The ladder of risk — COVID-19 edition

Figure 1: Illustration of COVID-19 viruses (source: Harvard University)

During the COVID-19 pandemic, just about everyone is at risk of getting exposed to the virus and getting infected. You don’t have to be a medical or scientific expert to understand how to protect yourself, but you do have to understand how your choices for protecting yourself can change your risk of infection. If you know even a little bit about ladders, you know more than enough about risk and how to make choices to reduce your risk.

COVID-19 realities

There are a few basic realities about the COVID-19 virus that everyone has to face:

• If you get infected with the COVID-19 virus, there is a chance that you can get seriously ill and possibly die.
• You can only get infected by the virus from another infected person.
• Unless you live alone, never go out, and stay away from people, you can get infected.

Public health professionals, medical doctors, government officials, and others who have either the expertise to understand COVID-19 or the responsibility to deal with the pandemic are very clear about all the things that you can do to protect yourself from this virus. It is up to you to figure out how much you want to do to protect yourself or to protect the people around you. To do that, you have to understand enough about risk to make reasonable and appropriate decisions.

What is risk?

There are many ways to model risk, and I follow the approach used successfully by the aviation industry for the last several decades. In that approach, a risk has three parts:

1. The hazard,
2. The bad outcome from that hazard, and
3. The probability or likelihood of that bad outcome.

Usually, a risk is modeled with numbers, and there are plenty of experts on television and elsewhere who do that very well. Here, I’ll use a different kind of model that will help you understand risk without using numbers.

Using a ladder to model the risk of COVID-19 infection

Sometime in your life, you have either used a stepladder or have seen someone use a stepladder. With any stepladder, falling off the ladder and getting seriously injured or killed is a bad outcome you want to avoid. You also know that the higher the fall, the greater the chance of injury or death. You can break up the risk of using the ladder into three parts:

1. Falling (the hazard)
2. Getting seriously injured or killed (the bad outcome)
3. How high up you go (increases the likelihood of injury or death)

For COVID-19, a similar risk description would look like this:

1. Getting infected (the hazard)
2. Getting seriously ill or dying (the bad outcome)
3. Not taking actions to avoid the virus (increases the likelihood of sickness and death)

Think of every step on that ladder as something you didn’t do to keep the virus from infecting you or infecting someone else, things like:

• Staying away from people or crowds of any size (social distancing),
• Washing your hands with soap,
• Using hand sanitizer,
• Wearing a mask,
• Wearing gloves,
• Avoiding unnecessary trips outside your home,
• Avoiding situations where people around you are not wearing a mask, washing their hands, or practicing social distancing, or
• Getting a COVID-19 vaccine as soon as you are able to do so.

Imagine that taking any of the previous steps eliminates a piece of the risk takes away a rung of the ladder. In other words, the more protective or preventive measures you take, the shorter the ladder. The picture below shows you what I mean:

Figure 2: Different ladders, different risks (sources: Home Depot and Pixabay)

The ladder on the left represents making no effort at all, meaning you behave exactly like you did before the pandemic. The middle ladder may represent following many of the Trump Administration’s guidelines published in early 2020, including the following:

Figure 3: Risk advice from the Trump Administration

The shortest ladder on the right may represent doing everything you can to avoid the virus, including social distancing, wearing a mask, washing your hands frequently, and getting a COVID-19 vaccine as soon as you can.

Choose your ladder, choose your risk

Just about all of us can be exposed to the virus, and even if you take every reasonable precaution, you can still get infected. You have a choice in what kind of ladder you want to use. In the words of transportation safety expert and Former NTSB Board Member John Goglia, “Risk is like a ladder. If you raise the risk and go up the ladder, the danger of falling gets greater and greater.”

Doing nothing is living life on the biggest ladder possible, and poses the greatest risk. Doing anything to make your ladder shorter will reduce your chances of getting infected, getting sick and dying. The choice of how much or how little you want to do to reduce your risk is yours and yours alone.