In fact, at this point, it’s not even “just the flu.” If dying is your only concern, you’re actually better off with COVID in England than influenza. New data from the Financial Times:

NEW: for the first time in the pandemic, a Covid infection now carries less mortality risk than a flu infection in England, the result of widespread immunity and the emergence of a less virulent variant in Omicron.

Our story: https://t.co/BnFWG7xwaS pic.twitter.com/ck4Db9jEjk

— John Burn-Murdoch (@jburnmurdoch) March 10, 2022

To be clear, infection-acquired immunity has also played an important role in building immunity, but by overlaying cumulative vaccination and infection rates onto IFR, we can see that vaccination was by far the biggest driver of the reduction in lethality.

Science: it’s good! pic.twitter.com/jNTXC6CE43

— John Burn-Murdoch (@jburnmurdoch) March 10, 2022

Omicron currently kills 35 people per 100,000 there while influenza kills 40 per 100,000. Flu is the deadlier virus among all age groups too, not just the young and healthy.

Still, in important ways, COVID remains more than “just the flu” even in the UK. Total deaths were higher this winter than in pre-pandemic years despite COVID’s diminishing fatality rate, probably because Omicron is so damned contagious. It’s less likely to kill the average infected person than influenza is but it’s infecting many, many more people than flu typically does, leaving a larger body count. COVID is also different from the flu in that there’s no reason to believe it’ll surge just once a year during the cold months, as flu does, going forward. If you live in the southern U.S., you know by now that summer is as likely to produce a wave as winter is.

There’s another frightening difference between the viruses. Typically, when you’re done with a bout of the flu, you’re done. With COVID, we’re learning that many infected people lose brain tissue during their illness. One study of older Americans who’ve recovered from the virus showed that “months after infection some people show as much as a decade of normal aging” with “cognitive decline, degeneration in parts of the brain, and brain shrinkage” observed even in those who’d had mild cases. We spent two years during the pandemic managing COVID itself. It appears the near-term post-pandemic years will be spent managing the biological aftershocks.

Meanwhile, on the other side of the world, a jurisdiction on the other end of the COVID spectrum from England is discovering what Omicron can do when you have no immunity wall to speak of.

There is no other graph like this for the pandemic. It gets worse each day.
Even the log plot is nearly vertical.
Omicron's impact in a population without infection-acquired or adequate vaccination-induced immunity. https://t.co/3VeKaCsEfW pic.twitter.com/xszCf5NMlb

— Eric Topol (@EricTopol) March 6, 2022

Prior to the end of January 2022, Hong Kong had never averaged as many as 100 cases a day. They were following the same “zero COVID” policy as mainland China, to great success. Then Omicron arrived and managed to find a foothold. A few days ago Hong Kong was averaging 44,000 cases per day, which would be the equivalent of *two million* daily in the United States when adjusting for population. Hong Kong took for granted that the virus would never spread aggressively locally, which explains why just 15 percent of nursing-home residents have been vaccinated. COVID is now burning through the city’s facilities for the elderly just like it did in New York in March 2020.

Beijing is watching this with trepidation, knowing that catastrophe awaits if the virus gains a similar foothold on the mainland. China’s vaccines are iffy and there’s hardly any natural immunity among the population, leaving a billion Chinese as dry tinder for a COVID wildfire. Their hospital system stands no chance of coping if a major outbreak occurs:

The experience shows how vulnerable China’s vast yet patchy hospital network — hobbled by lopsided distribution of resources and under-investment — is to the virus. Add to that the likelihood of unprecedented cases and deaths if China were to let the disease spread like it has in other parts of the world, in an environment where most people are vaccinated with less effective local shots, and it’s clear why the country is reluctant to embrace endemic Covid. Officials are said to plan on keeping the existing playbook through 2022, even as they signal a willingness to adjust policy marginally…

Statistical modeling by Peking University shows China could have a “colossal outbreak” with as many as 630,000 or so people infected in a single day if the country removes most of its restrictions as the U.S. did…

China could quickly see an intensive-care crisis, with only 3.6 ICU beds for every 100,000 citizens, compared with 25.8 and 33.9 in the U.S. and Germany, respectively.

How many deaths are they looking at potentially if they lift the “zero COVID” insta-lockdown approach? Three million conservatively, per the Chinese CDC, as nearby Hong Kong fires off viral sparks in the form of fleeing locals. Some Chinese cities are offering huge rewards for information about Hong Kongers being on the mainland illegally, in fact, because they’re terrified of someone sneaking in and seeding a mega-wave inadvertently.

Without good vaccines, there’s no exit strategy from “zero COVID.” You’re stuck with it forever, or at least until the fateful day when the virus finally outmaneuvers the policy.

If you’re wondering how the U.S. is doing, the short answer is: Well, but not as well as England. Average daily cases have dropped below 40,000 for the first time since last July. But daily deaths are still north of 1,400 on average, much higher than the 100 or so per day that the UK is averaging. (Adjusted for population, that’s 500 per day in the U.S.) Scientists’ best guess as to why the disparity persists in our two countries despite the high level of immunity in each is that the Brits have done better getting their older citizens vaccinated and boosted. We’ll catch up eventually, but likely not before we reach a million dead. A million.