How Many People Have Died From Influenza
Every year, flu kills 12,000 to 56,000 people and sends as many as 700,000 to the hospital. CDC estimates flu deaths by looking at how many more people than usual died of flu and pneumonia, but even those calculations miss people who may have died from flu complications, such as a heart attack set off by a bout of flu.
About 61000 People Died In The 2017
Since not everyone sick with the flu visits a doctor, and not all flu deaths occur in the hospital, the CDC uses mathematical modeling based on its surveillance data to estimate the total number of illnesses and deaths. This model considers factors like testing frequency, the likelihood of seeking medical care, and underreporting on death certificates. The flu can lead to death by pneumonia, congestive heart failure, or chronic obstructive pulmonary disease in which case flu testing may occur too late or not at all. According to the CDC, only counting deaths where influenza was recorded on a death certificate would be a gross underestimation of influenzas true impact. For comparison, CDC death certificate data shows that just 5,894 people died of the flu in 2019.
Still, state-level unadjusted death certificate data can help show how flu mortality rates vary across the nation.
Death Rate From Covid Now Comparable To The Flu
Right now just 130 people are dying from the coronavirus every day in England at what is believed to be the peak of the Omicron outbreak, compared to 1,300 last January before vaccines were widely available.
For comparison, Government estimates show there were more than 400 influenza deaths per day at the peak of the last bad flu season in 2017/18, and almost 300 daily fatalities the previous year. Just like this winter, hospitals were forced to cancel routine operations and patients were told to steer clear of A& E units during both of those outbreaks.
Professor Paul Hunter, an infectious disease expert from the University of East Anglia, said the figures showed that the burden of Covid is now comparable to flu.
He told MailOnline Covid would almost certainly get weaker every year as people develop natural immunity and eventually become a common cold that kills only the very vulnerable further down the line.
MailOnline analysis shows the UKs case fatality rate the proportion of confirmed infections that end in death has shrunk 21-fold from 3 per cent last winter to 0.15 per cent at the end of December. For comparison, seasonal influenza is thought to have a case-fatality rate of around 0.1 per cent but fewer tests are done.
Countries with therapeutics like ivermectin, Vitamin D, zinc, and HCQ do even better.
Recommended Reading: Flu Symptoms Loss Of Taste
Death Lag By Paperwork
Part of the problem with communicating the true death rate is that COVID-19 fatalities have been especially challenging to track in a timely manner. Registering that a death has occurred and determining its cause are two basic functions of public health. Even in situations less chaotic and slower-moving than COVID-19, it can take several days for state officials to receive notification of a death. States then forward their data to the CDC’s National Center for Health Statistics, where the death and its cause are logged.
Due to the significance of the COVID-19 pandemic, the CDC has added an extra step in which the agency uses humans instead of computers to verify the information on the death certificate before they formally add it to their tally. Although the CDC has gotten much faster at performing this task since March, it is still taking around a week to formally record a coronavirus death, says Kirk Bol, manager of the Vital Statistics Program at the Colorado Department of Public Health and Environment.
Add everything up, and it could take more than a month to go from infection to death.
This bureaucratic delay exists on top of the natural biological processes of illness, says Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security. If someone is infected with the coronavirus today, they generally wont start to show symptoms for four to five days, on average, but it could take up to two weeks.
Data Can Include Deaths By Poison
Another model assumes that every extra death that happens in the winter is a flu death. At the risk of oversimplifying, this is the basic formula of that model: winter deaths summer deaths = death by flu virus.
That includes winter deaths from slippery sidewalks, snowy roads, freezing temperatures, plus all the winter heart failure, lung failure and deaths from cancer. In the language of the computer model, all excess mortality in winter is considered “death by flu.”
The model extrapolates that the flu virus will cause more deaths across all causes, including “disorders of the nervous system,” stroke and “disorders of the digestive system.” Which means that according to the model, flu causes 33 more “accidental falls” every year, 18 more “accidental poisonings,” and 68 more deaths from “psychotic conditions.” But what does flu have to do with deaths from accidental poisonings or accidental falls?
‘If they don’t collect that information, how do they know that their policies will work? This is called faith-based medicine.’ Dr. Tom Jefferson
The models are only as good as the data sets that are fed into them. And death can be complicated. If someone already extremely fragile with heart or lung disease is tipped over the edge with a flu infection, is that a flu death, or a heart death or a lung death? Which database gets to claim it?
Don’t Miss: Flu Shot For Over 65
How Many People Die Of The Flu Each Year On Average
According to data collected by the CDC from 2010 to 2020, the agency estimates that the flu has caused 12,00052,000 deaths annually. During that time, the flu also caused 9 million41 million illnesses, and 140,000710,000 hospitalizations. Globally, the World Health Organization estimates that the flu kills 290,000 to 650,000 people per year.
Those numbers can vary so much from year to year, because what we know as “the flu” isn’t one specific thingit’s actually made up of different influenza strains that circulate. “How many people die of the flu each year of the flu is definitely related to the strains that are circulating, how accurately researchers were able to predict what should go into the flu vaccine, and how many people are vaccinated,”Anjali Mahoney, MD, MPH, family medicine specialist with Keck Medicine of USC, tells Health.
Certain influenza strains can also be more severe than others. “Sometimes there are years where there are big genetic shifts, and we can see a very different virus,”Cassandra Pierre, MD, MPH, an infectious disease physician at Boston Medical Center, tells Health. Robert L. Murphy, MD, a professor of infectious diseases at Northwestern Medicine Feinberg School of Medicine, agrees, saying that the flu virus is always changing. ” it can be a nastier strain,” he tells Health. “It goes up and down.”
Flu Models Versus Counts
Getting back to the question of how deadly influenza really is, fate did offer up a chance to check the model predictions when the flu pandemic hit in 2009, and the world faced a new influenza threat called H1N1.
Back then a flu expert told me that the pandemic would be a rare opportunity to check the true death toll from flu, because, for the first time, there was widespread lab testing, a national reporting system, and all eyes were on potential flu-related deaths. The final count: 428 deaths, which is much closer to the seasonal average of around 300 recorded in the vital statistics tables than to the 2,000 to 8,000 deaths estimated for the average flu season by the computer models.
So how did the models rate after a real life test? “The predictive models of 2009 of influenza have actually been a complete failure,” respiratory-infection expert Jefferson said.
“Ranges like 2,000 to 4,000 or even 8,000 influenza-related deaths a year are thrown around each flu season, and policy decisions and flu shot campaigns are based on these numbers,” Michael Gardam told me. “I think it is important for us to remember that these numbers are estimates and certainly not written in stone. These numbers vary a great deal depending on which research paper you read.”
Don’t Miss: Flu Shot Cost Without Insurance Walgreens
Figure : In England A Higher Proportion Of Deaths Due To Covid
Proportion of deaths due to influenza and pneumonia or COVID-19 by place of occurrence, England, occurring between 1 January and 31 August 2020 and registered by 5 September 2020
The highest number of deaths in England in 2020 due to both influenza and pneumonia , and the coronavirus occurred in hospitals. Deaths due to influenza and pneumonia were lower than the five-year average across all settings. The proportion of deaths due to influenza and pneumonia that occurred in hospitals was higher for the five-year average than in 2020 while the proportion in care homes, private homes and other settings was higher in 2020 than the five-year average.
Around 15.4% of deaths in 2020 occurred in care homes, compared with 15.3% for the five-year average. In 2020, 13.5%, 0.5% and 0.9% of deaths due to influenza and pneumonia occurred in private homes, elsewhere and in other settings respectively. In comparison, 11.1%, 0.4% and 0.6% of deaths occurred in private homes, elsewhere and in other settings for the five-year average.
For deaths due to COVID-19 in England, a smaller proportion of deaths occurred in hospitals and private homes compared with 2020 deaths due to influenza and pneumonia and the five-year average. However, 30.0% of deaths due to COVID-19 occurred in care homes, around twice the proportion observed for 2020 and the five-year average for deaths due to influenza and pneumonia.
What Do We Mean By ‘years Of Life Lost’
Years of life lost is a way of estimating how long someone would have lived, had they not died from COVID-19. To calculate it, we use life tables. These tables tell us the life expectancy of someone at each age for example, they tell us that a man aged 80 in England or Wales could expect to live 8.2 more years, a woman 9.7. If a man aged 80 died from COVID-19 we therefore assume he has lost 8.2 years of life. By summing all these lost years we come up with an overall estimate of the total years lost due to COVID-19.
There are limitations to this method. Primarily, we have used average life expectancies at each age when we know it is likely that those who died from COVID-19 were more likely to have co-morbidities than their peers, and therefore may have had lower life expectancies. We may therefore have overestimated the number of years of life lost. However, our estimates do not include the additional deaths that occurred during the pandemic but were not directly caused by COVID-19.
Recommended Reading: Costco Cold And Flu Medicine
Myth : Those Who Died From Covid
In the year since the start of March 2020, around 1.5 million years of life have been lost from COVID-19 in the UK.
On average, each person who died with COVID-19 lost 10.2 years of life. Looking at England and Wales alone the years of life lost was 1.4 million years, with a greater loss for men , than for women . While women can expect to live longer than men men have been up to around twice as likely to die from COVID 19 as women of the same age.
Even if we look only at deaths among people older than age 75, a total of 600,000 years of life have been lost around 6.5 years for each death.
Figure : People Aged 85 Years And Over Had Statistically Significantly Higher Rates Than All Other Age Groups For Deaths Due To Influenza And Pneumonia And Covid
Age-standardised and age-specific mortality rates for deaths due to influenza and pneumonia and COVID-19, Wales, occurring between 1 January and 31 August 2020 and registered by 5 September 2020
In 2020, age-standardised and age-specific mortality rates for deaths due to influenza and pneumonia were statistically significantly lower than the five-year average for all age groups in Wales. Those aged 85 years and over had the highest age-specific mortality rates, with 1,031.4 and 1,601.8 deaths per 100,000 people for 2020 and the five-year average respectively. These rates were statistically significantly higher than all other age groups.
The largest absolute difference in influenza and pneumonia mortality rates between 2020 and the five-year average was observed in those aged 85 years and over, with a difference of 570.4 deaths per 100,000 people. However, the largest percentage change was observed in those aged under 65 years, with mortality rates due to influenza and pneumonia in 2020 being 41.3% lower than the five-year average.
Comparing COVID-19 and 2020 influenza and pneumonia mortality rates, the largest absolute difference in rates was found in those aged 85 years and over, with a difference of 712.9 deaths per 100,000 people. In comparison, when comparing COVID-19 and the five-year average for influenza and pneumonia, the largest difference was found in those aged 80 to 84 years .
Read Also: Do You Need A Flu Shot Every Year
How Does Flu Risk Vary Byage
As with COVID-19, most flu deaths occur among Americans aged 65 or older. As of March 19, almost 81% of people who have died from COVID-19 have been in this age group. This is within the range of a normal flu season, with older Americans making up 62% of flu deaths in the 2019-2020 season, 75% in the 2018-2019 season, and 83% in the 2017-2018 season.
Please Note That It May Take Up To 5 Days For The Peer Review Documents To Appear
For research papers The BMJ has fully open peer review. This means that accepted research papers published from early 2015 onwards usually have their prepublication history posted alongside them on bmj.com.
This prepublication history comprises all previous versions of the manuscript, the study protocol , the report from the manuscript committee meeting, the reviewers comments, and the authors responses to all the comments from reviewers and editors.
In rare instances we determine after careful consideration that we should not make certain portions of the prepublication record publicly available. For example, in cases of stigmatised illnesses we seek to protect the confidentiality of reviewers who have these illnesses.In other instances there may be legal or regulatory considerations that make it inadvisable or impermissible to make available certain parts of the prepublication record.
In all instances in which we have determined that elements of the prepublication record should not be made publicly available, we expect that authors will respect these decisions and also will not share this information.
Don’t Miss: How Long Does Flu Season Last
Antigenic Drift And Shift
Two key processes that influenza viruses evolve through are antigenic drift and antigenic shift. Antigenic drift is when an influenza virus’s antigens change due to the gradual accumulation of mutations in the antigen’s gene. This can occur in response to evolutionary pressure exerted by the host immune response. Antigenic drift is especially common for the HA protein, in which just a few amino acid changes in the head region can constitute antigenic drift. The result is the production of novel strains that can evade pre-existing antibody-mediated immunity. Antigenic drift occurs in all influenza species but is slower in B than A and slowest in C and D. Antigenic drift is a major cause of seasonal influenza, and requires that flu vaccines be updated annually. HA is the main component of inactivated vaccines, so surveillance monitors antigenic drift of this antigen among circulating strains. Antigenic evolution of influenza viruses of humans appears to be faster than influenza viruses in swine and equines. In wild birds, within-subtype antigenic variation appears to be limited but has been observed in poultry.
How The Coronavirus Compares With The Flu
Follow this story and more bysigning up for national breaking news email alerts.
For more than two months, global health and government officials have been trying to stem the coronavirus outbreak, quarantining citizens, locking down towns, regions and even the entire country of Italy and creating triage protocols in hospitals where the contagious, deadly novel virus has taken root.
As of early March, the coronavirus outbreak had infected more than 100,000 people and killed more than 3,000 globally, the majority in China, where the illness was first detected in December. More than 750 people in the United States have been diagnosed, including at least 25 people who have died.
By comparison, influenza known as the common flu has infected as many as 45 million Americans since October and killed as many as 46,000, according to estimates from the Centers for Disease Control and Prevention. President Trump invoked the large number of flu deaths each year in a tweet on Monday.
Both the coronavirus and influenza are respiratory illnesses. Both have similar symptoms. Both are contagious. Both can be deadly.
So why the nationwide coronavirus frenzy?
The key difference between the novel coronavirus and influenza, said Melissa Nolan, an infectious disease epidemiologist at the University of South Carolina, is this: We know what to expect from the flu.
Read Also: Where To Swab For Flu Test
Deaths In Flu Pandemics
There have been several known flu pandemics throughout history. Some were more widespread in specific parts of the world, but the impact of a pandemic is usually felt, at least to some degree, worldwide.
- 1889 Russian flu pandemic: Resulted in about 1 million flu deaths.
- 1918 Spanish flu pandemic:Responsible for at least 50 million flu deaths, including about 675,000 in the U.S. The flu infected about a third of the world’s population.
- 1957 Asian flu pandemic: Tallied some 1.1 million flu deaths, including about 116,000 in the U.S.
- 1968 Hong Kong flu pandemic:Led to 1 million flu deaths, with 100,000 in the U.S.
- 2009 H1N1 flu pandemic:Between 8,870 and 18,300 deaths in the United States, and up to 575,000 deaths worldwide, were seen during the first year.
The chart below illustrates these numbers, but it also helps to highlight the sheer scale of the 1918 Spanish flu’s effects.