Tuesday 1 March 2022

Worse case worlds

Sometimes, regulation is the best way of dealing with a problem. Other times, leaving people alone to weigh up risks and decide things for themselves is best. 

And we can always argue the toss about cases in the middle. 

But what is really dangerous is cases where people think they're in a "government is protecting me against this risk so I don't have to think about it" world when they're really in the other world. 

It's dead obvious when you think about bank bailouts and deposit guarantees. If everyone knows there's no chance of bailouts, then everyone exercises prudence and banks are disciplined. If there's deposit insurance that charges a fair risk-rated premium, that can work too. I prefer the former, but the latter can also work. What really sucks is when people expect there'd be a bailout, and so exercise that level of prudence, but they're really not in that world.

I worry about the transition to the current Covid phase.

For two years, Kiwis had a very compliance-focused mindset. The government was setting piles of rules and changing them regularly. The rules often didn't make a lot of sense and were hard to apply in particular circumstances. So folks focused on how to comply with the guidelines - with a few notable exceptions. Companies that contracted for regular Covid testing of their staff - they were taking a more risk-focused approach. But that was the exception. Baseline risk was low, so a compliance-focused approach wasn't crazy. 

We're not really in that world anymore. Baseline risk is very high. The government's guidelines are, at best, a minimum - and often downright wrong and misleading. 

Consider the advice about masking in indoor exercise venues.

The advice about masks and exercise is downright wrong and dangerous. Exercise in indoor settings with poor ventilation is one of the very highest risk activities for transmission. Lots of people breathing heavily in an enclosed space. 

Here's what Otago's people said about masks in exercise, back during Delta.

Bars, nightclubs, gyms, restaurants, churches, and indoor social settings – While there may be hesitation to utilize masks in settings which involve maximal respiratory effort (e.g. singing in churches, exhaling heavily during exercise in gyms, energetic children in primary schools, active indoor workplaces, and nightclubs where there is often dancing), it is precisely these venues that pose higher risks for transmission of SARS-CoV-2 from airborne particles expelled by heavy exhalation [3, 20]. New Zealand’s own experience during this current outbreak highlighted how there was a high rate of transmission of COVID-19 amongst individuals in the Mangere church cluster.

Plenty reasonable to argue about cost-benefit of masks in indoor exercise settings when baseline prevalence is low. If there's hardly any Covid around and people are vaccinated, there's not a lot of risk to be guarding against. But when positivity rates in asymptomatic surveillance testing by Rako are currently 4.5%, you only need 25 people in the gym to have an expected case there. And that case is going to spread. 

We've been pulling the kids from indoor activities that are unmasked. Before doing so, we get in touch with the venues they attend. They're in a ton of activities. 

One kung-fu centre where they train refuses to implement a mask requirement, explicitly citing the Ministry's mask guidance saying that no masks are required in exercise. Our kids will not be going back there for a while. The other centre has shifted to outdoor training, in part because their floor is being resurfaced, so they can continue at that one. 

One of the kids also does circus. The circus venue also pointed to the Ministry's guidance as reason they're not requiring masks - but they're at least looking at the Otago work. 

If I thought there were any method to the Ministry's madness, I'd have to conclude that they want to have as hard and fast of spread as possible, to get it through before winter. But the more plausible explanation is inertia and incompetence. 

Bottom line: Do not consider government guidance as anything other than a minimum. A very poor minimum. 

No comments:

Post a Comment