times that we hear the phrase "Stay safe!" everywhere. While I know it's well meaning, it has started to grate on my nerves like nails on a chalkboard.

Oftentimes it closes a communication, or comes as advice, with the addition of "stay home" - as if we can stay safe by staying at home. While true with regard to those most at risk, as a general matter this can create the illusion of safety and mask real danger.

When we talk about safety, we should also consider the economic tsunami washing over our nation. The usual argument between "staying safe" and "opening the economy" presents a false choice based on the illusion that a safe path actually exists.





Stay Safe Handwritten

I'm not going to engage in second-guessing the shutdown itself. I think we can give those who executed it the benefit of the doubt for having made the best decision they could with the information they had. We can also assume that it helped avoid the feared broad meltdown of the healthcare system and that it saved lives. However, we have to hold our leadership accountable for the decisions they're currently making in the name of safety, particularly as more information becomes available.

It's clear that the debate around reopening the economy has become highly political along red/blue lines. Frankly, I don't think we should care about the politics of it all, but I do think we should care about the truth. So, as you listen to advocates of the "lock down" versus the "open up", I ask you to consider the following questions:

Who has skin in the game?

Many people have been able to work from home through this disaster with little financial impact, at least for now. Thank goodness, or the economic pain would be even more widespread. That said, those individuals should have compassion for the many kinds of work that cannot be done remotely as well as for the entire sectors of the economy that have been vaporized by the shutdown.

No one has been unaffected, but some people have more economic skin in the game with respect to reopening the economy. Others have more skin in the game with regard to exposure to COVID itself. This leads to the confounding choice between "safety" and opening the economy. There are varying degrees of risk exposure based on the short, mid, and long term consequences of continued shut downs.

What is actually happening to our health system?

One of the main justifications to shut down our economy was to make sure that the health system wouldn't be overwhelmed and increase lives lost. We accepted that and marched along like good soldiers. We even eliminated so called "elective" procedures (like treatment for cancer patients) in order to prepare for a surge.

Our health care professionals adapted and found ways to care for the sickest of the sick alongside COVID patients and even dynamically improved the outcomes for COVID patients. It seems that the shutdown has been gradually working.

But, we also have to look at the situation on the ground as some of our healthcare systems must lay off thousands to compensate for empty beds as well as the loss of highly profitable elective procedures. In the meantime, hospitals are empty while people die at home for fear of going to the hospital.

We ill-serve our citizens - especially the ill - as well as our system itself by unnecessarily prolonging this situation in the name of safety.

What about another potential growing public health crisis?

Our healthcare experts have spent years evaluating the environmental contributors to poor health. Healthcare connects to every aspect of our lives as a matter of promoting health and wellness. We know that stress and anxiety lead to poor health, suicide rates spike based on desperation, abuse at home arises from hopelessness, unsettled home situations lead to poor health, food insecurity leads to poor health, poverty leads to poor health, and homelessness presents a national health problem. All of these things are environmental contributors to poor health.

Roughly 30 million Americans are out of work. The average household is 2.52 people, which means that tens of millions of our population now face those environmental contributors to poor health. COVID is a real threat, but so is this collateral healthcare crisis. In this light the statement "stay home and stay safe" ignores the suffering of tens of millions of fellow citizens who stand to benefit from a reopened economy. We have to look at the total public health picture in balance, and COVID is only one element of that picture.

How bad could the economic picture get, really?

Unfortunately, the notion of keeping the economy shut down indefinitely until COVID somehow goes away is a form of magical thinking. We have every reason to expect that COVID will be with us for a while and future outbreaks could come in waves. So, one can understand the desire to hunker down long enough to outlast that risk. However, this is at odds with the interconnected nature of the economy.

Consider rent and mortgages. Think about how many rents and mortgages are not getting paid by people and businesses as a result of the shutdown. Who should absorb those losses and how? Behind every rent or mortgage payment stands a bank or investment fund. Banks and investment funds do not have unlimited money. Rather, they have the money their customers invest for safe keeping, which they in turn invest. At the end of the day, your savings and investments are tied up in institutions that have lent those funds out to the market.

Consider the many industries that have been crushed by the shutdown: travel, airlines, aerospace, hospitality, brick and mortar retail, automotive, etc. Just the obvious ones are about 20-30% of the economy. But nearly every kind of business is suffering to one degree or another. As firms cut back or go out of business, as other firms lose business accordingly and don't get paid, imagine all of the dominos that will fall.

There is no government program large enough to bail everything out. In a worst case scenario, we'd see massive failures across supply chains, financial institutions, and within the basic systems that keep our society functioning. So much so that there would be little safety for anyone.

What about risk and human nature?

Experts have projected two million deaths in America from COVID-19. The World Health Organization states that globally, about 3.4% of reported COVID-19 cases have died. Studies by Stanford University and the State of New York indicate that actual mortality could be 0.05% or less. We don't know absolutely and it is critical to find out, but at this point the actual mortality seems to run below the worst case scenario.

This is not to say that a small percent of a big number is not a lot of people, nor to say that we shouldn't care about those who are at risk. However, as the risk becomes more knowable, it can be evaluated on a personal basis.

For example, we know that there's elevated risk based on age and comorbidity. Wouldn't it make sense to manage that risk in a focused way to assist the most at-risk and vulnerable? Especially since nearly everyone seems to agree that COVID is not going away and is highly contagious?

Further, risk is part of life. We live with risk every day and innately evaluate it to make decisions. Individuals left to their own devices will make their own decisions as to what risk they'll tolerate with regard to COVID, based on their own profile. A true understanding of the intersection of risk and human nature entails disseminating accurate information regarding actual risk levels and letting people make their own decisions.

Undoubtedly, that will affect the economy and change behavior, but it needs to be efficient, effective, and driven by choice rather than by government mandate.

The definitive death rate of being alive is 100%

None of us get out of here alive. Life remains inherently unsafe and no amount of "lock down" will change that. On the contrary, a lock down shifts from one risk to a different kind of risk, both of which cause real suffering and real health concerns. Based on individual circumstances and profiles, each approach has different winners and losers. But, guaranteeing safety is just not possible. We should understand that one is not for or against "safety" based on looking to balance different kinds of risk.

It's easy to be angry about this entire situation. It's easy to blame others. It's easy to feel that you know how people ought to behave. That said, there is no "safe" answer between a rock and a hard place. No matter what we do, we can't "stay safe".

In closing, I want to add this observation: the "war metaphor" has been used time and again during this pandemic, and it doesn't make sense. After the Twin Towers fell, New Yorkers bound together and felt aligned against the awful threat of terrorism spawned by a militant group who killed thousands of innocent people. And every American became a New Yorker.

In many ways, the government's handling of COVID-19 has had the opposite effect. People are running away from each other, unwilling to ride in the same elevator, or say hello on the street. It's pitting neighbor against neighbor.

The governmental mismanagement of testing and quarantine status and tracing has hurt the culture and the global economy in ways that will wreak untold havoc for years to come. And it has exacerbated the already polarized politics in an America that is starting to feel positively "un-American".

It's time for a change.

Margaret Caliente is a professional athlete turned internet entrepreneur and Manhattan-based journalist.

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