Cleared For Departure
Travelog by Lance Darcy​​​​​​​
Sample from Series 6: South Africa
TL;DR Bathtubs and canoes are deadly, sky diving much less so. Turns out assessing risk is tricky. A 5 minute discussion on the emotion of risk. 
15 hours from departure.  
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I got up at 4 today in an effort to push my clock forward and help ease the jet lag.  Rebecca, I’m sad to say, didn’t make it.  
One question Rebecca and I have repeatedly asked ourselves, “Is going really a good idea?” Some of you have asked that too, with varying degrees of subtlety. Given all this pandemic unpleasantness, it’s worth some thought. The answer, however, is a nuanced one. 
Humans are quite terrible at assessing risk. People refuse to fly but routinely drive (which is incredibly dangerous by itself) after having consumed an alcoholic beverage (or two). We know it’s risky, but we do it anyway. I’ve said before: This century more American civilians have died in their bathtubs than in all the terrorist attacks combined. The War on Bathtubs, however, is not forthcoming. Skydiving … incredibly dangerous, right? Not really. Your chances of dying are 1 in 100,000 (or 1 in every half a million tandem jumps). Death by canoe? A full order of magnitude more likely. Poisoned Halloween candy? Parents beware! Neighborhoods on alert! (Actually, it’s an urban myth and has never happened.) The very real health dangers of childhood, and later, adult obesity? Pass me the Mini-Snickers. You know, make it two. Death by motor vehicle accident? I suggest never looking it up.

A downright cute little virus.

Establishing the inherent risk of an activity is difficult enough. However even if we do establish risk, using an enormous data set from a long period of time, we rarely alter our behavior because of it. I’ve explained the risks to people afraid of flying and — would you believe — not one has thanked me and stopped being afraid. Fear is emotional, and therefore immune to logic. Instead of data, we tell ourselves stories. So with driving we internalize the story of our above average driving, (which is, overwhelmingly, a complete fantasy given the data), or our safe vehicle (even though above a certain speed survivability boils down to an unknowable interplay between luck and physics), or the story of being in control (which only ever extends to a single person, you, to the exclusion of everyone and everything else on the planet your accident may involve). That said, I wonder how in control anyone really is of themselves.

I pulled this from “How to explain COVID to your kids."

But that’s it, isn’t it? Control. Are we in control? Or do we feel in control, and thus safe? Not so in airplanes or falling from the sky or wafting through mutant viral particles floating on the breeze (felt to be risky), but yes in bathtubs and in canoes and our cars (felt not so risky). Home, controlled. Africa, wild and untamed, “third-world,” risky. Ultimately the numbers don’t matter, it’s how we feel. The numbers justify how we feel, the stories add buttressing.
Less cute.  More factual.
Regarding home, I am not sure how safe and controlled it really is. The United States is an incredibly dangerous place for catching COVID. Large parts of our population think mask wearing is ineffective or inconvenient, an infringement on their liberty, despite the data. During a study last fall, we accounted for 22% of the world’s COVID deaths but are only 4% of the world’s population. As of March 20th the U.S. sits at number 11 in deaths per 100K, meaning except for ten countries, every other country on the planet is doing better at limiting transmission. Scenes from Miami might explain why. The U.S. mortality rate is a mediocre 1.8%, which is close to the international median. In Yemen, it’s 22%, Israel, .7%, in South Africa it’s 3.4%. In terms of catching COVID, leaving the country might be the safest course of action. In terms of surviving COVID, there are better places to be than South Africa. Most travel insurance covers repatriation for such a circumstance.

At the size of a virus, there’s no such thing as color.  So humans added some.

However the United States is not monolithic, and neither is South Africa. Plenty of regions here have greater or lesser risk, as do places in South Africa. The two provinces we are in for most of the trip have approximately 2,000 active cases, as of mid-March. So in an area encompassing 78,000 square miles, roughly twice the size of Portugal, are about 2,000 sick people, give or take. In New York City, about 300 square miles, there were approximately 12,000 active cases on March 20th. But New York City is not monolithic either. In my rich, mostly white neighborhood there are very few active cases. In the poorer areas of the city, the numbers look very different. South Africa has a similar distribution. Risk is nuanced. We generalize when we either don’t know or don’t care enough to look.

The coronavirus compared to the size of a red blood cell.

So what’s the actual, quantifiable risk minus my emotional baggage? Reading from the story of science, transmission on airplanes is not a thing, PPE works when used correctly, wear two masks, take the vaccine, wash your hands often, stay socially distant, don’t stay indoors for long periods of time unprotected with others, eat meals outside when possible, take COVID tests before travel, during travel, and after travel, quarantine until you’re proven negative, and don’t be a selfish, entitled jerk by not considering other people and their health. If you take these actions, your risk and the risk to others drops to almost zero. That’s the story we’ve internalized. In South Africa, we can do all these things. Almost zero works for us. 

This looks very sinister.

What about the various strains? Well, they’re already here. And there. It’s a bit of chaos introduced into the equation. It greatly affects the emotional side, (We have even less control than we thought!) but I don’t see much evidence it affects the logical side. The same guidelines listed above still apply.
Speaking of control …. Rebecca and I realized years ago living in NYC we basically control nothing about our daily lives and have mostly grown used to it. I don’t even have control over the temperature in my own home. It’s either hot, or moderately less hot, year round. We don’t own our apartment, but instead own shares of a corporation. A board of (usually) benign Big Kings and Queens, along with a largely incompetent managing agent acting as Corrupt Sheriff, make decisions about this Little Kingdom I inhabit that I just have to accept. It’s an asinine system of home ownership only a population of self-loathing individuals who enjoy doing things the most difficult way possible would voluntarily ascribe to, i.e., New Yorkers. Since home ownership is already too easy, let’s make every decision a fight to the death for added spice! Just commuting to work takes the effort of scores of people, all of whom I will never meet, doing some aspect of my commute I have zero say over. Life here flows, and the most successful New Yorkers learn to flow with it. But I digress … 

Scenes from Italy.

Sadly, the data suggests this testing, mask wearing, and increased health risk will evaporate anytime soon. We’d all better get used to a little more chaos in our lives, of having less control and certainty, and managing it.  If that thought turns your stomach, travel — international travel especially — may feel too risky for years to come.

A refrigerated morgue truck to hold all the bodies in NYC.

I saw COVID kill enough seniors at my hospital gig to last a lifetime, so beyond this post I likely won’t mention it again. Rest assured Rebecca and I will be as safe as possible. Travel is a gift, a trip to South Africa especially so, and it seems wrong to sully the whole thing by focusing on the virus. We’ve all talked of nothing else for a year now. 
Let’s talk about something else.
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