COVID-19: The Endurance of Empathy

Self-isolation makes it feel like winter has come early to the Southern Hemisphere. I find myself hankering for stew and cornbread, rich, hearty things that fill me up and fortify me. The illusion has seeded itself so deeply in my mind that I put on too many layers before leaving to walk along the nearly empty tracks that weave through the reserve near my home. I return to the house sweaty, weighed down by the jackets and pullovers tied around my waist.

Winter is my favorite season. I like the sharpness of the air. I like burrowing down in the warm den of my bed in the brisk morning chill. But as with any season, part of winter’s charm is that it ends all too quickly. Self-isolation and social distancing make no such promise. With a vaccine more than a year away by the best estimates, it is likely that the global community will need to practice social distancing for months at a minimum. So I find myself asking, like any good Game of Thrones character might, what do I do now that the long winter is here?

Social distancing and self-isolation have been described as acts of empathy, because the majority of those who take part (which should be more or less everyone) are not at the highest risk of severe disease. But empathy, which Paul Bloom defines as “the act of coming to experience the world as you think someone else does” [1], and which I take to be a composite of compassion and understanding, is a challenge even in the best of times. It’s hard to bridge the gap between ourselves and other people, even those we love. It’s harder still to act on that empathy every day for weeks on end.

That’s why we see people, often young, healthy people, filling beaches and bars, taking a sledgehammer to social distancing [2,3]. As a group, their risk is much lower than for the elderly or the immunocompromised, and empathy—seeing the world as someone else does—is hard. That’s not because they’re selfish or immature (though of course, they may be those things as well), it’s because they’re human. And they don’t understand risk.

Risk a tricky thing. It’s hard to wrap your mind around because it relies on statistics, and humans—even statisticians, who despite their reputation are also humans—are terrible at statistics. As Michael Lewis explains in The Undoing Project, “Whatever human beings did when presented with a problem that had a statistically correct answer, it wasn’t statistics” [4]. Instead, we use our intuition, and our intuition often fails us.

Sometimes this is just a matter of not seeing the forest for the trees. When we hear that there is a 5% chance of something, it doesn’t immediately sink in that 5% is equal to 1 in 20. But on other occasions it’s a bit more complicated than that. When a public health official presents a risk—for instance, that there is a 13% chance of treading on bubblegum (in case it’s not clear, I have made this whimsical statistic up)—it is what we epidemiologists would call a population risk, a kind of average risk across a whole group. But population risk is only an estimate of our individual risk. Let me explain.

Imagine you go to your doctor and they tell you that you have a 13% chance of treading on bubblegum today. If they were being statistically honest with you, which is like regular honesty only more boring, they would say that you belong to a group of people whose overall risk is 13%. But, your doctor would go on to say, no one can measure your individual risk, the risk to you personally. So while your risk is likely to be around 13%, it might be 2% (1 in 50) or it might be 20% (1 in 5).

The same is true of COVID-19. That’s because there are too many factors at play in individual risk and not all of them are obvious or possible to measure. There are genetic factors, the predisposition you’ve inherited from your parents, unique to you. There are environmental factors, the things you’ve been exposed to over the course of your life, everything from sunshine to smog. There are lifestyle factors, like smoking or exercise. And there are health factors, like pre-existing conditions, some of which may be unknown to both you and your doctor.

The disconnect between individual risk and population risk is why some young, healthy people have become seriously ill from COVID-19. These people are unlucky, certainly. But they aren’t unlucky in a cursed-by-God kind of way. They are unlucky in a we-are-products-of-our-genetics-and-environment-and-we-don’t-have-much-control-over-either kind of way. This kind of bad luck isn’t a thunderbolt from on high, it’s a losing hand of cards; it isn’t randomness, it’s unmeasured risk.

Your risk of developing COVID-19 might not be equal to the risk for your age group. That is the population risk; it doesn’t belong to you. Your individual risk cannot be measured. It might be much lower or much higher than population risk, and there is no way to know for sure. Banking on the population risk to protect you is “gambling on chance and chance is on nobody’s side” [5].

That uncertainty—the fact that there is a non-zero chance that you are less like your peers and more like an 80-year-old asthmatic—narrows the gap between us. It makes it easier for us to imagine the world as other people see it, because there’s a real chance that we’re more alike than we know. The message is simple: we are all at risk and when we take action to save others, we are saving ourselves.

So long as our empathy endures, so do we.

References

  1. Bloom, Paul. Against Empathy: The Case for Rational Compassion. Penguin Random House, London, p.16
  2. Smee, Ben. Bondi beach closed after crowds defy ban on gatherings of 500-plus. The Guardian 21 March 2020. Accessed 22 March 2020. Available at: https://www.theguardian.com/australia-news/2020/mar/21/bondi-beach-closed-down-after-crowds-defy-ban-on-gatherings-of-more-than-500-people
  3. Chan, Tiffany. South Boston bars crowded Saturday despite calls for social distancing. CBS Boston 14 March 2020. Accessed 22 March 2020. Available at: https://boston.cbslocal.com/2020/03/14/coronavirus-south-boston-bars-crowded-social-distancing/
  4. Lewis, Michael. The Undoing Project. W.W. Norton & Company, New York City, p.157
  5. Camus, Albert. The Plague. Penguin Classics, London, p. 151