We can 100% win this. It won't be easy. And the odds are we lose. As Antonius mentioned we do seem to struggle with the Bills. Particularly we can never seem to defend Josh Allen. And Buffalo is one of the few teams we do not hold a QB advantage over IMO.
But I am not writing this off as an automatic loss.
I find the Bills often simply play to the level of their competition. And they might well be looking past the Rams to their big game vs. Detroit the following week. The Rams, by contrast, you would hope would be fully locked in and motivated with the season on the line. Buffalo has already clinched their division (though is still playing for home field of course) which might also make them complacent. We're at home. They'll be on the road and travelling across the country. Our o-line is finally healthy. Looking at the Bills' schedule, they haven't played many truly strong teams. No heavy-weights. Baltimore, Kansas City, and Houston are probably the strongest opposition they have faced. They've lost 2 out of those 3 games. I think we have a decided coaching advantage with McVay over McDermott.
The biggest key will be avoiding another disastrous start. We are bottom of the league in Q1 point differential. If we spot a team like the Bills a 2 or 3 score lead out of the gate, there is 0 way we claw back IMO. We need better from our coaching staff on both sides of the ball. Q1 is, in large part, about preparation.
This is a game we will definitely need lots of points in. I'd be aggressive on 4th down.