Hasn’t COVID-19 become more dangerous than the flu for most people?
It’s a question scientists are debating as the country heads into a third pandemic winter. At the start of the pandemic, COVID was estimated to be 10 times more deadly than the flu, fueling fears for many people.
“We’ve all wondered, ‘When is COVID like the flu?’,” says Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco. “And, I would say, ‘Yes, here we are.'”
Gandhi and other researchers say most people today have enough immunity — acquired through vaccination, infection, or both — to protect them from serious illness from COVID. And that’s especially true since the omicron variant doesn’t seem to make people as sick as previous strains, says Gandhi.
So unless a more virulent variant emerges, the threat of COVID has diminished significantly for most people, which means that they can go about their daily lives, says Gandhi, “in a way that you used to experience with rampant seasonal flu”.
But there are still many differing views on this subject. While the threat of COVID-19 may be approaching the peril posed by the flu, skeptics doubt it has reached that point yet.
“I’m sorry – I just disagree,” says Dr. Anthony Fauci, White House medical adviser and director of the National Institute of Allergy and Infectious Diseases. “The gravity of one compared to the other is really quite striking. And the potential to kill one compared to the other is really quite striking.”
COVID is still killing hundreds of people every day, which means more than 125,000 additional COVID deaths could occur over the next 12 months if deaths continue at this rate, Fauci notes. COVID has already killed over a million Americans and it was the third leading cause of death in 2021.
A bad flu season kills about 50,000 people.
“COVID is a much more serious public health problem than the flu,” Fauci said, noting that this is especially true for the elderly, the group most at risk of dying from the disease.
Discuss how deaths are counted
The debate over the COVID death rate hinges on what counts as a COVID death. Gandhi and other researchers say the number of daily deaths attributed to COVID is exaggerated because many deaths attributed to the disease are actually from other causes. Some of those who died for other reasons also tested positive for coronavirus.
“We are now seeing consistently that more than 70% of our COVID hospitalizations fall into this category,” says Dr. Shira Doron, an infectious disease specialist and professor at Tufts University School of Medicine. “If you count them all as hospitalizations and then those people die and you count them all as COVID deaths, you’re overcounting quite significantly.”
If deaths were classified more accurately, the number of daily deaths would be closer to the flu toll in a typical season, Doron says. If this is true, the chances of a person dying if they contract a COVID infection – known as the case fatality rate – would be about the same as the current flu, which is estimated at around 0.1%. , or even less.
In a new report from the Centers for Disease Control and Prevention released Thursday, researchers tried to filter out other deaths to analyze death rates for people hospitalized “primarily for COVID-19.” They find that the mortality rate decreased significantly in the omicron era, compared to the delta period.
But Fauci argues that it is difficult to distinguish between deaths that are caused “because of” COVID and those “with” COVID. The disease has been found to put stress on many body systems.
“What’s the difference with someone who has mild congestive heart failure, goes to the hospital and gets COVID, then dies of deep congestive heart failure?” he asks. “Is it with COVID or because of COVID? COVID definitely contributed to that.”
A second reason many experts believe the death rate from COVID is likely lower than it appears is that many infections are currently going unreported due to home testing.
The death rate is a ratio – the number of deaths to the number of confirmed cases – so if there are more real cases, it means the likelihood of an individual dying is lower.
“I believe we’ve reached the point where, for an individual, COVID poses less risk of hospitalization and death than the flu,” Doron said.
Dr. Ashish Jha, the White House’s COVID-19 response coordinator, agrees, not least because COVID vaccines and treatments are better than those for the flu.
“If you are up to date on your vaccines today and using the treatments, your chances of dying from COVID are extremely rare and certainly much lower than your risk of getting into trouble with the flu,” Jha told NPR. .
The risk remains high for the elderly and frail
But Jha points out that omicron is so contagious and infects so many people that it “at the population level poses a much greater threat to the American population than the flu,” and it can still cause more deaths. in total.
Additionally, mortality rates for any disease vary by age and other demographic factors. It is important to note that COVID remains far more deadly for the elderly and medically frail than for the young. Recent data from the CDC shows that compared to 18 to 29 year olds, people aged 65 to 74 are 60 times more likely to die; those aged 75 to 84 are 140 times more likely; and those 85 and older have a 330 times higher risk.
The danger is particularly high for those who are not vaccinated, boosted and treated correctly. And as COVID continues to spread widely, they remain vulnerable to exposure through social contact.
While younger, otherwise healthy people can sometimes get very sick and even die from COVID, this has become rare.
“I think it’s really important for people to have an accurate sense of reality in order to live their lives,” says Dr. Jake Scott, an infectious disease specialist at Stanford University. “If their risk assessments are driven or influenced by these overstated hospitalization and death rates, I think that’s problematic.”
Waiting to see if the model is confirmed
Other researchers still argue that COVID remains much riskier than the flu.
“However you slice it, there has never been a case where COVID-19 was milder than the flu,” says Dr. Ziyad Al-Aly of Washington University in St. Louis , who has done research comparing COVID to the flu.
“We have never, ever in the history of the pandemic, in all of our studies from the beginning until now, found that COVID-19 is so dangerous for the flu,” Al-Aly says. “He always carried a higher risk.”
Some experts are waiting for more data showing a clear trend of reduced death rates.
“I’ll probably feel more comfortable saying something like, ‘Oh, COVID is similar to the flu’ when we actually see a pattern that looks like that,” says Dr. Jeremy Faust, emergency physician at Brigham and Women’s Hospital of Boston in the Division of Health Policy and Public Health. “We’re kind of just starting to see that, and I haven’t really seen that in a sustained way.”
Many also point out that COVID can increase the risk of long-term health issues, like long COVID.
“Even people with mild to moderate COVID symptoms can end up with long COVID,” Fauci says. “That doesn’t happen with the flu. It’s a totally different ball game.”
But Gandhi also questions this. Much of the estimated risk for long COVID comes from people who became seriously ill early in the pandemic, she says. And if you take that into account, the risk of long-term health problems may not be greater with COVID than with other viral infections like the flu, she says.
“It was really bad COVID that led to long COVID. And as the disease has subsided, we’re seeing a drop in long COVID rates,” says Gandhi.
In fact, some experts even fear that this year’s flu season could be worse than this winter’s COVID surge. After very mild to non-existent flu seasons during the pandemic, influenza has hit Australia hard this year. And what happens in the southern hemisphere often predicts what happens in North America.
“If we have a severe flu season and if omicron variants continue to cause mostly mild illness, next winter could be a much worse flu season than COVID,” says Dr. William Schaffner, infectious disease researcher at Vanderbilt University.
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