On COVID-19: Urging A Certain Kind Of Urgency

I know you’re overwhelmed. But I have to talk about COVID-19, aka coronavirus. It would be irresponsible not to.

Humans are extraordinarily bad at assessing risk. We have hundreds of cognitive biases that make us both overreact and under-react to danger. We’re more likely to be killed by a falling icicle than by a shark, but we’re way more afraid of sharks.

Usually, our inability to find the correct balance between calm and crisis isn’t life-threatening. But this is exactly the kind of situation where we need to be disciplined about risk assessment. We can't afford not to be.

Let’s be clear: No matter how severe the situation, we should not be freaking out. Here is a useful, two-question algorithm to determine whether you should freak out:

1. Do I have the data I need to freak out? Maybe, but... 2. Will freaking out help? No, it will not.

What we must be doing, however, is following the recommendations of experts in terms of the specific actions we can take as individuals to slow the spread of the virus.



What we must be doing is taking action before it seems necessary.

What we must be doing is treating the situation with the seriousness and the urgency it requires.

As I write this, we've passed 128,000 confirmed cases worldwide, with more than 68,000 recovered and more than 4,700 deaths. The number of actual cases is certainly much higher. The virus is in 111 countries or regions.

So what? I'm sure we've all seen posts comparing those numbers to the number of people who get the flu every year, or who die from cancer or diabetes. But the critical thing to be looking at is not the current number of cases. It's the transmission rate.

In the case of COVID-19, the transmission rate, or R0, is estimated to be around two to three.This means that every person infected is likely to infect two to three additional people.

And that means we're dealing with an exponential curve.

If transmission of COVID-19 continues exponentially, we could be looking at infections in the tens of millions, hundreds of millions, or more. Read Our World In Data's summary of this growth curve here.

That exponential curve is why whole countries have shut down. It's why airline capacity and stock markets are plunging. It’s why everything has been canceled. Not because 4,700 people have died, but because of the trajectory of the virus.

Please be aware that it is highly uncertain whether the transmission rate will continue to be exponential. But gathering people in public places makes it much more likely to continue on that path.

“OK,” you may be thinking, “but even if millions get infected, the vast majority only experience mild symptoms, right?”

Your calculation cannot be based on whether you yourself are in a high-risk group.

The more people who are infected, the more people will get infected.

And no matter what the fatality rate is, the more people who get infected, the more people will die.

Also, the more people who get infected, the greater the risk that we exceed the capacity of our healthcare system.

Caring for the critically ill requires expensive equipment that is limited and that we can’t easily get more of. The more people who get infected at the same time, the higher the likelihood that our healthcare system gets overloaded.

If our healthcare system gets overloaded, both the infection rate and the fatality rate will skyrocket.

So what we need to do is “flatten the curve”: spread out the infections so they happen over time instead of all at once. This explainer by New Zealand Dr. Siouxsie Wiles is essential reading.

To do that, we need to slow down the transmission rate, limiting the number of people who get infected at any one time, thereby avoiding overloading our healthcare system.

How do we do that? This is where we come in: Ordinary citizens, living our lives. This is where individual actions make a huge difference. These actions work, even if they seem overly simple on the one hand or overly dramatic on the other:

  • Wash your hands for the full 20 seconds — or, as the city of Round Rock, Texas, says — "like you just got done slicing jalapenos for a batch of nachos and you need to take your contacts out."
  • TRY to keep your hands away from your face. I know. It's super-hard. Try.
  • Practice social distancing. Don’t shake hands. Don’t kiss and hug. Stay six feet apart from each other. Do this even if you feel silly.
  • Practice safe social support. While you don’t want to be a physical vector to the elderly or immunocompromised, make sure you’re offering emotional support. Call. Skype. Make sure they can get groceries and medicines delivered.
  • Stay away from crowds. Whether your event is canceled or not, whether your school is closed or not, whether you feel safe or not.

Here is the thing to understand about flattening the curve.

It only works if we take necessary measures before they seem necessary.

And if it works, people will think we overreacted. We have to be willing to look like we overreacted.

As Tomas Pueyo eloquently argued this week, lives depend on it.

Boma Global is hosting a free virtual conference on COVID-19 on Monday, March 23rd; details here.

Stay safe out there, everybody.

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