The 1918 Spanish flu pandemic, which claimed an estimated 50 million lives worldwide, stands as the most frequent point of comparison to the current coronavirus scourge.

In some ways, according to a new study, the COVID-19 pandemic has been worse.

The study, published Thursday in the medical journal JAMA Network Open, compares the two months since the first recorded death of COVID-19 in New York City – the epicenter of the U.S. epidemic for weeks – with the deadliest two months of the 1918 calamity.

Although the number of New Yorkers per 100,000 who died monthly was higher at the time – 287, significantly more than the average of 202 from March 11 to May 11 of this year – the deviation from the norm in 2020 is considerably higher.

About 100 New Yorkers per 100,000 died of all causes every month in the four years before the Spanish flu, a figure that nearly tripled in October and November of 1918, the peak of the pandemic in the city.

This time around – with more advanced medical care and public health systems bringing fatalities down to 50 a month per 100,000 during the same March-to-May dates the previous three years – the number of deaths quadrupled.

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That puts in stark terms the impact of a disease some still downplay in part because approximately 40% of those infected might not develop symptoms.

“They’re comparable events in terms of magnitude,’’ said Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston and the lead author of the study.

“I think maybe we imagine pandemics and plagues and other calamities to be this sort of historical events where the streets are lined with dead bodies and there’s pestilence and filth, but what our numbers show is that what happened in New York was pretty similar to what happened in the greatest modern pandemic.’’

A doctor testing for COVID-19 in Miami Lakes, Florida.

Another expert not involved in the study reached a similar conclusion, noting that the new report puts in perspective the enormous toll extracted by a virus that has infected nearly 5.2 million Americans and killed more than 165,000 – in just seven months. An estimated 675,000 Americans died in the Spanish flu pandemic.

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“The gross numbers per population were higher for flu, but when you account for the changes in death rates due to healthier cities in 2020, COVID has resulted in far more excess deaths than the flu pandemic,’’ said Dr. Eric Cioe-Peña, director of global health for Northwell Health in Long Island, New York. “A reminder of just how bad this pandemic is and how swiftly this virus can kill.’’

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Faust acknowledges his report represents a case study that’s not necessarily applicable to other cities or the rest of the nation. That remains to be seen as the coronavirus continues to spread and disrupt life across the country.

He pointed out nobody knows whether we’ve seen the worst or just a preamble of the damage that can be inflicted by the virus. Many public health experts fear that the arrival of the flu season in the fall and winter combined with the continued prevalence of the coronavirus could lead to catastrophic results.

Faust also warned against equating the COVID-19 epidemic with a bad flu season, as those who seek to minimize the danger the new virus presents have often done.

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In a JAMA article published May 14, Faust and Dr. Carlos del Rio – also his co-author on the new study – noted that conditions at hospitals treating coronavirus patients have often been much more dire than during a flu season. They also argued that the way the Centers for Disease Control and Prevention estimates flu-related deaths overcounts them.

By Faust’s estimation, the epidemic the U.S. is going through now, with 25% of the world’s COVID-19 cases and 22% of its deaths, is 20 times worse than a typical flu season.

“What we’re experiencing is truly historic and unusual, and it shouldn’t be shrugged off,’’ Faust said. “We’re sort of used to a very low level of deaths, and for us to suddenly experience a quadrupling, it gives us a sense of the magnitude of the public health crisis we’re dealing with.’’

This article originally appeared on USA TODAY: COVID-19 worse for New York than Spanish flu of 1918, new study shows



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