No, COVID-19 Is Not Like The Flu—And People Need To Stop Comparing Them

As part of Northwell Health Physician Partners, we at Westchester Health would like to share the following article from Northwell Health concerning the COVID-19 outbreak.

In brief, the article discusses:

  • the differences between COVID-19 and the flu
  • how COVID-19 is more deadly and much more contagious
  • no one has immunity
  • the danger of thinking COVID-19 is just like the flu

The full article is reproduced below.

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What an infectious disease expert wants you to know about the two viruses.

I don’t know why everyone is freaking out. The flu kills tens of thousands of people each year, and no one is shutting down borders because of that.

Sound familiar?

It’s a common refrain from the past few weeks as the novel coronavirus, also known as COVID-19, made its way across borders from Wuhan, China. It’s something I (now shamefully) admit to saying, myself, when this all first started. And the confusion is understandable. So why is this one causing so much panic?

“We are familiar with coronaviruses because, for a long time now, strains of coronavirus have circulated in our community and caused respiratory illnesses such as ‘the common cold’. But COVID-19 is a different strain of coronavirus—one that we’ve not previously encountered,” says Dr. David Hirschwerk, an infectious disease specialist at Northwell Health. “It doesn’t happen often, but when we do discover a new or emerging infectious disease, we have to take it seriously until we better understand it.”

Here’s what we do know:

It’s more deadly—and much more contagious.

Though we won’t know the actual death rate until COVID-19 is contained and under control, we do know that it’s proving to have a higher death toll—or, in epidemiological terms, “case fatality rate.” According to the Centers for Disease Control (CDC), the case fatality rate for the seasonal flu is approximately 0.1%. Thus far, the case fatality rate for COVID-19 in the US has been cited anywhere between 1% and 5%—a death rate 10 to 50 times higher. However, this is based on the known mortality numbers for patients who have had confirmed cases of COVID-19.

Given the lack of availability of testing as well as the early messaging that patients not sick enough to be in the hospital should remain at home to recover, it is very likely that the case fatality rate in the US could be lower than 5%. Ultimately, we won’t have a fuller understanding until after the crisis is over.

And though the elderly are the hardest hit by this virus, they aren’t the only ones at risk. One report in China found serious illness occurs in approximately 16% of cases. The average age of the patients studied—47.

“These numbers are preliminary, but there is a significant proportion of younger, healthy people who are receiving care in our intensive care units after developing illness from COVID-19,” says Hirschwerk. “While the elderly and immunocompromised are more vulnerable populations, there are still lots of young, otherwise healthy people who develop serious symptoms.”

Another concerning statistic: Each infected person spreads COVID-19 to an average of 2.2 other people. By comparison, those with the seasonal flu infect approximately 1.3. And since testing is still ramping up, we have no way of knowing how many people total are infected in the U.S.—especially since many show only mild symptoms and some are asymptomatic altogether.

We don’t have immunity.

“Even though we lose many people in the U.S. to the flu each year, we do have a vaccine for it and antiviral medication to treat with,” says Hirschwerk. “We don’t have any of that yet for COVID-19. And when a new infectious disease emerges in a community without preexisting immunity, there is a risk for more severe disease and for spread as a pandemic.”

Even though there are several strains of what we collectively call “the flu,” getting the annual flu vaccine helps us develop a type of herd immunity; without that, the case fatality rate would be much higher, as it currently is with this new virus. We also have prescription medications to treat it, while there is no antiviral drug (*as of time of print) for COVID-19.

The flu is also something that comes every season, which means it’s predictable in its patterns and symptoms. We know when it will occur, we know approximately how many people it will infect, and we know that it will die off in the warmer months. That gives us time to prepare. With this novel coronavirus, we’re learning all these lessons the hard way—trial and error—and we don’t have many of the answers yet.

Misinformation is dangerous.

In a time of “fake news” and rapid information-sharing through social media, we’re learning more than ever that words have power. Comparing the current novel coronavirus to the flu is irresponsible and dangerous because it creates distrust in the professionals who are advising us to take this seriously. It suggests that we shouldn’t be careful and don’t need to take precautions; it encourages us to ignore recommendations to be prepared for something much worse.

“Flu season has already peaked,” says Hirschwerk. “We’re seeing fewer and fewer cases as the weather gets warmer. So, at this point, flu-like symptoms are more likely to indicate infection with COVID-19. And given the higher infectivity and death rates, we need to take that seriously.”

So if we have to acknowledge that this is serious—and we do—what does that mean? The recommendation across the board from our physicians and infectious disease experts has been not to panic, but to follow CDC guidelines: Wash your hands for a minimum of 20 seconds, avoid unnecessary trips to the store and other public places, and maintain a 6-foot distance from others. Stay home if you feel sick. And, of course, contact your physician if you’re feeling significantly under the weather. Even if you’re young and healthy, these precautions could save your life—or someone else’s.

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