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When reports about the novel coronavirus SARS-CoV-2 began circulating earlier this year and questions were being raised about how the illness it causes, COVID-19, compared to the flu, it occurred to me that, in four years of emergency medicine residency and over three and a half years as an attending physician, I had almost never seen anyone die of the flu. I could only remember one tragic pediatric case.
Based on the CDC numbers though, I should have seen many, many more. In 2018, over 46,000 Americans*died from opioid overdoses. Over 36,500*died in traffic accidents. Nearly 40,000*died from gun violence. I see those deaths all the time. Was I alone in noticing this discrepancy?
The 25,000 to 69,000 numbers that Trump cited do not represent counted flu deaths per year; they are*estimates*that the CDC*produces*by multiplying the number of flu death counts reported by various coefficients produced through complicated algorithms. These coefficients are based on assumptions of how many cases, hospitalizations, and deaths they believe went unreported. In the last six flu seasons, the CDC’s reported number of actual confirmed flu deaths—that is, counting flu deaths the way we are currently counting deaths from the coronavirus—has ranged from 3,448 to 15,620, which far lower than the numbers commonly repeated by public officials and even public health experts.
The question remains. Can we accurately compare the toll of the flu to the toll of the coronavirus pandemic?
To do this, we have to compare counted deaths to counted deaths, not counted deaths to wildly inflated statistical estimates. If we compare, for instance, the number of people who died in the United States from COVID-19 in the second full week of April to the number of people who died from influenza during the worst week of the past seven flu seasons (as reported to the CDC), we find that the novel coronavirus killed between 9.5 and 44 times more people than seasonal flu. In other words, the coronavirus is not anything like the flu: It is much, much worse.
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