COVID is far more dangerous than flu

The risk of dying (mortality) from COVID during the pandemic was hotly debated and became a heavily politicized issue. Some argued that catching coronavirus was not more dangerous than the flu, whereas others claimed that it was far more lethal than the flu.

One way of assessing the risk is by counting the number of deaths by different causes. According to the CDC data from 2020, the estimated number of deaths in the United States from the leading causes of death were the following:

• Heart disease: 659,041 deaths
• Cancer: 606,520 deaths
• COVID-19: 383,142 deaths
• Unintentional injuries: 215,830 deaths
• Stroke: 149,672 deaths
• Chronic lower respiratory disease: 147,101 deaths
• Alzheimer's disease: 132,962 deaths
• Diabetes: 103,436 deaths
• Influenza and pneumonia: 53,941 deaths
• Kidney disease: 52,027 deaths

It is important to note that these numbers are subject to change from year to year, although the data were broadly similar in 2021. Also, the numbers did not change much from 2019 except there were no COVID deaths.

The influenza and pneumonia category includes both deaths from flu and from pneumonia that is not flu-related e.g. bacterial pneumonia. According to the CDC, there are about 36,000 deaths annually from flu. Thus, roughly speaking in 2020, there were approximately 10 times as many deaths from COVID as from flu. This is most likely a considerable underestimate of the overall danger posed by COVID given all of the mitigation efforts taken in 2020 to prevent the spread of COVID such as social distancing; without these stringent mitigation efforts the death toll would have been far higher. So some estimates put COVID at 10 to 100 times more deadly than flu with the number of flu deaths most likely considerably less than 36,000 in 2020 (Figure 1) as a result of social distancing.

Another claim that was made was that COVID was no more dangerous than driving. Deaths from motor vehicle accidents fall under the unintentional injuries category which refer to deaths that occur as a result of accidents or other unplanned events, such as falls, drowning, poisoning, fires, and transportation accidents. In the United States, unintentional injuries are a leading cause of death, and they can occur at any age, but are more common in younger age groups.

Some examples of unintentional injury deaths include:

• Motor vehicle accidents
• Falls
• Accidental poisoning (e.g. drug overdoses)
• Fires and burns
• Suffocation (e.g. from choking or inhalation of smoke)
• Drowning
• Sports-related injuries
• Workplace accidents

It's important to note that intentional injuries (e.g. suicides, homicides) are not included in the category of unintentional injuries.

According to the National Highway Traffic Safety Administration (NHTSA), in the United States, there were 38,680 motor vehicle traffic fatalities in 2020. This represents a 7.2% increase from the 36,096 fatalities reported in 2019. This number is not too different from the annual flu death toll and once again was approximately 10-fold smaller than COVID deaths. 

Thus, this crude analysis demonstrates that COVID is far more dangerous than flu or motor vehicle accidents, and without the extensive mitigation efforts, the COVID death toll would have been significantly worse than the already very high numbers.

Finally, for a given individual, the risk posed by COVID will depend on a variety of factors, including personal health status, the severity of the disease in the community, and the measures taken to protect against infection. In particular, age and a weakened immune system are significant risk factors. It's important for individuals to make informed decisions based on the latest information and guidance from public health authorities and to take appropriate measures to protect their health and safety.

Figure 1. Weekly COVID-19 deaths compared with flu deaths (data from CDC, Fortune).