Health & Wellbeing

NYC study concludes COVID-19 is as deadly as the 1918 Spanish Flu

NYC study concludes COVID-19 i...
New research suggests COVID-19 is as deadly, or potentially more deadly, than the Spanish Flu that killed millions during the history-making 1918 pandemic
New research suggests COVID-19 is as deadly, or potentially more deadly, than the Spanish Flu that killed millions during the history-making 1918 pandemic
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New research suggests COVID-19 is as deadly, or potentially more deadly, than the Spanish Flu that killed millions during the history-making 1918 pandemic
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New research suggests COVID-19 is as deadly, or potentially more deadly, than the Spanish Flu that killed millions during the history-making 1918 pandemic
As part of their analysis of the Spanish Flu and the COVID-19 pandemics, the researchers calculated a baseline monthly death rate, averaged over the three years leading up to both events
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As part of their analysis of the Spanish Flu and the COVID-19 pandemics, the researchers calculated a baseline monthly death rate, averaged over the three years leading up to both events

Comparing data from two vastly different pandemics, with more than a century separating them, is perhaps an impossible task. But, a new analysis published in the journal JAMA Network Open, is suggesting a novel metric for comparing the 1918 Spanish Flu pandemic to our current pandemic, and the conclusion is COVID-19 is just as deadly, possibly even more so.

Between 1918 and 1920 around one third of the world’s population became infected with H1N1 Influenza virus. Tens of millions died, including up to 675,000 in the United States. It was one of the worst pandemics the world had ever seen.

A new study has attempted the perilous task of comparing the current COVID-19 pandemic to the 1918 Spanish Flu. The big challenge of course, is finding an effective frame of reference to compare these two dramatically different events. Directly comparing the virulence of the two viruses is impossible, and the evolution of modern medical science means a number of interventions we have now to save lives were obviously not available 100 years ago.

So, simply comparing deaths, as a proportion of cases, is not useful because it doesn’t truly indicate whether SARS-CoV-2 is a deadlier virus than H1N1. This new analysis, led by Jeremy Faust from Brigham and Women’s Hospital, looked to compare excess deaths in New York City across the first two months of COVID-19, against the same datapoint from NYC in the worst two months of that pandemic.

The analysis calculated 287 deaths per 100,000 people in NYC at the peak of the Spanish Flu pandemic. In comparison, the city saw 202 deaths per 100,000 during the COVID-19 peak in March and April. So the Spanish Flu was clearly more deadly than COVID-19 right? Not exactly …

The research calculated a baseline monthly death rate, averaged over the three years leading up to both pandemic events. Leading up to the Spanish Flu peak in 1918, NYC saw around 100 deaths for every 100,000 residents. More recently that baseline death rate has dropped to around 50 deaths per 100,000, meaning relatively speaking, COVID-19 is at least as deadly as the Spanish Flu.

As part of their analysis of the Spanish Flu and the COVID-19 pandemics, the researchers calculated a baseline monthly death rate, averaged over the three years leading up to both events
As part of their analysis of the Spanish Flu and the COVID-19 pandemics, the researchers calculated a baseline monthly death rate, averaged over the three years leading up to both events

“…because baseline mortality rates from 2017 to 2019 were less than half that observed from 1914 to 1917 (owing to improvements in hygiene and modern achievements in medicine, public health, and safety), the relative increase during early COVID-19 period was substantially greater than during the peak of the 1918 H1N1 influenza pandemic,” the authors write in the study.

While more people in totality died during the acute initial outbreak of the Spanish Flu in NYC compared to COVID-19 at its worst in March and April, the spike in excess deaths seen earlier this year was higher. Faust suggests this means COVID-19 is at least as bad as the Spanish Flu.

“They’re comparable events in terms of magnitude,’’ says Faust, in an interview with USA Today. “I think maybe we imagine pandemics and plagues and other calamities to be this sort of historical events where the streets are lined with dead bodies and there’s pestilence and filth, but what our numbers show is that what happened in New York was pretty similar to what happened in the greatest modern pandemic.’’

Eric Topol, from the Scripps Research Translational Institute, is suggesting another, more ominous, perspective on these comparative numbers. Speaking to the New York Times, Topol says, taking into account all the modern medical innovations that save lives today, it is concerning that COVID-19 is delivering even similar death rates to the Spanish Flu.

“There was no such thing as an intensive care unit, there was no ventilator, there was nothing,” says Topol. “I mean, they basically had masks and distancing. We have so much more, and yet the mortality is roughly comparable.”

In the conclusion to the latest analysis from Faust and his colleagues, it is suggested the goal of this analysis was to help people contextualize the, “unusual magnitude of the COVID-19 pandemic.” Understanding the significance of the unfolding pandemic is the first step towards working to decrease transmission.

The new analysis was published in the journal JAMA Network Open.

13 comments
usugo
I think it is safe to assume that the real lethality of the virus should be calculated considering that 90+% of patients admitted to an ICU would have died 100 years ago, instead of about 30% today.
paul314
Even patients not admitted to ICU still get supplemental oxygen, IV drips for hydration and a long list of other care that wasn't available in 1918. If the US had only taken the virus seriously this would be an entirely historical discussion.
Vahawkeye Hawk
I think mismanagement by our largest population areas leaders are skewing those results to much higher lethality percentage...Also if just one age group (80+) was protected the lethality of this virus would be far less.
nick101
Something tells me the researchers wanted to promote a certain narrative! As someone here pointed out, the fatalities would be far, far less if the elderly populations had been protected.
buzzclick
If Covid 19 peaks in the fall like the 1918 flu did, it's gonna get much more serious. Cold temperatures increase the longevity of the virus. We may have a more advanced medical system today, but many people are in denial. There's also much more chaos in the streets of America. It may become a very unpredictable witches brew. Whoever wins the election is going to have to face a lot of criticism and negative emotion if the situation worsens.
ArdisLille
Let's call it the 1918 Flu. It didn't originate in Spain, and some people perpetuated the polarizing misnomer "Spanish Flu" for political reasons.
aksdad
I did a double-take when I read the title. Of course COVID-19 isn't as "deadly" as the 1918 Spanish Flu, for reasons other commenters have noted, and also accounting for global population that is 4 times larger today.
But in NYC, which is where the "study" draws its comparisons, it might be just as deadly thanks to the perverse policies and response by Governor Cuomo and Mayor DiBlasio that tragically increased the number of deaths, especially among elderly people. No other state comes anywhere close to the total deaths and death rate of New York.
Signguy
The only reason this Flu has been so destructive is because it was handled incorrectly; they should not have made EVERYBODY go home, but ONLY those who were sick. People are going to die; whether by this virus or by some other means; but so many more died needlessly because of drugs, depression, suicide, and the greatest tragedy was how the entire global economy has been needlessly undermined which ends up destroying people who were already barely surviving.
ljaques
The Spanish Flu was much more deadly than Covid19, until the Cuo...erm, mismanager of our largest population area pooed the scrooch.
toni24
This is like comparing apples to oranges, the H1N1 was very deadly and had Covid-19 been just as deadly, then we would already have lost over a billion lives, even with our advanced medicines. But part of the problem with our numbers is the fact that dome States like Washington actually counted many unrelated deaths as "Covid-19 Related" They even counted at least 57 murders as Covid related. Hello, I think that the bullet holes and knife wounds had more to do with the deaths
What I am more curious about is where the reservoir of new Covid-19 viruses came from after the March to May Lock Downs? Those lock downs and mask wearings were supposed to have depleted the pools of viruses. So where did the new sources come from, unless someone has been deliberately introducing the virus back into the population? Some of the worst outbreak locations are also strange. Major food processing plants were hit very hard, yet those workers are constantly using personal protective equipment. So how were they being infected??? Just food for thought