Acute risks vs chronic risks

[Millennie Al]

...we'll constantly be deceived into thinking acute risks are more serious than chronic risks.

The same level of acute risk is not more serious than if it were chronic, but it does justify more mitigation measures. It's like the difference between spending £1 every day for 40 years or £14,610 at once. If you can reduce the amount by 10% in each case you save the same amount, but it's a lot easier to save 10% on one big transactio, where you can put more effort into analysing the situation than to do it 14,610 times.

And, of course, an apparently one-off acute risk might turn out to recur, making mitigation measures better value. Similarly, the apparently chronic risk might decline, meaning effort put into mitigation might be uneconomical.

[dyqik]

With something like CoVID, there's acute risks which have risk of knock on chronic effects.

And with your example you have to think about opportunity costs as well. Many people can easily spend £1 a day without really caring or experiencing any hardship as a result. It's a non-existent hazard for most people.

Most people can't easily afford £14k at once, and having to pay it might well harm their life for several years if they have to pay interest on it, by substantially more than £1 a day would.

At 4% APR over 40 years, you'd be paying the £14,610 over forty years, and paying an additional £1 a day in interest on top of that as well.

(Obviously 40 year loan terms are kind of extreme, but the same point applies to £2 a day and 8% APR interest, etc.)

[sheldrake]

The analogies with money here dont work for me because lives are equally precious over time. We could think about years of life saved, but that would make covid look even less dangerous than autoaccidents because majority of covid deaths are in the elderly who are already ill, whereas autoaccidents affect the young much more.

I take the point about chronic effects of covid, but I havent yet seen quant data on them to compare to other common diseases (heart inflammation is a known longterm sideeffect of flu, for example)

[plodder]

Risk is probability x impact.

By chronic risk, do you mean high probability / low impact?
By acute risk, do you mean low probability / high impact?

There are a number of things you can do with risks - accept, mitigate, avoid, transfer, reduce etc. They all have pros and cons and need to be dealt with on an individual basis.

Risk management is a discipline and I'm not sure the "acute vs chronic" definition makes any sense, especially if the suggestion is that e.g. acute risks should all be managed in the same way.

[bob sterman]

The existence of chronic risks is not, in itself, a good reason to fail to take steps to mitigate acute risks - as these are additional to the background chronic risks.

And in any case, if you want to go down this route you need to also factor in the costs (drawbacks) of taking steps to mitigate acute risks vs chronic risks.

E.g.most people consider it reasonable to wear a helmet when cycling, or a seatbelt when driving - every day for many decades - to reduce the chances of dying or being seriously injured on the road. Many people find both these precautions uncomfortable.

Accordingly, if you're faced with an acute risk (not going to mention a specific one!) that creates the same risk of death within a 12 month period, that the chronic risks create over a lifetime, then during that 12 month period you should be willing to take much more significant steps to avoid it.

You should be prepared to do something - for 12 months - equivalent to compressing all the annoyance and discomfort associated with the things you do to avoid chronic risks - into a 12 month period.

[sheldrake]

Risk is probability x impact.

By chronic risk, do you mean high probability / low impact?
By acute risk, do you mean low probability / high impact?

There are a number of things you can do with risks - accept, mitigate, avoid, transfer, reduce etc. They all have pros and cons and need to be dealt with on an individual basis.

Risk management is a discipline and I'm not sure the "acute vs chronic" definition makes any sense, especially if the suggestion is that e.g. acute risks should all be managed in the same way.

Chronic risks and acute risks can share the same probability*impact, but a chronic risk will see it realised over a longer period of time.

Example:
In the US, the average person has a 1 in 103 lifetime risk of dying in an autoaccident, but their risk of dying this year is not very high. That's the kind of thing I mean by 'chronic risk'.
A bad flu strain might present a 1 in 1000 lifetime risk of death if you catch it (after you survive, you're immune to that strain). This would be a more acute risk.

In the year that flu strain is present, people who catch it are at greater risk of dying from it that year than from driving that year. But over the course of their lifetime, driving is more dangerous to them than that flu strain is.

[sheldrake]

The existence of chronic risks is not, in itself, a good reason to fail to take steps to mitigate acute risks - as these are additional to the background chronic risks.

In principle yes, but I think the mitigations should be proportionate to the overall level of risk and that's where the devil is in the detail. My starting point for understanding what's proportionate is to think about what we consider reasonable to mitigate other existing risks.

My concern here is that some of the mitigations proposed for Covid (e.g. use of digital identity on an almost daily basis to enter places of work) do not seem proportionate to the lifetime level of risk.

[plodder]

Risk is probability x impact.

By chronic risk, do you mean high probability / low impact?
By acute risk, do you mean low probability / high impact?

There are a number of things you can do with risks - accept, mitigate, avoid, transfer, reduce etc. They all have pros and cons and need to be dealt with on an individual basis.

Risk management is a discipline and I'm not sure the "acute vs chronic" definition makes any sense, especially if the suggestion is that e.g. acute risks should all be managed in the same way.

Chronic risks and acute risks can share the same probability*impact, but a chronic risk will see it realised over a longer period of time.

Example:
In the US, the average person has a 1 in 103 lifetime risk of dying in an autoaccident, but their risk of dying this year is not very high. That's the kind of thing I mean by 'chronic risk'.
A bad flu strain might present a 1 in 1000 lifetime risk of death if you catch it (after you survive, you're immune to that strain). This would be a more acute risk.

In the year that flu strain is present, people who catch it are at greater risk of dying from it that year than from driving that year. But over the course of their lifetime, driving is more dangerous to them than that flu strain is.

Do you know what the word “probability” means?

[plodder]

the “species lifetime” risk of enormous asteroid impact is actually pretty high. Therefore lockdown for CoViD needs to be considered in context? Is that the inference we’re being invited to make?

[lpm]

My concern here is that some of the mitigations proposed for Covid (e.g. use of digital identity on an almost daily basis to enter places of work) do not seem proportionate to the lifetime level of risk.

Are you talking about the 2020 and 2021 emergency measures here?

Or is your concern the current rules/proposals, and the prospects for 2022? Which countries, which actual proposals?

[sheldrake]

Do you know what the word “probability” means?

Yes. If you think the word 'probability' alone denotes a specific timescale, then you have misunderstood it. If you had said 'probability this year' in your given example, then you'd have a point.

eta: I don't think your asteroid example is illuminating. Focus on risks we've measured for an ordinary human lifespan. Like driving, or other diseases.

[plodder]

Ian McCulloch (on the closure of the Cavern Club): Car parks are a bigger threat than war.

[plodder]

Do you know what the word “probability” means?

Yes. If you think the word 'probability' alone denotes a specific timescale, then you have misunderstood it. If you had said 'probability this year' in your given example, then you'd have a point.

eta: I don't think your asteroid example is illuminating. Focus on risks we've measured for an ordinary human lifespan. Like driving, or other diseases.

Oh, so it is time limited?

[sheldrake]

Are you talking about the 2020 and 2021 emergency measures here?

Or is your concern the current rules/proposals, and the prospects for 2022? Which countries, which actual proposals?

Some of the 2020-2021 emergency measures may have been disproportionate, but I'm more concerned about future 'Covid Passport' proposals now. We can't change the past.

[sheldrake]

Oh, so it is time limited?

Quite explicitly so, from the very first examples I gave.

[plodder]

then simply run the likelihood (in your goldilocks timeframe) and calculate the impact and proceed as normal. It’ll allow you to develop a hierarchy.

[sheldrake]

then simply run the likelihood (in your goldilocks timeframe) and calculate the impact and proceed as normal. It’ll allow you to develop a hierarchy.

The goldilocks timeframe I've been looking at is 'human lifetime risk'. Do you feel this is unreasonable?

[plodder]

I don’t accept the distinction between “chronic” and “acute” risk. If you want to muddle up the probability of something happening once every 100 years with something happening this year that’s up to you.

[plodder]

I *think* by chronic you mean high probability / low impact but I’m not at all sure.

[sheldrake]

I *think* by chronic you mean high probability / low impact but I’m not at all sure.

I don't think death is low impact, and the risks I'm talking about all result in death when realised.

I think it means what I said it means; probability in a given year is smaller.

You're familiar with calculus. Imagine two probability distributions over time. They both have the same area underneath, but one of them has a much taller spike. The one with the tall spike is more acute.

[plodder]

so death from driving over a lifetime is clearly high impact / low probability. Death from covid over a lifetime is clearly high impact and ??? probably higher than driving without mitigation ???

it’s easy to compare like with like. you haven’t labelled your axes. The graph idea is nice but I don’t think you have the data.

[sheldrake]

so death from driving over a lifetime is clearly high impact / low probability. Death from covid over a lifetime is clearly high impact and ??? probably higher than driving without mitigation ???

it’s easy to compare like with like. you haven’t labelled your axes. The graph idea is nice but I don’t think you have the data.

X is time, Y is 'probability of death'.

An argument I made in the other thread was that I think IFR for Covid is a good proxy for lifetime risk of death for the unvaccinated as it has a very low mutation rate (paper was cited) and the immunity you get from surviving it once is very strong (very small risk of reinfection, and the reinfected very rarely need hospital care or die). That argument may be wrong and it's worth exploring further.

[Bird on a Fire]

The risks and mitigations need to be considered on the same time scale for any comparison to make sense.

For covid, part of the worry was precisely the acute nature of the risk - overwhelmed hospitals and sudden mass mortality are more disruptive than spreading the illness and death over, say, a decade. Many of the consequences are nonlinear.

So, for example, you'd want to be comparing annual risks and annual precautions, especially as we don't know how long countries will be keeping vaccine passports (my guess is till after the winter, but then scrapping them if we get through ok).

Note that for driving there are a huge amount of preventative measures, from licences to use them in public, alcohol and drug restrictions, MOTs for vehicles, signs and lights absolutely everywhere, and so on. Freedom is massively curtailed for public safety.

[bob sterman]

An argument I made in the other thread was that I think IFR for Covid is a good proxy for lifetime risk of death for the unvaccinated as it has a very low mutation rate (paper was cited) and the immunity you get from surviving it once is very strong (very small risk of reinfection, and the reinfected very rarely need hospital care or die). That argument may be wrong and it's worth exploring further.

You didn't actually present an argument - you simply made the claim. And the relevance of the "lifetime risk of death" from COVID when deciding what precautions to take during a wave of the pandemic is unclear.

[bagpuss]

The risks and mitigations need to be considered on the same time scale for any comparison to make sense.

For covid, part of the worry was precisely the acute nature of the risk - overwhelmed hospitals and sudden mass mortality are more disruptive than spreading the illness and death over, say, a decade. Many of the consequences are nonlinear.

So, for example, you'd want to be comparing annual risks and annual precautions, especially as we don't know how long countries will be keeping vaccine passports (my guess is till after the winter, but then scrapping them if we get through ok).

Note that for driving there are a huge amount of preventative measures, from licences to use them in public, alcohol and drug restrictions, MOTs for vehicles, signs and lights absolutely everywhere, and so on. Freedom is massively curtailed for public safety.

There's also the complication, of course, that by not taking mitigating measures against an acute (by sheldrake's definition) risk, you are also increasing the risk of chronic conditions - for example if Covid cases become so high that the NHS has to pause or reduce operations, cancer treatments, etc, or for an individual if Covid combines with their other health condition(s) to cause a much earlier death than otherwise.

Driving is a good comparator in that preventative measures address a mixture of risks to the driver themselves, their passengers and other road users. It's also something that a lot of people want to do but is not an essential requirement for life in this country, so we can all choose whether or not to submit to having licences, registering and insuring our cars, ensuring that our cars are safe to drive. Likewise with Covid passports - in the UK they won't be needed for anything that is essential such as buying groceries or going to work (barring a very small subset of workers), so we can all choose whether or not to submit to the requirements or just not go to the theatre or whatever.