Doctors on this board: How many deaths have you diagnosed from the flu?

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In late February, when the stock market was beginning to fall over coronavirus fears, President Donald Trump held a briefing at the White House to reassure people that there was little chance of the virus causing significant disruption in the United States.

"I want you to understand something that shocked me when I saw it," he said. "The flu, in our country, kills from 25,000 people to 69,000 people a year. That was shocking to me."

His point was to suggest that the coronavirus was no worse than the flu, whose toll of deaths most of us apparently barely noticed.

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When reports about the novel coronavirus SARS-CoV-2 began circulating earlier this year and questions were being raised about how the illness it causes, COVID-19, compared to the flu, it occurred to me that, in four years of emergency medicine residency and over three and a half years as an attending physician, I had almost never seen anyone die of the flu. I could only remember one tragic pediatric case.

Based on the CDC numbers though, I should have seen many, many more. In 2018, over 46,000 Americans died from opioid overdoses. Over 36,500 died in traffic accidents. Nearly 40,000 died from gun violence. I see those deaths all the time. Was I alone in noticing this discrepancy?

I decided to call colleagues around the country who work in other emergency departments and in intensive care units to ask a simple question: how many patients could they remember dying from the flu? Most of the physicians I surveyed couldn't remember a single one over their careers. Some said they recalled a few. All of them seemed to be having the same light bulb moment I had already experienced: For too long, we have blindly accepted a statistic that does not match our clinical experience.

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The 25,000 to 69,000 numbers that Trump cited do not represent counted flu deaths per year; they are estimates that the CDC produces by multiplying the number of flu death counts reported by various coefficients produced through complicated algorithms. These coefficients are based on assumptions of how many cases, hospitalizations, and deaths they believe went unreported. In the last six flu seasons, the CDC's reported number of actual confirmed flu deathsthat is, counting flu deaths the way we are currently counting deaths from the coronavirushas ranged from 3,448 to 15,620, which far lower than the numbers commonly repeated by public officials and even public health experts.

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https://blogs.scientificamerican.com/observations/comparing-covid-19-deaths-to-flu-deaths-is-like-comparing-apples-to-oranges/

Similar to Covid, most people who die from the Flu are very aged or have chronic health conditions, or both

Yes there are exceptions. But they are the rare exceptions.

We get 1-2 otherwise perfectly healthy kids each year that have a bad reaction to the flu and die. Many times they get sick enough and turn septic. But 1-2 cases per year in a pediatric population of millions is still very rare.

Does the flu cause Pneumonia and then a patient could succumb to the pneumonia? That should count as a flu derived fatality

Have actually said this to a few people recently and even on a zoom meeting tonight with some non medical associates. I have probably signed death certificates with influenza as contributor to death once in the last two years. I've had more people die of RSV. I have lots of people die under my care as my patient population is very much lower socioeconomic with tons of chronic illness and very rarely is influenza a cause or contributor to death. I have lots and lots of influenza patients just very few, if any, ever die of influenza.

So I take it this means the IFR and CFR calculations we have been hearing about are also garbage for the flu.

https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm

JP_Losman said:

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The sloppy translation from the scientists to the journalists is what is resulting in the garbage. People are going to start having to go to scientific journals to validate anything these days

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You've probably been trying to drink 80 ounces of water per day. Sucker.

The whole pretext of the OP is sharing the exact problem I'm talking about. General public is being told one thing and it's actually something totally different

https://en.m.wikipedia.org/wiki/20172018_United_States_flu_season

Quotes from Fortune magazine cited that 4,000 Americans were dying per week in February 2018?
That's sounds hellacious to me. What am I missing?

JP_Losman said:

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The whole pretext of the OP is sharing the exact problem I'm talking about. General public is being told one thing and it's actually something totally different

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I think the general public has been told on numerous occasions that if this were counted like other viruses/diseases were counted, the number would be higher. I know this because I've seen portions of the general public lose their minds on this website when authorities and journalists have said such things.

The article is right that CDC flu deaths are apples and the current Covid-19 deaths are oranges. But one is a virus that's been studied for decades and the other is brand new.

FrioAg 00 said:

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Similar to Covid, most people who die from the Flu are very aged or have chronic health conditions, or both

Yes there are exceptions. But they are the rare exceptions.

We get 1-2 otherwise perfectly healthy kids each year that have a bad reaction to the flu and die. Many times they get sick enough and turn septic. But 1-2 cases per year in a pediatric population of millions is still very rare.

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Flu deaths in children seem to be pretty rare overall, across the the US there were under 200 for the 2017-2018 flu season.

Whatever their accuracy, reported flu deaths fluctuate a lot depending on the year. We clearly don't get the same thing all the time despite a handy descriptor and a vaccine for it with widely varying efficacy.

The difference between a good or bad year in Texas can be 5k deaths, which is at least triple the last estimate of total COVID deaths in Texas. So, we (in Texas) have paid many billions of dollars in economic impact to achieve something that we typically ignore altogether. That leaves everyone to argue their favored position of "look how pointless this all was" or "look how effective our approach was" depending on which team they want to cheer for in the internet debates/political talking head-dom demanding that the other guy prove the negative.

Actual leadership would try to resolve this, I see none because people at all levels from the internet to the Governors' mansions have retreated behind their moral superiority calling people science deniers or chicken littles.

I'm curious about how corona virus compares to RSV.

My twins almost died of RSV when they were babies. One was on a ventilator for a month and the other a week but she got brain damage because of some other RSV related issues.

I'm curious the infection and death rates of the 2. Obviously how they attack and who's at risk is different.

TheAngelFlight said:

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JP_Losman said:

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So if the flu deaths are warped by a large factor why the heck would u fault the public if they were suspicious of this coronavirus fatality number. Lot of garbage comes out of CDC is what I'm understanding

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The flu estimate shouldn't make you believe the CDC is vastly overreporting the Covid-19 deaths because the CDC isn't reporting Covid-19 deaths the same way, at least not right now. If that's what you took from that article, you didn't read it closely.

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The straight up answer to the media from Brix and Fauci saying they were being very liberal in what qualified as a COVID death is what gives people doubts about the death count.

https://www.foxnews.com/politics/birx-says-government-is-classifying-all-deaths-of-patients-with-coronavirus-as-covid-19-deaths-regardless-of-cause

Patients I have that die of RSV in the adult world have other chronic diseases like heart failure and asthma that predispose them to a worse outcomes. My clinical experience is it is a far more deadly disease in susceptible adults than seasonal flu which seems to be borne out in literature as well. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738863/

I lost a high school classmate to the flu in 2016. We were 40. He had a beautiful wife and three great kids.

Tragic.

fig96 said:

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FrioAg 00 said:

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Similar to Covid, most people who die from the Flu are very aged or have chronic health conditions, or both

Yes there are exceptions. But they are the rare exceptions.

We get 1-2 otherwise perfectly healthy kids each year that have a bad reaction to the flu and die. Many times they get sick enough and turn septic. But 1-2 cases per year in a pediatric population of millions is still very rare.

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Flu deaths in children seem to be pretty rare overall, across the the US there were under 200 for the 2017-2018 flu season.

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359 in 2009, the worst recent year.

https://www.chron.com/local/prognosis/article/Texas-toll-Flu-killed-nearly-10-000-this-season-13025291.php

Death Rates Above Average - NYT

I know this is from the "Failing" New York Times (and perhaps already cited), but I would appreciate if someone would explain to me how deaths from Covid-19 are being over-counted rather than under-counted.

Forum Troll said:

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Evidence worldwide (not just NYC) suggest COVID deaths are under reported by significant amount in some cases (like Ecuador). It just can't be proven directly which understandably bothers some. Its kind of like a diagnosis of exclusion in medicine.

However, I would say that not all the deaths recorded higher than average are due to COVID. I am sure there are some that are preventable diseases that people didn't go into the ER for out of fear of catching COVID, but even then you'd have to make a lot of assumptions to explain huge average death differences.

There's not some grand conspiracy going on like some think, its just Occam's razor.The

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The opposite. Deaths are being attributed to covid without a positive test. If they are "presumed to be" covid then they are counted. This doesn't give us good numbers.

Bruce Almighty said:

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My wife says that she sees multiple flu deaths every year. She had 3 in one week a couple months ago. When I asked her about this thread, she basically said its BS.

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Thanks for the response. I was genuinely asking for feedback from medical professionals

FrioAg 00 said:

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Similar to Covid, most people who die from the Flu are very aged or have chronic health conditions, or both

Yes there are exceptions. But they are the rare exceptions.

We get 1-2 otherwise perfectly healthy kids each year that have a bad reaction to the flu and die. Many times they get sick enough and turn septic. But 1-2 cases per year in a pediatric population of millions is still very rare.

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The 1918 Influenza pandemic was reportedly much worse for young adults than for the elderly. In fact, Influenza A is allegedly much more dangerous to children than to adults.