If the 1919 flu appeared today there is a fair chance COVID-19 would be seen as the worse threat. We haven’t seen something with COVID-19’s combination of fatality rate and reproduction rate spread widely since the 1919 flu.

COVID-19 is estimated to be significantly MORE contagious (R2.26) than the 1919 flu (R2) has been estimated to be.

As for fatality rate, what matters? It’s not the abstract of an estimated death rate as much as how likely it is to be harmful to YOU—which is a combination of how contagious, how fatal, how likely in your area, likelihood of overwhelming health care capacity, and other factors. Also, realize that if people get sick quickly or die quickly, that tends to LOWER the contagiousness (RO), as people become less mobile, take more precautions, and are easier to identify as ill and avoid.

A disease that is infectious during a long incubation, and is significantly more fatal than seasonal flu, as COVID-19 appears to be, is part of a worst-case scenario.

Let’s compare some known flus:

SARS had a high fatality rate, but a low reproduction rate. In common social situations, it had the potential to die out on its own. H1N1 had a very low fatality rate, although it had a somewhat higher reproduction rate than the seasonal flu. in fact, H1N1 now IS the seasonal flu for many people.

Now let’s look at some contagion numbers: Rounding DOWN, here is the difference between different R0’s. This just means how many people would contract the disease if one person got it, and infected the the number shown in one day AND infected no one else after those first people. Totals are after 31 time units. At R2, a time unit is the average time it takes one sick person to infect two others. Commonly less than a week.

.49 ………………………0. SARS 1
1.3 …………………… 26 (Seasonal flu)
1.5 ………………. 1,900
2.0 ………. 10,000,000 (1919 Flu)
2.27 …… 479,000,000 (Best COVID-19 estimate)
2.5 ….. 8,600,000,000

This is NOT death rate, which for COVID19 is somewhere between 6-25 times worse than for seasonal flu. COVID-19 has an estimated death rate less than the 1919 flu, but if the 1919 flu were to appear today, it would be much, much less lethal. For one thing, we have mass-produced antibiotics. Most 1919 deaths were from secondary bacterial infections, not from the flu itself, due to the general non-existence of antibiotics.

Similar differences in today’s situation vs 1919/WWI would reduce the 1919 flu’s contagion rate today.

THE BIG QUESTION

How different would you have to make your life to avoid getting infected? In other words, if it is contagious enough, you will probably not be able to permanently avoid getting it, statistically. If it is fatal enough, you will need a plan to deal with it.

Many estimates have 80% of the world getting infected by COVID-19 in coming months.

Did you realize that the #FlattenTheCurve movement is about planning HOW to get sick more than it is how to avoid getting sick?

And while there may be a vaccine eventually, it is NOT likely that if you catch COVID-19, you will be immune to catching it again. It IS likely that you will gain some PARTIAL immunity, just like most of us do with different flu strains. If you survive it once, you will probably survive it again.

So what should your plan be? Quarantine for possibly years until a vaccine is available? Try to get sick only when there is sufficient health care and you have sufficient savings/ income support/ insurance? Seek to alter health factors that put you at higher risk, such as quitting smoking? Try to reduce the severity of symptoms such as by taking taking Tamiflu, Quinine, Quinolone, etc.?

And how much time and attention should you put on helping others solve this problem, such as family, friends, neighbors, in part to flatten the curve, but also to help limit the severity of symptoms to increase survivability.

As to the 1919 Flu, because it’s believed most people died from secondary bacterial infections due to the fact we were not mass producing antibiotics at the time, if it were to happen today, that at least would not be the case in many areas. And of course the 1919 flu hit a lot of generally unhealthy group situations, such as soldiers kept close together in unhygienic situations who also spread the disease by traveling from one country to another.

As to seasonal flu, were you aware that it is worse for the elderly than COVID-19 as a percentage of deaths? In other words, as a percentage of deaths, COVID-19 is WORSE for younger people than seasonal flu? So much attention has been put on how it affects the elderly, but this is true of all respiratory illnesses.

I am 60, and have experienced respiratory issues. I am exploring a wider range of approaches for dealing with my respiratory issues in order to reduce my fatality risk, as it for the moment appears very likely impossible to avoid COVID-19 permanently.

On January 30, I told a friend, Michael Steinberg, over lunch that I expected COVID-19 to become a pandemic that would nonetheless be fairly controlled in the U.S. That made me realize I didn’t have the numbers to back that up. I started trying to research and learn what mattered and what didn’t. Finding out “what mattered” turned out to be harder than I thought. I became more serious in my research.

Three weeks ago, February 24, I began spending money working on the survivability problem. I have been researching this since before that time, and the danger looks ever more real all the time.

Some will call this alarmist. Many have been posting comparisons with the seasonal flu and using the comparison to be dismissive of probable issues with COVID-19. By the numbers, this really can’t be compared with seasonal flu.

PlanI do not wish to spread fear. I am not living in fear. I am living in plan B, and enjoying my family, friends and clients as much if not more than before.