Why doesn't seasonal flu overwhelm hospitals?

[LAS14]

Last edited Sun Apr 19, 2020, 12:45 PM - Edit history (1)

Somewhere recently I read that the corona virus is "approaching seasonal flu" on some measure. Sorry, don't remember which measure and can't find the reference.

tia
las

P.S. One replier inspired me to do more research. This from Johns Hopkins (not noted for right wing conspiracy theories, although maybe I'm out of touch...

The underlining below is mine. This may point to something, but if Johns Hopkins can be trusted, my question remains. Why doesn't the flu overwhelm hospitals?

Infections
COVID-19: Approximately 2,345,633 cases worldwide; 735,287 cases in the U.S. as of Apr. 19, 2020.*

Flu: Estimated 1 billion cases worldwide; 9.3 million to 45 million cases in the U.S. per year.

Deaths
COVID-19: Approximately 161,262 deaths reported worldwide; 39,090 deaths in the U.S., as of Apr. 19, 2020.*

Flu: 291,000 to 646,000 deaths worldwide; 12,000 to 61,000 deaths in the U.S. per year.

The COVID-19 situation is changing rapidly. Since this disease is caused by a new virus, people do not have immunity to it, and a vaccine may be many months away. Doctors and scientists are working on estimating the mortality rate of COVID-19, but at present, it is thought to be higher than that of most strains of the flu.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu

*This information comes from the Coronavirus COVID-19 Global Cases map developed by the Johns Hopkins Center for Systems Science and Engineering.

[Buckeyeblue]

1. I think seasonal flu gets spread out over several months.

Covid-19 has spiked in a short period of time.

[Ohiogal]

2. Because many people get flu shots perhaps?

[tinrobot]

3. For one - they invented this thing called a flu shot

Most seasonal flu cases are also not as severe, and not as contagious.

[The Velveteen Ocelot]

4. It's way beyond seasonal flu. To suggest that it's anything like the flu

is a common right-wing talking point. Because it isn't anywhere near as contagious as COVID-19, not nearly as many people get it in the first place; therefore the number of people who get sick enough to be hospitalized isn't enough to overwhelm or even burden the hospitals. Furthermore, there are vaccines and treatments (Tamiflu) for it. This virus has far exceeded seasonal flu in all measures.

[JenniferJuniper]

10. I'm not the OP,

but I think the question relates to the number of hospitalizations and the reason why they don't overwhelm the system.

During a bad flu season, there can be 700,000 hospitalizations and 56,000 fatalities in the US. The reason the system doesn't become overwhelmed, however, is because the curve is naturally flattened. Cases occur over a much longer period of time, October through March usually. This has been a much shorter period of time, and the system isn't prepared for so much happening at once.

[LAS14]

12. You inspired me to do more research. This from Johns Hopkins (not noted...

... for right wing conspiracy theories, although maybe I'm out of touch...

The underlining below is mine. This may point to something, but if Johns Hopkins can be trusted, my question remains. Why doesn't the flu overwhelm hospitals?

Infections
COVID-19: Approximately 2,345,633 cases worldwide; 735,287 cases in the U.S. as of Apr. 19, 2020.*

Flu: Estimated 1 billion cases worldwide; 9.3 million to 45 million cases in the U.S. per year.

Deaths
COVID-19: Approximately 161,262 deaths reported worldwide; 39,090 deaths in the U.S., as of Apr. 19, 2020.*

Flu: 291,000 to 646,000 deaths worldwide; 12,000 to 61,000 deaths in the U.S. per year.

The COVID-19 situation is changing rapidly. Since this disease is caused by a new virus, people do not have immunity to it, and a vaccine may be many months away. Doctors and scientists are working on estimating the mortality rate of COVID-19, but at present, it is thought to be higher than that of most strains of the flu.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu

*This information comes from the Coronavirus COVID-19 Global Cases map developed by the Johns Hopkins Center for Systems Science and Engineering.

[Demsrule86]

5. Look at the graphs...we had huge numbers of people needing to be hospitalized and intubated

in a short period of time (about a month)We had 30,000 die in one month...and a huge number needing hospitalization...straight up graph...that is a pandemic...you can't compare a 'flu' to this. Also, Covid 19 is way more contagious than flu and way more lethal.

[LAS14]

15. Can you give me a link for "way more lethal?"

I'm not saying you're wrong, but compare that to "mortality rate is thought to be higher than most strains of flu." See more info in my reply #12.

https://www.democraticunderground.com/100213313659#post12

[lapfog_1]

6. because this is spreading much faster than flu

more like measles... the r0 number here is like 2.5 or more.

That is an high exponential growth rate.

It also causes a much higher CFR... anywhere from an estimate 0.6 to 1.5 or even 2.0.

In places where it HAS overwhelmed the ability of the health care system (like Italy and NYC), you will see these CFR spike to 10%... a ridiculous number compared to the flu.

And that's not all... a full 10% of people that show ANY symptoms (cough, fever, etc) can end up in the hospital (like boris johnson) even if they don't end up in the ICU.

That is a shit ton of people all of a sudden.

Last, but not least, if you DO get sick from Covid-19, expect to BE sick for 4 weeks or longer, there are reports of people on ventilators (this is after 2 weeks of showing symptoms) for as long as 3 weeks. Normal stay in an ICU with ventilators is more like 5 days with some other respiratory illness. This is why people on ventilators have such a high mortality rate (75%).

We are going to hit 100,000 dead (if we are lucky) because the midwest states (that haven't seen the case load YET) are about to enter into the hot zone status... and they don't have the hospital beds or doctors and therapists and nurses that the coastal metro area have.

And while some of the numbers are going down... the death rate (a lagging indicator) is likely to remain high in places like NYC for another week.

[LAS14]

20. Thanks. This looks well grounded in facts. Can you tie it in with...

.... the info from Johns Hopkins that I posted in reply 12? That exercise is a little beyond my non-scientific brain.

[lapfog_1]

24. I have some of my information from John Hopkins

but quite a lot of the math is done by this guy.

&t=377s Dr. John Campbell

watch his entire series (once a day youtube videos)

It's a real education on pandemics and daily numbers from around the world.

Plus some hard science

[LAS14]

28. Thanks yet again! nt

[Make7]

7. Humanity has been dealing with the seasonal flu for centuries.

The health care system in place has already accounted for the expected cases of the flu. It is not set up to handle the additional requirements caused by the rapid onset of a previously unknown highly contagious disease.

Over the past decade, the U.S. averages 35,000 to 40,000 fatalities from the seasonal flu - but that number is spread out over a longer time frame than the Covid-19 deaths of the past few weeks.

[Maine-i-acs]

8. COVID-19 is more infectious, more severe, no vaccine, and the hysteria factor

when they get sick they are more likely to get gravely sick (ICU). Recovery takes longer.
people swarming HC facilities with the symptoms anxious for a test
each infected person can transmit to many more people than Flu can
Flu vaccine lessens transmission and severity.

Flu deaths - 17,000-60,000 per year when millions get infected. Mortality decreasing generally with vaccine improvements.

COVID-19 deaths 30,00 and counting so far with less than a million confirmed cases, in the space of a few months.

[edhopper]

9. A comparison

The H1N1 outbreak in 2009 saw 12,000 deaths in the US over the course of a year. We have had at least triple that many deaths in one month.

[Midnight Writer]

11. It did overwhelm our local hospital last winter.

I had an emergency, and they set me up with a bed in the hallway, with movable screens around me.

All the rooms were full, all ICU units were full.

Covid has not hit here yet, with just 8 cases confirmed in the county.

[hlthe2b]

13. Even years when the flu vaccine is least effective (strain mismatch), it reduces severe illness

to managable levels and dramatically reduces the impacts on our health care system.

This virus erupted in a "virgin" population with much higher infectivity, zero herd immunity, and much more deadly consequences across a broad swath of the population (not just the elderly).

With one person on average infecting 6.5 or more people and (unlike flu) being infectious PRIOR to symptoms in many cases, this is a whole different ballgame.

[mucifer]

14. Hospice is also a factor. People with co morbidities often die at home in hospice with the flu

So they have a positive flu test in the hospital so it's counted as a death by the flu. But they go home to die. Oh and the medical staff had their flu shot so hospitals are safer.

This all said, we are now seeing more covid in hospice.

[Bernardo de La Paz]

16. 1) Much less severe, 2) Lower spreading rate, 3) Some natural immunity, 4) Vaccines

For example, this year's flu apparently recapitulates a lot of viral features from one in the 1950s, or perhaps 70s. So, many elderly actually have antibodies to it.

[Aristus]

17. It's a combination of things.

1. As pointed out above, there is a vaccine for the flu. Most people still get it every year. Anti-vaxxers can blither whatever they want to about the relative effectiveness of the yearly vaccine, but acquired immunity from influenza is largely responsible for the fact that people no longer die in the millions from influenza. Dying in the tens of thousands is bad enough, but the vaccine saves an immense number of lives.

2. I don't know how the official numbers of seasonal influenza patients are calculated; positive clinical testing, I would hope. But I can't count how many patients I've had who thought a little cough and a sniffle meant they had the flu. Not to mention those who have no respiratory symptoms whatsoever, but diagnose themselves with 'stomach flu' because they have nausea and vomiting. (There is no such thing as 'stomach flu.')

[LAS14]

22. Interesting! That bit about there being no such thing as "stomach flu." Thanks. nt

[gulliver]

18. One reason might be that hospitals build in capacity for seasonal flu.

The social distancing would be expected to reduce flu infection rates too...and colds. I can't find any good sources of numbers on anything, though.

For example, here's an article that says flu rates are going up, but it also points out that more people are going in for respiratory illness care due to covid-19.

https://www.medscape.com/viewarticle/927904

I had bad flu symptoms a short while ago and went to an urgent care to be tested. I tested positive for flu, so I am now part of the flu statistics for the country for this year. If there had been no covid-19, I would have just assumed flu and stayed home without bothering to get tested.

[Silent3]

19. Why isn't a race car chained to a giant cement block faster than a bicycle?

In just seven weeks, COVID-19 has killed more people than die from flu in an average full year of flu deaths, and is well on track to soon exceed the worst years for flu since 1918.

And that's WITH all of the social distancing and other safety measures we now have in place in most of the country. Even instituted later than they should have been done, those measures are the giant cement block tied to the metaphorical race car.

If we were taking no safety measures at all, we'd probably have a million or more dead.

[Ms. Toad]

31. Good response. They are entirely different illnesses. n/t

[Squinch]

21. Because the flu death numbers are wild guesses that seldom reflect reality.

[Roland99]

23. Seasonal flu presents itself more quickly, too

Covid-19 can take two weeks (average is 5-6 days)

And many people remain asymptomatic and, thus, can more easily spread it to more people

[TeamPooka]

25. Because we have vaccines for it

You’re supposed to get it every year, your flu shot

[Victor_c3]

26. Good question, I've wondered about this too n/t

[Fiendish Thingy]

27. Flu shots and partial pre-existing immunity

Most seasonal flu strains contain DNA with at least some similarities to past strains, and so a large number of people also have partial immunity due to past exposure or immunization.

COVID is called “novel” because it’s genome has no similarities with past viruses, hence the potential for pandemic infection worldwide.

[LisaL]

29. I believe not that many people with flu end up needing to go to a hospital.

I always just stayed at home if I got the flu. With over the counter meds.

[Ms. Toad]

30. COVID 19 requires weeks of ICU bed-space

The flu, when it (rarely) requires hospitalization requires, at most, days of hospitalization - even more rarely ICU hospitalization. That means while the infection is growing exponentially for two weeks, every single patient who was admitted to the hospital is still there (unlike the flu, in which people leave after a couple of days). Not only are they still there, but they are sedated and in ICUs for the time, making those resources unavailable for the newer patients who still need them.

We have experienced the entire flu season of cases in less than a month. So even if the flu used the same resources, it would have been spread out over 7 months, not 1 month. (Remember - we don't have testing, so we are only identifying the worst of the worst - we have almost certainly already experienced as many cases as a normal flu season)

COVID 19 is insanely communicable for several days before symptoms arise (and by some in whom symptoms never arise). Influenza is not. When you experience symptoms - most people self-isolate. By the time a COVID 19 patient experiences symptoms s/he has already exposed tons of people becuase they were unaware they were ill.

[struggle4progress]

32. Most "flu deaths" in US are "flu with pneumonia" deaths

The flu weakens you and then you get an opportunistic pneumonia infection that carries you off

People can get vaccines that reduce the chances of contracting flu or pneumonia