COVID may be no more risky than the flu for many people, some scientists argue – shots

A New York City pharmacy is offering COVID-19 and flu shots. Some researchers argue that the two diseases may pose similar risks of death for those infected.

Ted Shaffrey/AP

hide caption

toggle subtitle

Ted Shaffrey/AP

A New York City pharmacy is offering COVID-19 and flu shots. Some researchers argue that the two diseases may pose similar risks of death for those infected.

Ted Shaffrey/AP

Hasn’t COVID-19 become more dangerous than the flu for most people?

That’s a question scientists are debating as the country heads into a third pandemic winter. Early in the pandemic, COVID was estimated to be 10 times more lethal than the flu, fueling many people’s fears.

“We’ve all been questioning, ‘When does COVID look like the flu?’ ” says Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco. “And I’d say, ‘Yeah, we’re there.'”

Gandhi and other researchers argue that most people today have enough immunity, acquired through vaccination, infection, or both, to protect them from serious illness from COVID. And that’s especially so because the omicron variant doesn’t seem to make people as sick as the earlier strains, Gandhi says.

So, unless a more virulent variant emerges, the threat of COVID has greatly diminished for most people, meaning that they can go about their daily lives, Gandhi says, “in a way that you used to live with endemic seasonal flu.”

But there are still many different opinions on this topic. While the threat of COVID-19 may be approaching the danger posed by the flu, skeptics doubt it has yet reached that point.

“Sorry, I just disagree,” says Dr. Anthony Fauci, White House medical adviser and director of the National Institute of Allergy and Infectious Diseases. “The severity of one compared to the other is really quite marked. And the kill potential of one against the other is really quite marked.”

COVID is still killing hundreds of people every day, which means more than 125,000 additional deaths from COVID could occur over the next 12 months if deaths continue at this rate, Fauci notes. COVID has already killed more than 1 million Americans and 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 says, 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 death rate of COVID depends on what counts as a death from COVID. Gandhi and other researchers argue that the daily death toll attributed to COVID is exaggerated because many of the deaths attributed to the disease are actually from other causes. Some of the people who died for other reasons also tested positive for coronavirus.

“We’re now consistently seeing more than 70% of our hospitalizations for COVID 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 deaths from COVID, you’re overcounting dramatically.”

If deaths were more accurately classified, the daily death toll would be closer to what the flu does during a typical season, Doron says. If this is true, the odds of a person dying from a COVID infection, what is called the fatality rate, would be about the same as the flu now, which is estimated at about 0.1%, or maybe even lower.

In a new Centers for Disease Control and Prevention report released Thursday, researchers tried to filter out other deaths to look at death rates for people hospitalized “primarily for COVID-19.” They find that the death rate has dropped significantly in the Omicron era, compared to the Delta period.

But Fauci argues that it is difficult to distinguish between deaths that occur “because of” COVID and those that are “with” COVID. Illness 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 has COVID, and then dies from deep congestive heart failure?” he asks “Is that with or because of COVID? COVID definitely contributed to it.”

A second reason many experts believe the COVID death rate is likely lower than it appears is that many infections are now going unreported because of at-home testing.

The fatality rate is a ratio (the number of deaths over the number of confirmed cases), so if there are more actual cases, it means that the probability of a person dying is lower.

“I think we’ve gotten to the point where, for a person, COVID poses less risk of hospitalization and death than the flu,” Doron says.

Dr. Ashish Jha, the White House’s COVID-19 response coordinator, agrees, especially since vaccines and treatments for COVID are better than those for the flu.

“If you’re up-to-date on your vaccines today and taking advantage of your treatments, your chances of dying from COVID are very rare and certainly much lower than your risk of having problems with the flu,” Jha told NPR.

The risk remains high for the elderly and frail

But Jha stresses that Omicron is so contagious and is infecting so many people that, overall, “at a population level it represents a much greater threat to the American population than the flu,” and it can still cause a greater number of total deaths

And, death rates for any disease vary by age and other demographic factors. Importantly, COVID remains far more lethal for the elderly and medically frail than for younger people. Recent CDC data shows that compared to 18-29 year olds, people aged 65-74 are 60 times more likely to die; those aged 75 to 84 have 140 times more risk; and those 85 and older have a 330 times greater risk.

The danger is especially high for those not properly vaccinated, reinforced and treated. And with COVID still spreading widely, they remain vulnerable to exposure from social contact.

Although younger, otherwise healthy people can sometimes get very sick and even die from COVID, this has become rare.

“I think it’s very important that people have an accurate idea of ​​reality in order to get on with their lives,” says Dr. Jake Scott, an infectious disease specialist at Stanford University. “If their risk assessments are being driven or influenced by these overestimated hospitalization and death rates, I think that’s problematic.”

Waiting to see if the pattern is confirmed

Other researchers still argue that COVID remains much more risky than the flu.

“In any case, there was no 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.

“Never, ever in the history of the pandemic, in all our studies from the beginning until now, have we found that COVID-19 is as risky as the flu,” says Al-Aly. “It always carries a higher risk.”

Some experts are waiting for more data to show a clear trend in reducing death rates.

“I’ll probably feel more comfortable saying something like, ‘Oh, COVID is similar to the flu,’ when we’re actually seeing a pattern that looks like this,” says Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Boston Hospital in the Division of Health Policy and Public Health. “We’re just starting to see it, and I haven’t really seen it in a sustained way.”

Many also note that COVID can increase the risk of experiencing long-term health problems, such as long-term COVID.

“Even people with mild to moderate symptoms of COVID can end up with long-term COVID,” Fauci says. “That’s not the case with the flu. It’s a whole different ball game.”

But Gandhi also questions this. According to her, much of the estimated risk of COVID comes from people who became seriously ill at the start of the pandemic. And when you take that into account, the risk of long-term health problems may not be greater from COVID than from other viral infections like the flu, he says.

“It was very severe COVID that led to long COVID. And as the disease has gotten milder, we’re seeing lower rates of long COVID,” Gandhi says.

In fact, some experts even fear that this year’s flu season could be more severe than this winter’s COVID surge. After very mild or non-existent flu seasons during the pandemic, the flu 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 disease, next winter could be a flu season far worse than COVID,” says Dr. William Schaffner, an infectious disease researcher at Vanderbilt University.

Leave a Reply