I would have never thought that the flu would surpass covid19 hospitalizations. Yet here we are. Even with more vaccinated with the flu vaccine than the covid19 vaccine. I know we just started 2024. It will be interesting to see how the percentages change by the end of the year.
I think this is a very important post and I'm surprised there are so few comments: it does feel like progress to me. That said, sometimes I think the hospitals are almost willfully blind: we sent over a covid + patient with lab abnormalities, and the ED just didn't acknowledge the Covid diagnosis. I still consider Covid a more lethal virus than flu--and the weekly deaths don't compare, right?
You are correct that until recently, Covid deaths have dominated over flu deaths. But not sure re: Dec and Jan yet--too much lag.
For eons, the CDC has multiplied flu deaths by a factor of 5-10x on grounds that we don't pick up all cases. I've long felt that this was (pardon the pun) overkill, unless they were looking at flu as a *contributing* rather than *underlying* cause of death.
Meanwhile, they have never done that with Covid. Actually, CDC did it once, but never after, given that there was essentially universal testing at some point.
All to say, "capture" is operative term here. Are we catching all cases of either virus? Of others? Hard to say.
I've been seeing the data on Covid deaths during this JN.1 virus as 1500-1800/week. (no idea how accurate that is) CDC data says 13,000 flu deaths so far this season. Did they take 1300 and multiply them? https://www.cdc.gov/flu/weekly/index.htm
Readers will understand that you're discussing the acute phase of ILI, but perhaps it's important to spell that out. Long Covid should be mentioned every time we discuss cvd, even just one sentence for clarity.
I'll agree with you in part here. LC is always on my mind when I think about this disease. But I don't think I can mention it every time I discuss it though. I just can't have hard and fast rules like that in a limited setting (ie, it is very important that I keep word count as low as possible to maintain attention). Same is true about disparities. It's such a huge part of how I think about public health response that it's always part of any analysis I do, whether explicitly stated or not. Sometimes, it is essential to mention. Other times, I want readers to get one or two messages from a piece, and adding other angles can distract. I hope you see the nuance on this one! But I also appreciate the reminders :)
Thanks for the article as always. One thing to note - the non-pharmaceutical interventions that help reduce SARS-2 transmission also work for influenza. As an older person, even in the absence of covid, I would continue to use a mask in places like public transit during times of high flu prevalence. Some HVAC infrastructure improvements in terms of filtration and increased fresh air would helpful for both.
100%. And the "invisible public health" stuff is so important. Lindsay Marr got a MacArthur for her work on this and Joe Allen has been highly influential. We should check in with them!
I think you are correct. It is not off-track to intuit a sort of “progress” by noting that “Flu has now outrun Covid". But one thing instructive for me about the pandemic has been the necessity to refresh awareness of the Relative Privation Fallacy. Nobody says squat about that fallacy in the literature of epidemiology, even in material issued by the Big Cigars themselves. It seems sometimes almost automatically too easy for humans (mainly lay folks) to deflect concern about disease or condition X by noting some bad feature about disease or condition Y and then lapsing into the Yabut mode if another person voices concern about “X being horrible”: “Yah, but Y is really bad too and it happens more often” as if that solid fact somehow ameliorates the threats of X.
"Relative Privation Fallacy" is the fancy term for "ya but" eh? I never heard that one.
I think the key is to query how bad each threat is in relation to what we can do about it.
Example: if it turns out that cell phones increase brain cancer rates by a small amount, are we really willing to stop using them? Or would be try to find ways to reduce the risk (new tech, change how we use them).
Fingers crossed it’s progress, we need all the progress we can get. Will anyone make Covid Vaccines like they make the flu vaccines? I wonder if that would make the hesitant people more comfortable in taking them?
Do you mean using non-mRNA technology? Good question. Eventually. I do wonder, though how many people are actually avoiding vaccination for that reason. I think a lot of people who don't get vaccinated have other reasons, but find something like "new technology=scary" to blame.
I would have never thought that the flu would surpass covid19 hospitalizations. Yet here we are. Even with more vaccinated with the flu vaccine than the covid19 vaccine. I know we just started 2024. It will be interesting to see how the percentages change by the end of the year.
I've learned to let nothing surprise me!
I think this is a very important post and I'm surprised there are so few comments: it does feel like progress to me. That said, sometimes I think the hospitals are almost willfully blind: we sent over a covid + patient with lab abnormalities, and the ED just didn't acknowledge the Covid diagnosis. I still consider Covid a more lethal virus than flu--and the weekly deaths don't compare, right?
You are correct that until recently, Covid deaths have dominated over flu deaths. But not sure re: Dec and Jan yet--too much lag.
For eons, the CDC has multiplied flu deaths by a factor of 5-10x on grounds that we don't pick up all cases. I've long felt that this was (pardon the pun) overkill, unless they were looking at flu as a *contributing* rather than *underlying* cause of death.
Meanwhile, they have never done that with Covid. Actually, CDC did it once, but never after, given that there was essentially universal testing at some point.
All to say, "capture" is operative term here. Are we catching all cases of either virus? Of others? Hard to say.
I've been seeing the data on Covid deaths during this JN.1 virus as 1500-1800/week. (no idea how accurate that is) CDC data says 13,000 flu deaths so far this season. Did they take 1300 and multiply them? https://www.cdc.gov/flu/weekly/index.htm
Thank you for the data and context.
Readers will understand that you're discussing the acute phase of ILI, but perhaps it's important to spell that out. Long Covid should be mentioned every time we discuss cvd, even just one sentence for clarity.
Thanks very much for your good work.
I'll agree with you in part here. LC is always on my mind when I think about this disease. But I don't think I can mention it every time I discuss it though. I just can't have hard and fast rules like that in a limited setting (ie, it is very important that I keep word count as low as possible to maintain attention). Same is true about disparities. It's such a huge part of how I think about public health response that it's always part of any analysis I do, whether explicitly stated or not. Sometimes, it is essential to mention. Other times, I want readers to get one or two messages from a piece, and adding other angles can distract. I hope you see the nuance on this one! But I also appreciate the reminders :)
Thanks for the article as always. One thing to note - the non-pharmaceutical interventions that help reduce SARS-2 transmission also work for influenza. As an older person, even in the absence of covid, I would continue to use a mask in places like public transit during times of high flu prevalence. Some HVAC infrastructure improvements in terms of filtration and increased fresh air would helpful for both.
100%. And the "invisible public health" stuff is so important. Lindsay Marr got a MacArthur for her work on this and Joe Allen has been highly influential. We should check in with them!
I think you are correct. It is not off-track to intuit a sort of “progress” by noting that “Flu has now outrun Covid". But one thing instructive for me about the pandemic has been the necessity to refresh awareness of the Relative Privation Fallacy. Nobody says squat about that fallacy in the literature of epidemiology, even in material issued by the Big Cigars themselves. It seems sometimes almost automatically too easy for humans (mainly lay folks) to deflect concern about disease or condition X by noting some bad feature about disease or condition Y and then lapsing into the Yabut mode if another person voices concern about “X being horrible”: “Yah, but Y is really bad too and it happens more often” as if that solid fact somehow ameliorates the threats of X.
"Relative Privation Fallacy" is the fancy term for "ya but" eh? I never heard that one.
I think the key is to query how bad each threat is in relation to what we can do about it.
Example: if it turns out that cell phones increase brain cancer rates by a small amount, are we really willing to stop using them? Or would be try to find ways to reduce the risk (new tech, change how we use them).
Great points
Fingers crossed it’s progress, we need all the progress we can get. Will anyone make Covid Vaccines like they make the flu vaccines? I wonder if that would make the hesitant people more comfortable in taking them?
Do you mean using non-mRNA technology? Good question. Eventually. I do wonder, though how many people are actually avoiding vaccination for that reason. I think a lot of people who don't get vaccinated have other reasons, but find something like "new technology=scary" to blame.