The Strange Case Of The Disappearance Of ‘Flu

Apparently, according to WHO figures, influenza cases from Week 15 (April) of 2020 have declined by 98% compared to 2019, whilst Covid-19 cases have correspondingly soared. This is very strange, you have to admit. Here are the figures:

So what on earth is going on? Is it a conspiracy? Have health departments all across the world been wrongly assigning ‘flu cases as Covid-19 cases, in effect faking the entire Covid-19 pandemic? Has the emergence of SARS-CoV-2 somehow ‘driven out’ ‘flu since April, preventing people from being infected with the ‘flu virus if they are already infected with SARS-CoV-2? Has mass mask wearing and social distancing prevented the spread of the ‘flu but not, bizarrely, the spread of SARS-CoV-2? All these explanations seem a little far fetched.

But we need an explanation. The transition from ‘flu to Covid is stark indeed. Here are the case statistics for North America and Northern Europe:

It’s ridiculous isn’t it. How can ‘flu just suddenly disappear? My guess is it did not. Flu and pneumonia are still mentioned on plenty of death certificates. My guess is that the focus on testing for Covid-19 has meant that ‘flu cases are being sidelined, but that moreover, people presenting with severe respiratory disease and dying from severe respiratory disease are those same people who, in a normal year would have presented with the ‘flu and died from it. SARS-CoV-2 appears to have usurped the role of ‘flu in the vulnerable population this year and carried off the susceptible. Not only that, it did so in many countries in a much shorter period, around March and April. It also carried off those who would have died naturally from other diseases too, like cancer, heart disease, stroke etc.

In this respect, Covid-19 is not a pandemic, but a syndemic. It has killed people all over the world by acting in synchrony with – and in some cases by displacing, as with ‘flu – other known morbidities. Very few healthy people under 60 have died directly from Covid-19. Here is what Richard Horton in the Lancet has to say and I believe it is very significant:

As the world approaches 1 million deaths from COVID-19, we must confront the fact that we are taking a far too narrow approach to managing this outbreak of a new coronavirus. We have viewed the cause of this crisis as an infectious disease. All of our interventions have focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen. The “science” that has guided governments has been driven mostly by epidemic modellers and infectious disease specialists, who understandably frame the present health emergency in centuries-old terms of plague. But what we have learned so far tells us that the story of COVID-19 is not so simple. Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic. The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.

2 comments

  1. I’ve said all along that we would obtain any sort of meaningful picture about the fatality rates connected with Covid-19 only after the end of this year, when we might be able to see what the ANNUAL excess death rate looks like. It is of course very sad if people have died a few weeks or months earlier than would otherwise have been the case, but I have long suspected (and obviously it is no more than a hunch) that many of the people who are said to have died from Covid-19 earlier this year, would probably have died this year anyway, whether from an underlying health condition, or from some other disease such as ‘flu.

    If lots of people die far earlier than would otherwise be the case because of Covid-19, then it might be worth causing untold misery and economic damage to avoid. But if most of the victims would have died this year anyway, I think that’s a much harder call to make, especially if many others, who might have had many meaningful years ahead of them otherwise, have been collateral damage, dying because the closed NHS failed to diagnose and/or treat their cancer, heart disease or other health issues.

    Of course, that leads into the final statistical problem. If we do still face apparently large numbers of excess deaths in 2020, how do we differentiate between those caused by Covid-19 and those caused by the lockdown?

    Liked by 1 person

  2. The Telegraph today confirms that Covid is indeed currently claiming the lives of people who would otherwise die of ‘flu or pneumonia; either that or deaths from ‘flu and pneumonia are being registered as Covid deaths. Either way, excess deaths are normal for this time of year.

    “There is no sign of a second coronavirus wave, experts have said as new Office for National Statistics (ONS) figures showed that deaths are just 1.5 per cent above the five-year average and tracking on a normal trajectory for the time of year.

    Although Covid deaths rose to 438 for the week ending October 9 – an increase of 36 per cent from the previous week, when the figure stood at 321 – overall deaths rose just 143 above the five-year average. There were also 19 fewer overall deaths than in the same week last year.

    Researchers also found there would usually be around 1,600 weekly deaths from flu and pneumonia for the same week. Deaths from coronavirus, flu and pneumonia are currently running at 1,621, suggesting there is virtually no increase in expected respiratory deaths.

    The ONS figures show that, since the week ending September 4, registered coronavirus deaths in England and Wales have been roughly doubling every fortnight.

    However, the country is now entering the winter flu season, and an increase in respiratory deaths is expected. Public Health England (PHE) surveillance of respiratory diseases shows there is virtually no flu in the community at the moment.”

    https://www.telegraph.co.uk/news/2020/10/20/second-wave-not-sight-ons-figures-show-deaths-just-15-per-cent/

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