comparison of 1918 and COVID-19 pandemics

There are a slew of new articles comparing the 1918 pandemic and our current COVID-19 pandemic, this is a good one from Washington Post:

https://www.washingtonpost.com/health/covid-19-death-toll-rivals-fatality-rate-during-1918-flu-epidemic-researchers-say/2020/08/13/48e1dbf2-dd01-11ea-b205-ff838e15a9a6_story.html

Covid-19 death toll rivals fatality rate during 1918 flu epidemic, researchers say

Lenny Bernstein

August 13, 2020 at 8:00 a.m. MST

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The increase in deaths in New York City during the early months of the covid-19 pandemic rivals the death toll there at the peak of the 1918 flu pandemic, according to an analysis published Thursday.

The comparison, published online in the medical journal JAMA Network Open, found that the number of deaths from all causes was roughly equal during the two peak months of the flu epidemic and the first 61 days of the current outbreak.

The H1N1 flu pandemic eventually killed 50 million people a century ago, about 675,000 of them in the United States. The current pandemic has claimed at least 746,000 lives worldwide, about 162,000 of them in the United States, according to a tally kept by The Washington Post.

A medical worker in April tends to a covid-19 patient inside an intensive care unit at Maimonides Medical Center in New York. (Jon Gerberg/The Washington Post)

“For anyone who doesn’t understand the magnitude of what we’re living through, this pandemic is comparable in its effect on mortality to what everyone agrees is the previous worst pandemic,” said Jeremy S. Faust, an emergency physician at Brigham and Women’s Hospital in Boston who led the team that conducted the data review.

(The AIDS epidemic has killed more than 700,000 people in the United States since it began in 1981.)

There were 31,589 deaths from all causes in New York during the peak period of the flu epidemic, about the same as the 33,465 tallied in the 61 days after the first death on March 11 of this year, the analysis shows.

New York in 1918 had a population of 5.5 million people, so the death rate of 287 per 100,000 person-months was greater than the 202 of the current covid-19 pandemic. Person-months is a way of measuring the number of deaths in a population during a specific period of time.

But the current outbreak has seen a more dramatic rise in “excess deaths” — the number of fatalities above what would be expected in a normal year. With better medical care, public health, hygiene and medicines such as antibiotics, New York typically has about half the death rate of a century earlier — about 50 per person-month instead of 100. So the current outbreak has quadrupled the death rate, while the flu pandemic nearly tripled it.

“Because baseline mortality rates from 2017 to 2019 were less than half that observed from 1914 to 1917 . . . the relative increase during early covid-19 period was substantially greater than during the peak of the 1918 H1N1 influenza pandemic,” the authors wrote.

The Post has reported that the United States recorded about 37,100 excess deaths in March and the first two weeks of April, nearly 13,500 more than were attributed to covid-19, the disease caused by the novel coronavirus, during that time. The report was based on an analysis of federal data conducted for The Post by a research team led by the Yale School of Public Health.

The Post later reported that many of the excess deaths in New York City and five hard-hit states in March, April and May could be attributed to heart problems and a handful of other diseases.

That analysis, which also used the model developed by the Yale research team, suggested that many patients suffering from serious conditions died as a result of delaying or not seeking care as the outbreak progressed and swamped some hospitals.