Wednesday, May 13, 2020

Going Out, Coming In


I have a foot in both worlds during the C19 shutdown.  I don’t think that gives me any special insight into what we should be doing, but I do understand the contrasting impressions.  Most of my days, I don’t have to come in contact with anyone but my wife.  If I do speak with someone, it is outdoors and fairly distant.  I like grocery shopping and used to go 3-4 times a week, varying where I went because of what they carried and where I felt like driving.  Just an old guy dropping by to pick up a few things and maybe run another errand on the way, either before or after my daily walk. With risk of contagion, I make some adjustments and reduce my risk significantly.  I do not go to the grocery stores in the adjoining towns which have a higher number of cases, and avoiding going indoors anywhere but home at all. I have considerable control over my movements, and because of a very few decisions, go about my day with little sense of risk.  Once the adjustments are made, I am walking around in what feels like a risk-free world. If the risk increases, I can shop even farther out, and even less often. 

I imagine myself in the shoes of those who need money and can’t go to their job in that situation.  It feels like no danger, and even if that changes, I can likely make some adjustments to reduce risk.  So why the hell can’t I go to work? I admit I have less sympathy for the other parts of that, of people railing against masks and cloves and standing farther apart.  Even if masks turn out to be completely useless, it’s a frigging mask, Jake. If you think that’s a big deal, it’s because you are making it a big deal in order to prove…something. There are tourism jobs related to fishing, golfing, or other entertainments and I get that those people care a great deal about things opening up. It’s their work. But I don’t think it is that big a deal that people can’t participate in hobbies.  That the restrictions seem illogical or inconsistent is annoying, but not tragic.

Most of my income is independent of my current work status, so I don’t feel that pressure as others do.  On the other hand, that is a product of a lifetime of decisions, which includes never having had much of a salary as a tradeoff for having stable health benefits for five children and predictable hours to be with them.  I like stability and traded a lot of cash for it over the years.

When I go into the hospital, all this reverses.  We have little control of what risks come in the door, and have to simply adjust to whatever happens.  We know very well that each individual mask or recleaning of doorknobs or moment of distancing has only a negligible effect on overall safety. However, because of the concentration of dangers, those negligible effects add up. We are indoors.  There is a constant HVAC system, with a vent blowing pretty directly on us all day. There are a lot of people here, each of whom has a range of further contacts outside of here.  The other agencies we deal with are in largely the same boat, assessing and reassessing risk throughout the day. If ten people in your town test positive that may not change your impression much.  If one person in your building tests positive and they ain’t leavin’, thus continuing to breathe into that system, that’s a vulnerability everyone is aware of.  There is also the arithmetic.  If it’s a staff member who tests positive, their cumulative effect was the few days of contagion before you found out about it, and then you send them home.  A week’s work, 40 hours, is about the max exposure.  But a patient comes in and breathes more than four times that long in a week, and it doesn’t necessarily stop there.  They breathe 168 hrs/week. Some of them aren’t careful, which is how they became infected to begin with. 
 
Health care workers get focused on what is coming in to their environment, and spend a lot of energy in reducing the risk from everything new.  They can’t drive farther out to get lunch. Lunch comes to them and they don’t know who made it. They look at the world outside their hospital or nursing home and know that a lot of the people who make bad decisions are coming in to make bad decisions right next to them, in addition to some people with inexplicable bad luck, which reminds us that bad things can happen to you even if you do everything right. ER workers don’t have to watch the news to encounter dangerous people making bad decisions.

Regardless of what the actual dangers are, this would cause those who can deal with risk by going farther out to underestimate the overall danger to society, and those trapped by what is coming in to overestimate it, wouldn’t you think? We don’t like to think that feelings and impressions rule us, but I am aware of different impressions in my different worlds.

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