What makes COVID-19 so scary for some and not others?
For some, the virus is just a part of the risk of life and nothing to be terribly concerned about; for others, the virus is terrifying and any risk of exposure is too much.
Several aspects of the pandemic foster fear, especially in people who are risk averse and uncomfortable with the unknown:
- A fraction of infected people will become desperately ill or even die, but we have no way of knowing who those people are in advance.
- No universally effective treatment is available for those who will become severely ill with COVID-19, so we don’t know if treatment will work.
- Every death is reported as if no deaths from this virus are acceptable or expected, setting the perception of risk as very high.
For me, the fear comes not so much for myself, but for my family members in the high-risk groups. From talking with friends and family, this is not uncommon. I have heard many people say, “I’m not worried about me, but I am worried about my ____.” Fill in the blank with grandmother, brother with cancer, immune-compromised friend who had a transplant, friend with a heart condition…
Young healthy people are generally less in touch with their own mortality and are more likely to feel invincible. No doubt this is partly why the cases are increasing among this group. Unless they are extremely cautious by nature, they are high risk themselves, or they live with a person that is high risk for becoming severely ill with COVID-19, many young adults feel that the risk of getting sick with COVID-19 is not high enough to avoid going out or socializing without social distancing. As the parent of two people in their early 20s, I fear for them. Each of them certainly does more in-person socializing than I do. Each of them eats out, either carry out or in restaurants, more than I do.
This fear for my children is not unique of course. Many of the parents of children in K-12 grade and of young adults attending college are afraid for their children. Indeed, the reactions I have seen from teachers and parents about whether or not it is safe for children to go back to in-person school shows how divided the reaction to the SARS-CoV-2 coronavirus is in the US.
When I am feeling especially stressed, I remind myself of these words from Michael Osterholm, PhD, MPH (Director of the Center for Infectious Disease Research and Policy, University of Minnesota):
This virus doesn’t magically jump between two people — it’s time and dose.
So, as long as we keep our distance, wear our masks, and limit contacts with those outside our “germ circle” (as I have taken to calling the people I live with and the few I see socially in person), we should be reasonably safe.
I think of it this way. My risk depends on 3 factors:
- How likely is the person outside my germ circle to be infectious with the virus that causes COVID-19?
- How exposed will I be?
- How well will my immune system fight the virus?
The only one of those I can control and know for sure is the second one. So, I control how close I get, how long I am close, and whether I wear a mask or insist the other person also wears a mask.
The same three elements define my risk of passing the virus to someone else:
- How likely is that I am asymptomatic or presymptomatic for COVID-19?
- How much will I expose the other person if I am infectious?
- How well can the other person fight the virus? (Or how at-risk is the other person?)
When deciding who to see and whether to risk an indoor encounter with or without a mask, those are the three factors that I consider.
When considering invitations to social events, I consider whether I could provide contact tracing information for each person at the event if I should later test positive for COVID-19. Can others provide my information if one of them should test positive? How many other germ circles will intersect with mine?
Is the event outside or inside? Will I be able to sit near with people inside my germ circle or will other attendees be seated with us? Can I wear my mask comfortably during the event? Will I be tempted not to wear my mask when I should be wearing it? How likely are the other attendees to be practicing social distancing and wearing masks?
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