How worried should you be of contracting COVID-19 after being fully vaccinated?
How worried should you be of contracting COVID-19 after being fully vaccinated, spreading it to others, or being hospitalized with the disease? Is the new delta-variant going to evade our immunity from the vaccine? What about the theta-phi variant (yet to be detected) with a mortality rate 3 times greater than the delta variant?
I recently read Stephen Dubner and Steven Levitt’s Freakonomics, a book that examines the hidden side of human behaviour and economics. I particularly enjoyed their perspective on risk, hazard, and outrage. Dubner and Levitt argue that what we perceive to be a “risk’’ is a combination of hazard and outrage. “When hazard is high and outrage is low, people underreact, but when hazard is low and outrage is high, they overreact.’’
For example, why do we fear guns more than swimming pools when the likelihood of death by pool (1 in 11,000) versus death by accidental gun discharge (1 in 1 million-plus) isn’t even close? Dubner and Levitt would suggest it is the outrage factor. Being shot in the chest with a gun is gruesome, dramatic, and horrifying — it’s outrageous. But a swimming pool does not inspire outrage, mostly due to the familiarity factor.
It turns out that how we perceive risk, hazard, and outrage is at the core of the COVID-19 pandemic and our response to it. Consider 62-year old Edward who is at higher risk for COVID-19. He has spent the last 16 months following the recommended public health measures of masking and distancing. Now that he has been fully vaccinated, he figures he is more protected, but not enough to change his habits. Living in downtown Toronto, Edward wants to avoid large crowds, so he typically goes for walks late at night. Edward thinks that he has made a smart decision to protect himself.
But according to the data, Edward’s choice is not smart at all. The risk of being murdered on the street late at night (1 in 19000) versus dying of COVID-19 after being fully vaccinated (1 in 127000) isn’t even close. In fact, Edward is nearly twice as likely to be murdered on the street than be hospitalized with COVID, let alone die from it.
So why do we fear contracting COVID-19 more than being murdered on the street? Both viruses and murder are caused by other people; staying far away from others will mitigate risk. While we tend to think that avoiding dangerous strangers will keep us safe, the data shows that the majority of homicides are committed by someone you know (one’s best friend instead of a stranger on the street). Murders also don’t inspire the same outrage as COVID-19 because of the familiarity factor; we don’t have daily counters and graphs of the number of homicides and the homicide rate has not changed dramatically over time.
However, unlike a murderer, COVID-19 can come from anyone; there aren’t sick people who purposefully set out to infect you. The stranger on the street is just as likely to infect you as your best friend, and neither of them have the intention to do so. The thought of a stranger passively infecting you with a virus that might put you in hospital on life support, fill your lungs will fluid, and eventually kill you is outrageous.
So why do we implement lockdowns and other COVID restrictions if the individual threat is astronomically low?
The original goal of the lockdowns was to “flatten the curve’’ so that the healthcare system would not be overwhelmed. Those who needed treatment would have an equal chance of survival regardless of the number of other patients in hospital. This would not change the total number of cases or deaths in the end, but instead make the virus more manageable.
As we approached producing vaccines, the goal then became to “delay the curve’’ and ultimately reduce the number of new infections and severe disease.
But now that we have such large vaccination numbers, what is the end goal? The fact of the matter is, COVID-19 is never going away. It will continue to mutate, spread, and kill people across the globe for a long time. There will always be a new variant, whether it’s alpha, beta, delta, gamma, or kappa.
Aside from the outrage, the hazard is low. Large crowds and other people are not a literal threat to your health if you’re fully vaccinated. Masking may help in a small way to mitigate further spread, but at what cost? Are we going to do this forever? It’s time that we move on from government implemented restrictions, be honest with the public about the astronomically low risk of COVID-19, and let people make individual decisions about their behaviour.
Data Context Notes
Risk of hospitalization and death after being fully vaccinated were calculated based on CDC data as of July 26, 2021 (see reference below). Out of 161 million fully vaccinated Americans, there were 6,587 hospitalizations with breakthrough COVID infection, 1598 of which were asymptomatic or not related to COVID-19, and 1,263 of which were deaths. This equates to a 1 in 32270 chance of being hospitalized with COVID and a 1 in 127,474 chance of dying after being fully vaccinated.
References
Centers for Disease Control and Prevention. COVID-19 Vaccine Breakthrough Infections as of July 26, 2021. Available from https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e3.htm
National Safety Council. Odds of Dying. Available from https://injuryfacts.nsc.org/all-injuries/preventable-death-overview/odds-of-dying/
Federal Bureau of Investigation. Expanded Homicide Data. Crime in the United States. 2011. Available from https://ucr.fbi.gov/crime-in-the-u.s/2011/crime-in-the-u.s.-2011/offenses-known-to-law-enforcement/expanded/expanded-homicide-data
This article was inspired by Stephen Dubner and Steven Levitt’s Freakonomics. See more at https://freakonomics.com/
