COVID-19 will kill between 5 and 45 times more people than seasonal flu, according to a new American analysis. The authors deplore the fact that many cite extrapolations about the flu to tackle containment.
Posted on May 20, 2020 at 3:00 a.m.
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“Some people look at the COVID-19 death toll figures and say it is not much higher than the seasonal flu,” said study lead author in the journal Thursday. JAMA Internal Medicine, Jeremy Faust, of Harvard University. “We cannot compare the extrapolations of probable mortality from influenza to deaths duly counted for COVID-19. “
The extrapolations used for influenza cannot be used to compare it to the current pandemic. “The extrapolations were intended to address the underdiagnosis stemming from the fact that influenza tests are not always done in the hospital,” says Dr.r Faust. The CDC thought it would encourage people to have better hygiene, to get vaccinated. So we came up with probably too high extrapolations. I always knew it was an academic fault, but I never thought it could have had such dire consequences. “
We see politicians relying on these extrapolations to justify the reopening of stores.
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The Dr Jeremy Faust, Harvard University
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The Centers for Disease Control and Prevention (CDC) estimates that the flu kills 23,000 to 61,000 people each year in the United States. But the number of deaths officially attributed to seasonal flu ranged from 3,348 to 15,620 per year between 2013 and 2020. This means that COVID-19 will be between 9.5 and 44.1 times more deadly than seasonal flu.
Probable death
Even if several public health departments have started counting under the heading COVID-19 deaths without testing, with the qualifier “probable COVID-19 death”, the Dr Faust believes that the actual number is probably higher. “We have false negatives in the tests, especially when the patient arrives late in the disease,” says Dr.r Faust. We see that the number of excess deaths compared to other years is higher. “
Is it possible that the number of deaths will fall below the annual average this summer because very old patients will have died a few months before term? “Yes, it is possible,” says Dr Faust. We must therefore speak of “years of life lost” to add the people who had their lives shortened by a few months. “
In the authorization process for new drugs, the concept of “quality-adjusted life years” (QALY) is often used, rather than simply “years of life” (LY), to give more weight to years spent in good health. Will this concept also be used in the context of COVID-19? “I thought so, but obviously it’s very delicate, you don’t want to sound like you say some lives are worth less than others. “
Is it possible that the number of deaths officially attributed to influenza is also underestimated? “It is true that if a person has a heart attack, arrives at the hospital, has a positive test for COVID-19 and then dies, we will attribute the death to COVID-19,” says Dr Faust. It is difficult to say what happens in such a situation if the patient has the flu instead. First, we don’t systematically test every patient for the flu. But I have doubts about the mortality actually attributable to the flu. If you look at the mortality curves for the past 20 years, it is impossible to determine the years when the flu was more severe. “
The truth about Diamond princess
Another comparison is possible with the cruise ship Diamond princess, which has been stuck for weeks in Japan with 3,700 passengers. “I was one of the first to point out in early March in Slate, that the Diamond princess could give us the actual death rate because everyone on board was tested says the Dr Faust. Adjusting for the age of the passengers gives a rate of 0.5% [une infection mène à la mort dans 1 cas sur 200]. That’s five times more than the official flu rate. But the death rate from the flu is not very solid, and COVID-19 will be 10, 20, 50 times worse because you don’t have group immunity. “
In numbers
752.4: weekly mortality during the peak of the influenza season, average of the 2013-2020 seasons, in the United States
15,455: weekly mortality during the peak of the first wave of COVID-19 in the United States
SOURCE: JAMA
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