An updated Covid risk calculus

Covid is still very much with us, and will remain a significant public health problem for the foreseeable future. However, the Covid landscape has changed substantially over the nearly 4 years since it arrived. I recently spent some time reviewing and updating my assessment of my risk and my process for deciding what I am comfortable doing.  

I will start with my understanding of my personal risks, which I divide into three categories: acute or short-term risks, chronic risk related to long Covid (PASC), and long-term risks from Covid’s impact on other disease processes.

Successful safe socializing in the era of SARS-CoV-2

I was invited to a New Year's Eve Day gathering of some friends who have met annually for a couple decades or more, but who had not met during the pandemic. Our group number 25-30, all in our 70s now. The invitation said masks were 'welcome' but said nothing more about precautions. I was thrilled and excited, but also puzzled at the lack of mention of testing.

Covid and RAT testing: Timing is everything!

A friend recently shared online that he was at Day Seven of a flu that had been ‘kicking my butt all week’. With fever, sweats, cough, fatigue, muscle aches. He’s a smart and responsible guy and had RAT-tested himself twice at the onset of his symptoms and assumed because his two RATs were negative and his symptoms were consistent with Influenza A which was known to be present in his areas, it meant it he didn’t have Covid.

I suggested he retest himself (the explanation is below) and he reported a definite and nearly immediate positive:


Using the CRAP test

I spend a great deal of time these days keeping up with the tsunami of information about SARS-CoV-2 (the virus) and COVID-19 (the illness), with a goal of sharing valid and useful information with others. I've taken to suggesting that people identify crap with the CRAP test:
Currency - the timeliness of the information:
● When was the information published or last updated?
● Have newer articles been published on your topic?

Responding to the 'but 99% survive' argument

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.

My proposed treatment for our COVID-19 pandemic

The impact of the COVID-19 pandemic across multiple spheres of American society is a novel event. Some have used the term black swan, Taleb's term for an event that can't be anticipated because it is outside the realm of experience. I prefer to think of it as a gray rhino, Michele Wucker's term for the big and obvious thing coming at you that you don't want to acknowledge. I think of this as a threat to our society writ large, not just as a threat to our economy or even just to public health. I think those narrow framings guarantee inadequate analysis and response.