By the numbers, Covid-19 was never 'like the flu'

  • Stats show that comparing Covid-19 virus to flu doesn't match up
  • US President Trump had said the virus was "like a flu"
  • Researchers say any comparison between the two is pointless


In the early days of the coronavirus pandemic, US President Donald Trump announced that Americans need not worry because the new coronavirus was "like a flu".

Now, new report finds the comparison was never valid.

"Public officials continue to draw comparisons between seasonal influenza and SARS-CoV-2 mortality, often in an attempt to minimise the effects of the unfolding pandemic," wrote Dr Jeremy Faust, of Harvard Medical School, and Dr Carlos del Rio, of Emory University School of Medicine in Atlanta.

But those comparisons are "apples and oranges", the physicians reported in an article published on 14 May in the journal JAMA Internal Medicine.

'Calculated estimates'

That's because the numbers comparing Covid-19 and flu just don't match up.

For example, the US Centers for Disease Control and Prevention produces an annual tally of deaths caused by flu. During the 2018–2019 flu season – by all accounts a moderate one – 34 200 Americans are thought to have died from complications linked to the flu. In more severe flu seasons, that number can go higher – the 2017–2018 season was linked to more than 61 000 deaths, for example.

However, Faust and del Rio noted that confirming that flu caused a patient's death (and not some other underlying condition) is often tough, so the CDC long ago issued their numbers as "calculated estimates" – not actual death counts as verified by death certificates.

An annual number for verified flu deaths also exists, however, and it's much smaller than the calculated estimates.

Between 2013 and 2019, "the number of counted influenza deaths was between 3 448 and 15 620 yearly," the report authors noted.

Conversely, Covid-19 deaths occurring in 2020 have all been counted, not estimated.

Simply no comparison

That means that by 14 May, the more than 84 000 deaths from coronavirus are already about 5.5 times higher than the highest annual death count for the flu over the past seven years.

Those ratios widen even further when deaths are looked at on a weekly basis.

"Statistics on counted deaths suggest that the number of Covid-19 deaths from the week ending 21 April was 9.5-fold to 44.1-fold greater than the peak week of counted influenza deaths during the past seven influenza seasons in the US," Faust and del Rio said.

Finally, there's simply no comparison between flu and Covid-19 when it comes to what medical staff are experiencing on the frontlines.

"In some hot zones of the pandemic … ventilators have been in short supply and many hospitals have been stretched beyond their limits," the two experts noted. This overwhelming demand on hospitals, "has not happened before in the US even in the worst of influenza seasons".

Finally, they said, the actual death count of Covid-19 may be even higher than current estimates, because "indirect" deaths linked to the pandemic aren't factored in. Those include deaths that occurred because people with other, often fatal conditions couldn't get the help they needed as health care systems became overwhelmed by Covid-19.

Vigilance and strict adherence 

Dr Robert Glatter is an emergency physician working at the forefront of the pandemic at Lenox Hill Hospital in New York City. He agreed with the new report.

"The bottom line is that any comparison of Covid-19 to seasonal influenza is pointless both in numbers, transmissibility as well as severity of disease," Glatter said. "We must be vigilant in not comparing these two viruses – in any respect – so as to create any illusion that Covid-19 is like the flu."

That doesn't mean that influenza might not morph someday and become just as lethal as Covid-19, similar to what occurred in the 1918 Spanish flu pandemic, Glatter said. That outbreak is thought to have killed up to 50 million people worldwide.

In the meantime, however, Covid-19 is here, and there are ways to fight it.

"The approach to Covid-19 requires vigilance and strict adherence to physical distancing, wearing of facial coverings and adherence to stay-at-home orders to reduce transmissibility of the virus," Glatter said. "Our lives depend on it."

Image credit: Getty Images

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