Did you wake up on your last birthday and think: “Oh good, my risk of death just went up by 9%”? Probably not, though it is statistically true. Before Covid-19 filled our news feeds and our conversations with awful stories of bereavement, and stern warnings to stay indoors and save lives, we tended to think about our mortality only when something brought it starkly into view: a serious illness or accident, or the loss of a loved one.
For most of us, this is entirely sensible. In developed countries, healthy people are very unlikely to die before retirement age. If you’re under 60, the chance of somebody your age dying in the next year is less than one in a hundred, and that includes the skydivers, the trawlermen, and those with serious health conditions. For women, your cohort won’t hit the 1% mortality rate till your 70th birthday. In your twenties, the risk of not reaching another birthday is less than one in a thousand, even including the idiots who drive too fast, take illegal drugs, and fall off things while taking a final selfie.
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But that was pre-Covid-19. Now, young nurses are dying horrible deaths, and daily briefings from the Government come adorned with hazard warning signs: Stay Home. Protect the NHS. Save Lives. The majority of Britons are not only happy to comply with lockdown rules, but are in favour of continuing them for the foreseeable future.
According to an Ipsos Mori opinion poll at the beginning of May, around two-thirds of UK residents would not feel comfortable using public transport or going to bars or restaurants, even if the government said they could. More than a third are not keen to send their children back to school, and nearly a third don’t want to go back to work. It’s not easy to go from existential terror to a balanced approach to personal risk.
There’s still too much we don’t know about coronavirus. But we now have enough UK, as well as international, data to see some patterns emerge. For example, the general rule that average risk of death doubles every eight years after childhood is mirrored by the danger to people who catch Covid-19. Your chance of dying if infected also doubles every eight years.
Professor David Spiegelhalter, of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, describes catching Covid-19 as “packing what amounts to your current annual risk into a few weeks”: whatever your risk of dying in the next 12 months, you add the same risk again as a one-off event.
You could think of this in the same way as going skydiving, which brings a 1 in 100,000 chance of dying with every jump. A woman in her twenties could double her annual risk with three jumps. For a man in his forties, it’s 20-odd jumps. If you land safely every time, the risk is over and you are back to your normal, underlying risk levels.
“This is an additional risk, of course,” says Spiegelhalter, “and certainly does not mean that these deaths would have occurred anyway in the following year (although some would have).”
If you were not worried about the prospect of your own death as you cut your last birthday cake, because life experience or familiarity with statistics told you that few people like you would die before you got to do this again, you should also view Covid-19 as a minor risk to you, personally. If you are not in a higher risk category, doubling a very small chance still gives you a very small chance.
But there is much more to risk than mathematics. We play roulette, but not Russian Roulette, because the stakes are infinitely higher. Existential, in fact.
We wear seat belts, though we hope we’ll never need one to save our life. We observe speed limits while driving, more or less, because we know that breaking them could endanger unknown others more than ourselves. We view the morality of taking risks that affect others, like unwittingly hitting a frailer person with a Volvo or a virus, more severely than taking risks on our own behalf.
Personal willingness to accept risks varies. As a motorcyclist, I am not happy to say that an average 100 mile journey gives me a 12 in a million risk of dying. Though I comfort myself by thinking that as I am neither an under-experienced moped rider approaching a junction, nor an over-confident middle-aged man taking a powerful sports bike around a left-hand bend, I have avoided the two riskiest situations. In a car, I would be 100 times safer. Nevertheless, I continue to ride a motorcycle.
You may be more of a Volvo driver than a motorcyclist, willing to forego pleasure, freedom and opportunity in return for enhanced safety. To you, one Covid-19 bullet in a chamber of 1,000 holes may still sound too many. Comfort yourself by comparing that risk to others you take all the time without worrying. Like riding a motorcycle for 10,000 miles, doing 100 skydiving jumps, or living another year.
It’s also true that in a pandemic we are often acting to reduce risks to others more than to ourselves. By staying at home we have been slowing the rate of infection, and keeping demand for medical treatment below a threshold the NHS could manage. Just as we adhere to 20mph speed limits for the benefit of children and cyclists, we have (mostly) been willing to endure lockdown to help our more susceptible neighbours and relatives avoid serious illness.
But we don’t impose 20mph speed limits on motorways. Reducing all transport speed that drastically would save more lives, but impose vast costs in human time, spent on motorways instead of doing all the things that make life worthwhile. As a consequence, economic costs would make anything involving road transport far more expensive; congestion and pollution would rise as vehicles crawled along; civilisation itself would slow down.
We don’t close down the whole road transport network in order to save a few thousand lives every year. We recognise, as a society and as individuals, that the benefits of road transport are proportional to the risks. We try to make it safer, but we accept a degree of risk for ourselves and others whenever we travel by road.
Coronavirus has already claimed ten times as many lives as the roads do each year in Britain. If current measures work well, the total death toll may be similar to that of seasonal flu. If not, it may be closer to heart disease, still the leading cause of death in the UK, at one in ten of all deaths each year.
Nevertheless, we would have done better to talk about Covid-19 more like road accidents, as a risk that can’t be eliminated altogether, but can be mitigated. Instead, the Government invoked the language of existential threat, in the face of which no measure is too great. Now, weighing the risks of resuming more normal life against the risks of continuing in suspended animation, they are struggling to coax a fearful population out of lockdown.
It’s easy to turn on the tap of fear as a motivational force, and much harder to switch it off in the absence of concrete reassurance. But the Government could have foreseen that we would need to resume more normal activity before any medical breakthrough could reduce the risk of Covid-19 to zero. Why did they not use the language of risk to communicate their policies, and the thinking behind them?
Risk is a useful and much misused idea.
We tend to view it as a symptom of the terrifying uncertainty of the world, instead of as a way to analyse, even quantify, that uncertainty, in order to decide and act. It’s most often invoked against taking actions with unknown consequences, which in practice means any new or experimental action. We tend to see it as a state of existence beyond our control, something that happens to us rather than an action we decide to take — being At Risk, not taking a risk.
We would do better to see risk as an unavoidable aspect of life, often an opportunity to explore the unknown and find new possibilities. Without our forebears taking physical risks we would not have aeroplanes (now the safest way to travel), or vaccination (which we hope will be our way out of the coronavirus trap).
Instead of trying to frighten us all into staying at home, the Government should have harnessed our altruism, inviting us to join a grown-up conversation about risk. That would have left the door open to invite us all, now, to weigh the risk of Covid-19 against the lost opportunities of continuing to hide from the world.
For some, that will mean personally deciding to take risks in order to get society moving again. For most, those additional risks will be small, probably less than a daily bacon sandwich habit, or motorcycling to work to avoid the train.
For all of us, it means accepting that to be human is to live in a risky world, where we must act without perfect knowledge of the consequences of our actions. Mathematics can help us put our fears in perspective, but the only thing that will let us take control of risk is courage.
Human beings constantly take risks for causes beyond themselves, whether that’s protecting the weak or trying to achieve great things. We call those people heroes. Today, we urgently need to rediscover our appetite for heroism, for taking calculated risks, and for valuing something higher than staying safe.