Absolute risk is the likelihood an event will occur. Relative risk is the likelihood an event will occur in one group compared to another. In CoVID-19 terms, the absolute risk of dying from the disease is low. However, if we look at very old residents of care facilities who have multiple health problems compared with healthy, average weight 25-year-olds, the relative risk of the elderly patients dying from CoVID-19 is high.
It is impossible for an individual to confidently predict relative risk.
Death is easy to measure. You either are or you aren’t. Disease is not so easy to measure. Assessing whether an individual is likely to get CoVID-19, let alone how bad their subsequent CoVID- 19-induced adverse effects will be is much harder to measure. It is no wonder that governments have chosen universal measures based on absolute risks to attempt to contain the pandemic, rather than trying to help individuals assess their relative risks.
It is clear that governments aren’t going to create a relative risk assessment tool, even though they could if they shared data and expended intellectual capital. After all, risk calculators are not new. Cardiovascular disease calculators have been around for more than half a century. And there’s plenty of CoVID-19 data at this point. It’s just that research centered on risk assessment isn’t encouraged or funded.
In the absence of any existing matrix that can help us assess our own relative risk compared with other risky activities in which we engage, The Thinker asks you to consider your own risk against these relatively risky activities and give yourself a personalised risk score (that is assess which of these activities you have done at least once in the last month):
- Not social distancing at all.
- Not social distancing outdoors far enough, for example 6 feet/ 2metres in non-windy environments and up to 20 feet/ meters in high wind flow environments or when around infected opera singers or coughers or sneezers.
- Not social distancing indoors far enough, for example 2 feet/ <1 metre might be too close if the indoor environment has inadequate or misdirected ventilation.
- Close physical contact with too many people.
- Close physical contact with people you know have CoVID-19, e.g., family members, patients.
- Close physical contact with people you know have had contact with CoVID-19 sufferers.
- Not washing hands (and/or face) before touching your face.
- Not washing hands (and/or face) for 20 secs before touching your face.
- Only using a hand sanitizer.
- Not wearing a mask outside.
- Not wearing a mask inside in locations away from home.
- Not wearing a mask appropriate to your risk, e.g., N95 masks for high-risk clinicians.
- Not changing your mask frequently enough.
- Reusing your mask too much.
- Traveling from a high-CoVID-19 risk area.
- Traveling to a high-CoVID-19 risk area.
If we assign one point for each positive answer to the above categories, there is little doubt that you are at a higher risk of contracting CoVID-19 than someone who answers “no” to all 16 questions. Still, there is no perfect score. At this time, it is almost impossible for an individual to confidently predict their relative risk , without the assistance of an epidemiologist trained in assessing community risk. The ugly truth is that even after more than seven months of living with CoVID-19, there is still a great deal of uncertainty. This uncertainty is at the heart of CoVID-19 paranoia, misinformation and rising unrest. Learning to live with this uncertainty would be an excellent first step to coping with the situation in which we find ourselves.