The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85.
65+ is like 45,000,000 in the US. Half of them get infected, generously let’s say 3% die that’s 600,000 dead. A big part of the IFR in the spring for NYC and Sweden(and probably lots of other places) was determined by the virus getting into care homes or not.
This being said I am leaning towards herd immunity being a decent solution with 2 major caveats:
1. You really need the 65+ demographic to stay reasonably locked down while you’re burning through the rest of the population. And for countries where multiple generations are living together that’s not possible. And for countries where a ton of older people don’t worry about the virus that’s also not possible.
2. You can’t variolate(?) too quickly, otherwise you just blow out your hospital system and suddenly those nice 0.4% death rates blow up into ?? who knows.
I’m super worried about Europe, because I think several countries are going to get pushed to medical system collapse and beyond. Assuming the study above is reasonably representative, let’s say 4% of 40-59 year olds are admitted to hospital, based on the graph above(a group with an IFR of like 0.2%). If the hospital is full what percentage of people that needed to be admitted dies? Does he IFR go up x3? x5?
Was hoping to visit my family in Romania for the holidays, but at this stage I’m probably hunkering down in good old blighty til spring :(
EDIT. Basically I think the situation for herd immunity is both better and worse than what I derive from your post: The IFR for the groups of people we want to get the disease is well below 0.4% on average. But we REALLY want at risk groups to be in close to lockdown mode while variolating.
As an extra wrinkle, viral load seems to have a significant effect on disease severity. If a country is purposefully going for herd immunity, at the peak of the process viral load in closed spaces will be a lot higher than it is these days. That may or may not shift IFR higher for a while.
I feel like the herd immunity section is overly simplistic given how much IFR varies based on age group.
Using https://www.medrxiv.org/content/10.1101/2020.07.23.20160895v7
65+ is like 45,000,000 in the US. Half of them get infected, generously let’s say 3% die that’s 600,000 dead. A big part of the IFR in the spring for NYC and Sweden(and probably lots of other places) was determined by the virus getting into care homes or not.
This being said I am leaning towards herd immunity being a decent solution with 2 major caveats:
1. You really need the 65+ demographic to stay reasonably locked down while you’re burning through the rest of the population. And for countries where multiple generations are living together that’s not possible. And for countries where a ton of older people don’t worry about the virus that’s also not possible.
2. You can’t variolate(?) too quickly, otherwise you just blow out your hospital system and suddenly those nice 0.4% death rates blow up into ?? who knows.
Briefly looking for estimates of hospitalization rates I found https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493765/
I’m super worried about Europe, because I think several countries are going to get pushed to medical system collapse and beyond. Assuming the study above is reasonably representative, let’s say 4% of 40-59 year olds are admitted to hospital, based on the graph above(a group with an IFR of like 0.2%). If the hospital is full what percentage of people that needed to be admitted dies? Does he IFR go up x3? x5?
Was hoping to visit my family in Romania for the holidays, but at this stage I’m probably hunkering down in good old blighty til spring :(
EDIT. Basically I think the situation for herd immunity is both better and worse than what I derive from your post: The IFR for the groups of people we want to get the disease is well below 0.4% on average. But we REALLY want at risk groups to be in close to lockdown mode while variolating.
As an extra wrinkle, viral load seems to have a significant effect on disease severity. If a country is purposefully going for herd immunity, at the peak of the process viral load in closed spaces will be a lot higher than it is these days. That may or may not shift IFR higher for a while.