Early in the pandemic some were saying that COVID was just like the flu, not worse. Well … here we are, three years later. The data say they were “dead” wrong.
A research letter just published in the journal JAMA reported the mortality results from analyzing over 11,000 hospitalizations due to either COVID or influenza from October 2022 to January 2023. The cases were from the Veterans Administration, St. Louis (Missouri) Health Care System, and the report was authored by Dr. Ziyad Al-Aly and colleagues.
The study checked records from VA databases of 8,996 COVID diagnoses and 403 flu diagnoses at admission. 5.97% of COVID patients died within 30 days of admission and 3.75% died from flu in 30 days after admission.
The raw numbers for deaths were 538 vs. 76, or 7 times more patient deaths from COVID. This difference translated into a 61% higher risk of death in the COVID group. This validates the statement that COVID is deadlier than influenza.
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The COVID death rate in this study is still vastly lower than in 2020, the pandemic’s beginning. At that time death rates ranged from 17% to 21%, depending on the study, roughly 3 times higher than this study. Flu death rates were virtually the same, with 3.8% in 2020. The authors wrote, “The decline in death rates among people hospitalized for COVID may be due to changes in the SARS-CoV-2 variants, increased immunity levels from vaccination and prior infection, and improved clinical care.”
Increased risk of death in COVID vs. flu was greatest among patients not vaccinated against COVID. Risk significantly decreased with the number of COVID-19 vaccinations. The authors wrote that these are, “findings that highlight the importance of vaccination in reducing risk of COVID-19 death”.
COVID patients were also at higher risk of dying vs. flu patients if they were over 65 or received no outpatient treatment, like Paxlovid or Lagevrio (molnupiravir) pills or remdesivir intravenously.
These data and numbers show us that COVID is not done with us yet, even though many people seem to be done with it. In the week ending April 5 approximately 1,700 people in the U.S. died from COVID. Yet, the U.S. national emergency measures to respond to the pandemic officially ended when President Biden signed a congressional resolution to bring it to a close, even though he personally opposed the closing. The public health aspect of it is set to expire May 11.
We really don’t know where we are statistically in relation to the virus activity, because records are not being kept nearly as much, people are not getting or doing tests nor reporting home test results. Because our biological relationship with the viral variants is a much less vicious expression of disease than it was, we are becoming nonchalant about having it. Some celebrities are even advocating not doing anything preventively and/or downplaying the viral presence.
Likely, a lot of folks are getting infected, experiencing mild illness, not testing for it, and getting over it, which is much different than the bad old days. But some immune systems don’t handle an infection well, and their owners die from it. There are no tests to do to determine how you will respond to a COVID infection. Ya gets what ya gets.
The VA study has limits, as they all do, because it’s an older, predominantly male population. In this one the average age was 73, 71% were white, 23% black, and 95% were male. About 63% were current or former smokers. (As a medical student in 1972 on a “rotation” in our VA hospital, I vividly recall a patient being pushed down the hall in a wheelchair, on oxygen, puffing away at a cigarette.)
This paper makes a good point that COVID isn’t just like a “cold.” It is more lethal than flu in this population and is not to be sneezed at. If you get a “worse cold,” do your testing, not just for yourself, but to try to protect those around you. They count as well, better alive than dead. I’ll end on that cheerful note.