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This suggests, without an overwhelmed health system, the IFR for the overall population may be between 0.025%<ref>https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/</ref> to 0.5%.<ref name="basedsite">https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/</ref>
This suggests, without an overwhelmed health system, the IFR for the overall population may be between 0.025%<ref>https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/</ref> to 0.5%.<ref name="basedsite">https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/</ref>
Antibody testing in a German city found an IFR of 0.37%.<ref>https://www.reddit.com/r/COVID19/comments/fxp6ux/heinsberg_covid19_caseclusterstudy_initial_results/</ref> But the overall IFR will vary based on the prevalence of old and fat people.<ref>https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1</ref><ref>https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22831</ref>
Antibody testing in a German city found an IFR of 0.37%.<ref>https://www.reddit.com/r/COVID19/comments/fxp6ux/heinsberg_covid19_caseclusterstudy_initial_results/</ref> But the overall IFR will vary based on the prevalence of old and fat people.<ref>https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1</ref><ref>https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22831</ref>
This IFR would make the disease still several times as deadly as the common flu,<ref name="basedsite"></ref> and the course of disease is more severe with three times longer hospitalization than the flu.<ref>https://archive.is/js5bL</ref> Moreover, the disease is mild among the young and overall immunity is low, enabling quick spread. Together, this explains how the virus caused overwhelmed hospitals in various places.
This IFR would make the disease still several times as deadly as the common flu,<ref name="basedsite"></ref> and the course of disease is more severe with three times longer hospitalization than the flu.<ref>https://archive.is/js5bL</ref> Moreover, the disease is mild among the young and overall immunity is low, enabling quick spread. Together, this explains how the virus caused overwhelmed hospitals in various places. Only randomized serology tests would produce an accurate IFR.  In Denmark, randomized testing was done in Danish blood donors, showing a total IFR of 0.16%.  Meaning the virus is less deadly than the flu assuming those who donate blood represent a random sample of the Danish population.<ref>https://www.dr.dk/nyheder/indland/doedelighed-skal-formentlig-taelles-i-promiller-danske-blodproever-kaster-nyt-lys</ref>


In Italy, the average fatality age was 81. More than 99% of deaths were older than 50 and 99% had an existing underlying condition.<ref name="baseditaly">https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf</ref> Half of the fatalities had three or more chronic diseases,<ref name="baseditaly"></ref> so more than half of the fatal cases would presumably have died in the next few years anyhow. Further, despite extremely overwhelmed hospitals, there were close to ''zero'' fatalities younger than 30,<ref name="baseditaly"></ref><ref>https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates</ref> different from the Spanish Flu.<ref>https://en.wikipedia.org/wiki/Spanish_flu</ref> Healthy people younger than 65 only accounted for 0.3%, 0.7%, and 1.8% of all COVID-19 deaths in Netherlands, Italy, and New York City.<ref>https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1</ref> In addition, Italy has a history of overwhelmed hospitals during flu season, e.g. in 2017/2018, Italian hospitals delayed surgery and rationed care due to the flu.<ref>https://milano.corriere.it/notizie/cronaca/18_gennaio_10/milano-terapie-intensive-collasso-l-influenza-gia-48-malati-gravi-molte-operazioni-rinviate-c9dc43a6-f5d1-11e7-9b06-fe054c3be5b2.shtml?refresh_ce-cp</ref>
In Italy, the average fatality age was 81. More than 99% of deaths were older than 50 and 99% had an existing underlying condition.<ref name="baseditaly">https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf</ref> Half of the fatalities had three or more chronic diseases,<ref name="baseditaly"></ref> so more than half of the fatal cases would presumably have died in the next few years anyhow. Further, despite extremely overwhelmed hospitals, there were close to ''zero'' fatalities younger than 30,<ref name="baseditaly"></ref><ref>https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates</ref> different from the Spanish Flu.<ref>https://en.wikipedia.org/wiki/Spanish_flu</ref> Healthy people younger than 65 only accounted for 0.3%, 0.7%, and 1.8% of all COVID-19 deaths in Netherlands, Italy, and New York City.<ref>https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1</ref> In addition, Italy has a history of overwhelmed hospitals during flu season, e.g. in 2017/2018, Italian hospitals delayed surgery and rationed care due to the flu.<ref>https://milano.corriere.it/notizie/cronaca/18_gennaio_10/milano-terapie-intensive-collasso-l-influenza-gia-48-malati-gravi-molte-operazioni-rinviate-c9dc43a6-f5d1-11e7-9b06-fe054c3be5b2.shtml?refresh_ce-cp</ref>
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