Thanks. The NYC data is something I want to add in there eventually. I agree with your assessment and reached a similar number myself. The main thing that gives me some doubt is it seems plausible that we'll retroactively find that the deaths directly attributable to COVID-19 were somewhat overstated, in the sense that my understanding is a presumed COVID-19 diagnosis is accepted in lieu of having a positive test. (Which BTW I don't necessarily disagree with because testing was and is a bottleneck so the overstatement is almost certainly less than the understatement would have been if being more rigorous). We also know that there is [financial incentive](https://www.factcheck.org/2020/04/hospital-payments-and-the-...) to code deaths as COVID related. I'm really curious how the influenza mortality data ends up looking for these months - the key question being, do we see a large dropoff in Influenza deaths that might indicate that basically any ILI is being written up as COVID-19?

The above being said, I think the new york numbers are a perfect upper bound for something close to what a worst case scenario looks like. Although we'd have to look at the age breakdown and obesity rates there; it's definitely very imaginable that there might be other cities in the US with relatively more at-risk individuals.

(BTW I didn't explain it thoroughly in the writeup but New York's data is why I gave a really broad range of .1-.7% net IFR - and it should be clear but this is still very napkin math-y on my part)

I'm also curious if NY serological data includes <18 year olds - if it doesn't include children we need to account for that when extrapolating in the 100% infection scenario.

Anyway, the above is all a really drawn out way of saying that I agree :P

> Additionally, if we give up on social distancing, then those people will die in a large wave, overwhelming our hospitals.

If we gave up everything, certainly. I think with mitigation targeted at the at-risk, that's less likely.

For me "ending lockdown" doesn't mean that everyone stops wearing masks and/or trying to maintain physical distance where possible. But I do want to avoid a scenario where we're mandating that people wear masks outside as opposed to just encouraging them to.

But I do agree that just because we haven't overwhelmed hospitals yet doesn't mean that we're in the clear. I was considering saying as much in the doc but wanted to keep the word count down for the first iteration.

However I do think that since pretty much every city has at least some low amount of infection, and that we will have some capacity to do some clever shuffling of ventilators, tents, etc, that hospital overrun isn't nearly as much of a risk at this point overall.

> 4. I would love to see a plan that keeps seniors safe and lets everyone else out. So far, that plan is not forthcoming. It’s hard to see how we keep them safe if their family living with them and their caregivers are all infected. So far, we’ve done a piss poor job of keeping them safe in senior living facilities, even with a lockdown.

Yeah, really the best thing would be voluntary exposure of people surrounding the at-risk individuals. But I don't foresee that actually happening. I really think nursing homes are the low-hanging fruit here, and as you indicated it seems like we've already kind of screwed that one up in a lot of places.

But essentially, in the alternative of full containment+waiting for vaccine, it seems to me much harder for the caregivers surrounding the extremely-at-risk to be able to avoid getting infected and passing it on to the at-risk, whereas in a scenario where they can get it over with then they don't have to worry at all going forward. But that requires being able to detect that you're sick before infecting the at-risk individual so that you can isolate while recovering, which obviously requires really good testing capacity.

Basically, it would be great if we could selectively redirect the bulk of our testing capacity for individuals in these situations. But there's not a very clear way to do that, the last thing we want is having a bureaucrat decide if you're eligible for a test or not. So perhaps the best we can do is - and this is a theme here - encouraging those who are surrounding at-risk individuals to get tested extremely frequently.

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Lastly just wanted to call out this:

> I think you’ve gotten a lot right, and i think analyses like this get down to the point where we can have a rational discussion.

That means a lot. I really want us as a society to get to a point where there is broad agreement on what the facts on the ground are, so that differences in policy come down to differences in philosophy/values rather than where it feels like we're at now as a society, which is basically two warring factions each with non-intersecting sets of facts ("the death rate is 5%!" versus "no the death rate is .03!)