Covid-19 vs. the Flu Reality Check

Something bothers me a lot when I hear radio show hosts and politicians comparing covid-19 to the flu and attempting to use flu mortality to minimize the risk of covid-19. This was even stated here on this site in the politics section a week ago, in a thread that was closed before I got the chance to respond to it: “It is my opinion, the Wuhan virus (sic) statistically will prove less damaging medically than the flu. What is far more damaging has been the way it’s been politicized and allowed to destroy our economy”.

This is simple math, so if I got anything wrong, I’m sure you’ll let me know.

Deaths in the US last year from the flu: 35,000. Population of New York state: 20 million out of US population 330 million.

Deaths in New York state from the flu last year (as percentage of population): 2100.
Deaths in New York state from the flu last year per week: 40 per week.

Deaths in New York state this week (3/24 to 3/30) from Covid-19: 1187.

Current death rate Covid-19 compared to the flu: 1187 compared to 40 or 2900 percent higher.

Note this is the current death rate in New York, not a projection of peak.

See why my head is about to explode?


See @Chris’ fascinating graphic about how much worse than the flu COVID-19 shows up to be:

Interesting Visualization of Covid-19 Deaths compared to other causes (US) - Share - FUDiabetes

It is actually frightening to see this growing death rate on the animation.

This virus has directly hit my family back home. It makes me angry when people play with people’s lives for the sake of politics. This virus is nothing like the flu: it is a deadly pandemic, and nobody should be repeating this lie. I never look at the politics category (except as an admin) and I will certainly not look up this thread.

Here the words of an ER nurse in NYC:
BBC News - Coronavirus: ‘Nurses prepare for the worst but not this’

Read this and tell me who is ready to tell this health responder that COVID-19 is like the flu?


12 posts were merged into an existing topic: Moving info about my sister’s condition [COVID-19 patient] in the lounge

To update this with the latest figures:

Deaths in New York state from the flu last year: 40 per week.
Deaths in New York state this week (3/20 to 4/6) from Covid-19: 3416 per week.

So, 85 times the number of deaths from Covid-19 experienced last week, compared to the number of deaths expected from the flu.

To all the idiots who said this is going to be “less damaging medically” than the flu, what the f^ck do you say now?

There’s my head again, getting ready to explode.

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that’s not even counting many people who may have died of COVID-19 but could not be tested…

I’m hopeful that most of the country will avoid the magnitude of death being seen in NYC; I really think the density and the subways there, combined with all the people coming from everywhere, made it a perfect storm.

But there’s no doubt that it will be bad everywhere, even with our entire economy stalled for weeks on end.


Not to mention the lack of ICU beds. The current UW model shows the US short of 16,000 ICU beds at the peak in 8 days, and New York is contributing 6,000 of the 16,000. It is a very densely populated area with a bottom quartile of ICU beds available. Perfect storm conditions.

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What I say now is look at the antibody study out of Santa Clara, CA, (Dept. of Homeland Security) in which they basically conclude that Covid-19 has a 0.12% mortality rate, which is pretty much on par with seasonal flu. And mitigation makes hardly any difference because the disease is so widespread.

I hope your head is not exploding. Now go ruin the economy and shred the Constitution.

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docslotnick refers to a mortality rate much lower than any I’ve heard before. It’s an intriguing result, so I went looking for background. Here’s what I found.

An article informally describing these results: https://spectator.us/leaked-homeland-security-report-coronavirus/

A pair of slides from Homeland Security 3/31/20 via New York Times: https://int.nyt.com/data/documenthelper/6874-fema-coronavirus-projections/1e16b74eea9e302d8825/optimized/full.pdf

A discussion from fox news: https://www.foxnews.com/health/coronavirus-antibody-testing-finds-bay-area-infections-85-times-higher-reported-researchers

The pre-print of the non peer-reviewed paper abstract: https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1 full paper: https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1.full.pdf which states that the study was funded by donations from many individual donors.

I am unable to assess the actual work to judge its credibility. If it turns out to be true, it is good news indeed, and deserves to have a significant impact on how the world deals with this pandemic.


@docslotnick, I saw that study. The problem with that study is that if the incidence of COVID-19 is fairly low (say 0.5%), then a 98% specificity (as this antibody test, which has just been approved, has in the best case, according to their own data) means that the vast majority of positives you have are false positive. WE actually don’t know if the test’s specificity is that good all the time; it’s not FDA approved, which may not be a huge issue, but to validate the test, they conducted a few hundred samples .Not sure that’s enough to feel confident about the results.

Example: Imagine 1,000 people. 5 truly have COVID. But 20 will test positive for COVID.

A 0.12% mortality rate is not consistent with data from NYC, in which already more than 0.1% of the population has died (city population = 8.2 million, deaths = ,8843, presumed COVID deaths = 12,000ish). And the few antibody tests done in NYC suggest around 15% prevalence there. Now, NYC’s health is poorer than Santa Clara’s, on average, but I’m having a really hard time squaring the assumed seroprevalence they’re finding with the actual, on the ground mortality rates we’re seeing in hard-hit areas.

There’s a bigger problem i my mind. This sample was drawn from a population of people solicited via Facebook ads. I can tell you, as someone who rushed to sign up for an NIH antibody study, that I did so because I had some extremely suspicious symptoms in February (fever of 102 with dry cough for 5 days, followed by what I thought was improvement, followed by a week or more of worsening cough, followed by 3 weeks of chest pain). Five days earlier I had flown on a flight, and it was the last day flights from China were being allowed into SFO. People from China were on my flight. But because I didn’t meet testing criteria at the time, no one even considered the possibility that it was COVID. Anyways, the point is, my guess is that the 3,300 people they sampled were so eager to go through drive-through testing, tugging their kids in tow, because they suspected they had the virus already. Which makes it not representative of overall prevalence.

Believe Wuhan numbers or not, but they found seroprevalence amongst healthcare workers of about 2-3%. In a German town with a large outbreak, they found seroprevalence of 14%, and in pregnant women in NYC with no covid symptoms, they also found about that seroprevalence. Extrapolating from Santa Clara’s number of symptomatic cases/true infection rate would mean that ALL of NEw York had the disease, and that just doesn’t match data.

Anyways, I think it’s interesting and we need more testing like that. But I don’t think it can tell us that much quantitatively about fatality rates yet. My personal guess is that the true IFR will wind up being somewhere between 0.3 and 1%, depending on the population. But if it’s on the lower end, it’s much more transmissible, which means it’s going to hit almost everyone in the population, and total deaths could be almost as high as if you had a higher fatality rate but a lower attack rate.

Either way you slice the data, a lot of people are going to die.


Oh really? So you’re congratulating yourself for being right all along, that this virus is no big deal and we should have just let this virus run its course the way our idiot leader first proposed? You actually think you’ve been proven right???

The only problem with your pompous leader’s perpetual self-congratulation is the minor problem of simple mathematics. Obviously not his strong suit.

With a population of 20 million, the state of New York saw about 2100 deaths last year from the flu, which is 40 deaths per week. So what is the rate of deaths last week (4/11 to 4/18) from covid-19? Gee, too bad, but it is 9044 deaths per week, which is 225 TIMES the number of deaths from the flu last year. Comparable to the common flu - really? - sorry but I don’t think so.

OK, then, lets look not at the weekly death rate but at how many actual deaths we’ve had so far in one month in New York state from covid-19. And lets use simple mathematics to examine it. 2100 deaths from last years flu. Even with social distancing in place for the full time, there have been 17656 deaths in the last month from covid-19, which is more than eight times the number of deaths from last year’s flu. Eight times the number of deaths so far, in one month compared to a full year! And note that this is in New York state, not just New York city. There are large parts of New York state that are not experiencing the pandemic to any where the degree that the city is, so clearly the deaths are not over, though hopefully they are plateau-ing due to social distancing.

The truth is that we still don’t know what the mortality rate of this virus is, because we have never had enough testing in our country, despite repeated claims to the contrary by our so-called leaders. Because of the lack of testing, we have only one small study of 3000 people in one county in California. Hopefully larger studies in other areas will bear out these statistics, though the actual results being seen in New York make this seem unlikely. But here’s the rub - the only way to know is to get the tests manufactured and distributed so that we can find out where we really are and get the country working again. Maybe the federal government should finally be focusing on this instead of self-congratulations and personal attacks on news reporters and governors.

Excuse me, but it isn’t me who is ruining the economy and shredding the Constitution. It is the idiot in charge who refused to take this global pandemic seriously, thereby leaving us in the situation we are now in.


There are other options out there: Sweden has done an interesting job:
And honestly, to compare NY to California is kind of a stretch. I think it is likely the strain on the west coast is quite different from the strain on the east coast, and the number of ICU beds in NY is amongst the lowest in the country so a higher death rate in NY is highly likely as compared to CA.


Zero sympathy for anyone who dies because they choose to downplay the seriousness of this virus. Natural selection at work…

@jag1 Is there some perverse reason why you are only looking at New York? There’s a lot of country beyond New York. In fact, I would say that because New York is so densely populated that they are atypical compared to all points west.

There are large swaths of our country that have no or very minimal deaths. Don’t they count in your perverse mind? Do all those people need to deal with your idiotic idea of closing the economy?

And I don’t think our President is “idiotic”. First, by all accounts, he mitigated the virus by the travel ban for China, the seed of the pandemic. And he did this before you ever heard of Covid-19, and while your idiotic party was calling him racist and xenophobic. And well before Nancy Pelosi was inviting everyone to Chinatown in San Francisco.

And aside from the travel ban he has been following the advice of the doctors on his Task Force. Which, by the way, was formed before the first US Covid-19 death. Are the doctors “idiots”, and you are the only one with all the answers? I would say that, by his actions, President Trump has taken the pandemic very seriously.

You are obviously expecting the President to be a magician and pull 350 million tests along with a rabbit out of his hat? You are being absolutely ridiculous. As it is, because of the President’s urging, the number of tests and test methods have ramped up pretty remarkably.

And I beg to differ, but you’re resistance to reopening the economy is what’s going to be it’s ruin. And you’ll have to talk to Gov. Whitmer about the Constitution.

So tell me genius what are you going to do about all the suicides, beaten wives, mental problems, drug deaths, and other maladies brought about by our soon to crumble economy and quarantine orders? I truly mourn the people who have perished from Covid-19, but I also mourn for the deaths and destruction to come from your politically destroying this country.

@ClaudnDaye I don’t think the meteor directly killed the dinosaurs. They died when there was no vegetation left to keep them fed.

See how that works?

they’ve done a ton of genetic analysis – the strains are not markedly different in any appreciable way. All three major lineages are circulating in NYC

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This conversation is devolving fast. I think we all know what political side many of us lie on, and I am not sure its super productive to keep rehashing those various party lines. We can talk about the numbers, but talking about what the president or this or that governor did or didn’t do isn’t going to change any minds, just lead to hard feelings.

I will say, @docslotnick, that at this point there are very few counties where there is no coronavirus circulating. Take your state of Texas, for instance; as of Friday 191 out of 254 counties were reporting cases of coronavirus. Sure, few US cities are likely to be quite as hard hit as NYC due to its density and connectedness, but many, many places (and the vast majority of population centers) WILL be hard hit. Any place where this virus gets a toehold and runs unchecked, it causes a significant spike in mortality that overwhelms the system.

Seattle has seen 346 deaths so far and typically gets 200 in a typical flu season. In Louisiana, 1,296 deaths so far; and yearly flu deaths are 1,400. In Michigan, 967 people died of flu so far in the 2019-2020 season and 2,391 people have died of COVID in a month. And in all those places, the outbreaks are yet over, and the drop down to zero cases will be slow and long. By mid-May, I would be very surprised if deaths don’t double at least. And that is WITH stay-at-home orders in the vast majority of places. Imagine if everyone was just doing their ordinary stuff?

So, yes, there are places that are unlikely to be hard hit. I happen to think Texas, with large, open spaces, car culture and houses with lots of land, might be a place where it’s relatively easy to get this under control. Easy to keep 6 feet between you and other people when stores are huge, spaces are big and your home is comfy enough to hang out in indefinitely. But make no mistake, if people don’t take prudent measures to limit the biggest risks, it will get bad really quick there, just as it has everywhere else where it’s allowed to spread unchecked.

I think reasonable people can disagree about the best course of action to deal with coronavirus – there’s no mathematical model that combines, say, deaths due to unemployment and poverty caused by shut-down orders with deaths caused by an overwhelmed healthcare system + an economy that’s also shutdown by mass mortality. We have to make guesses and take actions based on those guesses. Which really sucks because we know so little about this disease.

But in making those decisions, I think we should be clear-eyed about the data we do have – and none of that data supports the idea that this is basically like the flu.


@TiaG This is not a one size fits all situation. And I’m not trying to minimize Covid-19, just give some perspective.

I live in East Texas, and in my county there are 14 cases, no hospitalizations, and no deaths. Here, we shouldn’t be under the same restrictions as New York City. Social distancing, sure. But total quarantine and economic shutdown? I don’t think so.

What are we going to do when the virus subsides and we can resume “normal” life? Experience shows we will only succeed in postponing a viral comeback.

There are really only two ways to defeat this virus. A vaccine, which is a year or more away. Or working to develop herd immunity. If we wait a year or more for the vaccine to reopen, you won’t need mathematical models to assess the damage.

If we take advantage of the risk group model, herd immunity should be accomplished in a few months and we would be rid of the virus. Dr. David Katz, a renowned public health doctor, has made the case.

I am certainly in a very high risk group. But I certainly don’t want to spend the rest of my life avoiding crowds and watching the economy crumble.


I thought this is what they initially tried in the UK, but they quickly realized the healthcare system was heading for overload and collapse, so they locked down. And paid a high price in dead bodies.

Going for the herd immunity approach over a few months would require dynamic management of the number of concurrent infections like we have to manage our BG trends. But even harder, because “going high” in this case would mean hospitals collapsing and body bags piling up in the refrigerated trucks. To prevent this while opening up quickly would require really fine control over the number of people out and about and fine control over which venues need to be closed for disinfection. That sounds like a daunting problem. My impression of the 3-stage approach that was developed by the federal working group and announced by our President is that they intend to open up and get herd immunity, but slow enough that they can prevent the highs before they develop. They need widespread test and trace to accomplish that.

Anyway, do we actually know any properties of herd immunity for covid, like how strong the post-infection immune response is, and how long it lasts? We risk disaster if we run that experiment in the wild based only on a sense that it will work out ok. If it goes wrong, someone will be blamed. People don’t seem to be concerned about body bags in the abstract, but when they see them locally the pitchforks come out.

@docslotnick, not to put to fine a point on it, but as a person of a more, shall we say, august age with preexisting conditions, you would likely be recommended to not go into large groups or crowded spaces for a while, even if everyone else was doing those things. And while your East Texas county has only 14 cases, I would recommend you assume it’s ten to twenty times that number at least, in terms of your own safety. Texas has done relatively little testing per capita, so we have less picture of how many people are infected there than in other large states.

Also, no one is seriously discussing shutting everything down for years on end. (Well, some wonky epidemiologists, but when they say “social distancing into 2022” I think they basically mean people won’t go to massive concerts into 2022, not that restaurants will be closed till then.) As far as I can tell, between people in charge, there isn’t a huge amount of daylight between them, if you ignore their rhetoric. There are governors like Abbott, who say they want Texas open for businesses – but when you look at the reopening he’s suggesting for Monday, with just two people in place at a time in stores/shops/businesses, plus temperature and symptom checks – it does not amount to a large reopening that will reemploy masses of people. Then there are the governors who want things closed until we make sure a series of steps are in place before reopening (more tests, decline in caseload and contact tracing), and those seem pretty reasonable to me. My guess is there’s a month difference between these two scenario and actually not a huge economic difference, because even if a state is wide open, most people will still be reluctant to go out until they have a clear sense of the risk they’re facing. For instance, Sweden has not locked down, and a) their cases are rising more rapidly than other Nordic countries, but b) they also have plummeting economic demand, because people are choosing not to go out. In SF, restaurant use plummeted 72% before the shutdown was imposed, because people were scared. There IS a huge constitutional difference in my opinion between people choosing to stay home and being told to, which is not negligible (suspending peoples’ fundamental rights is a huge deal to me). But from an economic and life on the street perspective, my guess is it won’t feel hugely different to be in Texas in two weeks vs. California in two weeks.