πŸ” Are flu/cold comparisons now valid enough for Covid risk-communications?

I’m not a scientist of diseases, but in 2020 when there was no immunity, one of the easiest ways of spotting a dummy was the words “it’s just like a cold/flu” coming out of their mouth/Zoom-chat/blogpost*.

Firstly, it wasn’t true per individual: flu’s hospitalisation rate is about 1 in 50 & common-cold much less frequent, whereas Covid’s was much more frequent.
Secondly, and more importantly, wasn’t true per society: flu’s a variant of something we have historic immunity to, whereas Covid was snowballing through a fresh population with an R-rate much higher than 1

But in summer 2022, in a post-vaccine & widespread infection world - where 95%+ of pop built immunity to some Covid variant - is the comparison now valid, not necessarily for scientists or policy-makers but as a day-to-day heuristic to help non-scientist humans manage their daily risk by drawing on wisdom they grew up with?

Here’s my back-of-envelope reasons why:

Hospitalisation rates in West are much lower. In US last week 1 in 30 (calc’d from OWID) which is in flu ballpark. Covid harm-per-case is especially low for young people, and symptoms experience more like colds.

If we accept the comparison is valid, then we can potentially reduce the worried well’s anxious case-number watching.
In a ‘cold/flu’ framework, tracking the right-tail - i.e. spikes in hospitalisations & (mainly elderly) deaths - becomes more important than cases (until you start reaching nationwide hospital capacity, as Dom Cummings thankfully pointed out to No.10).
A fellow blogger’s family recently saw same-month reinfection. But “adults have an average of 2-3 colds per year, and children have even more” (CDC on common colds), so perhaps frequency alone is not cause for alarm, especially for children.

From a public-health comms standpoint you don’t have the massive mountain of new-expert aversion & conspiracy-theories to climb, because you are appealing to generational wisdom on colds&flu.
Public are fatiguing from alarm about BA 4 & 5. Note that public aren’t generally communicated the subtype markers of each seasonal flu variant:

list of flu variants

And yet they do tend to stay off work for at least the crucial first few days of symptoms with “the flu”.

Finally, have to consider the opportunity-cost of keeping our most creative&productive age-group isolated during (especially the latter stages of) infection. Maybe the ©old advice to “keep going” (outside, back to work after 5 days from symptoms etc.) is best.
Perfectionist forms of long self-isolation (eg 10 day from test) should be avoided in favour of mental-health.
In this world, more young people will test and we’ll actually stop spreading in high-contagious 1st few days, particularly among the 1/3 asymptomatic cases which do seem to be a unique hallmark of Covid.

Therefore, if Covid is similar enough to flu in society, then I believe embracing an analogy will make for more sustainable - albeit less ambitious - public-health messaging.
Would love to hear thoughts from any disease-scientists on which metrics they think would need to be different enough that we switch on the alarms and put it in a different category again?

*Appendix: why I’m writing a blogpost about Covid

Independent blogposts about Covid basically shouldn’t be read due to the preponderance of misinformed eegits writing them.
Usually if I communicate about Covid, I’m mentioning it briefly in a more creative form (“6 Foot”, “Spitfire” in the new record) or asking questions to any disease-scientists & doctors whose brains I can get hold of IRL.
However, I’m currently on the tail-end of Covid having recovered from symptoms, have the faintest whispher of red on T on an LFT after 30mins but still being socially-pressured to isolate: so a) I have time to write this blogpost and b) I’m wondering why!!

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