deaths from COVID-19 versus death from influenza

According to the CDC, when comparing deaths from COVID-19 versus deaths from influenza the numbers appear similar, but is that comparing apples to oranges?

Although both viruses can spread in a similar fashion and both can be deadly, is it fair to compare the number of deaths from COVID-19 to deaths from influenza?

Doctors from Harvard Medical School and Emory University School of Medicine recently performed an assessment of the way death data is reported for each disease. Their assessment was published in the journal JAMA Internal Medicine. 

To determine whether the current comparison of death data is fair, the way the death rates for each virus are calculated needs to be examined. Every year the death rates for the flu are calculated by the CDC. However, the CDC does not report the actual number of deaths due to the flu but reports an estimate. 

The CDC uses estimates for several reasons. First, many cases of the flu are not serious enough to call for medical treatment. Second, patients often put off seeking medical care until they have had the virus for some time. At this point, the flu tests are not exactly accurate and can often present with false negative results. Third, states are not required to report flu deaths to public health authorities. Also, the flu can cause health complications to pre-existing conditions which lead to death, but the flu will not be listed as the cause of death.

For example, the number of actual deaths due to the flu reported in the five years before the pandemic were 3,448 to 15,620 annually. During that same time, the CDC estimates of flu deaths were reported as 23,000 to 61,000 annually. 

The data for deaths due to COVID-19 are currently being reported as the actual number of deaths and is not an estimate. To get an accurate comparison, say apples to apples, the weekly counts of COVID-19 deaths should be compared to the weekly counts of flu deaths. 

The average number of flu deaths from the top week of flu season over the last seven years was 752.4 deaths. For the week ending April 21, 2020, COVID-19 deaths were reported as 15,455 deaths. That is twenty times higher than the average death rate for influenza. 

The analysis of the deaths from COVID-19 versus deaths from influenza points out limitations in data reporting for COVID-19, such as undercounting due to limited supply of tests or false negatives, testing in latter stages of the virus, and data reporting differences. 

The doctors’ analysis suggests that when deaths from COVID-19 versus deaths from influenza are compared but not calculated identically, the true threat to public health from COVID-19 is not accurately reported. 

Written by Rebecca K. Blankenship

References:

1. Faust J, del Rio C. Assessment of Deaths From COVID-19 and From Seasonal Influenza. JAMA Intern Med. 2020;180(8):1045. doi:10.1001/jamainternmed.2020.2306

2. Preliminary In-Season 2019-2020 Flu Burden Estimates. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm. Published 2020. Accessed August 5, 2020.

3. Why CDC Estimates the Burden of Season Influenza in the U.S. | CDC. Cdc.gov. https://www.cdc.gov/flu/about/burden/why-cdc-estimates.htm. Published 2020. Accessed August 5, 2020.

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