That is wonderful, because then 100% of NYC should have been infected. Unfortunately antibody tests say that only 25% has been infected.
Reality meets "realistic estimate"
Or two other possible 'realities':
1) Something about NYC caused more deaths than elsewhere.
2) Data from NYC are not accurate.
And maybe not everybody gets infected, even when the virus enters their bodies...
For the first time, the US Centers for Disease Control and Prevention (CDC) has given a realistic estimate of the overall death rate for COVID-19, which in its most likely scenario is 0.26 %.
But does the CDC really say this, or is it twisted through a partisan filter? That site leans right-wing, right?
If they do say this, colour me surprised.
The NY Times has now REMOVED its excess death counter for NYC. And switched it with US only, I think this this is political. In any case it was 24,800 before it was taken down.
The CDC DOES now say .26% death rate but I think this is wrong due to the data from NYC which says we have 25K dead. If baseline immunity (children + young the virus totally bounces off of) is 20%+, that means NYC is now 50-60% immune, which means the virus is going to have a very hard time sustaining any subsequent rounds of transmission, especially because those infected were the most SOCIAL, which means those remaining are less social and inherently less prone to spreading the virus.
My concern with the data from NYC is multi-pronged.
1) I do think it is accurate that we saw about 25K deaths here for an IFR of .75-1%.
2) I don't think NYC is special. The highest spread was in the Outer Boroughs, with the last number of cases in Manhattan. My zipcode's fatality rate is LESS than the overall US fatality rate (Lower Manhattan -- some neighboring zips are actually at ZERO still, we have 1 fatality in my zipcode).
3) Is 30-40% infection in the primary wave of this virus in a location an upper bound, or is it actually a LOWER bound? NYC was misfortunate because it was one of the last major cities in the NHEM where the late arrival of spring precluded an early end to the virus (perhaps more pop-wide vit D deficiency in NYC is to blame especially in people of color, who have died 2X the rate vs. white people and Asians). But perhaps this "primary" wave of the virus was actually ABBREVIATED in NYC because it became so severe as the seasons shifted from winter to spring / summer? Thus NYC now has partial / possibly sufficient infected pop for herd immunity.
These congruencies lead to an observation that NYC was UNIQUE (alongside perhaps Lombardy and Wuhan) as a location where the first wave of COVID is likely to be the deadliest and most impactful by a very wide margin (IMO). But between these unique settings, we saw a first wave of COVID that was 55% as deadly as all THREE waves of Spanish Flu in NYC (relative to total population), and 86% as deadly as the autumnal wave of Spanish Flu, with peak mortality HIGHER vs. overall pop at peak of COVID vs Spanish Flu (about 6.5X vs 6X).
The fact that this happened most prominently in the Outer Boroughs and in rural Lombardy means that it is going to happen EVERYWHERE when the embers of the disease ignite again in September and early October. Even WITH containment protocols, as in Buenos Aires, the disease is going to explode, it just may take longer to do so (and this time, unlike the start of Vit D production in mid-April just two months from COVID's beginning in the West, it is seven months to mid-April from mid-September).
I think that had the pandemic's evolution in NYC *not* met the headwinds of spring, it is possible it could have accelerated to have been WORSE. How much worse? I don't know. It could be 10%, or 20%, or 50%. None of those numbers sound implausible, though I doubt it would have been much worse than 50% (which would put the single wave of COVID at about 80% of the cumulative Spanish Flu toll or relatively HIGHER than the Autumnal Wave's impact).
In any case, in NYC, we have literally just moved beyond a period of pandemic disease that had a primary wave of death 86% as bad as that of Spanish Flu's Second Wave. That is TREMENDOUSLY bad. Like, we talked about nightmare Spanish Flu equivalents, and this was it in NYC, except it hit old people and those with pre-existing conditions rather specifically and VERY hard, with little impact in young people.
I think the hospital admission charts also support the notion that this actually spread through the schools. After the drop in seasonal admissions for 0-17 year old, there was a big spike in early-mid March. This spike was then seen in the 17-45 year olds around the 22nd of March, in 45-64 the 27th, in 65-74 the 1st, and then in 75+ the 1st-7th (or thereabouts, the sequencing of the peaks is roughly accurate). This supports the notion that the virus arrived in NYC sporadically on travelers, it got into the schools, it then spread through the schools like wildfire undetected for the most part (=increasing ER visits NOT admissions for 0-17 year olds), and then it cascaded through each elder segment of the population within the next 5-7 days (i.e., the kids gave it to each other en-masse, then they gave it to their parents, then the parents gave it to their grandparents and aunts and uncles, etc).
I think the epidemiology of what happened in NYC is alarming precisely because NYC is NOT unique, or rather, where this happened at its worst was NOT Manhattan, but the fabric of the Outer Boroughs that is common to all American cities with major pre-war density. What happened here can happen in Chicago, or San Francisco, or Philadelphia. And maybe it can even happen in Atlanta, and Miami, and Los Angeles as well.
NYC is now inoculated pretty well, I would imagine a very large proportion of children have already been exposed. But when schools open up around the country in September, this is going to begin spreading like wildfire through kids after 9/15 or so, and it will do so most INVISIBLY. There will be some increases in emergency room visits for kids, but they will mostly be turned away (those few that actually show symptoms). In the ensuing two-four weeks, the virus' embers are probably going to re-ignite, and we will see what happened in NYC play out everywhere else but possibly in an even worse way.
Unless we get a vaccine, and unless it works, and unless it is deployed by 10/1. That is only four months away at this point.
If not, NYC's IFR could actually be a LOWER bound relative to many other regions. If NYC's IFR is approximated in the rest of the US, btw, the death toll will be about a million when all is said and done which means we are about 12.5% of the way there (rounding up to 125K estimated current dead based on the NYT's #s). That means that nationally, the virus is likely to be 8-9X *worse* assuming wide regions do not fair worse than NYC did, with its world-class medical system that actually WAS available and worked well at providing surge capacity.
I think there is a very plausible scenario where most regions of the US ultimately see a HIGHER IFR than NYC did due to 1) more obesity and 2) substandard healthcare. I would think much of the South and Midwest will be utterly devastated, with IFR 50%+ above NYC, and they will also have a disproportionate number of young people dying due to morbid obesity which will yield cries of "it's mutated" when the actuality is, fat men in particular are very prone to dying from this disease, and it becomes a major problem (i.e. mass hospitalizations) after the age of THIRTY in this group.
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