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Putting the Risk of Covid-19 in Perspective Putting the Risk of Covid-19 in Perspective
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How dangerous is it to live in New York City during this pandemic? How much safer is it in other places? Is the risk of dying from Covid-19 comparable to driving to work every day, skydiving or being a soldier in a war?How dangerous is it to live in New York City during this pandemic? How much safer is it in other places? Is the risk of dying from Covid-19 comparable to driving to work every day, skydiving or being a soldier in a war?
We are awash in statistics about Covid-19: number of deaths, fatality rates, contagion rates. But what does this all mean in terms of personal risk?We are awash in statistics about Covid-19: number of deaths, fatality rates, contagion rates. But what does this all mean in terms of personal risk?
In 2011, another invisible danger, radiation, sowed fear and confusion in Japan, where I served as the U.S. Ambassador’s science adviser after the nuclear meltdown at Fukushima Daiichi. Then, as now, the news was full of scary numbers. And then, as now, there wasn’t nearly enough context for people to make sense of them, much less act upon them.In 2011, another invisible danger, radiation, sowed fear and confusion in Japan, where I served as the U.S. Ambassador’s science adviser after the nuclear meltdown at Fukushima Daiichi. Then, as now, the news was full of scary numbers. And then, as now, there wasn’t nearly enough context for people to make sense of them, much less act upon them.
Fortunately, there are tools for assessing risk that can help us put the daily torrent of numbers in perspective. I found the best way to communicate the level of risk was to put it in terms that allowed easier comparison to other, more familiar, risks. One could then talk, for instance, about how dangerous living in a contaminated city was compared to smoking a pack of cigarettes a day.Fortunately, there are tools for assessing risk that can help us put the daily torrent of numbers in perspective. I found the best way to communicate the level of risk was to put it in terms that allowed easier comparison to other, more familiar, risks. One could then talk, for instance, about how dangerous living in a contaminated city was compared to smoking a pack of cigarettes a day.
A useful way to understand risks is by comparing them with what is called a “micromort,” which measures a one-in-a-million chance of dying. Note that we are considering only fatality risks here, not the risk of growing sick from coronavirus, or morbidity. The micromort allows one to easily compare the risk of dying from skydiving, for example (7 micromorts per jump), or going under general anesthesia in the United States (5 micromorts), to that of giving birth in the United States (210 micromorts).A useful way to understand risks is by comparing them with what is called a “micromort,” which measures a one-in-a-million chance of dying. Note that we are considering only fatality risks here, not the risk of growing sick from coronavirus, or morbidity. The micromort allows one to easily compare the risk of dying from skydiving, for example (7 micromorts per jump), or going under general anesthesia in the United States (5 micromorts), to that of giving birth in the United States (210 micromorts).
The average American endures about one micromort of risk per day, or one in a million chance of dying, from nonnatural causes, such as being electrocuted, dying in a car wreck or being struck by an asteroid (the list is long).The average American endures about one micromort of risk per day, or one in a million chance of dying, from nonnatural causes, such as being electrocuted, dying in a car wreck or being struck by an asteroid (the list is long).
Let’s apply this concept to Covid-19.Let’s apply this concept to Covid-19.
Using data from the Centers for Disease Control and Prevention, New York City experienced approximately 24,000 excess deaths from March 15 to May 9, when the pandemic was peaking. That’s 24,000 more deaths than would have normally occurred during the same time period in previous years, without this pandemic. This statistic is considered a more accurate estimate of the overall mortality risk related to Covid-19 than using the reported number of deaths resulting from confirmed cases, since it captures indirect deaths associated with Covid-19 (because of an overwhelmed health care system, for example) as well as the deaths caused by the virus itself.Using data from the Centers for Disease Control and Prevention, New York City experienced approximately 24,000 excess deaths from March 15 to May 9, when the pandemic was peaking. That’s 24,000 more deaths than would have normally occurred during the same time period in previous years, without this pandemic. This statistic is considered a more accurate estimate of the overall mortality risk related to Covid-19 than using the reported number of deaths resulting from confirmed cases, since it captures indirect deaths associated with Covid-19 (because of an overwhelmed health care system, for example) as well as the deaths caused by the virus itself.
Converting this to micromort language, an individual living in New York City has experienced roughly 50 additional micromorts of risk per day because of Covid-19. That means you were roughly twice as likely to die as you would have been if you were serving in the U.S. armed forces in Afghanistan throughout 2010, a particularly deadly year.Converting this to micromort language, an individual living in New York City has experienced roughly 50 additional micromorts of risk per day because of Covid-19. That means you were roughly twice as likely to die as you would have been if you were serving in the U.S. armed forces in Afghanistan throughout 2010, a particularly deadly year.
The quality of data varies from state and state, and continues to be updated. But for comparison, using the C.D.C. data, Michigan had approximately 6,200 excess deaths during this same time period. That is roughly the same risk of dying as driving a motorcycle 44 miles every day (11 micromorts per day). Living in Maryland during this time would be roughly as risky as doing one skydiving jump a day for that duration (7 micromorts per jump).The quality of data varies from state and state, and continues to be updated. But for comparison, using the C.D.C. data, Michigan had approximately 6,200 excess deaths during this same time period. That is roughly the same risk of dying as driving a motorcycle 44 miles every day (11 micromorts per day). Living in Maryland during this time would be roughly as risky as doing one skydiving jump a day for that duration (7 micromorts per jump).
Now, if you’re infected with the virus, your odds of dying jump dramatically. Estimates of the fatality rate vary as doctors continue to learn more about this virus and how to care for people sickened by it, but let’s assume it is 1 percent for sake of this discussion. That translates into 10,000 micromorts. That risk is comparable to your chances of dying on a climb in the Himalayas if you go above 26,000 feet, where the tallest peaks, such as Everest and K2, stand (using climbing data taken between 1990 and 2006).Now, if you’re infected with the virus, your odds of dying jump dramatically. Estimates of the fatality rate vary as doctors continue to learn more about this virus and how to care for people sickened by it, but let’s assume it is 1 percent for sake of this discussion. That translates into 10,000 micromorts. That risk is comparable to your chances of dying on a climb in the Himalayas if you go above 26,000 feet, where the tallest peaks, such as Everest and K2, stand (using climbing data taken between 1990 and 2006).
Updated June 24, 2020 Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
But that risk estimate is for the entire population, with an average age of 38. If you happen to be older, the fatality rate can be as much as 10 times higher, which is just slightly less than flying four Royal Air Force bombing missions over Germany during World War II.But that risk estimate is for the entire population, with an average age of 38. If you happen to be older, the fatality rate can be as much as 10 times higher, which is just slightly less than flying four Royal Air Force bombing missions over Germany during World War II.
The acceptability of risk depends, of course, on one’s own attitudes and proclivity to take risks, and whether one has a choice in the matter. Unlike skydiving or hang-gliding, in which the risk is limited to the person making the leap, with Covid-19 the actions of the individual change the risk levels of everyone in the community.The acceptability of risk depends, of course, on one’s own attitudes and proclivity to take risks, and whether one has a choice in the matter. Unlike skydiving or hang-gliding, in which the risk is limited to the person making the leap, with Covid-19 the actions of the individual change the risk levels of everyone in the community.
So while there are many thrill seekers who happily jump out of planes, they might think twice about forcing their frail grandmothers, or their neighbors, to jump with them.So while there are many thrill seekers who happily jump out of planes, they might think twice about forcing their frail grandmothers, or their neighbors, to jump with them.
David Roberts (@DRobertsNYC), a former academic physicist, served as the U.S. Ambassador’s science adviser in Tokyo during the post-Fukushima recovery. Micromort examples came from “The Norm Chronicles” by Michael Blastland and David Spiegelhalter (2014).David Roberts (@DRobertsNYC), a former academic physicist, served as the U.S. Ambassador’s science adviser in Tokyo during the post-Fukushima recovery. Micromort examples came from “The Norm Chronicles” by Michael Blastland and David Spiegelhalter (2014).