While deaths with COVID-19 as their underlying cause have fallen from previous peaks, they remain higher than those caused by flu and pneumonia.
While 90% of deaths involving COVID-19 in the U.K. in spring 2020 and early part of 2021 were due to the condition, the same was true for 62% of COVID-19-related deaths in the week ending April 1st, 2022.
To know whether COVID-19 is behaving similarly to the flu or pneumonia, the ONS conducted an analysis of deaths from COVID-19, pneumonia, and flu between 2020 and 2022.
Medical News Today contacted six experts to discuss how COVID-19, pneumonia, and the flu may be compared and how the public may act on the findings.
The ONS report was published on May 23rd, 2022.
For their analysis, the ONS used data from death certificates to count deaths from COVID-19 and other causes. This, they note, is different from public health measures that include deaths within 28 days of a positive COVID-19 test.
They used the term “due to COVID-19” to refer only to deaths caused by COVID-19. When taking into account all of the deaths that had COVID-19 mentioned anywhere on the death certificate, whether as an underlying cause or not, they used the term “involving COVID-19.” The ONS researchers used the same terms for flu and pneumonia.
From their analysis, the ONS noted that while deaths from COVID-19 occurred more evenly across age groups than flu and pneumonia, the elderly were more likely to be affected.
They noted that between 2020 and 2022, 73.7% of deaths due to flu and pneumonia occurred among those 80 years and over, compared to 58.3% of deaths due to COVID-19.
“The elderly do still make the largest portion of deaths,” Dr. Fady Youssef, a board-certified pulmonologist, internist, and critical care specialist at MemorialCare Long Beach Medical Center in Long Beach, CA, told MNT.
“However, early on, COVID-19 did cause a much [higher] rate of deaths in younger age groups, with the sharpest rise in those aged 40 to 79 — meaning that COVID-19 posed a serious health risk to a young age group that [is] typically shielded from the worst outcomes when it comes to flu or pneumonia,” he added.
The ONS also found that there have been more deaths due to COVID-19 than flu in every year since 1929. They noted that 73,766 deaths in 2020 were due to COVID-19, and 67,258 in 2021, while there were 73,212 deaths due to flu in 1929.
Deaths due to flu, the researchers noted, also fell to record lows since COVID-19 started, to under 20,000 per year. Although deaths due to flu and pneumonia increased in the most recent winter, they remained below pre-COVID pandemic levels.
“These are all disease entities affecting the lungs and your ability to breathe and keep oxygen getting to your body and vital organs,” noted Dr. Dana Hawkinson, medical director of Infection Control and Prevention at The University of Kansas Medical Center.
“These infections and our immune response can significantly reduce the proper functioning of our lungs leading to respiratory failure and death,” he told MNT.
Dr. Hawkinson noted, however, that there might be limitations in defining the conditions:
“I would like to point out that ‘pneumonia’ is merely an infection of the lower respiratory tract, i.e. the lungs. This infection may be caused by a virus (such as SARS-COV-2), a fungus, or a bacteria — I am assuming this article is referring to bacterial pneumonia, but it’s unclear if they are including other non-influenza, non-SARS-COV-2 viruses or fungal causes of pneumonia.”
Dr. David Cutler, family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, told MNT that it is also important to note that COVID-19 and flu affect the body in different ways:
“COVID-19 and flu are two very different diseases, with very different effects on the human body, and certainly very different levels of fatal outcomes.”
“So, by comparison, in the 2018–2019 flu season, before COVID-19 arrived, there were about 34,000 flu deaths in the U.S., an average year. In 2019–2020, just as covid was hitting and our behavior about masking and distancing changed, there were 22,000 flu deaths.”
“And from October 2020 until July 2021 when mask mandates and lockdowns were in effect, there were only 748 documented flu deaths.”
“By comparison, in the last 2 years, there have been over a million COVID-19 deaths, and we are still averaging over 300 deaths per day. Life expectancy in our country has fallen by 1.8 years, the most from any event since World War II. COVID-19 is now in the top three causes of death for all adult age groups, something flu has never come close to achieving.”
– Dr. Cutler
When asked about the similarities between deaths due to COVID-19, pneumonia, and flu, Dr. Ali Mokdad, Chief Strategy Officer for Population Health at the University of Washington, told MNT: “With time, they will become similar.”
“All of them are seasonal, more present during winter (indoor activities) and will have a bad season some year depending on the variant — flu and COVID-19 will have more variants ahead.”
“We will need a vaccine before winter for all of them. I do not think that it will be mandated, but [rather] recommended for older people, those with risk factors and immunocompromised, and those working with patients or the older population (nursing homes),” he added.
When asked about major differences to bear in mind between COVID-19, flu, and pneumonia as a cause of death, an ONS spokesperson told MNT:
“It is worth bearing in mind that testing of patients for COVID-19 was more widespread during this period than it would have been for influenza and pneumonia, making it more likely to be identified as a cause of death.”
“The data is also impacted by the fact that widespread flu vaccinations have been available in the U.K. since 2000, whereas COVID-19 vaccinations for the most at-risk population only began in the U.K. in December 2020.”
“Perhaps a better way of comprehending the impact of COVID-19 is to look at total excess deaths,” noted Dr. Cutler, “These are the number of deaths over and above the number anticipated by historical averages. During the past 2 years, the World Health Organization puts this number at 15 million.”
“This is in contrast to the 6 million worldwide deaths currently attributed by individual countries to COVID-19. But even these large numbers do not give a full picture of the impact of COVID-19 and why we need to all take action to reduce the number of infections, serious illnesses as well as deaths,” he added.
When asked what this report means for the public, Dr. John Segreti, Professor at the Department of Internal Medicine at Rush Medical College, told MNT:
“I think this report reminds us that flu is a significant health threat and that we need to take it as seriously as COVID-19. Mitigation strategies for both are the same: vaccination, avoid crowded poorly ventilated indoor areas, and consider wearing a mask when in public indoor spaces.”
Dr. Youssef added: “The report shows the deadly impact that COVID had over 2020-2021. As vaccines were rolled out and variants became less lethal, the deaths started down-trending.”
“The report adds further evidence to the need to adhere to public health guidance, understanding that while the guidance shifts over time, it is because our understanding of the data and the disease are evolving.”
“With the advancement made in medicine over the last several decades and a worldwide effort to combat the pandemic, the deaths caused by it have not been seen since 1929. If we did not have the response we had, the death would have likely been much higher,” he concluded.
‘This too shall pass away’ this famous Persian adage seems to be defeating us again and again in the case of COVID-19. Despite every effort