Ill WillThe Problem With Individualizing COVID Risk

Young couple wearing face masks waiting in airport area (Photo credit: izusek/Getty Images)

Rebecca Epstein-Levi is Bitch Media’s 2020 Sacred Writes Writing Fellow

American society has a massive risk problem. Our tendency to understand risk in all-or-nothing terms has been typified in modern decades by the perseverance of abstinence-only rhetoric around sex and drug use; the most recent iteration of this tendency, however, has come into sharp focus during the COVID-19 pandemic. Donald Trump’s chief of staff, Mark Meadows, illustrated this recently (and egregiously) when he recently told CNN’s Jake Tapper that, despite surging transmission rates, the U.S. government is “not going to control the pandemic.” The rise in cases in the past month alone, meanwhile, speaks to another feature of the American view of risk: It’s a realm where individual liberty takes primacy over collective responsibility. Public-health messaging refers to “high-risk” or “low-risk” individuals; the wearing of masks is framed as “virtue signaling” and the refusal to do so as admirably masculine and nonconformist.

As cases surge, hospitals are swamped, and public-health experts plead for us not to gather for the imminent winter holidays, it’s absolutely critical to revisit this tendency, especially with regard to real-life concerns about quarantine fatigue and questions about balancing COVID risk against other risks, including material precarity and psychological stress. Economist Emily Oster recently called for K-12 schools to reopen in person, noting in a piece for The Atlantic that they seemed to present a much lower transmission risk than initially feared (although there are some questions about the studies she cites). Also in The Atlantic, epidemiologist Julia Marcus argued that we should find lower-risk ways to enjoy a degree of recreation and in-person social contact. And in a recent open letter that called on universities to take less punitive approaches to student socializing, Marcus and more than 100 coauthors compared strict campus isolation policies to abstinence-only sex education, drawing a parallel between sexually transmitted infections and COVID.

Marcus and her colleagues aren’t the only ones to draw this parallel. In the nine months since COVID arrived in the United States, experts and laypeople alike have compared the desire for in-person socializing to the desire for sex, COVID-19 testing to STI testing, and face masks to condoms. As a Jewish ethicist who studies sex, contagion, and social risk, I’m intrigued by these rhetorical moves. The parallels might not be uniformly apt, but the one between COVID and STIs in particular offers an important opportunity to observe our relationship to risk and what informs it. COVID-19 and STIs both teach us that an all-or-nothing approach to risk isn’t just wrong; it’s dangerous. At the same time, however, calls for greater COVID risk tolerance can fail to appreciate the ways uncontrolled COVID spread disproportionately affects already-marginalized communities. A set of ancient texts that I study extensively may have some resources for helping us think about these risks more justly.

The rabbis of the Mishnah—a written record of rabbinic oral discourse from between 70 and 200 CE—spend quite a lot of time engaging with the subject of “ritual impurity,” a socially communicable condition that’s incompatible with the presence of holy objects. Ritual impurity is neither rare nor unique; rather, it’s a condition humans constantly pass in and out of. One might contract impurity from a bodily discharge, or from numerous kinds of physical contact or proximity with already impure persons or objects. For example, one could become impure by causing someone with an irregular genital discharge to move in specific ways or by being under the same shade as a corpse. Thus, the rabbis of this time treat impurity as a ubiquitous, multifarious form of social contagion requiring ongoing and vigilant management. The moral focus of their discourse isn’t on whether or not a person is impure; it’s on diagnosing ritual impurity correctly and managing it attentively—being aware of one’s risk for contracting or transmitting impurity and responding appropriately to that risk. In my own work, both academic inquiry and public scholarship, I’ve argued that we can draw several lessons from rabbinic impurity discourse and apply them to discussions of STI risk management and sexual health more broadly. Three major features of this discourse are also helpful for thinking about COVID, and each can help us think about risk in ways that prioritize justice and acknowledge the material realities in which real people live and die.

Risk Is Complex, and Shaming People is Wrong

Marcus and her colleagues are correct to point out that social shaming and punitive enforcement of public health measures are both ineffective and unethical. Studies from the realm of STI management, especially the HIV-AIDS pandemic, have found that shaming and policing tactics shift undue responsibility for contagion management from institutions to individuals, and places further burdens on communities that, in the case of COVID, already suffer disproportionate rates of infection. As Marcus and her colleagues point out in their open letter, for example, the same young people who are targets of an outsized share of both social stigma and harsh punishment for risky behaviors are also likely to hold public-facing jobs out of economic necessity, especially if they are also marginalized in other ways.

The open letter’s authors are also correct to recognize that risks are never unidirectional and that risk management always involves weighing multiple factors. Just as STIs aren’t the only risk people must consider when making decisions about sex, COVID-19 is not the only risk people have to consider when they make decisions about most aspects of their daily lives. Sheltering in place means sacrificing vital ways of relating to one another. It may involve significant psychological distress, and it puts many individuals at greater risk for domestic violence. Hospital and medical protocols can mean delaying care for non-COVID conditions, and an inability to work from home means very real, material risks—losing income, losing housing, losing the ability to provide and care for families. Shaming people for their risk behaviors isn’t just unethical and ineffective—such behaviors are not a binary matter of “risky” or “not risky,” but one of choosing which risks to take.

Get Bitch Media's top 9 reads of the week delivered to your inbox every Saturday morning! Sign up for the Weekly Reader:

The rabbis of the Mishnah understood this. They didn’t shame people who had contacted or transmitted impurity. They understood it was ubiquitous, and that people would have a number of concerns and priorities as they went about their day-to-day business, of which impurity was only one. Not only was contracting or transmitting impurity not in and of itself morally shame-worthy, but some activities that inevitably transmitted impurity—for instance, preparing a corpse for burial—were in fact ritually commanded. Where our responses to individuals’ choices during this pandemic are concerned, we should take a lesson from them, and respond with care and compassion.

Needlessly Endangering Others is Also Wrong

That said, it doesn’t follow that treating the subject of risk management with nuance and compassion means being lax about spread or flattening things out to the lowest common risk denominator. The rabbis believed it was critical to correctly diagnose, manage, mitigate, and treat impurity as it occurred, and to do their best to keep it from having major communal consequences. They also understood that not all forms of impurity shared the same level of severity or posed the same risk of transmission to the same people at the same time. This is important with regard to STIs, whose management burden falls disproportionately on women, BIPOC, and LGBTQ people. It’s an even more critical thing to remember with regard to COVID, which is far more easily transmissible and whose uncontrolled spread has massive consequences for nearly every aspect of public life. 

Marcus is correct that it’s important to find ways to help people live their lives during the pandemic. But doing so must not come at the expense of other people’s ability to stay alive, let alone be in public at all. Defaulting to the risk profile of a less marginalized group without seriously considering the (higher) risk profile of a more marginalized group is itself a form of incorrectly flattening risks—one with deadly consequences. In particular, many disabled and chronically ill people are at far higher risk of serious illness and death from COVID, both because of medical complications and because medical ableism means that providers might decide that their lives are already worth less and withhold lifesaving resources and care. This isn’t just speculation—in June, for example, a Black disabled man named Michael Hickson died after his doctors decided that aggressive COVID treatment would be futile due to his spinal-cord injury. The more cavalier that nondisabled people are about containment measures, the longer many disabled and chronically ill people will have to maintain the strictest possible ones simply to stay alive.

It’s true that all social activities bear some level of risk. This doesn’t mean that we have no choice but to jettison our collective responsibility for risk management.

Tweet this

It’s true that all social activities bear some level of risk. It’s equally true that, to a certain extent, we must each decide how to balance the risk of contracting and transmitting the virus against the psychological, social, economic, and often competing medical risks of limiting various kinds of activity. This doesn’t mean that we therefore have no choice but to jettison our collective responsibility for risk management. On the contrary: the fiendish complexity of risk management during this pandemic requires all of us to be better, more considerate social actors. This, again, is something the rabbis understood, given that nearly all day-to-day activities risked transmitting one kind of impurity or another. But the unavoidability of ritual impurity required them to talk about it intensively and figure out its workings in exhaustive detail. The inherent inescapability of the condition made it all the more imperative to pay careful attention to one’s impurity status, to clarify what activities someone who’d contracted a given type of impurity should refrain from, and to assiduously cultivate socially responsible habits. When we as individuals make decisions about what risks to take, we should look at the details soberly and seriously consider how our choices affect what choices are available to others in our communities. And then we should think about who we might not have thought about the first time.

Risk Management Is Always Systemically Located

In a July 2020 interview with NPR, Marcus said that her anger about the unchecked pandemic “is more directed at institutional failures than individual ones.” She’s not alone: The amount of COVID-related talk that’s exclusively about individual risk management is neither accidental nor inevitable. Rather, it’s a consequence of the massive dereliction of duty on the part of federal, state, and local governments whose job it was to give clear information and distribute the resources necessary for everyone to shelter in place, and when that wasn’t an option, to stay safe and protect others. It’s equally a consequence of the ways our political and healthcare systems already make it gratuitously difficult to access vital care and resources—whether that’s by way of medical racism, inadequate health coverage, mass incarceration, or the warehousing of elders and disabled folks in congregate facilities that drive massive outbreaks—in ways that reinforce existing hierarchies of race, gender, class, sexuality, and disability, long before this pandemic.

Put bluntly: The almost exclusive focus on individual risk that has characterized U.S. public discourse on COVID persists because institutions tasked with substantially lightening individual risk burdens can’t or won’t do their damn jobs. We saw this play out in the HIV/AIDS pandemic in the United States, when queer people, especially queer people of color, were forced to figure out how to proceed amid caring for one another and watching more and more of their number die while Ronald Reagan refused to even acknowledge the crisis. And we continue to see it now with COVID, as Donald Trump and his allies hold superspreader events, block relief measures while disparaging mask-wearing, withdraw the United States from the World Health Organization, and attempt to undermine the Centers for Disease Control’s efforts to mount a coordinated response to the pandemic.

One of the most important things to understand about the rabbis’ discussion of impurity is that their conversations happened after the Jerusalem Temple—the central institution responsible for regulating ritual purity—had been destroyed by the Roman Empire during a crackdown against a failed rebellion. This emphasis on individual attention to purity status is especially poignant and unsettling when one realizes that their discourse occurred in tandem with  their awareness that the infrastructure necessary to manage that status lay in ruins, a grim tribute to imperial will to power. 

And that is something we should be aware of as well, with COVID and STIs alike. Our public institutions have the obligation to make sure that infection risk can be managed and mitigated in ways that allow everyone—not just nondisabled straight, white, wealthy cis men who have “acceptable” ways of socializing, but everyone, especially BIPOC, disabled people, trans people, queers, sex workers, drug users, poor people, and other people our society treats as dangerous or disposable—to flourish, to maintain social bonds and lifegiving human connections. In the case of both COVID and STIs, those institutions have failed spectacularly. We must not lose sight of where the burden of risk management ought to fall. We must not fall prey to the temptation to punish individuals, especially marginalized individuals, for institutional failures. And we must hold those institutions accountable for their unconscionable dereliction of duty. The people responsible for this have let more than 236,000 Americans (and counting) die as grim tribute to their own will to power without apparent risk to their own welfare. They, too, should be forced to grapple with a massively increased burden of risk.

photo of Rage member Jae Hermonn, a Black woman with shorn hair and wearing glasses, holding up a yellow mug with the words “Filled With Rage” Like what you just read? Help make more pieces like this possible by joining Bitch Media’s membership program, The Rage. You’ll get exclusive perks and members-only swag, all while supporting Bitch’s critical feminist analysis. Join Today

A white woman with short, wavy brown hair and wearing a grey wool blazer looks back over her shoulder.
by Rebecca Epstein-Levi
View profile »

Rebecca Epstein-Levi teaches Jewish Studies and Gender & Sexuality Studies at Vanderbilt University. She’s an expert on Jewish sexual ethics and is revising a book about sex, risk, and rabbinic text. In her copious free time, she enjoys cooking, sharpening her overly large collection of kitchen knives, and hanging around (and just maybe writing for) her smallish corner of fandom. You can follow her on Twitter @RJELevi.