Let’s talk about risk

It’s not new. We quite often need to determine what we will do given that there’s the possibility of a negative or improved outcome as a result. And there’s generally someone on the box, expert or otherwise, to explain it, put it into context and to provide some yardstick which might make it easier to comprehend.

Some years ago my GP recommended that I take a statin because that would reduce the risk that I’d have a heart attack. It would do so by reducing the level of bad cholesterol in my blood and since such cholesterol is what clogs up arteries and since the level in my blood was rather high such a recommendation made sense. However because the reduction in risk seemed modest and that came with some side effects I chose not to take it.

As readers of this blog will be aware I was lucky. I came close to a heart attack and had a developing blockage cleared just in time at, it’s worth noting, great expense to the NHS. I now take a statin, I’ve modified my diet to eliminate a lot of sat fat and the level of bad cholesterol in my blood is now at an acceptable level.

Insurance if course is about mitigating risk. I pay a small premium every year to avoid a possible big expense. The fact that I pay out more over a period of time doesn’t bother me because I know that I have or will avoid the one off expense which I could not afford.

I’m making other risk based decisions all the time. Some explicitly, some rationally, some not. For example I used to wear a cycle helmet when using my road bike but not my town bike. But I’ve thought again and now I wear it all the time.

Today the big decision is about Covid-19: is what I’m going to do risky or not? That would seem fairly straight forward but actually it’s not.

It’s not straight forward because what might seem to be a simple trade off at the personal level overlooks the risk at the societal level because the result of many people individually accepting a small risk of infection results in a significant risk to society because the infection gets passed on.

It’s not the same as my statin decision. It didn’t matter that I got it wrong, except for the drain on the NHS, because my cholesterol problem wasn’t infectious. Covid is.

Let’s just explain it with a simple example and some silly numbers.

A bunch of people think they, individually, might go to a local beauty spot, like Barnard Castle for example, and each one reckons that there’s a 1% chance of being infected with Covid which they think is no big deal so they go. That’s a perfectly rational, albeit high risk, way of thinking. However if we step back and consider that maybe 100 people make the same decision in the same way and as a result one of them does get infected. That’s bad news for him or her but it’s much worse news for society because infection has been picked up and will now been passed on spreading Covid and not containing it as the rules are framed to do.

Neil Ferguson who resigned from the government’s scientific advisory group SAGE got it right in a radio interview this week. He rightly resigned in May when he violated the lockdown rules. He explained this week that he had made a mistake and took a decision based on his own individual risk assessment. He said that that was wrong because the rules were in place to reduce societal risk and that he should have realised that and not made such a personal decision.

Good for him and maybe the man who went to Barnard Castle could have made a similar admission and apology. And for that matter so could the chap who’s just been to Greece by way of Bulgaria just to confirm that his holiday home was fit to be rented out this summer.

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