Informed Caution: Control Your Response to COVID-19

 
“Not taking risks one doesn’t understand is often the best form of risk management.”
— Raghuram G. Rajan
 
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Update: 4/11/20

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Frontline Responders Fund | Check out Flexport.org

Currently, Flexport.org is focusing all our resources on getting critical supplies to frontline responders combating COVID-19. 

Spotify COVID-19 Music Relief

Michael Osterholm, Ph.D.: COVID-19—Lessons learned, challenges ahead, and reasons for optimism and concern

COVID-19 for kids with Olivia Attia

Paul Conti, M.D.: The psychological toll of a pandemic, and the societal problems it has highlighted

I believe this conversation with Paul to be incredibly insightful, and we should consider many of the points made with serious reflection. Now roughly a month into the shelter in place order, I’ve seen a sense of paranoia and distrust begin to creep in. That’s the scary thing about the virus’ it attacks what it means to be human, and we look at our neighbors as possible threats. We can’t let old programming rip apart our society more than what this virus has; maybe its exposed cracks, but we can start filling those cracks. 

Update: 3/21/20

Here is a great video outlining the situation currently - this video was posted 3/19/20

Let's take a look at risk and how we can react to events that are outside of our control. First, the underlying panic related to COVID-19 will have farther reaching impacts than we all realize. For this reason alone, I think avoiding the televised news coverage of this virus is useful to limit the amount of panic-inducing information. 

I hope this post will put context around a complex issue to allow myself to react appropriately. The point is that the situation is developing, and we need to tune ourselves to the strongest signal, not the first one that pings back. I reason that many of the thoughtful people I follow have yet to weigh in with any concrete evidence. They have access to experts but have not given any stark guidelines on what is the optimal path. Think of it this way. We're getting the first outlines on an image we are trying to get into focus.

 

Here some of the actionable advice I've summarized:

  • Pay attention to high-quality sources of information (surprisingly, twitter is great for curating a COVID-19 knowledge community that updates in real-time. I found this list to be useful.)

  • Limit large social gathers and travel plans as necessary. Upon further look, some experts recommend total isolation.

    • For further guidance here, understand the following:

      • Are you in a community that is seeing a larger number of cases?

      • Are you part of a higher risk group? Smoker, type 1 and 2 diabetes, autoimmune deficiency - not comprehensive.

  • Continue any wellness routines you use; eat healthily, get enough sleep, stay hydrated, wash hands, etc.

 

Beyond this list, what each of us can do is limited. Ruminating on projected harm will limit your ability to execute in your daily life. Here is a question I ask myself: Why ruminate on what could be? Why not do what I can have an impact on today? 

This question is broadly applicable, but when society seems to have its attention captivated by this novel disease, I think it highlights a necessary skill we can all exercise more often. The lesson is that we get sucked into the possibilities before us that are outside of our control. 

We get distracted by the ebb and flow of the stock market and gush when you are making significant gains but panic when it dives. We stand proud when we get a promotion, but blame circumstances when we get passed over for a promotion. 

I think the best antidote is pausing and absorbing the best information available, but don't make a hasty decision because it seems to flow in that direction. Sometimes it's best to be a rock in the stream. Let things flow around and past you, before you pick which direction to go. Allow yourself to make the decision, not those of the crowd. 

So stop, breathe, and be cautious but don't panic. Control your response to the situation, not society at large. Take the necessary precautions for yourself and your loved ones.

 

After putting in the effort to think about COVID-19, my concerns have shifted from the overall harm the virus will cause and to the impact that will come in the form of stressing the societal infrastructure in place. 

The first impact will be in hospitals will be taxed to their limit, and with no vaccine for the foreseeable future, what can be done for those infected is limited. Beyond that, if businesses begin to mandate shutdowns or work from home, we will see slowing down of the public transport and service-related industries. We've seen the impact of this already with the closure of large social gatherings impacting smaller businesses. 

I believe it's up to each person to make the judgment call with a situation that is continuing to develop at the rate that it is. I hope that this is ultimately wrong and seen as an overreaction in three months, but it could quickly get worse. The asymmetrical risk here can not be understated; what seems ok now could be disastrous in a month. In this scenario, I think its good to be prepared and not need it than need it and not be prepared. 

Below you'll find high-quality information from sources that I trust and have collected here. While I don't intend to be a one-stop source, I do think providing access to information that cuts through the noise is why I've done the work here.

Read what you can and make the decision that feels right for you. I'm erring on the side of caution. While where I live has only seen a few cases thus far, I will adjust if events unfold differently, for now, I'll on carry business as usual.

Links I found useful:

Coronavirus: Why You Must Act Now

#97 – Peter Hotez, M.D., Ph.D.: COVID-19: transmissibility, vaccines, risk reduction, and treatment

#98 – Peter Attia, M.D. and Paul Grewal, M.D.: Coronavirus (COVID-19) FAQ

Why outbreaks like coronavirus spread exponentially, and how to “flatten the curve”

LJI scientists identify potential targets for immune responses to novel coronavirus

COVID Q&A Video #1, #2, #3, #4 - Peter Attia

Coronavirus: The Black Swan of 2020

Sumant Ramachandra - President of Baxter on Linkedin

Coronavirus can travel twice as far as official 'safe distance', study says

How Public Health Policies Saved Citizens in St. Louis During the 1918 Flu Pandemic

Coronavirus Disease (COVID-19) (Overview)

Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU)

One Doctor's Life on the Coronavirus Front Lines. 'If We Fail, What Happens to You All?' (To get past paywall try this http://archive.vn/)

JRE #1439 - MICHAEL OSTERHOLM

Michael Osterholm is an internationally recognized expert in infectious disease epidemiology. He is Regents Professor, McKnight Presidential Endowed Chair in Public Health, the director of the Center for Infectious Disease Research and Policy (CIDRAP), Distinguished Teaching Professor in the Division of Environmental Health Sciences, School of Public Health, a professor in the Technological Leadership Institute, College of Science and Engineering, and an adjunct professor in the Medical School, all at the University of Minnesota. Look for his book "Deadliest Enemy: Our War Against Deadly Germs" for more info.

Why it's better to panic early: Nassim Nicholas Taleb & Yaneer Bar-Yam

Health, ScienceErich WenzelRisk, COVID-19, Asymmetrical Risk, Heal, Public Health, Assessment, Risk Assessment, Informed Caution, Control Your Response, CoronavirusComment