This short article by Dr. Aaron Carroll about Covid-19 and risk is excellent. I want to quote the entire thing here, punctuated only by increasingly emphatic YESes and THISes, but I will refrain. Somewhat.
Too many view protective measures as all or nothing: Either we do everything, or we might as well do none. That’s wrong. Instead, we need to see that all our behavior adds up.
Each decision we make to reduce risk helps. Each time we wear a mask, we’re throwing some safety on the pile. Each time we socialize outside instead of inside, we’re throwing some safety on the pile. Each time we stay six feet away instead of sitting closer together, we’re throwing some safety on the pile. Each time we wash our hands, eat apart and don’t spend time in large gatherings of people, we’re adding to the pile.
If the pile gets big enough, we as a society can keep this thing in check.
The article was published before today’s news that three PSG players — Neymar, Angel Di Maria, and Leandro Paredes — have tested positive for Covid-19 after returning from a vacation on Ibiza, but this could have easily been written in response:
To keep the pile big enough, though, we need to be willing to trade some activities for others. If people want to play on a sports team, for instance, they should consider giving something up to do so. Increasing their risk by participating in a group activity should prompt them to reduce their risk the rest of the time.
But we aren’t very good at discussing trade-offs. We want it all. We want to eat in restaurants, crowd into houses, go to work and celebrate occasions en masse.
We could choose to engage in just some of those things. We could decide to get a massage or get our nails done or have a haircut — instead of demanding that all of these and more be available to us simultaneously.
And this is just generally true:
If Americans were willing to invest in bigger-picture solutions, we could all have nicer things.
And this. This. THIS!! (sorry) THISSSSS!!!!:::
Instead of asking why we can’t do certain activities, we might consider what we’re willing to give up to do them more safely. Even better, we might even consider what we’re willing to give up so others can do them, too.
Go on, read the whole thing.
On March 10, Tomas Pueyo published a widely read and praised article called Coronavirus: Why You Must Act Now. Yesterday, in the wake of the Imperial College paper and the criticism of it, Pueyo has published a second article: Coronavirus: The Hammer and the Dance. I urge you to read it — it’s sobering yet hopeful. A summary:
Strong coronavirus measures today should only last a few weeks, there shouldn’t be a big peak of infections afterwards, and it can all be done for a reasonable cost to society, saving millions of lives along the way. If we don’t take these measures, tens of millions will be infected, many will die, along with anybody else that requires intensive care, because the healthcare system will have collapsed.
As the title indicates, Pueyo and his collaborators are suggesting an approach that combines initial aggressive action followed by a longer period of efficient vigilance. First comes the Hammer — we use aggressive measures for weeks, giving our healthcare system time to ramp up & scientists time to research the hell out of this thing and for the world’s testing capability to get up to speed.
And then we Dance.
If you hammer the coronavirus, within a few weeks you’ve controlled it and you’re in much better shape to address it. Now comes the longer-term effort to keep this virus contained until there’s a vaccine.
This is probably the single biggest, most important mistake people make when thinking about this stage: they think it will keep them home for months. This is not the case at all. In fact, it is likely that our lives will go back to close to normal.
But, here’s how the Dance works:
How come South Korea, Singapore, Taiwan and Japan have had cases for a long time, in the case of South Korea thousands of them, and yet they’re not locked down home?
In this video, the South Korea Foreign Minister explains how her country did it. It was pretty simple: efficient testing, efficient tracing, travel bans, efficient isolating and efficient quarantining.
That way, most people aren’t locked down, just those who need to be — the sick, the people who have been with those who have gotten sick, etc. Most people can go back to work, back to fairly normal routines.
I call the months-long period between the Hammer and a vaccine the Dance because it won’t be a period during which measures are always the same harsh ones. Some regions will see outbreaks again, others won’t for long periods of time. Depending on how cases evolve, we will need to tighten up social distancing measures or we will be able to release them. That is the dance of R: a dance of measures between getting our lives back on track and spreading the disease, one of economy vs. healthcare.
This piece in the Atlantic, This Is How We Can Beat the Coronavirus by Aaron E. Carroll & Ashish Jha, advocates for essentially the same approach.
We can create a third path. We can decide to meet this challenge head on. It is absolutely within our capacity to do so. We could develop tests that are fast, reliable, and ubiquitous. If we screen everyone, and do so regularly, we can let most people return to a more normal life. We can reopen schools and places where people gather. If we can be assured that the people who congregate aren’t infectious, they can socialize.
We can build health-care facilities that do rapid screening and care for people who are infected, apart from those who are not. This will prevent transmission from one sick person to another in hospitals and other healthcare facilities. We can even commit to housing infected people apart from their healthy family members, to prevent transmission in households.
From pediatrics professor Aaron Carroll, a list of guidelines for sensible & healthy eating.
1. Get as much of your nutrition as possible from a variety of completely unprocessed foods. These include fruits and vegetables. But they also include meat, fish, poultry and eggs that haven’t been processed. In other words, try to buy food that hasn’t been cooked, prepared or altered in any way. Brown rice over white rice. Whole grains over refined grains. You’re far better off eating two apples than drinking the same 27 grams of sugar in an eight-ounce glass of apple juice.
What’s more interesting than the guidelines is the admission up front that they’re not supported by rigorous science…and neither is nutrition in general. In the absence of science, “everything in moderation” seems to be the recommended course. (via @jimray)
Update: Julia Belluz recently interviewed Surgeon General1 Vivek Murthy for Vox and within, Murthy shares his four basic rules for health:
One is to eat healthy. I tend to avoid salt, added sugar, and processed foods whenever possible, and try to eat fresh fruits and vegetables as part of all my meals whenever possible.
Second is to stay physically active. That means not just going to gym but incorporating activity into whatever I do, whether that’s taking the stairs or converting sitting meetings to walking meetings whenever possible.
Third is making sure I’m focusing on my emotional and mental well-being. For me, an important part of that is the meditation practice that I do every morning. It’s a chance for me to center myself, a chance for me to remember who I want to be every day.
The fourth thing is I remind myself to stay away from toxic substances like tobacco and drugs.
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