Balancing COVID-19 risks and benefits

(September 9, 2020)

As the next wave of COVID-19 hits Manitoba, just as school resumes, there is a lot of conversation about risk. Unfortunately, much of that conversation is skewed and unhelpful, because people (and governments) use the word in two different ways.

First, there is risk management (or mitigation). Second, there is risk-benefit analysis. We need to be clear which one we mean, or our conversations about risk just turn into confusion and conflict.

Trying to live without risk is impossible. Even staying in bed is risky. Yet we find ways to reduce or mitigate risk every day.

For example, the best way to mitigate the risks involved in travelling outside your home is not to travel at all. Stay home. But obviously, few people are in a position to earn an income, receive services, get education, raise children and shop without ever leaving their home. We all assume some level of risk, therefore, every time we step outside the door.

Apply this to life in a pandemic: while our level of risk rises with the case count, we still need to accept there is unavoidable risk involved in all of our activities. Mitigating risk means reducing the probability of a bad event, but it is impossible to eliminate risk altogether.

Of course, the best way to mitigate the risk of COVID-19 infection is to stay away from other people, in groups or individually. But this is not easily done, and very much depends on where we live, how we live, and how we make a living.

So when you meet other people, mitigating risk means wearing a mask. It might offer you some protection, in terms of reducing your chances of contracting the virus, but it will certainly help to protect other people from any virus you might be carrying. Face-shields and other forms of PPE at work will help reduce your risk there, too.

This leads to the second way of understanding risk: risk-benefit analysis. Any risk I personally choose to assume needs to have a corresponding benefit. There is a risk to being employed, whether from commuting, workplace hazards or, now, from COVID-19, but we accept that risk because of the benefit.

It is unreasonable to expect someone to assume a personal risk when there is no personal benefit. This is the problem with everything from restaurants to shopping to school. If I want a burger, I can buy it many places. So I will eat at the restaurant that most mitigates my personal risk of getting COVID-19 — they get the benefit of my business, but I only get a burger.

I want groceries — but will shop at the grocery store that takes every precaution to protect its customers, from sanitizing everything in sight to requiring masks on employees and customers. That store gets the benefit of my business, because the store (and its employees) demonstrate they care about the personal risks I am assuming for shopping there.

I want my kids to go to school, but the benefit to them (and to me) has to balance against the risk. Otherwise, it is not reasonable to send my kids to school, knowing there is a danger for them and for everyone in my family bubble. The school system has to mitigate whatever risk there is, or the kids (and their teachers) should stay home and find some other way to learn.

The problem with school, of course, is that while there is clearly a public benefit to public schooling, from employing teachers to educating students to become useful citizens, the risks are entirely personal. Granted, there are also some family benefits — child care being one of them — but there also need to be benefits to students for the risks they are assuming.

The greatest benefits of going to school are mostly social (not the curriculum, which can be taught at home quite effectively) — where “social” means kids interacting with friends and teachers. I have to wonder if, these days, such social benefits balance against the personal risks involved in returning to face-to-face classes, when students are masked, physically distanced and not allowed close encounters of any kind during the day.

Of course, being able to study at home is difficult (or impossible) for too many children — especially those who depended on the breakfast and lunch programs in schools before. But finding alternative ways of delivering education and food to these students is different from claiming the only educational option is “back to regular classes for everyone” and expecting it will work in the midst of an ongoing pandemic.

Yes, there is a risk in sending kids back to in-person learning at school. But has that risk been mitigated, when provincial and federal governments are only now releasing funds (minimal at that) to make the institutional changes required? I don’t think so — we would be lucky to make upgrades to things such as school ventilation systems by January.

Have the benefits been clearly identified of returning to face-to-face classes, in comparison to other less risky forms of education? What’s more, given the explosive rate of new infections experienced elsewhere when kids return to school, how long will this situation even last, before everyone is packed home in isolation/lockdown, unprepared once again to teach or learn from home?

What about the psychological effects on children, who will obviously be anxious not only for their own health, but afraid of infecting their families, just because they went to school? What do we say to the children whose parent or grandparent gets sick (or possibly dies) as a result? “Do your homework”?

Deciding to assume risks during the COVID-19 pandemic is — and should be — a personal choice, made in the family context of the people with whom we are sharing our “bubble.” Mitigating those risks is only common sense, but coercing people to do what they don’t want to do “for the greater good of society” is a dangerous step for any government to take, especially when there are other options.

I am concerned about my neighbours’ health, and am willing to adjust how I live to decrease the chances of me hurting them. So I wear a mask in public, reduce the number of times I leave home, and limit the number of people with whom I interact.

But personal decisions like these also need to consider what real benefits are involved. Demanding personal risks for vague social benefits — or none at all — will guarantee people stop listening to the government, at whatever level, and do what clearly benefits them and their family instead.

Yet community problems require community solutions — not just everyone looking out for themselves. We have already seen how that worked, back in March and April, both to flatten the curve and to care for fellow Manitobans, spontaneously, despite being caught by surprise.

This September, there is no surprise — except that we have wasted the summer on wishful thinking, instead of preparing a pandemic response that appropriately balances risks and benefits for everyone affected.

As the acorns fall, the leaves turn colour and the birds fly south, we know that winter is coming, all too soon.

There are some things we can’t change, but we can adapt and prepare for what we know surely lies ahead.

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