How to talk to your boomer about COVID-19
First, don’t just send them this article, actually talk to them. Preferably at a safe distance, outside, or over the phone.
Why should I try?
Because they’re your grandparents, your parents, your co-workers, your neighbors, and your friends. In several ways I’ll go into below, they likely under-appreciate the problems they face. Furthermore, they’re dramatically more at-risk than people under the age of 60. Anyone who is older than 60, and/or who has severe health concerns such as obesity or diabetes, will likely fare poorly if infected by COVID-19.
Italy is currently turning their older citizens away from hospitals to die at home because their healthcare system, one of the best in the world, is completely over-taxed and failing.
Don’t let that happen to your grandma because you didn’t try to talk to her.
Explaining exponential growth
Over the past few days I’ve talked to five different people, all 60+, two with diabetes. Despite their elevated risk levels none of them have been taking even low-impact commonsense steps to lower their exposure to the new Coronavirus.
The first problem is that most people don’t really get exponential growth rates. We usually live in a linear world, where things grow or decline at steady rates. Sometimes things change slowly and sometimes they change quickly, but usually the best way of telling what a stock price or a tree height will be tomorrow is to ask what it is today.
Exponential growth rates aren’t like that. They look like it at first, but then they get weird, suddenly. It’s hard for people to really intuit that, so I start out with two questions. In order to get peoples’ attention it’s best to launch straight into these questions as soon as the boomer indicates some skepticism about COVID-19 risk potential.
“This is going to be a little odd, but bear with me. Imagine there’s some lily pads in a lake. [Pause for eye contact and skeptical glares. Nod confidently and continue.] Every day the patch of the lily pads doubles in size. On the 20th day, they cover the lake exactly. One what day do they cover half the lake?”
Mathematically-inclined listeners will correctly answer “day 19”. For anyone who may not have figured that out themselves, explain “The lake is full on day 20, so in order to double and be full, the lake was half full on day 19.” [Wait for dismissive ‘well, duh’ nods from the ones who got it right, and sheepish ‘oh, duh’ nods from the rest.] Then ask them the really interesting question:
“What is the last day where less than 1% of the lake is covered with lily pads?”
This one is the super-important question. Anyone can grasp an increase that hits 100% on day 20, and hits 50% on day 19. That part is easy to visualize. What’s less easy to visualize is exactly how TINY AND IGNORE-ABLE AN EXPONENTIAL FUNCTION IS RIGHT BEFORE IT GETS HUGE.
It blows peoples’ minds that an exponential growth function that covers a whole lake on day 20 is still covering less than 1/100th of the lake on day 13.
Fortunately COVID-19 isn’t doubling every day. If it were, then it would only take about 30 days after Patient Zero to infect the entire population of the United States. (Drastically oversimplified, I know. Bear with me).
Unfortunately, confirmed COVID-19 cases are increasing at about 33% every day in the absence of containment. That’s a slower function, but it’s not all that much slower of a function.
Note: I’m aware that the curve is an ‘S’, not purely exponential. Up until the inflection point, there’s no difference between the two. Where that inflection point occurs depends on the containment actions we take today. Moving on.
Objection 1: “There’s no cases where I live”
Boomer: “There aren’t any cases where I live.”
Response: “Only because they haven’t tested anyone where you live.”
The CDC reports that 15,406 tests were accomplished as of March 11th. That’s about 0.0047% of the population of the United States. What percentage of people reporting dry, rasping coughs and flu-like symptoms is it? I’m not sure, because most places don’t keep as good of symptomatic health data as NYC.
EpiQuery | Search for data, surveys and records on the health of New Yorkers
Count of cases reporting flu-like symptoms in NYC hospitals, 2020. a816-health.nyc.gov
NYC’s count of cases presenting flu-like symptoms has a spike from our normal seasonal flu, trailing off in mid-February. That resurgence afterwards? Probably mostly COVID-19.
The lack of testing conducted by the CDC has been addressed at this point, but apparently some people haven’t gotten the message. People infected with COVID-19 are frequently contagious before they display any symptoms.
Any reasonable risk assessment should assume that there are plenty of cases which haven’t been detected yet, due to a combination of lack of symptoms and poor testing accomplishment rates. Some of those cases are almost certainly where you live.
People arrive in hospitals with flu-like and pneumonia-like symptoms every day. Currently they’re not being tested for COVID-19 outside of large cities with outbreaks already underway. Tests are finally being distributed and we should have a better idea of how widespread COVID-19 is within the next week or two. However, that week or two we lost is a critical time on the exponential growth chart, and will likely ultimately cause the infection of many more people.
Until tests are commonplace in your community, assume that the virus is present, and implement social distancing and disinfecting and similar precautions.
Objection 2: “Scares like this happen all the time, and they always fizzle out”
Most of the boomers in my life are Californians. Californians don’t have natural disasters. They have scares, but nothing ever comes of them. After 60 or 70 years of being alive and never having an anticipated disaster actually cause any serious problems, I’m sympathetic to how easy it is to think that one never will.
This is called normalcy bias, and it has killed more people throughout history than any plague, army, or earthquake. People watch people to see what they should do. We also have a tendency to adjust our imaginings of what might happen based on our experience of what has happened. That excellent Bayesian reasoning works well with problems that crop up a few times in a given lifespan, but it works very poorly on problems that only crop up once every hundred years or longer.
Comparisons of COVID-19 to the Spanish Flu abound, but I feel most people aren’t sufficiently sympathetic to how hard it is, mentally, to decide that the same thing could absolutely happen to us again.
When I talked to my own boomers I spent awhile talking with them about disasters they’d personally experienced: how anticipated the disasters were, how damaging, and so forth. I shared my own experiences living through two local disasters in the midwest (a flood and a Cat 5 hurricane), and eventually it sunk in.
I don’t think there are any shortcuts for this conversation. I expect it would be harder to convince people who live in San Fransisco or Phoenix than people who live in New Orleans or Miami, but it’s worth doing either way.
Nobody who has lived their whole life in the United States has any significant experience with a truly widespread disaster. When hurricanes or forest fires hit it’s always been a tiny bit of the country that was affected. The rest of the country is sympathetic and undamaged, and help has been swift and massive.
If you know any people who immigrated from countries fleeing massive social order breakdowns they might be able to provide a little more useful experience on how things go when everyone is having the same terrible problems at the same time.
Objection 3: “But Trump _____!”
I found it darkly humorous that both the red tribe boomers and the blue tribe boomers I’ve talked to had reasons why “But Trump ____!” meant that they didn’t have to prepare.
The blue tribe’s was “But Trump is just blowing this all out of proportion so he can seem like he’s doing something in an election year!”. The blue tribe also had “But Trump isn’t doing enough!”. From the same people, oddly…
The red tribe’s was “But Trump is shutting down international travel, and he’s doing an awesome job and we don’t have to worry about it!”.
Double ugh. Listen, I don’t know how to be more clear about this:
What Trump does or doesn’t do, or should or shouldn’t do, doesn’t matter one bit when it comes to what YOU need to do.
Whatever tribe’s propaganda your boomer prefers, the assumed presence of the virus in your community demands certain actions. Governmental response is important for coordinating effective supply sharing between states. It’s important for controlling the rate of spread of the virus in a large scale. It’s important for coordinating knowledge and containment.
But governmental action or inaction doesn’t change the fact that you and your boomers should be implementing some basic precautions right now. It doesn’t change the fact that we’re all already at risk. It doesn’t change the fact that most projections dramatically exceed the number of hospital beds we have available.
It doesn’t change the fact that this “flattening the curve” meme is delusional.
What to recommend
Begin by following the advice from the CDC as far as disinfecting, social distancing, and food storage. Errands should be avoided if possible, and saved up and grouped together if necessary. Following a set of errands, your boomer should carefully clean and disinfect themselves and their clothes, and try to do the same to any acquired items.
Where we can help our boomers is by using our relative health to run any errands for them that they need done, following the same precautions. Picking up medications and groceries should be coordinated and minimized.
To build an example with numbers that I make up entirely, if there’s a 10% chance that a sick person infects a well person through contact, then the more jumps the virus has to make before it gets to our boomers, the better. If I’m healthy and I go pick up groceries for my Aunt, there would be a 10% chance I’d get infected if I have an unlucky contact, and then a 10% chance my Aunt would catch it from me. That resultant 1% chance of my Aunt getting sick is much better than anything she’d get running errands herself.
Where we could hurt our boomers is by assuming that we’re healthy, and not maintaining proper distances from them.
There are already plenty of sources for precautions to take. Do what you can, and help your boomers find good sources and implement plans.
I hope this all fizzles out, but that’s looking less and less likely every day.
Help the people who are most likely to be hurt.
Do what you can where you are.
This is your call to action, stop waiting for politicians to tell you to do the things you already know you need to do.