I've been thinking about degrees of risk lately. I wish more people did:

1st degree: My risk. “I feel safe going into crowds maskless because I don't think I'll get #COVID19 or it will just be mild.”

2nd degree: My risk to people I know. “I feel safe going into crowds maskless and then seeing people I love because the chance I get them sick is slim.”

3rd degree: Our risk to each other. “I feel safe being part of the crowd ignoring COVID risks because I think the risks to everyone are mild or moderate.”

This thought came to mind after speaking to a peer this week. She's been dismissive of COVID risks, going out to crowded nightclubs regularly. When I met some work friends in an empty restaurant during a COVID lull before the holidays, she spoke of how she'd twice been in crowded pubs that past week and how fun it was to sing with everyone.

This week, we chatted virtually, and she shared her holidays were ruined by COVID. She visited her parents over the holidays, both of whom have significant health risks, and both got COVID. She was upset the pandemic had intruded on her plans, with her and her family isolating due to their exposure. Although she claimed she tested negative (implying she wasn't the source of the infection), she clearly didn't see the irony of her behaviors.

My peer only saw the first- and second-degree risks, but her part in the third-degree risk was lost on her. (Her parents are suffering because people behave as she does, and for all she knows, other people's parents are suffering because of her risky decisions.)

My social feeds are full of people doing the same. They don't care or think the first-degree risks are great, so they feel safe in crowded bars, restaurants, conferences, and events.

But I wonder how many partying like it's 2019 are conscious of second-degree risks--do they see elderly parents a day or two after a crowded event, not realizing they could be asymptomatic and infectious? Do they go out to crowded places on consecutive days, possibly spreading to others a pandemic virus that remains a top cause of death and is causing an historic shortening of lifespans?

https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/#Life%20expectancy%20at%20birth%20in%20years,%201980-2021

How does U.S. life expectancy compare to other countries? - Peterson-KFF Health System Tracker

The U.S. has the lowest life expectancy among comparable countries, but spends nearly twice as much as them on healthcare per person, on average.

Peterson-KFF Health System Tracker

If we were a bit more conscious about how our decisions affect the people we love, we'd avoid being the millionth story like this: “Like many, I thought the pandemic was over – until I infected half my family on Thanksgiving. I was to blame for giving #COVID19 to my elderly, high-risk, medically sensitive dad. Soon after, my wife and son tested positive. Now I was responsible for three people I love contracting the virus.”

https://eu.knoxnews.com/story/opinion/2023/01/09/opinion-i-thought-the-pandemic-was-over-until-i-infected-my-family/69754755007/

I thought the COVID-19 pandemic was over – until I infected my family | Opinion

Former Titan joins "GEAR UP, Tennessee!" campaign to raise awareness of infection danger and encourage COVID vaccinations.

Knoxville News Sentinel
It's the widespread disregard for the third-degree risks of COVID that concerns me. Even if WE don't get sick and aren't the superspreader in our family or workgroup, we should still care about being part of the larger solution that keeps everyone safe. Few seem to have that sense of empathy or responsibility. We're like friends leaving a bar drunk, each getting behind the wheel--if one of us kills someone, don't we all bear responsibility for not being part of encouraging safer decisions?
If a pandemic virus were only an issue of first-degree risk, then we could all do what we want. For example, if we eat badly and diminish our lifespan or quality of life, it doesn't affect others' physical health. (There have been some studies that show bad eating habits are, in fact, contagious, but we'll set that aside.) If COVID were only a matter of personal risk, then my concern would only be whether people truly recognize the risks and are making informed decisions. https://drtomfrieden.medium.com/understanding-long-covid-9c24f9150172
Understanding Long Covid - Dr. Tom Frieden - Medium

Author Note: This piece is written largely based on and because of the extensive research conducted by Andrew Gall and the Prevent Epidemics team at Resolve to Save Lives. I raised the risks of long…

Medium
But this pandemic remains a threat that demands we take our responsibility to each other seriously. Posting constant photos of your concerts, conferences, and bars only encourages others to abandon cautions and join you. And being a part of those crowds isn't just a personal decision but a matter of second- and third-degree risk. There's a reason why COVID continues to cause repeated surges and is evolving rapidly--that doesn't happen unless we ignore our part of the larger risks to everyone.
This week, White House COVID coordinator Ashish Jha voiced concerns about the long-term impact of high-levels of evolving COVID on the health-care system. “I am worried that we are going to have, for years, our health system being pretty dysfunctional, not being able to take care of heart attack patients, take care of cancer patients, take care of the kid who’s got appendicitis because we’re going to be so overwhelmed with respiratory viruses for 3 or 4 months a year.” https://www.washingtonpost.com/health/2023/01/12/covid-winter-surge/
The doctor won’t see you now: Covid winters are making long hospital waits the new normal

“I’m so sorry that you’re still in the emergency room,” one doctor told a stroke patient who was waiting for days.

The Washington Post
“I just think people have not appreciated the chronic cost, because we have seen this as an acute problem. We have no idea how hard this is going to make life for everybody, for long periods of time.” And that, right there, is the impact of our unwillingness or inability to appreciate or adjust even a little to our role in the third-degree risks that everyone faces.

COVID is not over. It is not yet endemic. We can't simply “live with COVID” and pretend our risks are the same as in 2019. Our economy will be harmed, healthcare workers will be overburdened, and we'll impact the quality of life and lifespan of billions.

You don't need to isolate constantly. But if you're the type who won't go out when there's a blizzard or monitor weather to see if you'll need an umbrella, then stay home or #WearAMask when transmission levels are high. https://covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=all_states&list_select_county=all_counties&data-type=Risk

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

Centers for Disease Control and Prevention

@augieray How I wish this was so.

"low transmission" was only happening because people were staying home, masking, etc. One you decide you can do more because transmission is low, you're removing a constraint. Transmission increases.

Low transmission is an indication that countermeasures are working. It's a time to be even more careful, because if we should happen keep Rₜ solidly negative for a couple months we could get case numbers low enough to actually prevent transmission.

@augieray The reason we need to outright prevent transmission is because COVID is cumulative. Getting it over and over again isn't survivable as a person or as a society. "Reducing the rate of transmission" amounts to deciding to die slower, but still die.