An acceptable level of risk

Even with a vaccine, we’re going to have to live with this virus for a while. So how do we live, and not just exist?

In my last post, I talked about — at length, apparently — about why you don’t need to spend much time worrying about theoretical risks when it comes to the coronavirus. Obsessive cleaning doesn’t seem to help, and can even end up hurting by distracting people from actual problems.

But there are other types of risk that, while not significant, aren’t theoretical either. It’s a grey area of high-risk — namely, things to avoid — and theoretical risk — namely, those you shouldn’t worry about. And this is where a lot of the controversy is currently happening. Is it a serious problem if two friends who don’t live together go for a walk while wearing masks? What if they grab a bite, then sit down at a park to eat and remove their masks while seated a good distance apart? What if those two people decide to spend the night at one of their places?

And what about your reaction to any of these? Would you refuse to see someone who had gone for that walk? How about the one who had the bite at the park? Or spent the night at a friend’s place?

And who’s right? Well, let’s examine this. But I can give you a spoiler answer right now: There is no right answer. (Highlight the text to reveal the shocking answer.)

To answer this question, I’m drawing on my experience with a pandemic in my community. It’s not coronavirus. It’s HIV. This particular scourge has been a serious problem among gay men for about 40 years now. Forty very long, painful years.

I was a kid when it was at its worst; I came of age just as the first medications were becoming widespread. And that didn’t matter. To say I was paranoid about getting HIV is an understatement. Any sort of sexual contact made me petrified.

It was not a good way to live. Constant dread and fear — it’s about as fun as you might think. (Sorry to my friends who had to deal with that back in the day.)

But I got better at dealing with it. Part of it was educating myself on the risks. And not just what was risky, but what the actual risks were. Statistical risks. Getting numbers helps put things in perspective. Then a very important thing: reminding myself that I’m just not that lucky. If the odds are low enough, you’re talking lottery-winning stuff. I have yet to win a lottery.

And how can you mitigate the risk? Well, condoms are the obvious answer, but in an emergency, one can ask for post-exposure prophylactics (PEP). In essence, if you think you’ve been exposed (or even possibly exposed) to HIV, you can get a four-week course of medication. It drops your odds of getting HIV significantly.

Over the years, I went from a nervous wreck to being able to cope with the specter of this virus. Then the game changer: pre-exposure prophylactics (PrEP). With one pill a day, I can reduce my odds to near-zero. And as discussed in the last post, that means that, as long as I mitigate the risk via PrEP, HIV is not something that should freak me out.

Mindful of, yes. Panic about, no. I can now enjoy a good kiss (and even a fair number of other things) knowing my odds are very, very low. I learned what my acceptable level of risk was.

So how does this relate to coronavirus? Overall, a lot. We already know some risks aren’t worth panicking about. What about some higher-risk activities beyond grabbing your packages? (I said packages, not package. Get your mind out of the gutter.) Well, washing hands comes to mind. Social distancing, masks, avoiding large indoor gatherings — you know the drill very well by now.

How about other mitigating factors? This is where things get a bit more complicated. Getting the vaccine, when available in your area, will be the game changer, and yes, it’s safe, so get the vaccine.

Aside from that, we know that this virus is overwhelmingly an indoor problem. So if you must be inside, see about opening a window (assuming you are in no position to overhaul the place’s ventilation systems). It helps disperse aerosols, reducing — although not eliminating — the risk. Also, if you ever felt like being a bit more German, here’s your chance!

Similarly, encouraging people to meet people not in their house or bubble outside is a great way to reduce the risk. So cities ordering parks closed and banning people from going for a socially distanced walk together or even having a beer together outside is baffling (especially as some of them allowed restaurants to stay open). At the end of May, the French government did not allow Paris to open parks for some time after lockdown ended. The end result was that streets and public squares were loaded with people. Unintended consequences and all that. The city learned from this, apparently: When we went back into lockdown at the end of October, parks remained open. So during your hour-long escape from the house for exercise, sitting in a park was an option, provided you lived within a kilometre of a park.

The strange aversion to outdoor gatherings of small groups illustrates why these mitigating actions are important: because people will gather regardless. So by mitigating these factors for others, we make everyone safer (including those who choose not to partake in them). For those who’ve ever been raving or are familiar with needle exchanges, you’ll be familiar with the concept of harm reduction. That’s exactly what I (and many others) are proposing here, because harm reduction is better than nothing at all. Note that nothing eliminates the risk. For that, you’d have to end contact with all people, everywhere, in any setting. And for the vast majority of us, that just isn’t feasible. A version of harm reduction is the next best thing.

Which brings us back to the original question: What is an acceptable level of risk? Of course, there is no single answer. For me, going for a walk in on the streets with a friend is acceptable; I might even crash at a friend’s place on rare occasion. But that might be too much for you, and you might not want to have me visit yours (or even go for a walk with me, although I hope it wasn’t something I said).

Similarly, very occasionally being inside a friend’s house that’s ventilated isn’t necessarily a big deal for me. Going to a party in a storage locker is right out, no matter how well ventilated that place is. And if you’ve been to a party in a storage locker, not only will I judge and refuse to associate with you, I’ll worry about you getting the virus as well.

Whatever you decide, it’s your decision and your decision alone. My only request is that we all respect each other’s decisions. (And that includes with me: You have every right to deny me access to your home if you think I’ve been too risky.) And part of my request involves being honest with each other, and treating others with empathy, something that has been in short supply in some circles. People have every right to know what kind of risk they’re taking given your actions, so don’t lie. Conversely, when people tell you they did something you consider risky, lashing out and shaming won’t do anything except drive the problem underground. And maybe instill a false sense of superiority.

But that’s a topic for my next blog post.

(This post could be updated with current information should it be relevant.)