In early March, United States of America President Donald Trump tweeted a statistic that stirred confusion amongst the public and it has caused lasting uproar amongst many media personnel, everyday people and within various health sectors.
The tweet that generated almost 300,000 retweets was a comparison of the flu (influenza) to the current novel coronavirus, SARS-Cov and the deadly disease that it causes, COVID-19. “The flu killed 37,000 Americans and it averages between 27,000 and 70,000 per year”, POTUS reminded. At that time, only 546 confirmed cases of coronavirus were listed and the rest of the tweet read a lot like a downplay to the severity of the virus.
A lot of people, besides the president, have been comparing the new SARS-Cov Coronavirus to the flu. Innumerable write-ups and blogs, all over the internet, have been trying to pacify people about the coronavirus by repeating this comparison without any facts or scientific basis; only hyperbole. The problem with this downplaying is it comes off as a dangerously short-sighted attempt to abolish the truth about the virus. Yes, the flu is a yearly threat to our health and that is something that no one should overlook but the novel coronavirus, SARS-Cov, has all the potential to be worse than a typical flu season, as has been very clearly demonstrated to date. Comparing the two is not particularly helpful right now and it is just adding fuel to the fire.
As of April 15, a total of 618,325 cases were documented for SARS-Cov Coronavirus/COVID-19 in the United States of America, as well as 26,290 deaths; with this, the United States of America now leads the world in total confirmed cases and the total number of people who have died. It is truly appalling to see how this virus affects the world: immobilizing various industries and corporate sectors while showing no clear sign for abatement because new outbreaks are being reported on an almost daily basis and there is no clear proof that we can build immunity to the virus or whether said immunity, if it develops, is lasting.
The SARS-Cov Coronavirus/COVID-19 outbreak continues to evolve by numbers and in mutations — inflicting tremendous tolls on people around the country, including racial minorities. Since various comparisons and misinformation has been making rounds in the public discourse lately, let me discuss the important differences between the two viruses and how they spread.
SARS-Cov Coronavirus/COVID-19 Vs. Influenza: The Similarities
First off, Influenza (commonly referred to as the flu) and SARS-Cov coronavirus have comparable disease presentation. Both viruses typically cause respiratory infection, which results in a broad spectrum of illnesses from asymptomatic or mild through to serious condition.
In terms of transmission, both viruses are transmitted by contact, droplets, and fomites. Consequently, the same public health measures (coughing into the elbow or into a tissue) and wearing masks are encouraged to prevent infection.
SARS-Cov Coronavirus Vs. Influenza: The Differences
The transmission speed, termed transmissibility, seems to be a crucial point of difference between influenza and COVID-19. The serial interval or the time between successive cases for influenza is shorter than that for SARS-Cov Coronavirus. Influenza’s median incubation period, i.e. the time from date of infection to the manifestation of symptoms, is also shorter than for SARS-Cov Coronavirus. Specifically, the serial interval (time between successive cases in a chain of transmission) for SARS-Cov Coronavirus is estimated to be around 5-6 days and up to 14 days, while that for influenza virus is at around 3 days. This means that an influenza outbreak is generally faster to identify and thus, it also makes it more straightforward to identify/trace contacts and possible sources of infection for the flu, as compared to SARS-Cov Coronavirus.
Children are major drivers of influenza transmission in the community while initial data for SARS-Cov Coronavirus suggest that children are generally less affected than adults and that clinical attack rates in the 0-19 age group are low.
Although it appears that the range of symptoms for both viruses is similar, the fraction with serious disease appears to be different. In COVID-19, data shows that up to 80% of infections are mild or asymptomatic while about 15% to 20% develop severe infections requiring hospitalization with need for oxygen supplementation and about another 5% develop critical infections requiring use of a machine (a ventilator) to help them breathe. These fractions for COVID-19 show serious and critical infection would be higher than what is observed for flu infection.
A simple case of influenza typically resolves after about 3 to 7 days following symptom onset while it seems to take 7 to 14 days for COVID-19. Although, for some people, fatigue and cough may linger for up to 2 weeks or longer after onset of influenza symptoms. For seasonal influenza, just over 1 percent of the infected people are hospitalized. However, mortality is, to a large extent, determined by the quality and availability of health care.
Those most vulnerable for severe influenza infection are pregnant women, children, elderly, persons with underlying chronic medical conditions, and those who are immunosuppressed. For COVID-19, current figures and general current understanding show that older age and persons with underlying conditions are at an especially increased risk for severe infection but this is still quite new information and some of the data seen in the US is starting to challenge this early notion.
The above supports that mortality and morbidity for COVID-19 appears to be higher than for influenza. Although the true mortality of COVID-19 will take some time to fully quantify and understand, as the pandemic is still on the rise in many places and available testing is limited, the current figures that we have obtained so far, suggest that the rough mortality rate for SARS-Cov Coronavirus/COVID-19 is between 1%-4% for the general population and between 6%-10% for those with underlying diseases like Diabetes, Hypertension, Lung disease and Heart disease. This is in stark contrast to seasonal influenza which has a mortality typically well below 0.1%. However, mortality from an infectious disease is, to a large extent, determined by access to and quality of health care, including availability of effective vaccines and treatment.
With the current figures that we have, it is safe to say that the SARS-Cov Coronavirus/COVID-19 is deadlier than influenza. Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases along with many medical practitioners, epidemiologists and virologists agree by consensus to this conclusion. Scientists and Clinicians have studied seasonal flu for decades. So, despite the ingrained danger of it, we already have proven effective vaccines and generally know what to expect each Flu season, including where to seek effective and proven medication and treatment. On the contrary to this, the SARS-Cov Coronavirus is a new virus and people, in general, have less know-how about its repercussions; including no vaccines and no proven treatment. This means that we are yet to know how far this virus will spread and how many fatalities it will ultimately cause while we await an effective vaccine and proven safe and effective treatments.
Psychic Numbing Can Kill, Too
An article asking folks to stop comparing the flu to the novel coronavirus is not complete unless we address the underlying mindset that seems to be driving people to even formulate such a comparison. First, we must acknowledge that the flu has become a normal annual phenomenon for most of us. As a result, its toll is something most people have grown numb to. This psychology and human hierarchical approach to grief has taught most people to feel indifferent about the multitude number of people getting harmed by an occurrence. In short, the level of empathy and ability to care, decreases. This is called psychic numbing — those people who downplay the virus want us to think that tens of thousands of people dying from the flu and those now succumbing to the new SARS-Cov/COVID-19 disease is not a big deal.
With SARS-Cov Coronavirus’ rapid spread and with COVID-19’s high mortality rate, it is time to open our eyes and recognize that the virus is real and all around us. The SARS-Cov Coronavirus is not the Flu and moreover, it is not okay that people are dying from either one. Although both conditions share similar symptoms and characteristics, the novel coronavirus has infected a myriad number of people across the globe and its mortality, and morbidity, rate is something we should not devalue. The number of people who are severely affected by but recovered from COVID-19 and who will be left with long term debilitation cannot be ignored. In fact, these statistics that we are starting to receive hit a lot of risk buttons — telling us to be fearful and mindful, at the same time.
The comparison of COVID-19 to flu is downright misleading. The novel SARS-Cov coronavirus is new, vague, and hard to control through individual or partial societal action. However, if we all get on the same page, we can collectively survive this pandemic and thrive! It is okay and natural to be scared in these trying times. Being human means we will feel fear and anxiety, especially when caught off guard by the changes caused by this pandemic.
I can also understand why many people came up with the flu comparison, to the point of downplaying it, in an attempt to maybe reassure and pacify themselves to the stark reality that we’re facing. However, we cannot be numb all the time. We cannot just ditch the reality that it’s killing people and may harm us, if we do not take action. We must act now and channel our fear into useful tasks. The challenge is that people will not act in a way that they really need to, if they are being fed lies and false reassurances or comparisons. During a flu season, offices and schools are not typically shut down and people are not usually asked to stop shopping at malls or going to the movies. Yet, in order to fight the coronavirus, we need to accept and adjust to this reality and its relative disruption in our lives.
If you see people make illogical flu comparisons, do not be fooled into thinking that coronavirus is an equivalent. We need to stay on top of our actions and take precautionary measures to prevent contagion and deaths. Believe me when I say that You have the power to determine whether you will just be part of the grave statistics or whether you will become a catalyst for the solution!