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There are a boatload of known unknowns and unknown unknown with this pandemic, but the overwhelming death in New York City (and Italy) is a fact. At a minimum, any talk of this being roughly like a bad flu is sheer stupidity at this point.

This comparison with the flu has become the new Hitler - never to be used in any comparison. But you and Jim and others should drop your holier than thou kick - it’s a perfectLy reasonable comparison to make.

SARS-CoV-2 is a bug that’s ‘newer’ than the common flu bug (less immune experience), and so would seem to have the potential to infect more humans. It also seems somewhat more contagious, so in normal, non-lockdown conditions, it spreads faster (despite a longer incubation period - five days instead of two.) It’s lethality, in symptomatic cases, is much higher than for symptomatic seasonal flu (about 1-2% instead of 0.1%), but the really big unknown is the proportion of asymptomatic cases, which we thought until recently was about half, but may be far smaller. Recent information from influenza-like illness excesses, sewage analysis, and jurisdictions like Iceland with high rates of testing, indicate that we can be cautiously optimistic on that score.

The Gangelt cluster analysis is the most convincing, and suggests that the infection fatality rate is 0.37%, much better than the 0.65% that previously seemed like the best estimate, and that would correspond to a rate of asymptomatic disease more like 80%. That would still mean we might get 80%*0.37%=0.3% of the population dying, which is still a million Americans, or 20 times the ‘bad flu’.

The somewhat less certain conclusions of the Silverman study would put us much closer to a bad flu, but with highly concentrated deaths in a few weeks rather than the typical whole winter. That would be fantastic news, if it’s right, but it’s too soon to say. Seroprevalence surveys that have started already should answer the question pretty definitively in the next 2-3 weeks, and we will know whether we can start ending the lockdown quickly or whether it has to be lifted slowly, starting with the young, healthy 60% of the population (below 50) for whom this coronavirus really is ‘just a bad flu’.

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