Rethinking Risk

The tulips and daffodils have faded, replaced by azaleas and rhododendrons in full bloom. Rows of seedlings fill the stalls at the farmers market—herbs, tomatoes, peppers—and neighbors plant their windows boxes with flowers. The mood in NYC has finally begun to feel more hopeful. A month ago, every interaction with another human felt perilous and potentially lethal. Each day’s headlines brought more grim news about the virus’s toll; it felt as though we were in a tunnel descending into darkness, with no indication of when we might reach the bottom. On our worst days, we lost around 800 New Yorkers, or about one every two minutes. And while the economic fallout will continue for years, the death toll now hovers around 100 per day—still higher than anywhere else in the US, but a drastic improvement from the peak in April.

As summer approaches and we move toward déconfinement, we’re hearing encouraging news that the risks of viral transmission outdoors are probably much lower than previously thought. This makes running and walking outside more possible, less fraught. At the same time, the risks of transmission in an indoor space with people who are talking, shouting or singing seem to be greater than researchers presumed. As we discover more about the coronavirus, the recommendations will change. But according to this new information it appears that sitting in a park, wearing facial coverings and keeping an appropriate distance from others, might be less risky than we thought, while it could be a very long time before audiences once again feel comfortable attending live theater and music performances in enclosed spaces.

As the risks of contracting the coronavirus in various ways continue to be elucidated, I’ll be keeping an eye on how we think about the role of personal responsibility in avoiding COVID-19 and whether—and why—it might shift. For illnesses including HIV/AIDS, lung cancer, heart disease, and obesity and its associated health issues, a strong element of moralism shapes social attitudes toward the afflicted. We have a responsibility to be healthy, the thinking goes, by eating well, exercising regularly, and avoiding unnecessary threats to our well-being. One’s ability to do all of this, of course, depends on resources of time, money, and accessibility that are further shaped by gender, race, and racism.

But as researchers learn more about the transmissibility of SARS-CoV-2, we may find that people who become sick—at least those working outside of health care settings—will be held responsible for their own failure, or perceived failure, to take appropriate precautions. Already we’ve seen Health and Human Services Secretary Alex Azar blame meatpacking workers for their high rates of infection, citing the “home and social” conditions of a largely immigrant workforce. This type of move deflects responsibility from public health authorities and governmental agencies tasked with making recommendations and enforcing regulations to keep us safe, and shifts it instead onto the individual, who is supposed to stay up to date about best practices and scrupulously follow them. Some variables are more straightforward to address. It’s a relatively simple matter, for instance, to protect those around us by wearing a mask in confined spaces. Other issues are more intractable: a family of four sharing a two-bedroom apartment with one bathroom cannot easily isolate someone who’s sick. The link between morality and illness predates our current crisis; it extends back long before AIDS, obesity, or lung cancer. But as the routes of infection for COVID-19 become less random and better understood, the way we think about the infected may shift, as well.