Genomic estimates suggest that there may be several thousand infected individuals, maybe many thousand, in Washington state. But we are only aware of a small handful of them. One explanation for this would be that many people are completely asymptomatic, or can't distinguish COVID-19 from a very mild cold. That would be in line with the NEJM article you shared, and explain why there haven't been any cases in children. If they don't have a strong enough reaction to require treatment or testing then it would seem they don't even get infected under the metrics that are established.
The major problem is systemic risk from many people requiring intensive care all at once.
The author of the linked blog post didn't mention an important and unsettling feature of the Spanish flu. It came in three waves. The first looked very similar to a bad seasonal flu or the current SARS outbreak. The second was the one that killed, by inducing a cytokine storm and immune overreaction in otherwise healthy, younger people. Deaths sometimes occurred in a matter of hours after the first appearance symptoms. Having an incredibly infectious virus cause a pandemic is one thing. Let's hope that we can monitor it's evolution to ensure that strains that it develops aren't significantly more dangerous. Its infectivity means that it will have a massive environment in which to evolve. Evolution rate is largely determined by population size.
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Genomic estimates suggest that there may be several thousand infected individuals, maybe many thousand, in Washington state. But we are only aware of a small handful of them. One explanation for this would be that many people are completely asymptomatic, or can't distinguish COVID-19 from a very mild cold. That would be in line with the NEJM article you shared, and explain why there haven't been any cases in children. If they don't have a strong enough reaction to require treatment or testing then it would seem they don't even get infected under the metrics that are established.
The major problem is systemic risk from many people requiring intensive care all at once.
The author of the linked blog post didn't mention an important and unsettling feature of the Spanish flu. It came in three waves. The first looked very similar to a bad seasonal flu or the current SARS outbreak. The second was the one that killed, by inducing a cytokine storm and immune overreaction in otherwise healthy, younger people. Deaths sometimes occurred in a matter of hours after the first appearance symptoms. Having an incredibly infectious virus cause a pandemic is one thing. Let's hope that we can monitor it's evolution to ensure that strains that it develops aren't significantly more dangerous. Its infectivity means that it will have a massive environment in which to evolve. Evolution rate is largely determined by population size.