News: COVID-19 deaths 20 times higher than seasonal flu, study shows
Research shows that counted deaths from COVID-19 in mid-April were about 20 times greater than seasonal influenza counted deaths recorded during peak weeks of the past seven flu seasons, HealthLeaders reported. As of this edition’s publishing, COVID-19 has killed more than 100,000 Americans.
"The demand on hospital resources during the COVID-19 crisis has not occurred before in the U.S., even during the worst of influenza seasons," study co-authors Jeremy Samuel Faust, MD, of Harvard Medical School, and Carlos Del Rios, MD, of Emory University School of Medicine wrote in the Journal of the American Medical Association (JAMA) Internal Medicine.
"This apparent equivalence of deaths from COVID-19 and seasonal influenza does not match frontline clinical conditions, especially in some hot zones of the pandemic where ventilators have been in short supply and many hospitals have been stretched beyond their limits,” the authors wrote.
The researchers said the confusion about lethality comparisons may be owing to "a knowledge gap" in how the Centers for Disease Control and Prevention (CDC) reports on seasonal influenza and COVID-19.
The CDC, they note, "like many similar disease control agencies around the world, presents seasonal influenza morbidity and mortality not as raw counts but as calculated estimates based on submitted International Classification of Diseases codes.”
Thus, between 2013 and 2019, the yearly seasonal influenza deaths ranged from 23,000 to 61,000. However, the actual number of counted influenza deaths over that timespan ranged between 3,448 and 15,620 deaths each year, reported HealthLeaders. On average, the researchers said, CDC influenza death estimates are about six times greater than the number of counted deaths.
Conversely, COVID-19 deaths are not estimated, but counted and reported directly. The researchers suggested that a more valid measure would be to compare weekly counts of COVID-19 deaths to weekly counts of seasonal influenza deaths.
During two weeks in mid-April, 29,933 COVID-19 deaths were counted in the United States. In contrast, according to the CDC, counted deaths during the peak week of the influenza seasons from 2013-2020 ranged from 351 (2016) to 1626 (2018). The mean number of counted deaths during the peak week of influenza seasons from 2013-2020 was 752.4, HealthLeaders reported.
"These statistics on counted deaths suggest that the number of COVID-19 deaths for the week ending April 21 was 9.5-fold to 44.1-fold greater than the peak week of counted influenza deaths during the past 7 influenza seasons in the US, with a 20.5-fold mean increase," the researchers said.
"The ratios we present are more clinically consistent with frontline conditions than ratios that compare COVID-19 fatality counts and estimated seasonal influenza deaths," they wrote. "We infer that either the CDC's annual estimates substantially overstate the actual number of deaths caused by influenza or that the current number of COVID-19 counted deaths substantially understates the actual number of deaths caused by SARS-CoV-2, or both."
Editor’s note: This article originally appeared in HealthLeaders Media. To read all of ACDIS’ coverage of the COVID-19 pandemic, click here.