The coronavirus vs. flu: real perspective

If you haven’t heard the coronavirus compared to the flu by now, and likely many more times than you care to recount, then it’s because you’re doing your best to not read anything or listen to anything that anything at all to do with coronavirus. And if you’re reading this, that’s probably not the case — which probably means you have.

The faulty logic of comparing coronavirus, which has killed a few more than 400 people in the U.S. thus far, and the flu, which has killed at least 22,000 people in the U.S. thus far this season, has been pointed out again and again by people who are a lot smarter than I am — by people who are much more of an authoritative voice on the subject than I am. (Which is not saying much, but you get my point.)

Yet, the subject continues to be broached, over and over. And I can’t help but say something about it. My first post on this subject, back on March 11, was “Yes, the coronavirus is more deadly than the flu.” In the two weeks (it seems more like two years) since then, the faulty logic of comparing coronavirus to the flu has only intensified.

Like many conservative blogs, Powerline Blog has been has worked hard to play down the threat of the coronavirus. I occasionally read Powerline; in fact, it’s the only conservative blog I ever read. But someone emailed me an article posted on the blog today by one of its authors, John Hinderaker.

His headline poses the question: “How does COVID-19 compare with regular flu?”

“I prepared the chart below to put the current hysteria over the Wuhan virus in perspective. It presents simple data in a simple fashion,” he starts off, before displaying a graph that compares seasonal flu deaths to coronavirus deaths, both at home and around the world.

But the interesting part about Hinderaker’s lede is that there’s no perspective at all in the comparison he presents. In fact, it’s completely illogical.

He lists a simple comparison of deaths: one bar for the average global deaths caused by influenza, one bar for the U.S. deaths caused by the 2017-2018 flu epidemic, one bar for the U.S. deaths caused by coronavirus to date, and one bar for the global deaths caused by coronavirus to date.

To avoid stealing his graph, I recreated it using his numbers:

Now, if you take that graph at face-value, it seems pretty clear that coronavirus is nowhere near the threat that seasonal flu is each and every year, right? Which is exactly what Hinderaker intended.

But Hinderaker is far too intelligent to post such nonsense with a straight face. I say nonsense because that’s exactly what it is. If you’re still comparing the flu to coronavirus, it’s either because you’re duped or because you’re trying to dupe others. It really is as simple as that.

Here’s why Hinderaker’s graph should induce eyerolls: he’s comparing numbers of a virus that has already played out against a virus that’s just getting started. We can’t possibly know if coronavirus will impact the world as badly as some experts are predicting, obviously. But we also can’t possibly know that it won’t. We can hope. But hope without giving the potential alternatives is blind. And blind hope is dangerous when people’s lives are at stake.

Obviously, Hinderaker’s data to this point is accurate. There have been so few coronavirus deaths in the U.S. — 416 this evening — that it doesn’t even show up on the graph when placed alongside each year’s global flu deaths and American flu deaths, which are 468,500 and 61,000, respectively.

(Hinderaker arrived at that data by taking the CDC’s estimated range for annual global flu deaths and splitting the difference, while also using the CDC’s estimated flu deaths in the U.S. during the 2017-2018 flu season. It’s interesting that he chose that season rather than the most recent completed season, 2018-2019, or the current season, which is nearly complete. He did so because 2017-2018 just happened to be one of the deadliest flu seasons in decades, magnifying the flu’s impact on the U.S. in his chart. But to each his own.)

The problem, though, as I’ve already pointed out, is that the chart completely lacks perspective. So let’s apply some.

If Hinderaker were being honest in his comparison, he would compare the deaths from seasonal flu against what coronavirus has the potential to do, if it continues at its current rate. Here’s what that chart would look like:

Ahh, it looks a little different, doesn’t it? Suddenly, coronavirus seems like much more of a threat.

For the record, I didn’t include the potential worldwide coronavirus deaths in the second chart because there would be so many (assuming the same number of people globally are infected as are usually infected by the flu, at a death rate of 1.2%) that the other bars would hardly show up on the graph. Also, because of extreme measures put into place by nations like China and South Korea, the coronavirus isn’t likely to infect as many people globally as the flu does…but the U.S. could be entirely different.

The flu deaths, both the global annual average and the U.S. estimate for the 2017-2018 flu season, are unchanged from Hinderaker’s graph. What I did with the U.S. COVID-19 bar is assume the same number of Americans would be infected by coronavirus as the 2017-2018 flu (44.8 million) and use the current U.S. coronavirus death rate of 1.2%. The result would be 540,000 deaths — nearly 8 times as many as were killed by the 2017-2018 flu epidemic, or a 785% increase. It would mean more people would be killed by the coronavirus in the U.S. this year than the flu’s average death toll for the entire world.

So can we agree that a case of coronavirus isn’t simply a case of the sniffles?

To be fair, my comparison isn’t perfect — not by a long shot.

For one, coronavirus got a much later start in the U.S. than flu does. The hope is that warmer weather will hamper the virus once it arrives. There are indications that might not be the case (see the coronavirus outbreak in Australia, which is transitioning from summer to fall). But we can hope.

For another, the mitigation efforts that are being put into place both across the U.S. and around the globe should help reduce the number of people who get sick. If we’re lucky, those efforts will greatly reduce the number of people who become infected. (Some politicians don’t believe this will be the case; New York Governor Andrew Cuomo said today that 80% of people will wind up with coronavirus…but, at this point, politicians are much like bloggers in that they all have an agenda to push. So, forgive my skepticism unless the statement is coming from a health expert. For the record, if Cuomo’s dire prediction proved true, and the coronavirus continues to kill at its current rate, that would mean 3.07 million deaths … far exceeding my estimate above.)

For yet another, if we’re lucky, the virus will simply kill itself as it mutates, which is certainly not outside the realm of possibility.

Finally, there’s hope that an effective treatment will be discovered before the coronavirus has time to push through the entire U.S. population.

But, there’s a flip side of the coin.

For one, the coronavirus is much more virulent than the flu. Medical scientists use a term called R0 (pronounced R-nought) to estimate the contagiousness of a virus. It represents how many people an infected person can pass the disease along to in a population that has been previously unexposed. An R0 of less than 1.0 means the contagion is in decline and will eventually die out. An R0 of greater than 1.0 means it will continue to spread. So, the flu has an R0 of 1.3, meaning each infected person can make 1.3 others sick. Preliminary studies have shown the coronavirus to have an R0 of between 2.0 and 3.0, according to a Feb. 28 review study published by JAMA. Therefore, it could be that coronavirus infects just as many people as the flu even with the mitigation efforts in place.

For another, the current death rate of 1.2% doesn’t account for what will happen if the health care system is overwhelmed. As has been shown in Italy, where the death rate is now 9% and climbing (and where there is a new report out today claiming that doctors have been ordered to deny ventilator treatment to any patient over the age of 60), the death rate climbs when the health care system is overwhelmed. Based on what’s happening in Washington State, which is fairly far along in its outbreak and still managing to tread water at its hospitals, we can hope that’s not going to happen in the U.S. But what’s happening in New York, where hospitals are on the verge of being overwhelmed, should give us all pause that it could.

At the end of the day, we can hope that what is happening in Italy isn’t going to happen here. And there are certainly reasons to be optimistic that it won’t. At the very least, it stands to reason that America’s rural areas might be spared from anything like what has happened in Northern Italy.

But if we’re going to take this contagion seriously — and it would be foolish not to — we should discuss it with the proper perspective. There’s a fine line between advising people of the possibilities and the precautions they should take, and creating unnecessary panic and hysteria. Sometimes, the news media tends to stray really close to that line. But, by the same token, it’s irresponsible to downplay the disease and act like it’s okay for folks to go about their lives as normal without precautions. And if we see this thing get out of control in the U.S. like it has in Italy, these blogs are going to have blood on their hands for their role in convincing people that it’s nothing to worry about.

Ben Garrett

Ben Garrett is a journalist from East Tennessee. He is publisher of the Independent Herald, a weekly newspaper serving the Big South Fork region of the Cumberland Plateau, with a sideline in website development and digital marketing. He is also an erstwhile blogger.

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