The Buffalo Bills’ $258 million deal reached earlier this month with quarterback Josh Allen had Dr. Jerome Adams rethinking his career choices – on Twitter.
“It’s times like this that make me wonder if I spent too much time in the library and not enough time outside working on my spiral,” tweeted Adams, who did OK for himself. A former high school running back, he became an anesthesiologist, then the Indiana health commissioner, and for most of the Trump administration, served as United States surgeon general.
“I would be happy with 1% of that contract,” added Adams, capping one of the more lighthearted posts in a Twitter feed that is loaded with posts promoting Covid-19 vaccines and mitigation measures such as masking.
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As surgeon general, Adams was frequently speaking from the White House Briefing Room podium, on national television interviews and touring the country meeting with local officials and community members. Now as a private citizen – which he became when President Biden took office and replaced him with Dr. Vivek Murthy – he’s remained a prominent voice in the pandemic discourse. Much of Adams’ message is encouraging people to follow odds and logic: For example, you’re exponentially more likely to have a catastrophic outcome from Covid-19 than you are from a vaccine.
Or, on a lighter note, a kid today has “a much better chance of being a doctor and the surgeon general of the United States than they do of becoming Josh Allen,” Adams told The Buffalo News in a telephone interview earlier this month.
Covid odds, quarterback odds – you’d think we would grasp these readily by now, but surprisingly, we often don’t. In this installment of Pandemic Lessons, we explore why people often grapple with gauging the information in front of us — even when it’s in hard numbers.
How are we struggling with information?
Emotions often outweigh logic – that’s human nature. Big-picture data and trends tend to tell us what’s happening, but heart-wrenching examples – and heartwarming ones, too – tend to stick in our minds.
This is why people are more afraid of flying than driving. Flying is many times safer, but because airline crashes are both sizable and rare tragedies, they get a lot of attention – and so we remember them. It’s also why you’ll see so many parents investing large sums of time and money in their child’s athletic career: That kid might just become the next Tiger Woods, Serena Williams or Josh Allen.
Might.
Adams, who visited the Pro Football Hall of Fame inductions earlier this month and spoke from his car as he drove home to Indiana from Canton, Ohio, noted that at the ceremonies, “they talk about the percentage of people who played high school football and the minuscule percentages that then make it to college, and make it to the pros and then make it to the Hall of Fame.”
Those percentages, which vary slightly based on how you calculate the factors, are essentially this: Just under 3% of high school football players make it to Division I, according to the NCAA, and 1.6% of college players make it to the NFL. The Hall of Fame represents roughly the top 1% of athletes, coaches and front office personnel in league history.
So yes, you’re more likely to become the next Jerome Adams than Josh Allen. And, as the former surgeon general has been pointing out on social media and in interviews, you’re more likely to get sick if you’re unvaccinated. Adams recently posted Covid-19 hospitalization graphics from San Diego (in one month, 521 unvaccinated; 13 fully vaccinated) and Houston (in a single day at one hospital system, 88 hospitalized, 79 unvaccinated, and all 13 people on ventilators were also unvaccinated).
“The simplest answer is usually the correct one,” he tweeted recently, reacting to notions that another respiratory bug – RSV – explains the rising number of children in hospitals and that something other than Covid is to blame for the hundreds of thousands of American deaths. “So why are so many twisting themselves in knots to try and explain why pediatric hospitalizations are skyrocketing (it’s not RSV) or 620,000 are dead (it’s not asymptomatic Covid plus something else). It’s a nasty #covid19 virus.”
How do you cut through emotions and make sound decisions?
Think in terms of “risk and benefit,” said Dr. Gregory Poland, director of Mayo Clinic’s Vaccine Research Group.
During a recent media briefing, Poland addressed one of the most oft-held fears about vaccines: that they can impact a person’s ability to bear children. Poland listed a series of indicators: There is “no evidence of any ill effect on pregnancy,” he said, and “no evidence” of impact on fertility, which is “a little harder to measure in women.” He noted “at least a couple studies in men showing no ill effect on sperm count or semen quality, which are both markers of fertility.” He also acknowledged that researchers are watching for rare examples of vaccine side effects – such as fever – temporarily impacting a woman’s menstrual cycle.
At this point, Poland said, there is no indication of a reproduction problem – and scientists are detecting vaccine risks “as low as 2 to 4 per million doses,” he added.
Poland then referenced Centers for Disease Control and Prevention data from “right before” the Delta variant hit the United States broadly. “They looked at 204 adolescents 12 to 17 that ended up getting hospitalized from Covid. So I'm going to worry here about (a) one in 10 million risk in regard to a transient perturbation” – the brief menstrual interruption – “in fertility. Or if I'm an adolescent, and I get hospitalized, a third of them needed ICU care, 5% of them ended up on a ventilator.
“Choose your risk.”
What’s our risk here of being exposed to Covid-19?
Western New York is not Florida, but we’re not good, either.
A real-time, interactive risk-level map created by Georgia Tech researchers indicated that if you attended a 50-person event in Erie County on Aug. 18, there was a 16%-25% chance that at least one person would have Covid. (Niagara County was 14%-22%.) By contrast, Miami-Dade County in South Florida had a risk of 81%-94%.
That differentiation from a Southern hot spot may be reassuring, but don’t take too much solace. Western New York’s seven-day average case count on Aug. 16 was 172 – more than 14 times higher than the average of 12 cases on July 1, and more than four times higher than the case count from one year earlier, when there were no vaccines available. Our hospitalization and intensive-care numbers are four to five times higher than one year ago. But Western New York's death numbers have not risen accordingly. In July, for example, Erie County reported 11 Covid fatalities – a stark drop from January, when the public could not yet be fully vaccinated and the county reported 269 deaths.
"Locally, cases and hospitalizations are up, but nothing like what is being seen elsewhere, particularly the south," said Dr. John Sellick, an epidemiologist with Veterans Affairs, Kaleida Health and the University at Buffalo. "So far, our deaths have remained steadily low, again unlike Florida and others. Regardless, school and more indoors activity likely will push up case numbers unless we get more people vaccinated and we all are compliant with distancing and mask use."
What’s the best way to make decisions going forward?
Adams offers three points for decision-making:
• Know your risk. “Am I someone who has medical conditions?” Adams said. “Am I someone who is young and healthy? You have to understand your personal risk. Am I someone who is helping to take care of a vulnerable individual at home? And in that instance, it's not just about your personal risks; it's about the risks that you present to others who you love, or who you care about, who you're going to be around.”
• Know your circumstances. Be aware of whether you’re going to be in an area of higher or lower transmission, or in a place where masking or proof of vaccination is required. “If I'm going out to a restaurant in New York (City)” – where proof of vaccination is mandatory for indoor dining – “I might feel more safe than if I'm going to a restaurant somewhere else,” Adams said.
• Know how to stay safe. That includes vaccination and masking, Adams said, and in some circumstances, distancing and handwashing. It also includes “making a choice to stay home,” he said, “if you feel like the risks are greater than the upside of you going to these different events.”
