Navigating Risk

Season 1: Episode 47
June 25, 2020

Photo via Centers for Disease Control

With COVID-19 cases surging across the nation, how can Americans fight their coronavirus fatigue while  staying safe?

Listen to the full episode below or scroll down for the transcript and more information.

Click here for more of our coronavirus coverage.

Ashish Jha: We all have to be humble about this virus and what we know and don’t know about it.

Dan Gorenstein: May was a big month. 

As stay at home orders expired, restaurants reopened, so did beaches, and churches, people emerging to commemorate Memorial Day together. 

DG: As social distancing restrictions have eased, some states are seeing record highs of coronavirus cases. Hospitalizations are up. And the Washington Post is reporting virus-related deaths are up too. 

As the saying goes, people may be done with the pandemic but the pandemic isn’t done with us. 

From the Annenberg Studio at the University of Pennsylvania, navigating our desire to return to normal and a virus that’s still early days. I’m Dan Gorenstein, and this is Tradeoffs.

DG: Before the pandemic, Dr. Ashish Jha saw himself as an evidence generating guy. 

The director of Harvard’s Global Health Institute, Ashish has published hundreds of studies on everything from wasteful health care spending to racial inequities.

Ashish Jha

But now — at a time when  what we know about the coronavirus can change overnight — he’s adopted a new role. 

AJ: Instead of just being a generator of evidence, I feel like I’m spending most of my time being a synthesizer and a communicator of evidence.

DG: Like most everybody, Ashish is worried about the recent outbreaks in Arizona, Texas and Florida.

But he says we know a lot more about the coronavirus now than when we saw the first huge spikes hit this spring.

AJ: What we know is that being outdoors is lower risk than being indoors. What we know is wearing masks reduces the risk. And what we know is that some amount of physical distance — six feet or more — is helpful. And then last but not least, if you’re in a neighborhood or a community or a town where there’s a pretty large outbreak, even being outdoors in a cafe six feet apart with a friend can be risky.

DG: It’s easy, maybe even comforting, to take Ashish’s comments as a roadmap for hosting stoop parties and having picnics.  

And maybe some of us will do that. 

But experts like Ashish have got a real credibility problem with some Americans. 

Like how much should we trust evidence especially when evidence changes so fast?

Fauci clip: Right now in the United States, people should not be walking around with masks.

DG: At first lots and lots of experts like Dr. Antony Fauci here in a 60 Minutes interview  said.

Fauci clip: (from 60 Minutes): Right now people should not be — there’s no reason to be walking around with a mask.

DG: There’s no need to wear masks. Until…

Fauci clip: So right now, unequivocally, the recommendation is keep the distance and wear a mask.

DG: Lots and lots of experts like Dr. Anthony Fauci said we should all be wearing  masks.  

Ashish got it wrong, too.

AJ: In mid-March, if you and I were having this conversation, Dan, and you said, how important is wearing masks? I would have shrugged my shoulders and said, yeah, maybe, not so sure. 

DG:  The virus is going to continue to surprise researchers, scientists. How much should people take to the bank that being outside is safer, wearing a mask is safer and social distancing is safer Do we know enough to actually definitively say that or could this change again?

AJ: It’s a good question. Could it turn out that social distancing just doesn’t matter? That would really mean that everything we understand about disease transmission. Not about just this virus, but every respiratory virus for a century is wrong. No. Like, I just think they could take that to the bank. Being outside, it really looks that way, like, the evidence is pretty good. The mask wearing is the one that has been the biggest shift, I would say, in the last couple of months. And, the way I see it is could that turn out to be wrong? I suppose it’s theoretically possible, but I’d be pretty surprised at this point. 

DG: One challenge with these late June spikes: convince skeptical people who are sick of social distancing to take steps they don’t want to take. 

DG: Have you seen any research, Ashish, in the last few weeks, months that informs the type of messaging you think needs to be coming from trusted leaders?

AJ: There is so much spread of misinformation out there, and figuring out how to how to essentially recruit people to be spreaders of truth as opposed to spreaders of falsehood is a really important challenge in front of us. And I don’t know that we’re paying enough attention to that.

DG: Back in April, we talked with several scientists who study human behavior. 

Based on years of research here’s their advice in a nutshell. 

The best way to ramp up social distancing is to get peers, or local leaders like pastors and coaches and even experts like Ashish to keep making three points. 

One: emphasize that most people are in fact social distancing.

Two: focus on the benefits of wearing masks. 

Three: point out how inconveniencing yourself actually helps other people.

AJ: So I have not sort of tried to describe this so much as like do it for America. I don’t know what that mean. While nobody gets that excited about doing something for quote, unquote, society, people can be motivated to change their behavior if it’s going to protect their parents their grandparents or their best friend who’s got cancer or like. Those are the things that can motivate people. 

DG: Now, during the summer months, it’s easier to be outside, to socialize.  

But as the fall approaches, schools are contemplating how to bring students back into the classroom.

Selfishly, I’m thinking about my 14 year old son, and whether he’ll be able to physically show up for his first day of highschool as a freshman. 

AJ: Yeah. So I’ve been talking to a lot of school districts, a lot of university leaders looking at a lot of plans. Most people want to try to open up and and open the schools this fall. My general geschtalt is that a vast, vast majority of them won’t make it much past Columbus Day because you’ll see large outbreaks. And then they may not open again till March.

DG: But Ashish says that scenario is totally avoidable if people get even more serious about fighting the virus.

AJ: And so there’s a set of strategies. I believe we should absolutely have universal masking laws, everybody. People are like “I don’t want the government telling me what to do.” And I’m like, you can’t go into a retail store and light up a cigarette. Not in most places. It’s the same thing in my mind.

But single biggest thing is we’ve got to have a really aggressive testing and tracing and isolation strategy with a lot more testing capacity than we have. I know it’s boring. It’s like it’s literally public health from the 19th century.

And then do really aggressive surveillance of schools and buildings when schools open up. It gives us a fighting chance. It makes it likely that we probably and at least get through Thanksgiving and maybe into early December.

DG: It’s sobering comments like this that have earned Ashish some enemies., definitely more than when he was doing his own health policy research on topics like hospital admission rates. 

AJ: A lot of people feel compelled to compose a letter by hand telling me what an awful human being I am and how I should go back to where I came from and all of that. 

DG: Ashish and his family emigrated from India to Canada when he was a kid. 

AJ: Some of it is like, you’re just a hack and this is nothing but the flu. That stuff is fine. I mean, it’s pretty standard. My my one of my favorites was just so, so pithy was the person said, you are nothing but a third rate, third world academic. And I thought third rate. Sure. But third world, did you have to throw that in? And it was like you could just insult my intelligence. But did you have to make it racist?

DG: Ashish guesses he’s gotten 100 to 200 responses like that. 

He’s also gotten positive responses and legitimate disagreements over the evidence — conversations, he says, he likes having. 

DG: Final question, if you had an opportunity, Ashish. If you could sort of respond to people collectively, the ones who’ve been hateful, what would you say?

AJ: You know, mostly. I try to think about what makes them hateful, and I think it is a combination of fear, worry that the stuff I’m saying may be right. When much of what they’ve been hearing in their world is that I’m wrong. And I think what I would respond back is with the notion that I am just trying my best to do the things that I care about. But I suspect they all care about I’m going to protect my family. I’m trying to protect the community that I live in. And I’m trying to protect and keep as safe as possible the country I live in. 

DG: Ashish says he’s learned that most people are doing their best to understand this virus and get through these hectic times. 

And he’ll keep sharing what he’s learning, no matter what shows up in his inbox. 

I’m Dan Gorenstein, and this is Tradeoffs.

Episode Resources

Select News, Analyses, Resources:

U.S. Hits 2 Million Coronavirus Cases As Many States See A Surge Of Patients (Bill Chappell and Rob Stein; NPR; 6/10/2020)

Seven states report highest coronavirus hospitalizations since pandemic began (Hannah Knowles, John Wagner, Hamza Shaban, et al; Washington Post; 6/23/2020)

Orange County won’t enforce Gov. Newsom’s statewide mask mandate (Steve Chiotakis; KCRW; 6/22/2020)

See How All 50 States Are Reopening (New York Times; continually updated)

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis (Derek K. Chu, Elie A. Akl, Stephanie Duda, et al; The Lancet; 6/01/2020)

Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US (Wei Lyu and George L. Wehby; Health Affairs; 6/16/2020)

Episode Credits

Guests:

Ashish Jha, K.T. Li Professor of Global Health at the Harvard T.H. Chan School of Public Health and the Faculty Director of the Harvard Global Health Institute

The Tradeoffs theme song was composed by Ty Citerman, with additional music from Checkie Brown, Purple Planet, and Blue Dot Sessions.

Additional thanks to:

Mahrokh Irani, Kim Ryan, The Tradeoffs Advisory Board…

…and our stellar staff!