To Navigate Risk In a Pandemic, You Need a Color-Coded Chart

Half a year since the emergence of Covid-19 and months since cities and states went into lockdown—and, to varying degrees, came out again—we’re more than familiar with the basics of what we should do to protect ourselves: Stay home if you can, social distance when you can’t, and wear a mask when you have to be less than arms-length from people.

That guidance is simple—too simple, perhaps. It doesn’t account for the complexities of how to live in a pandemic, or answer the questions that come up every day. Is it safe to return to an office? To undergo procedures at the dentist? To sit in a doctor’s waiting room? If you want to exercise, is shooting hoops smarter than tennis? If you need solace, is a library safer than church?

There’s no federal guidance for such questions, but there are beginning to be guides: color-coded charts that estimate the relative risks of everyday activities. They might look familiar, if you live in a place like Georgia where pollen count sliders tell you when it’s safe to go outside, or if you’ve visited US National Parks, where fire danger signs let you know it’s OK to light a campfire; they are mostly colored in the familiar hazard range of green-yellow-red. They come from individual scientists, from academic researchers, and from professional organizations, and they provide insight and support for the daily decisions of life in a pandemic: the equivalent of a traffic light flashing stop or go.

The first to be published, the Covid-19 Risk Index, is the creation of three public health experts. Ezekiel J. Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania, and formerly an adviser in the Obama White House, launched the guide in a personal blog post on June 30, explaining that the team plotted possible activities on a matrix with four axes: whether an activity would occur in an enclosed space; whether it would attract a crowd; whether it would subject someone to “forceful exhalations” (sneezing, yelling, singing or coughing); and how long the activity would last.

The other authors are James P. Phillips, a physician and the chief of disaster medicine at George Washington University Hospital, and Saskia Popescu, an infectious disease epidemiologist at the University of Arizona. Popescu simultaneously released it on Twitter, where it has been liked more than 2,300 times. The goal, she says, is to move communication about Covid-19 risks away from a binary “do this/don’t do that” message. “We wanted people to understand, as life opens up, that there is a range of possible risks, and there are things you can do to stay safe, and things you might want to avoid,” she says.

Giving people permission to do things that seem likely to be safe was an important part of formulating the next guide to be published, which was drawn up by the Covid-19 Task Force of the Texas Medical Association and released July 8. Like the Emanuel group’s guide, the Texas guidance starts in deep green and cascades to bright red, passing through lighter green, yellow and amber. Unlike its immediate predecessor, it stacks activities vertically instead of horizontally—and it also subdivides each color group into more and less risky activities. Within the light greens, for instance, it ranks playing golf as less risky than walking through a busy downtown; among the ambers, it judges a hair salon visit as less risky than a plane ride. (Since it originates in Texas, home of some of the country’s largest mega-churches, it specifically lists “religious service with 500+ worshippers” as something to avoid.)

social experiment by Livio Acerbo #greengroundit #wired