In 1998, Peter Bernstein wrote a book entitled THE REMARKABLE HISTORY OF RISK. It was part mathematics, part history and part psychology. The basic takeaway for me was twofold: 1. That risk is individual and based on experience and information 2. That the very process of avoiding risk—risk mitigation, can lead to unintended consequences that are actually riskier than the risk that is trying to be avoided.
When individuals or groups project their fear of risk onto other people who may have different experiences and perceptions, or come from a different set of life experiences, a common ground can be difficult to find. This is especially true when information is constantly changing and the goals of risk mitigation change—remember when “crushing the curve” was the goal of risk mitigation for Covid-19? How many times has that changed?
Hard to make an assessment of risk when the definition changes! Finally, any risk is ultimately a perception and can be anywhere on a spectrum of being real to fantasy. Understanding another person’s perception of their own risk can sometimes be impossible. One of my closest friends in surgery residency had been a Navy fighter pilot during Viet Nam. He had over 200 aircraft carrier landings at sea—half at night, yet Bob was afraid to climb up a stepladder more than two steps!
Many years ago, I attended a conference of trauma surgeons, safety engineers, and mechanical engineers. It was sponsored by the major automobile manufactures and the focus was on how to make cars “safer”. The most interesting talk was given by a safety engineer. He said the question of making cars safer and saving lives from being lost in car accidents were really two different questions.
Seat belts, safety shells, speed limits, engineering roads for safety with turning radii matched to grades all made traveling safer, but if you wanted to save lives he opined that manufacturers should replace the drivers’ airbag in the steering wheel with a great big spike that would impale the driver should they be in an accident that caused them to deaccelerate at a preset—like 20mph speed. In order for this to work, every single driver would have to have the spike installed in every single car.
If only half had the spike those that didn’t may have an accident with one that did and the whole idea would fall apart. If everybody had the spike, everyone would drive safer and there would be fewer accidents and thus fewer deaths. He showed us his models and explained about how this idea would be deployed. But something about an individual’s fear of impaling themselves in a parking lot low-speed accident, made the overall benefit to society seem to be not “worth the individual risk”. In fact of the 50 people in the room when asked who would vote to proceed with such an experiment nobody raised their hands—even knowing that this would ultimately save lives.
We know that as we try to mitigate risk by adding safety features to a car—seat belts, airbags, positraction, safety shells etc.—the very activities we are protecting against will become more widespread. People using safety belts are prone to drive faster. Same with motorcycle helmets and cornering. Wear a helmet and one is prone to corner faster with more “g’s”. It was recently shown that wearing masks lulls people into becoming lax with social distancing. Some people just decide not to ride motorcycles.
I recently saw two motorcycle riders driving past me 80mph wearing face masks and not helmets! Their choice. Modern day suspension and composite football helmets incentivize spearing and leading with the head while tackling. No helmets in rugby leads to fewer head injuries. No helmets—fewer head injuries. Think that will ever catch on with suburban mothers.
Mike Roe has written and appeared on YouTube presenting the idea of SAFETY 3RD INSTEAD OF SAFETY 1ST. His point is that in almost anything we do we will say “safety 1st” but that isn’t really true. What is true is that the act we are trying to accomplish—fix an electrical cable on a high wire line for example is actually the reason we are asked to perform the act. We aren’t asked to go be safe and then fix the problem. The problem and the risk is defined upfront and the mitigation is adjusted to fit the need. The mitigation is unique to the circumstances. Being safe 300 feet above the water may require different equipment than being safe 300 feet below the water. Being safe in a boat is different than being safe in a truck.
Our public health experts don’t understand the nuances of defining and mitigating risk. When they define a strategy for a population they have no “skin” in my individual game. If they were an employee in their day job, or had a government job do they understand the risk of a prescribed mitigation order should it shut down a family business and lay 60 people off? Maybe we should link their salaries to the economic impact that shutting down the local economy would have?
The majority of people who will be in defiance of government mitigation orders are smart people—at least as smart as the people sitting on the CDH Board. They are business people and entrepreneurs and housewives running a family with children who are being marginalized by not being able to work, go to school or church, or music lessons or football practice. They know their risks and they feel the pain of misdirected mitigations.
I listen to Russell Duke on the Kevin Miller show 5 days ago. He volunteered that the Founding Fathers did not anticipate in any of our founding documents the predicate or need of a public health nature to limit any of our civil liberties. He then opined that health was a “Right” and that because it was a right government had the authority to secure that “Right”. Seems like he took too many courses in public policy and not enough in political science.
Our Founding documents are read with an understanding of “Natural Rights” and the Bill of Rights preceding our Constitution defines a list of dispositive actions that government cannot participate in because they violate our Natural Rights defined by Natural Law of life liberty and the pursuit of happiness As Barak Obama lectured us The Bill of Rights are Dispositive declarations of what government cannot do. There are positive rules—laws that we live by that can be found in the Criminal and Civil Codes. We have legal and civil rights and property rights and even rights defined in Common Law. But please sir don’t get these rights mixed up with our basic Natural Rights, and don’t think we are so naive to believe that the bases for your actions closing down the economy can be found in Natural Law or our Founding Documents. We no better and we are smarter than that.
Finally, mitigation strategies against smallpox Yellow Fever, typhoid, and other disease were being deployed in North America under the British Crown for over 100 years before there was a revolution. Included in these laws were the right of quarantine and confiscation—a right that really pissed off the Colonists.
We need type three mitigation strategies. We need to isolate, separate, and segregate those most at risk. That is not what we are doing in nursing homes today. WE need to open up the economy and the schools. We need to let the people decide what is best for themselves and their families. We don’t need a baby sitter or a master to tell us what is best for ourselves. We The People have more knowledge and wisdom about how to move forward with our lives than any government bureaucrat or commissar.
One reply on “Public Safety and Individual Responsivity”
Dr. John. I agree with you completely. Very well said. Ted. I just finally realized your are the reincarnation of our Lord and savior Jesus Christ. Praise Alah! Are you a paid messiah troll or doing it for free? The problem with this republic is ineffectual chain rattlers like you. Me thinks you need medication. I’ll take dangerous freedom over safe slavery. Long live the republic.