Among the many candidates for arguments against taking action to protect our families, friends, colleagues, neighbors, communities and country from COVID, none make me angrier than the "but 99% survive" gambit. This argument is numerically illiterate (Mark Twain said “It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so”), racist, ableist, and inhumane. Let me explain.
First, it makes the false assumption that this is a strictly dichotomous or binary outcome issue: death or everything is fine. It ignores the fact that some large number of survivors appear to have 'long haul covid' with ongoing symptomatic and often disabling problems with pulmonary, cardiac, neurologic, and renal disease. We don't know whether these long haulers will be sick for months, years, or for life. We are beginning to discover that this happens not just to the old, frail, or severely ill - but also to the young and healthy and to those with minimally symptomatic infections. The percent appears to range between 20% and 40%.
Second, let's look at what 99% means. It means that overall 1 in 100 will die. What does 1 in 100 mean?
In Monopoly, if you throw any doubles three times in a row you go to jail. That's a 1 in 216 chance at the start of every turn. It isn't common - but it is common enough that Monopoly has a rule for it. Most regular Monopoly players have seen it happen, more than once or twice. Would you risk your life, or your mother's life, or your brother's life on these odds?
How about poker. Being dealt a straight happens with one in 250 deals. Would you risk your life, or your mother's life, or your brother's life on these odds?
Instead of a board or card game, think about something in your daily life that happens a couple times a year. You get to the car and realize you left your keys inside on the counter. You get to the store and realize you left the grocery list at home.
Let's play a little thought experiment to see how much you are willing gamble on these 1/200 events? What if I offer you a deal. (Cue music.) Perhaps I say I will pay off your mortgage or your student debt or buy you a car? All you have to do is agree that you will roll three dice and if they come up all 6, you die. Right there, on the spot. Or I will pay off your mortgage if you agree that I deal you 5 cards from a deck and if you get a straight, then you die. Right there, on the spot. Or that I will double your annual income after taxes, but you have to roll a pair of dice three times and if you get three doubles, you die. Right there, on the spot.
That's looking at it as an individual. What happens if we enlarge the scope and think about a group. Imagine collecting 1000 people you know: family, friends, neighbors, co-workers, and the like. Put them together in a room. The deal is that there are 1000 envelopes, 995 of which have $10,000 in them and 5 have a black X. One at a time, they draw a random envelop and open it. If they get the money, everyone cheers and they get to leave. If they get the X, they are dragged out and you hear the gunshot in the next room. How would you sell this game to your family and friends?
Third, let's recognize that the 99.5% is a fiction, an average. That abstract 1 in 200 risk of dying doesn't apply to everyone. If you are over 50, the risk is 30 x higher than if you are 25. If you are 75, the risk is 220x higher than if you are 25. If you are a person of color, the risk is four times higher than if you are white. At this point 1 in 1000 Black Americans have died of COVID-19. I won't talk about how I feel about folks who don't care if people of color or disabled people or obese people die, as long as they themselves are safe. And if you are a person of color who has hypertension and is over 60 years old, your risk might be over 9 in 10 of dying.
OK, now lets think about what happens the next time we run this experiment. Wait, what? We aren't done after we have survived COVID once? That's right. We don't yet know how effective immunity is or how long it lasts, so we may have to play some revised version of this game every 2 years or every 5 years or every 15 years! We won't know the answer to this for 5-10 years, at best.
So, whenever I see someone glibly minimizing the impact of SARS-CoV-2 with this 99.5% survival rate bullshit, I pause to ask myself: are they intentionally ignorant about what they are saying because they are too lazy to educate themselves, are they trying to rationalize what they know at some deeper level is unacceptable, or are they fully aware of the evil they are willing to accept?
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