U.S. coronavirus death toll exceeds 1918 influenza pandemic estimates

More than a century ago, the world was devastated by a pandemic which has been described by experts as “the deadliest in human history”.

The 1918 influenza pandemic killed at least 50 million people worldwide, according to the Centers for Disease Control and Prevention, which is equivalent in proportion to 200 million of the current global population. An estimated 675,000 of these deaths have occurred in the United States.

Today, 18 months after the start of the coronavirus pandemic, the virus has claimed more American lives than its counterpart a hundred years ago.

At this point, it has been confirmed that at least 675,446 Americans have died since the onset of the coronavirus pandemic, according to data collected by Johns Hopkins University, with thousands of American lives still being lost every day.

Exceeding the 1918 death toll is a dismal step, but experts suggest that there are key differences between the two pandemics that must be taken into account, given modern access to better medical treatments and vaccinations.

“They are two different viruses, at two different times in history, at two different times in medical history, with what you have to fight or treat it,” Howard Markel, professor of history told ABC. of medicine at the University of Michigan. New.

The 1918 flu epidemic began in the spring, with the transmission of the new H1N1 virus from birds to humans, and lasted for about two years. According to the CDC, about a third of the world’s population at that time, or 500 million people, were eventually infected.

According to experts, it is important to remember, when comparing data from the two pandemics, that the numbers of deaths linked to the 1918 pandemic are only estimates. In fact, according to Dr. Graham Mooney, assistant professor of the history of medicine at Johns Hopkins University School of Medicine, it is likely that these numbers were significantly underestimated, due to non-enrollment, missing records, misdiagnosis or underreporting.

Likewise, experts believe that the current death toll from COVID-19 may already be vastly underestimated, due to inconsistent reporting by states and localities, and the exclusion of excess deaths.

When comparing pandemics, Markel said, it’s important to remember that we now have many more people living in the United States than in 1918, when the population was around 105 million, according to census data, against 328 million people in 2019.

The United States currently has a death rate from coronavirus cases of 1.6%, compared to the flu death rate of 2.5% in 1918, Mooney noted. Normally, the death rate from influenza is less than 0.1%. And so, the death rate in the United States from COVID-19 remains significantly lower than that attributed to the 1918 pandemic.

Ultimately, compared on a per capita basis, the 1918 pandemic was far deadlier than this one, according to Christopher McKnight Nichols, associate professor of history at Oregon State University.

“The difference is that 1 in 500 Americans has died now, and about 1 in 152 died in 1918, although our numbers continue to increase,” Nichols told ABC News.

Vaccinations and traditional intervention methods at the heart of protection

Although the two pandemics were initially comparable, the introduction of the coronavirus vaccine made the differences between the two “stark,” Nichols said.

“People were in desperate need of treatment measures in 1918. People were in desperate need of a vaccine,” Nichols said. “We have effective vaccines now, and so what strikes me in the comparison, if you think about this milestone, this tragedy of death, it’s the same number but we have a really effective treatment, the thing they do. wanted the most in 1918 and ’19, we have them. And for many different reasons, we botched the answer. “

Similar to the onset of the coronavirus pandemic, no vaccine or treatment was available to protect people against the 1918 flu. So protection through non-pharmaceutical interventions was essential, Mooney said.

“The same kinds of measures – the so-called non-pharmaceutical interventions that were put in place in 1918 – were the same ones we saw last year: lockdowns, social distancing, hygiene masks, site boundaries. rally, ”Nichols said.

In fact, social distancing was also one of the great historical lessons of 1918, according to Markel, demonstrating that if taken early and for a long time, such measures can work.

Millions of different communities and demographics affected

A fundamental contrast between the two pandemics, according to Markel, is that different age groups have been affected the most. A disproportionate number of those who succumbed to the disease in 1918 were in the 18-45 age group. Young children and the elderly were also significantly impacted.

However, in the coronavirus pandemic, the age group most affected is the over 65s, which accounts for 78.7% of virus-related deaths.

Historical evidence suggests that racial and ethnic disparities, which affected communities of color throughout the coronavirus pandemic, were also present during the 1918 pandemic.

Black Americans had higher case fatality rates from influenza in 1918-19 than whites, according to a 2019 study published in the International Journal of Environmental Research and Public Health.

Likewise, black Americans account for almost 14% of COVID-19-related deaths, despite the fact that black Americans make up only 12.5% ​​of the population.

Become endemic

Nationally and globally, experts said, it will be crucial that uptake of vaccines increases, in order to mitigate the impact of the number of coronavirus deaths.

“I’m a little pessimistic as winter approaches, given that there is such a large unvaccinated population that it looks a lot like 1918,” Nichols said, adding that it will eventually be ” a combination of immunization of a larger part of the population, with vaccines and with infections. “

Ultimately, while “it’s not the worst ever, it’s pretty darn close,” Markel said of the COVID-19 pandemic. “It’s the worst of our lives, and it has changed our lives in so many ways.”

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