Now that the first batch of large data set clinical papers are starting to be published what is becoming obvious is that the only number that really matters is how many, and who, becomes critical. Due to huge differences in test regimes and death cause classification you really cannot do much comparative contrasting between counties. Especially China and Germany.
But looking at the hospitalization / critical symptoms ratio they look pretty constant in most countries from the papers published so far. And who becomes critical looks pretty consistent too. About 80/20 high risk people/ low risk people. The outlier cases mentioned in the media are just that, outliers. What also looks pretty constant is the critical survival rate. Low risk people mostly survive, high risk people mostly dont. The only difference for medical systems below or above surge capacity is that high risk people get triaged out when surge capacity overwhelmed so mortality rate goes from around 70% to 95% plus. And low risk peoples the morality rate also goes up, from 20% plus, but they mostly get triaged in. So not by so much.
What also comes out of the large data set papers is the two highest risk groups likely to end up critical and needing ICU’s are people with a subset of serious prior medical conditions. Coronary, immunologically compromised, and diabetes / morbid obesity. Those with the highest risk are 70 plus with an impaired life expectancy of 3 to 5 years. The next highest risk group are 60 plus with an impaired life expectancy of 8 to 10 years. Other serious medical conditions have elevated risk but much much lower than the coronary/ immunologically compromised etc high risk group.
When one starts looks at the full course of the epidemic over 180/360/720 days from initiation and the fact that SARs CoV 2 will reach an equilibrium infection rate of 60% to 80% by the end of the epidemic in the populations in all counties bar Taiwan, Singapore and maybe HK, South Korea, any and all lockdowns will have little impact on the final distribution of who will die. Those in the highest risks group will die at pretty much the same rate as a no action policy over the course of the epidemic. If the first wave does not get them the second wave, or third wave, etc will.
Given the already seriously impaired life expectancy of the high risk grouped like to die of COVID they would have a very high mortality rate even if a COVID epidemic was not ongoing. In next 720 days up to 40% of the highest risk group and 20% of the next highest risk group would probably die of their chronic illnesses anyway.
The whole test and contain strategy will not work with SARS CoV 2. It is not measles or smallpox. There will be no high efficacy / low risk vaccines. Without a high efficacy vaccine community spread containment and elimination is a non starter. The effectiveness of the SARs/MERs vaccines over the last two decades has been even worse than with influenza vaccines. So less than 50% success rate. And with much higher rates of serious side effects than influenza vacines.
But unlike influenza SARs CoV 2 is novel. Which means multiple vaccine shots to even have a hope of developing immunity. There will be no MMR type vaccine for this virus. Like with influenza vaccines any COVID vaccines would have much lower effectiveness rates with old people and people with serious health conditions. In fact immunio compromised people have very serious problems with most vaccines like these.
The seemingly inherent immunity to SARs CoV 2 of young people might provide a key to a short term effective vaccine. But I would not count on it. Plus it is unlikely t o be very effective for the people with highest risk of dying of COVID while the current epidemic runs its course.
The only thing the current lock down does is make the peak of the second wave of infection in September / October bigger and stronger. It defers but it will not change by much the final outcome. In 720 days plus. The only thing the current lockdowns does is cause immense economic damage and defer rather than eliminate most of the deaths of high risk people that will happen during the course of the epidemic.
In case you think I am being callous I am very aware of just what a horrible death COVID causes. The final phases produces pretty much the same physical effects on the lungs as with solders after a poison gas attack in The Great War. The patient usually drowns to death due to the fluid filled lungs and asphyxiates. If lucky they expire due to a heart attack, sepsis or multiple organ failure first. If not the only escape from terrible suffering in the final phase before death is a medically induced coma.
It is a particularly horrible way to die. And there is little any public policy, no matter how extreme, can do to change the final outcome by any serious degree in the long term. No matter how unpalatable or repugnant most people might find that conclusion. So the sooner panic driven politicians realized that basic fact then the less long term damage their panic will cause to the long term economic viability of the country. More low risk criticals can then be saved of the course of the epidemic and the high risk criticals who cannot be realistically saved can be allowed to die in dignity and humanely without the utterly hideous suffering too many of the current victims go through.
Thats what the new normal is starting to look like from now on and for the foreseeable future.