Breaking News May 27th: COVID-19 and Flu Mortality
Mel Herbert, MD and David Schriger, MD
Faust JS, del Rio C. Assessment of Deaths From COVID-19 and From Seasonal Influenza. JAMA Intern Med. Published online May 14, 2020. doi:10.1001/jamainternmed.2020.2306
Thomas T., M.D. - May 27, 2020 8:42 AM
Mel, you mentioned that the mortality rate for COVID-19 may be underestimated. However, I think the opposite is true. It would appear that there are many more cases than we know about because those involved are either asymptomatic or have such minimal symptoms that they don't seek medical attention. This of course would bring the mortality rate down. Recent information from the CDC estimates that the infection mortality rate is approximately 0.26%. That's still about double what the stated rate is for influenza but no where near what we thought originally
Mel H. - May 27, 2020 9:32 AM
The point is I think we don't know exactly what the mortality rate is (maybe never will exactly). It is certainly much less than the 1-2% we thought initially and it does seem to be about 0.3% (again we will see). The point of the piece is that in the clinical areas this is NOT seasonal flu. Chile, New York, Italy, Spain etc all within weeks of each other completely overwhelmed. We have never seen that in our lifetimes. So to those that say it is just a bit worse than flu by quoting mortality figures that are completely removed from what is happening in ED's and ICU's across the world, miss the point. This might only be 2-5 times "worse" than seasonal flu, but that is enough to collapse all but the best health care systems. It is also important wake up call, how much worse this could have been, and might be next time. We better prepare because pandemics are inevitable and despite all our science and manufacturing, we are still, at the very best, many months away from a vaccine. This late summer/fall might also see it reemerge with flu, and that could be even worse than the first wave. We only have a few months to prepare for that possibility...
Thomas T., M.D. - May 27, 2020 10:50 AM
I agree with all your points. This is certainly not the flu. However, now that we seem to have a better handle on the mortality rate and we have "flattened the curve", that should give us more confidence in opening up the economy. I'm fearful that too many policy makers are of the opinion that we can't open up until there is a vaccine or a cure. This is utter nonsense and the harm this will cause will be irreparable.
Mel H. - May 27, 2020 11:00 AM
I agree - as Jerry noted at this point in the US, the idea is flatten and get ahead, not to eliminate. We could eliminate it by completely locking down, then have no society left at the end...the trick is to let it burn at a safe pace for the hospitals and at the same let the economy open up without letting the virus explode...quite a trick to pull off...
Diane L. - May 27, 2020 5:39 PM
Where are the policy makers who think we can't open up until there is a vaccine or a cure. All that I have seen state after state is plans with phases based on metrics such as decreasing numbers of new cases, hospitalizations, deaths, etc. Also have seen states creating districts, or going by county level data.