Comparing COVID-19 Deaths to Flu Deaths Is like Comparing Apples to Oranges
S E E D E D C O N T E N T
Comparing COVID-19 Deaths to Flu Deaths Is like Comparing Apples to Oranges
The former are actual numbers; the latter are inflated statistical estimates
In late February, when the stock market was beginning to fall over coronavirus fears, President Donald Trump held a briefing at the White House to reassure people that there was little chance of the virus causing significant disruption in the United States.
"I want you to understand something that shocked me when I saw it," he said. "The flu, in our country, kills from 25,000 people to 69,000 people a year. That was shocking to me."
His point was to suggest that the coronavirus was no worse than the flu, whose toll of deaths most of us apparently barely noticed.
In early April, as social distancing measures began to succeed in flattening the curve in some parts of the country, an influential forecasting model revised the number of American deaths from coronavirus that it was projecting by summer downward to 60,400, and some people again began making comparisons to the flu, arguing that, if this will ultimately be no worse than a bad flu season, we should open the country up for business again. (On April 22, the model's forecast rose to 67,641 deaths.)
But these arguments, like the president's comments, are based on a flawed understanding of how flu deaths are counted, which may leave us with a distorted view of how coronavirus compares with it.
When reports about the novel coronavirus SARS-CoV-2 began circulating earlier this year and questions were being raised about how the illness it causes, COVID-19, compared to the flu, it occurred to me that, in four years of emergency medicine residency and over three and a half years as an attending physician, I had almost never seen anyone die of the flu. I could only remember one tragic pediatric case.
Based on the CDC numbers though, I should have seen many, many more. In 2018, over 46,000 Americans died from opioid overdoses. Over 36,500 died in traffic accidents. Nearly 40,000 died from gun violence. I see those deaths all the time. Was I alone in noticing this discrepancy?
I decided to call colleagues around the country who work in other emergency departments and in intensive care units to ask a simple question: how many patients could they remember dying from the flu? Most of the physicians I surveyed couldn't remember a single one over their careers. Some said they recalled a few. All of them seemed to be having the same light bulb moment I had already experienced: For too long, we have blindly accepted a statistic that does not match our clinical experience.
The 25,000 to 69,000 numbers that Trump cited do not represent counted flu deaths per year; they are estimates that the CDC produces by multiplying the number of flu death counts reported by various coefficients produced through complicated algorithms. These coefficients are based on assumptions of how many cases, hospitalizations, and deaths they believe went unreported. In the last six flu seasons, the CDC's reported number of actual confirmed flu deaths—that is, counting flu deaths the way we are currently counting deaths from the coronavirus—has ranged from 3,448 to 15,620, which far lower than the numbers commonly repeated by public officials and even public health experts.
There is some logic behind the CDC's methods. There are, of course, some flu deaths that are missed, because not everyone who contracts the flu gets a flu test. But there are little data to support the CDC's assumption that the number of people who die of flu each year is on average six times greater than the number of flu deaths that are actually confirmed. In fact, in the fine print, the CDC's flu numbers also include pneumonia deaths.
The CDC should immediately change how it reports flu deaths. While in the past it was justifiable to err on the side of substantially overestimating flu deaths, in order to encourage vaccination and good hygiene, at this point the CDC's reporting about flu deaths is dangerously misleading the public and even public officials about the comparison between these two viruses. If we incorrectly conclude that COVID-19 is "just another flu," we may retreat from strategies that appear to be working in minimizing the speed of spread of the virus.
The question remains. Can we accurately compare the toll of the flu to the toll of the coronavirus pandemic?
To do this, we have to compare counted deaths to counted deaths, not counted deaths to wildly inflated statistical estimates. If we compare, for instance, the number of people who died in the United States from COVID-19 in the second full week of April to the number of people who died from influenza during the worst week of the past seven flu seasons (as reported to the CDC), we find that the novel coronavirus killed between 9.5 and 44 times more people than seasonal flu. In other words, the coronavirus is not anything like the flu: It is much, much worse.
From this perspective, the data on coronavirus and flu actually match—rather than flying in the face of—our lived reality in the coronavirus pandemic: hospitals in hot spots stretched to their limits and, in New York City in particular, so many dead that the bodies are stacked in refrigerator trucks. We have never seen such conditions.
In that briefing in late February, Trump downplayed the likelihood that the virus would spread significantly in the United States and that extreme measures like closing schools would need to be taken, saying that "we have it so well under control" and returning again to the flu.
"Sixty-nine thousand people die every year—from 26 to 69—every year from the flu," he said. "Now, think of that. It's incredible."
We now know that Trump was disastrously wrong about the threat that the coronavirus posed to the United States. But his take that the cited numbers of flu deaths were incredible? On that, he was spot-on.
Jeremy Samuel Faust, M.D., M.S., M.A., FACEP, practices emergency medicine at Brigham & Women's Hospital, is an instructor at Harvard Medical School, and is president of the Roomful of Teeth Vocal Arts Project.
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In 8 1/2 weeks the known death toll has gone from exactly 1 to 61,361 and counting. Thousands more may have occurred that haven't yet been confirmed. This is with schools closed, sports leagues shut down, many businesses shuttered, and broad stay at home orders with social distancing for individuals.
And it's not over; the numbers are still increasing every day.
Why are some people still comparing this to seasonal flu?
Some of it is wishful thinking. Nobody wants to believe there's something floating around our communities that is easy to carry home and could easily harm us or our loved ones. Some of us protect ourselves mentally by denying the severity.
Some of it is financial. There are a lot of people brought to the brink of bankruptcy by the shutdown, necessary as it is. It's tempting to rationalize reopening by minimizing the effects of Covid-19.
And some is likely political.
Some of it is financial. Indeed it is. The "edgers" have a lot of money tied up in high-risk, high-reward businesses and business schemes. Such individuals, groups, and organizations leaders would rather die and be done with it than lose their investments and businesses. Consequently, they want/demand to take the risk to get out there and risk it all against this highly contagious virus. Either way: if they don't challenge the virus or if they do, there is a chance they're done for.
Subset to these people with every financial 'device' on the line, there are those risk-takers who love to live on the edge. It's an adrenaline rush to take on an invisible microbe—and not get 'caught' by it. What a story they will have after the vaccine arrives. . . .
Some of it is political. Of course it is. FOX NEWS has been championing President Trump for well over three years of a presidency; no matter his professional missteps, bad conduct, "can't help it, it's my nature to lie" deceptions, firings/ruining of professional careers, mockings, we all have watch the scores of routines going on. . . . Because Trump is the nearest means to get what right extreme conservatives have longed for 'forever'—complete and utter control over the levers of power to crush liberals and secularists and their political list of goals unrelentingly and once and for all into political 'powder' and holding a long-term minority position in Congress, Administration, and Courts.
Thus you can imagine how stunned FOX NEWS was to find it had been knocked into silence by an invisible enemy it could not pay off, talk off, or scare off! After spending sometime hemming and hawing like the rest of the world, right-wing think-tanks, conservative schools of thought, Fox anchors finally came across the whataboutism (the 'go-to' tactic which seems always to do wonders!): Coronavirus is a virus like. . . the annual flu! Yeah. We know about flu.
Real men and their women manage the flu virus and its annual deaths. We allow a number of the weakest links in society cave to it every season. No one even notices they are gone.With that it was time to take to the airways.
Let's go get our finances back in order. Ignore those trucks and institutions full of sick, dying, and dead Americans.
We have our narrative! This virus must be spoken of as nature doing what it does every year: Purging the weak. 'Culling the herd.'
Time to get back in the saddle, save Trump's exposed backside for leaving the nation's gate open and unchecked and those additional missteps on the way to campaign trail 2020. And let's get back to promoting four more years of Trump's driving liberals, democrats, progressives, and secularists (please don't forget them) back into the minority outcasts ranks of U.S. society.
The only good democrat, liberal, progressive, and secularist is one who is political impotent.
Well in reality the biggest difference right now between the two is one has had vaccinations for decades. The other doesn’t yet.
Beyond that we really don’t have enough data yet to know if one or the other is worse. That said it would be nice if the CDC or someone standardized how they counted either in terms of mortality caused.
The same type of “over counting” appears to be happening with covid19 as well.
Hi Sparty,
We do have one piece of critical data. That is number of hospitalizations. No flu in modern history has swamped the hospital system.
The mechanism to the disease is nothing like flu, and that makes it hard to count the dead. Many of the "underlying conditions" are tied to autoimmune issues. These people would have been fine with the flu, but this disease seems to operate on the immune system and puts it into overdrive, which these people have going on already. Now we know we have to calm the immune system down if they get covid, but normally we count on the immune system to fight disease. Now finding this out, is part of how we will combat the disease.
I hope that helps understand the problem with counting.
Well, like I said, the biggest reason for that is because of decades of flu vaccinations and the following built up immunities over time.
Without that, what we have known as the flu, would be much, much worse.
Its unlikely we have enough information yet to know if this virus is better or worse at this point.
The issue is not if this virus is any better or worse (if that can be measured), it's if our bodies know how to respond to it, and clearly it doesn't. That is always the issue. And sometimes the body never learns. Look at HIV, Ebola, rabies or polio.
The issue here is people complaining about comparisons. It’s not unreasonable to make comparisons.
Ask yourself how many deaths we would have from the flu if we didn’t have any immunity or vaccines. Clearly many, many more. Both are very similar viruses that we still don’t completely understand or have solutions for.
If we did, we wouldn’t have 20-70k annual deaths from a virus that’s been around for decades and that we have vaccinations for.
comparisons are not unreasonable at all.
....and of course we also cannot compare even the mortality rate, as we haven't sufficient testing to know just how deadly this disease is. That also doesn't take into account how many are infected that have not been diagnosed, and most likely never will.
CDC:
The CDC also says that the hospitalizations for the 2018-2019 flu season was 490,561. What's the math on that/100,000?
Agreed but it’s not unreasonable to macroscopically compare the two virus. If we had all the answers with “the flu” we wouldn’t lose 20-70k people per year to it.
Think about that variation. 20-70k ....... that spread is quite amazing for something that’s been around for decades.
And with a vaccine
If you were able to get a list of everyone that the CDC said definitely died from the flu
and then went and pulled the death certs, they would not list flu as the cause of death.
They would most likely list pneumonia or congestive heart failure, heart attack etc.
But the CDC counts the flu underlying cause.
With constantly changing strains, vaccines are only good when the CDC guesses
which strain will be dominant in a given season.
On the other hand, coroners are just now getting toxicology reports on home deaths that indicate people have been dying at home from COVID since early February.
Flu deaths are always overestimated.
COVID is being under reported every day because of undiagnossed home deaths, military OPSEC restrictions,
Nursing Homes not being accurately included ( if counted at all)
ans stupid rules like in FL where they only report "resident" deaths.
Well, that depends. The flu has been around as long as mankind can remember, but what happened in 1918, was a whole new strain came about and the body had no way to identify it. Also, only flu A causes pandemics while B,C, D don't.
Actually, we do understand the flu well. We don't always get the mutations right, since they are a guess, based on past experiences and so our vaccines might be better one year than another. On the other hand, coronavirus is rather new to humans and so we are at the early part of the learning curve.
Like I said the flu is tricky. It mutates very quickly. We are lucky that other viruses don't do that. And no matter the disease, unless there is a total inoculation for it, someone will die from them, since they are here to kill. That is their job on earth.
Again, that depends. Comparing flues, sure. But you wouldn't compare the flu to say ebola, yet they are both viruses.
This is really rather instructive and articulate. Thank you.
According to whom? I've read that if anything Covid deaths are being undercounted. The reasons include a lack of widespread testing, and people dying at home.
Well I’m sure you’ll hack away at the source but this article discusses that. Attack the content and not the source as the discussion sounds reasonable to me.
That's a little hard to do when RCP ends up redirecting me to an apparent fringe site called 'American Greatness.com', which was so ad-heavy that I could barely navigate the page, and where the obviously biased author used phrases like 'power-hungry government tyrants'.
I went ahead and read the article, but I wasn't convinced of a large reporting problem. The article is from a few weeks ago, when we had even fewer tests available than we do now.
The main argument seems to be that doctors were reporting based on observed symptoms and not on official tests, but if anyone has experience diagnosing symptoms, it's doctors, and as long as they were following CDC guidelines at a time when tests weren't exactly plentiful (including known contact with a confirmed infection), then I'm generally okay with that. I doubt they're doing as much of that now, with more tests available.
If anyone has a serious problem with the cause of death given to a loved one, then a post mortem could resolve their issue. We know they can do that. Post mortems have recently identified some previously unknown Covid deaths, adding to the total. There are probably many more of those out there than there are of incorrect attributions to Covid.
But, more to the point, are you arguing that this coronavirus isn't a bigger deal than the seasonal flu? Specifically in the here and now, when almost no one has immunity? Because that's something that keeps blowing my mind. I mean, we have hospitals renting refer trailers to store bodies in. That's not exactly a regular flu season thing.
Yep, called that one.
But, my comment is already very clear and concise. Not sure where the confusion is. Please read it again and explain how you arrived at that question.
I fail to see how you did.
Here's why I asked...
The past two months make it easy to know which is worse. Maybe after we have a vaccine it'll be about as dangerous as the seasonal flu, but in the here and now it's a much bigger deal. Do you really not agree?
I’ve made clear that I don’t think we have enough information yet to decide that and why.
Again, not sure why you seem confused about that.
That is 3,000 more than those killed in the Vietnam war and that lasted for more than a decade.
It's difficult to understand why some keep trying to compare it to the seasonal flu. My guess is that they, one, they have not had a relative or friend die from it. Second, it reinforces their view of the pandemic being manufactured for whatever reason or that scare tactics were being used for some political advantage. The ''deep state'' defense.
t's difficult to understand why some keep trying to compare it to the seasonal fl
Well, the seasonal flu has also killed as many Americans as American soldiers died during the entire Vietnam war. Not sure what that's supposed to mean.
In 8 1/2 weeks? With all kinds of shut downs, stay at home orders, and social distancing?
Not to mention the following from the article:
According to the CDC, the flu kills far fewer than the coronavirus. The flu numbers by the CDC are in the article.. The point is that the flu season is far longer than 8 1/2 weeks and kills far fewer people.
The coronavirus is far deadlier and moving at a much faster pace than the seasonal flu.
The comparison to the Vietnam war was that most Americans know the death toll from it. It's a shocking number and the comparison should be shocking as to the number of deaths by coronavirus in a time period that is a couple of months vs over a decade.
So if I'm comprehending this correctly in the last 6 years, give or take, the most flu deaths in any one year is 15,620, correct?
The United States has already had 67,000 plus deaths just since January of this year. That's not even 4 months. When we're talking flu deaths, we're talking over a 12 month period.. Multiply 67K by 4 and you get 1,340,000. And that's closer to the number the CDC originally predicted.
No that is not correct or what the CDC is claiming.
"This season CDC estimates that, as of mid-March, between 29,000 and 59,000 have died due to influenza illnesses."
I wonder if the CDC flu numbers in that report are the 'statistical estimates' the doctor who wrote this article is talking about?
According to him, if the CDC counted flu deaths the same way as Covid deaths, then they'd have to report far fewer every year.
That's because those who are playing down covid-19 are dong so to justify Trump's explanation for his delay and lack of action - Hey, it's just another flu, nothing special, why get excited about it?
In short, downplaying the threat of COVID-19 by comparing it with the flu is both wrong and dangerous.
Agreed. And yet...
Trump, and Fox, should all be arrested.
It's so damn obvious that between them both spreading FALSE INFORMATION, and or LYING,
American citizens have been DYING!
.
Ignorance ruling was a round about avenue to drive home the point, Trump and Fox are practicing ignorance fooling, and far too many pussies, are excelling at it, as thats' how Trump grabs em.
The Dumbing Down of America is outright concerning.
and Trump style STUPID !
A. Unlike SARS and swine flu, the novel coronavirus is both highly contagious and especially deadly, CNN Chief Medical Correspondent Dr. Sanjay Gupta said.
“SARS was also a coronavirus, and it was a new virus at the time,” Gupta said. “In the end, we know that SARS ended up infecting 8,000 people around the world and causing around 800 deaths. So very high fatality rate, but it didn’t turn out to be very contagious.”
The swine flu, or H1N1, “was very contagious and infected some 60 million people in the United States alone within a year,” Gupta said. “But it was far less lethal than the flu even — like 1/3 as lethal as the flu.”
What makes the novel coronavirus different is that “this is both very contagious … and it appears to be far more lethal than the flu as well,” Gupta said. “So both those things, in combination I think, are why we’re taking this so seriously.”
SOURCE:
The EO by Trump keeping the packing plants open is, IMO, going to make the spread of the virus worse. The plants have been hot spots all over the country and the workers are shoulder to shoulder and from reports, many of the plants do not have the proper PPE and rules.
The majority of the employees are black and Hispanic and some are illegal, and this order puts them in extreme danger.
Blacks, Hispanics, and Amerian Indians have some of the highest infection and death rates in the country.
The whining by the Tysons, Smithfield of the world seems to be the catalyst behind his EO. I doubt if the US is going to have a large famine because we can't get meat or meat is rationed.
The irony of this that the horror of having illegals in the US has been replaced with they are ''essential workers''...
The area around the meat processing plant in Southern MN has a higher infection rate today than the Bronx NYC. It's MN's highest infection corridor. To many of the workers are to sick to work so I don't know how they would even be able to fully reopen. They don't have PPE and the GoP wants to give these companies a legal pass to not provide it. So for the sake of our economy Trump and the States will force these companies to stay open. That will in turn make the companies force workers to work in unsafe conditions or not get payment or benefits. I can't even imagine all the effects that will ripple out from these decisions.
Is that the JBS plant in Worthington?
This is totally crazy and shows what the administration thinks of front line workers. This is a receipt for disaster.
The JBS plant in Green Bay WI. was closed 3 days ago when 200 of the 1200 employees tested positive for the virus.
Minnesota also had their highest daily number of new infections yesterday. As a matter of fact, they revised the number on our local news between the 6pm and 10pm broadcast to include and extra 120 or so. We are still going up here.
What is happening with the LM plant?
I didn't catch the name of the plant on the radio this morning (MPR), but I think it is.
The Governor of MN is a Dem and he's pushing it too. As I see it there are no good options here and no matter which way they go it's not going to be good.
Larry, I've been doing less TV news. I still get my WDIO phone alerts and stuff. It's depressing and was already fully depressed before this stay at home stuff. I miss going out for breakfast at the diner.
Add another idiot to the basket.
The CDC and national Guard were back at LM Windpower with additional testing last week. The numbers there are not good and so they shut down the plant for a complete cleaning. They say the shutdown now is scheduled for a week, and they will take it a week at a time. So for now, those folks are not working. Total testing so far has revealed 145 positives from LM alone in Grand Forks.
Many of my friends no longer watch the news, they get what they need online and relieve themselves of a lot of anxiety. Thank God winter is finally over up here, and a person can at least get out more.
Yes! I'm picking up a new scooter tomorrow so I can ride it to work on nice days. That should lighten my days up a little. Now I'll need a new backpack for my camera gear so I can take the scooter out for quick photo trips.
Winter is over in Florida as well...What, wait we had a winter, tell me it ain't so.
Well that should be fun! Post some picks of your new ride, love to see it :~)
Oh ,,,, the nerve of some people.....
OMG, it's EG.
That's hilarious!
I'll have one up in the Creative Art Group tomorrow afternoon.
Awesome,,,I'll check it out. My neighbor bought and fixed up an old scooter a couple of years back that he rides in summer. It's an old model and now super sharp. He is 8o years old and scoots all over town on it! :~)
Nice! That's very cool.
Anybody, is the meat safe? How should the public view the products gone out and coming out of such facilities? We have got to get ahead of any problem to end this 'situation' we're currently in!
almost as if, Trump and Bannon's dreams of a Whiter America, are being expedited by the virus.
sick shit
Comments like that show just how out of touch and obtuse some folks have become
yea, the truth is now an "obtuse" silly goose, for ou\t of touch Americans, who choose to not hold it so loose.
It is known to be some conservatives 'fever dream' if only to keep some group numbers tamped down. So what am I saying? It is known that a certain strand of conservatives want to keep the country open in spite of the losses of life and marching death count. A sensitive fact that some minority groups are being heavily beset upon and are in the crucible of this virus' attack zone does not matter to such conservatives who reckon "a good death" for the cause of liberty, freedom, and capitalism (over socialism) is the most important thing.
There's an outbreak at a poultry processing plant in our county. Those are major employers in our area. Kinda scary.
It seems that most of the meat packing and poultry plants are having huge coronavirus outbreaks.
And despite rump's orders to the contrary, many of those employees are not returning to work. There is going to be a run on meat in the next week or two...get to the grocery store before next week if possible.
Thinking of the movie "Marathon Man" what I want to know is this: Is it safe? Is the meat safe?
It should be. Even if there is some virus on the meat, cooking will destroy it.
It wouldn't hurt to wash your hands after handling the packaging, but you'd probably do that anyway, virus or not.
Yes! I am an amazing handwasher these days. That has not always been the case, however. Before this, I was mediocre clean. Nowadays, one would think I was in clean "college"!
Breaking news.
Nearly 900 workers at Tyson Foods plant in Indiana test positive for coronavirus
Holy cow! That would be nearly the entire plant
could be only the leaves, as some plants employ thousands
900 out of 2200 employees at the plant, a 40% infection rate.
I'm lousy at math and I didn't read your link.
I think we're in trouble. Trump won't open his mouth to test the country. What the hell is wrong with us in the country? Why are we sitting around letting this lousy cheat chump cull us legally through inaction?
When are going to demand that Trump properly test the populace of the United States? It ain't like we have more important tasks to manage. I mean being able to properly breath through our lung 'stacks' should be a top priority for each one of us.
And I see parents helter-skelter with arm babies in shopping with and without a mask! Walking babies, looking every bit like mommy or daddy- shopping with or without masks, and I wonder to myself. Are these parents who are trusting this administration to admit uniformly whether or not a child can get infected with this virus seriously bringing their children out in public without a mask while wearing one themselves?
What a rude awakening if CDC (at some future date) utters the horrible words: The kids are no longer simply asymptomatic carriers. The virus is active within them. All these months of no firm standard for wearing masks in our country. It is a poor standard of leadership!
A poor standard of leadership!
If the adults are not being properly tested and the kids are not being tested at all? How the heaven do we know the kids are not affected/infected?
If the kids are considered safe, then how come the kids are out of school? They're safe, right? In school or out. RIGHT?
If we don't know then why the heaven are we not officially mandating parents cover up the mouths and noses of tomorrow's children?
This is all wrong! Wrong! WRONG!!!
apples and oranges are both "fruits.
change my mind
Complete waste of time to argue with a closed mind.
Just whack.
that would be why I tend to ignore you... LOL
but hey, thanks for the whack attack
I'm so surprised a certain poster isn't on here who has been comparing CO-VID 19 to the flu all along.