Early in the pandemic, some speculated that COVID-19 could turn out to be no deadlier than a bad flu season. That seems like a very long time ago.
It's abundantly clear that the coronavirus is far worse than the flu in many ways, and new research from Beth Israel Deaconess Medical Center offers some numbers that suggest exactly how much worse.
The pre-publication paper compares Beth Israel’s experience with all the flu patients the hospital admitted over five years — more than 1,000 of them — to 583 COVID-19 patients hospitalized in March and April.
“We identified 119 deaths from COVID-19 in two months, compared to 34 deaths from influenza over five seasons, or 40 months," says the paper's lead author, Dr. Michael Donnino. "The ratio of those numbers is just astonishing.“
The number of COVID-19 patients who needed to be on ventilators in the two-month period was more than double the number of flu patients over five seasons — 174, compared to 84 flu patients.
The COVID-19 patients also needed to stay on the ventilators longer — for a median of two weeks compared to three days, says Donnino, an emergency and critical care physician and director of the hospital's Center for Resuscitation Science.
"So taken together," he says, "this illustrates not only the impact on patients and families, but also illustrates how overwhelmed an individual hospital or health care system can become."
Also of concern: The study found that 25% of COVID-19 patients who needed to be on life support had no major pre-existing conditions, compared to just 4% of flu patients on life support.
Donnino has been arguing since early in the pandemic, he says, that "you don't want to create excess worry or panic, but to recognize objectively what differences there are, so that you can take the appropriate precautions when dealing with COVID or flu."
The numbers offer just a snapshot from one hospital, but Donnino believes they're typical for big hospitals this spring in hot spots around the country. The experience at Massachusetts General Hospital confirms that impression.
Mass. General critical care specialist Dr. Walter O’Donnell says the pattern there was similar: COVID-19 is "more likely than flu to lead to ICU admission and need for a ventilator, more likely to afflict those without underlying medical conditions, much longer time on the ventilator, higher risk of death."
"Our overall numbers of COVID-19 patients hospitalized (floor and ICU) here since early March now exceed 1800," he writes in an email. "We also have been able to handle seasonal flu surges without the medical ICU expansion to 12 units that COVID-19 required."
He adds: "This is very timely, since we have already had a modest uptick in our ICU COVID-19 cases, and flu season is upon us. I tell my patients they should always get a flu shot, but this year especially."
Donnino seconds the flu vaccine recommendation, in hopes of minimizing the impact of flu on a health care system already coping with COVID-19.