Individual risk vs. community risk during a pandemic

It is human nature to think of risk in terms of how it pertains to us as individuals. It is understandable how one might think that their own risk is very low of being infected by SARS COV-2 virus, the virus that causes COVID19 disease, when only 10% of those who become infected in the USA develop symptoms severe enough to be hospitalized. An individual may also believe that their own risk is very low if they are generally healthy, not obese, not elderly, not a diabetic, or do not have other major health problems. However, the reality is that we are far from being able to assess our individual risk for most things, including getting severe COVID19 disease.

The concept of lowering risk in a community, versus the individual, is a principle used to fight communicable diseases. Communicable diseases are diseases that are infectious or contagious. Viruses, such as the one that causes COVID19, fall into this category. Unlike predicting the risk for a single individual, epidemiologists look at the big picture. They predict the risk within communities. Many factors are considered for these predictions that include defining the community, the percentage of people in specific age groups in that community, the size and population density of a community, environmental factors that may increase risk (like wildfire smoke), and many other important factors. Another important concept about risk is that it is never zero.

By understanding the community risk and the behavior of the infectious agent, appropriate interventions can be undertaken that reduce that risk. These mitigating actions also reduce individual risk, but the greatest impact is on the community, thus everyone's risk is reduced. This is what facial coverings, social distancing and vaccines do. Vaccines have the greatest impact.

A pandemic defines the community as a global community, that is, the infectious agent is prevalent worldwide. Obviously, there are many communities that make up the global community and each may have their own unique risk. However, they are all still part of the global community, especially, with the ability of many individuals to travel from one community to another. So, for risk reducing interventions to be most effective, it is best if they are practiced by all individuals. If they are not, the risk will not be lowered as much as possible, and some communities will have a higher risk than others depending upon the risk factors of each community. This gives the infectious agent opportunities to infect more individuals, spread, replicate, and mutate to become even more infectious.

In communities where risk reducing measures are not being used in a large portion of the population, and especially if the community is densely populated, the COVID19 virus will continue to infect people. This increases the numbers of people with severe illness needing hospitalization. These numbers can be large enough to overwhelm hospitals with those suffering from severe disease. This in turn has a negative impact on other members of the community who do not have severe COVID19 disease, but who may have had a heart attack, a stroke, or who may have suffered some sort of severe trauma and need hospital care. Their care can be delayed or substandard because resources are being directed towards the large numbers of those who have severe COVID19 disease.

Health care resources include the people who work in health care. The emotional and physical stress that such surges place on health care workers cannot be overstated. Many are suffering from anxiety, fatigue, depression, and burnout, and are leaving the health care profession. Some have committed suicide as direct result of dealing with the large amount of severe illness and death. The trauma they are experiencing is like that of veterans who have been in war. Their loss from healthcare will in turn negatively impact communities for some time to come.

Most of the individuals getting very ill, requiring hospitalization, and dying from COVID19 are not vaccinated. Individual risk does not equal community risk, but they are connected. So, every individual needs to do their part to reduce risk of serious illness and death for themselves, for their families, for their local community and for the global community. Show your concern and love for others by getting vaccinated.