Flu, Who Knew?

 

In poking around the Arizona Department of Health Service website for Chinese coronavirus updates and advisories, I accidentally clicked out a level and found myself looking at all infectious diseases. So I clicked on the AZDHS influenza link, and boy was I surprised:

Who knew? Where were the big news stories? Clicking on the link led to a November press release that should have caused at least one or two breathless news segments: this year’s flu was targeting more children and young people! [emphasis added.]

The Arizona Department of Health Services (ADHS) reported today that influenza cases in Arizona have tripled compared to previous seasons at this time with more than half of reported cases this season in infants, children, and adolescents. So far this flu season 950 laboratory-confirmed influenza cases have been reported compared to 290 cases for the same time period in 2018. All counties in Arizona have reported influenza cases.

“The best thing you can do to protect yourself and your loved ones is to get your flu vaccine now if you haven’t already,” said Dr. Cara Christ, director of the Arizona Department of Health Services. “Influenza is a highly contagious respiratory illness that can cause mild to severe illness and can lead to hospitalization or even death. With the holidays right around the corner and people attending gatherings with friends and family, getting a flu shot today can help stop the spread of the disease.”

Now I check the CDC and find that Arizona was not reporting an anomaly:

And what about the profile of flu victims this year?

  • Laboratory confirmed influenza associated hospitalization rates for the overall U.S. population remain moderate compared to recent seasons, but rates for children 0-4 years and adults 18-49 years are now the highest CDC has on record for these age groups, surpassing rates reported during the 2009 H1N1 pandemic.  Hospitalization rates for school-aged children (5-17 years) are higher than any recent regular season but remain lower than rates experienced by this age group during the pandemic.
  • Pneumonia and influenza mortality has been low, but 144 influenza-associated deaths in children have been reported so far this season. This number is higher for the same time period than in every season since reporting began in 2004-05, except for the 2009 pandemic.

Somehow, this is all perfectly normal, not worthy of headlines. No one is shouting questions about 22,000 deaths, let along howling about the obvious wild uncertainty in the numbers. Have there really been 55,000 flu deaths so far this year in the U.S.? During the H1N1 pandemic in 2009, the final estimates were “12,469 deaths (8868-18,306).”

Apparently 22,000 to 55,000 deaths from an infectious respiratory disease are acceptable to American medical experts if it happens over five months. There were no stories of doctors not treating patients in need, so the system is working. I appreciate Dr. Birx and President Trump’s repeated comments, noting that this is not acceptable and that we need to leverage the current media focus to get Americans to start really doing the basics better, so next year there are far fewer bad outcomes with the flu.

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  1. Caryn Thatcher
    Caryn
    @Caryn

    Yup.

    • #1
  2. Kozak Member
    Kozak
    @Kozak

    The vast majority of people who get the flu do not even need to see a doctor. Like 90%. Complete waste of their money.

    1% of people who get the flu end up in the hospital. 0.1% of people who get the flu die from it.

    The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    5-10% end up in the ICU with a prolonged stay.

    If thing goes roaring through the country, and at this point it sure looks like it will..

    Impact of non-pharmaceutical interventions (NPIs) to reduce COVID- 19 mortality and healthcare demand

    Please notice where we are on the graphs,  Barely the beginning.

     

    • #2
  3. Kozak Member
    Kozak
    @Kozak

    Clifford A. Brown: Have there really been 55,000 flu deaths so far this year in the U.S.?

    Actually the CDC has no idea how many people actually die of the flu every year because they lump it into a “flu like illness” grab bag.

     

    Heres the text of the CDC letter to me when I asked them about it.

    Thank you for contacting CDC-INFO. 

    We hope you find the following information about influenza surveillance regarding deaths helpful.

    CDC does not know exactly how many people die from seasonal flu each year. There are several reasons for this:

    • First, states are not required to report individual seasonal flu cases or deaths of people older than 18 years of age to CDC.
    • Second, influenza is infrequently listed on death certificates of people who die from flu-related complications.
    • Third, many seasonal flu-related deaths occur one or two weeks after a person became infected with flu, either because the person developed a secondary  bacterial co-infection (such as bacterial pneumonia) or because influenza infection aggravated an existing chronic illness (such as congestive heart failure or chronic obstructive pulmonary disease).
    • Many people who die from seasonal flu-related complications are not tested for flu. If care is sought for an influenza complication 7 or more days after flu illness onset, the virus may no longer be detectible in respiratory samples, even if they are properly collected.

    For these reasons, many flu-related deaths may not be recorded on death certificates. These are some of the reasons that CDC and other public health agencies in the U.S. and other countries use statistical models to estimate the annual number of seasonal flu-related deaths.

    Each year, CDC estimates the burden of influenza in the U.S. CDC uses modeling to estimate the number of influenza illnesses, medical visits, flu-associated hospitalizations, and flu-associated deaths that occur in the U.S.

     

    • #3
  4. Stina Inactive
    Stina
    @CM

    Kozak (View Comment):

    1% of people who get the flu end up in the hospital. 0.1% of people who get the flu die from it.

    The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    How much of that is demographic social behavior?

    Over protective mama bears shielding babies through social isolation practices common in that age bracket (schools and day cares are very touchy about fevers and illness) vs globe trotting old people? I worked around these people for a decade. They are one of the most entitled groups of people I have ever met… except 2-year olds who are still figuring out that there’s a difference between “need” that is always met and “want” that isn’t. 

    My very cynical side says the reaction to this is so high because the privileged in this country are old and this virus hits them really hard.

    And I have a limited sense of compassion for them because everyone dies eventually and the idea is it’s best when you are OLD. So old people dying, from illness or failed ticker in their sleep, seems like a perfectly natural occurrence in a world without immortality.

    • #4
  5. Kozak Member
    Kozak
    @Kozak

    Stina (View Comment):
    And I have a limited sense of compassion for them because everyone dies eventually and the idea is it’s best when you are OLD. So old people dying, from illness or failed ticker in their sleep, seems like a perfectly natural occurrence in a world without immortality.

    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    Remember the horror and finger pointing at Obama and his “Death Panels”?

    I guess that was just political posturing.

    But don’t get too comfortable.

    This is an evolving public health emergency.   And we don’t actually know the course this is going to take.

     

    • #5
  6. Stina Inactive
    Stina
    @CM

    Kozak (View Comment):
    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    It has always been socially acceptable until modern medicine has devised such incredible measures to make immortality a convincing illusion.

    Old people dying has been with us since Adam.

    • #6
  7. Kozak Member
    Kozak
    @Kozak

    Stina (View Comment):

    Kozak (View Comment):
    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    It has always been socially acceptable until modern medicine has devised such incredible measures to make immortality a convincing illusion.

    Old people dying has been with us since Adam.

    Sure thing.   Everybody dies.  Some younger.

    So you’re good with the death panels right?

     

    • #7
  8. Stad Coolidge
    Stad
    @Stad

    Like I’ve said, it’s because this strain has a name as compared to the more generic variety.  As a nation, we’re willing to accept 15000-60000 deaths a year from the flu.  However, I believe it’s the politicians who can’t accept 100-1000 deaths from coronavirus.

    The cynic in me thinks governments at all levels are flexing their muscles to see how much control we will accept when an emergency is declared.

    • #8
  9. The Reticulator Member
    The Reticulator
    @TheReticulator

    Kozak (View Comment):

    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    Remember the horror and finger pointing at Obama and his “Death Panels”?

    I don’t find any contradiction. I’m an oldster and am in no hurry to check out, but I don’t think keeping us alive should be the sole criterion. There are also other considerations. And I remain opposed to Obama and his death panels.  

    • #9
  10. Qoumidan Coolidge
    Qoumidan
    @Qoumidan

    Kozak (View Comment):

    Stina (View Comment):

    Kozak (View Comment):
    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    It has always been socially acceptable until modern medicine has devised such incredible measures to make immortality a convincing illusion.

    Old people dying has been with us since Adam.

    Sure thing. Everybody dies. Some younger.

    So you’re good with the death panels right?

     

    That’s a false comparison. It doesn’t have to be either.

    • #10
  11. Stina Inactive
    Stina
    @CM

    Kozak (View Comment):
    Some younger.

    And we have worked hard to create medical technology and science that gets them to “old.”

    But you seem to have an issue with my point that we were never aiming for immortality.

    • #11
  12. The Reticulator Member
    The Reticulator
    @TheReticulator

    The Reticulator (View Comment):

    Kozak (View Comment):

    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    Remember the horror and finger pointing at Obama and his “Death Panels”?

    I don’t find any contradiction. I’m an oldster and am in no hurry to check out, but I don’t think keeping us alive should be the sole criterion. There are also other considerations. And I remain opposed to Obama and his death panels.

    And for the benefit of those who have trouble entertaining more than one thought at a time in their minds, I will point out that I think keeping us alive is an important consideration, just not the sole consideration.

    Rats. That’s two thoughts. I give up. I don’t know how to condense it down to one thought.

    • #12
  13. Kozak Member
    Kozak
    @Kozak

    Qoumidan (View Comment):

    Kozak (View Comment):

    Stina (View Comment):

    Kozak (View Comment):
    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    It has always been socially acceptable until modern medicine has devised such incredible measures to make immortality a convincing illusion.

    Old people dying has been with us since Adam.

    Sure thing. Everybody dies. Some younger.

    So you’re good with the death panels right?

     

    That’s a false comparison. It doesn’t have to be either.

    How is it a false comparison?

     Both the death panels and the ” can’t close down the economy” argument are based on the notion that the elderly are expendable because, well old.

    And I keep pointing out that it’s not just the elderly who are going to die, unless  you consider people in their 50’s and 60’s elderly.

     

    • #13
  14. Kozak Member
    Kozak
    @Kozak

    From Italian physicians.

    The Italian Association of Biotechnologists wants to make clear that Covid-19 is not like a flu. To make this even more clear we have compared the available data on flu (season 2018-2019) available here with the Coronavirus data collected until March 15th 2020.

    In the season 2018-2019, flu was responsible of 812 cases that required Intensive Care Unit (ICU) hospitalization and 205 deaths in a span of 33 weeks (8th October 2018 – 20th May 2019). The peak of ICUs was in week 4 (2019) with 93 cases and the peak of deaths in week 5 (29 deaths).

    The data available for SARS-CoV-2 in Italy are on a completely different scale. The epidemic stated in week 9 of 2020, and the week after (10) registered 351 cases in ICUs and 131 deaths. This week (11) there are already 1672 cases in ICUs and 1661 deaths, and the situation is getting critical for the health system of many Italian regions.

    The main issue is that for a large number of cases (up to 10%) there is the need for an Intensive Care Unit (ICU) hospitalization, also for young people, and the therapy requires up to 2-3 weeks before passing the critical phase. This requires a tremendous effort by the health system to guarantee adequate care to all in need, and for such a long time, draining resources also for those with other pathologies.

    It is true that most of the deaths are elderly people, but only because the elderly often bear other chronic illnesses and do not tolerate invasive treatments well, but the hospitalization does not spare any age.

    So, get ready, assist your country to correctly inform its people and help them to respect the rules to stop the contagion. Do it for yourself, for the people you care, for your fellow citizens, especially the weakest.

     

    • #14
  15. Misthiocracy ingeniously Member
    Misthiocracy ingeniously
    @Misthiocracy

    Clifford A. Brown: Apparently 22,000 to 55,000 deaths from an infectious respiratory disease are acceptable to American medical experts if it happens over five months.

    To be fair, the idea that it’s not the total numbers but rather the short-term spikes in numbers that’s the problem for health care providers has been the dominant narrative during this whole coronacrisis.  It’s the whole point of the “flattening the curve” idea.

    • #15
  16. Misthiocracy ingeniously Member
    Misthiocracy ingeniously
    @Misthiocracy

    Kozak (View Comment):

    The vast majority of people who get the flu do not even need to see a doctor. Like 90%. Complete waste of their money…

    …The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    You do realize those are about the same numbers for both diseases, right?

    • #16
  17. The Reticulator Member
    The Reticulator
    @TheReticulator

    Kozak (View Comment):
    Both the death panels and the ” can’t close down the economy” argument are based on the notion that the elderly are expendable because, well old.

    That’s not exactly right. It’s certainly incomplete. And even if true, that doesn’t mean that one has to support death panels in order to be consistent while supporting more of a let-it-take-its-course policy. 

    I suspect a lot of your concerns are entirely warranted, but it doesn’t help your cause when you misrepresent the positions of others who don’t agree with your emphases.

    • #17
  18. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Misthiocracy ingeniously (View Comment):

    Kozak (View Comment):

    The vast majority of people who get the flu do not even need to see a doctor. Like 90%. Complete waste of their money…

    …The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    You do realize those are about the same numbers for both diseases, right?

    No. You are mixing numbers. Re read.

    • #18
  19. Jerry Giordano (Arizona Patrio… Member
    Jerry Giordano (Arizona Patrio…
    @ArizonaPatriot

    Kozak (View Comment):

    The vast majority of people who get the flu do not even need to see a doctor. Like 90%. Complete waste of their money.

    1% of people who get the flu end up in the hospital. 0.1% of people who get the flu die from it.

    The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    5-10% end up in the ICU with a prolonged stay.

    If thing goes roaring through the country, and at this point it sure looks like it will..

    Impact of non-pharmaceutical interventions (NPIs) to reduce COVID- 19 mortality and healthcare demand

    Please notice where we are on the graphs, Barely the beginning.

    Kozak, thanks for the info.  The problem with these graphs is that they assume an unprecedented, and difficult to believe, rate of spread of the WuFlu.

    The assumptions of the paper are different than what you reported (which I assume is from other sources).  The paper assumed 4.4% of cases are hospitalized, and 30% of those hospitalized require critical care.  This implies that 1.32% of cases require critical care.  For the US chart above, estimating the peak at about 280,000 critical care beds occupied by May 2020, this implies about 21 million cases.  This is many orders of magnitude above the current path in any country.

    There are multiple other problems in the linked paper, and the graph that you present.

    • Notice that none of the proposals prevent the healthcare system from being entirely overwhelmed.  They are all vastly above that little red line at the bottom.
    • Their proposal is not feasible.  The real model is not the one above — it is the most severe restrictions, maintained for 2 years.  Shut down the world for 2 years.  Of course, they do not estimate the cost of doing so.
    • Here is the graph that they include in the appendix, illustrating the pointlessness of the measures proposed a more modest — but still not feasible — 5 month lockdown:

    The measures proposed simply push the problem into the future.

    If the worst-case scenario regarding case growth is upon us, this indicates that there is nothing helpful that we can do.  We can impose extremely high costs — probably driving the economy into a depression — and it will merely postpone the problem by 4-6 months.  Frankly, if people can’t work during this period, I don’t know how we’re going to pay the rent or even buy food.

    On the other hand, there is evidence that the increase in cases is declining.  This may be an artifact, as the lower numbers reported might be the result of the quite limited testing performed.

    • #19
  20. Jerry Giordano (Arizona Patrio… Member
    Jerry Giordano (Arizona Patrio…
    @ArizonaPatriot

    Kozak (View Comment):

    The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    5-10% end up in the ICU with a prolonged stay.

    Kozak, I should have asked specifically about this.  With the second figure, do you mean that 5-10% of hospitalized cases end up in the ICU, or 5-10% of total cases?

    • #20
  21. Jerry Giordano (Arizona Patrio… Member
    Jerry Giordano (Arizona Patrio…
    @ArizonaPatriot

    Kozak (View Comment):

    Stina (View Comment):

    Kozak (View Comment):
    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    It has always been socially acceptable until modern medicine has devised such incredible measures to make immortality a convincing illusion.

    Old people dying has been with us since Adam.

    Sure thing. Everybody dies. Some younger.

    So you’re good with the death panels right?

     

    Well, I’m not good with “death panels” because I think that socialized medicine is a bad thing.

    But of course, I’m OK with “death panels” if it means that someone needs to decide whether to pay for care.  Would you to a heart transplant for a 90-year-old man?  

    This type of argumentation doesn’t help.  If the figures that you cite are correct, we are facing a very severe problem, and there are no viable solutions.  Lockdowns and other extreme measures only push the problem a bit into the future, while causing extraordinary economic harm.

    I am more optimistic, because I do not think that the disease will spread at such an extraordinary rate.  I realize that I may be wrong about this.  But if I am wrong about it, I think that you are wrong, too, to believe that there is anything feasible that can prevent the problem.

    • #21
  22. TallCon Inactive
    TallCon
    @TallCon

    Kozak (View Comment):

    And I keep pointing out that it’s not just the elderly who are going to die, unless you consider people in their 50’s and 60’s elderly.

    I have to admit I’m feeling like it.

     

    • #22
  23. Caryn Thatcher
    Caryn
    @Caryn

    TallCon (View Comment):

    Kozak (View Comment):

    And I keep pointing out that it’s not just the elderly who are going to die, unless you consider people in their 50’s and 60’s elderly.

    I have to admit I’m feeling like it.

     

    Get out of my yard, whippersnapper!  And my neighbor’s yard, too!!

    • #23
  24. MichaelKennedy Inactive
    MichaelKennedy
    @MichaelKennedy

    Stina (View Comment):

    Kozak (View Comment):

    1% of people who get the flu end up in the hospital. 0.1% of people who get the flu die from it.

    The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    How much of that is demographic social behavior?

    Over protective mama bears shielding babies through social isolation practices common in that age bracket (schools and day cares are very touchy about fevers and illness) vs globe trotting old people? I worked around these people for a decade. They are one of the most entitled groups of people I have ever met… except 2-year olds who are still figuring out that there’s a difference between “need” that is always met and “want” that isn’t.

    My very cynical side says the reaction to this is so high because the privileged in this country are old and this virus hits them really hard.

    And I have a limited sense of compassion for them because everyone dies eventually and the idea is it’s best when you are OLD. So old people dying, from illness or failed ticker in their sleep, seems like a perfectly natural occurrence in a world without immortality.

    I will be surprised, after all the testing and  consequences have occurred, if the ultimate mortality rate for the young (under 50) and healthy is greater than 0.1%, about the same as the flu.

    https://www.cebm.net/global-covid-19-case-fatality-rates/?fbclid=IwAR3cXplpY-

    IH2lnykUSvpfoJL1S7rbCxRSrREOec0s6fnH5aOMWEl6itLQ8

     

    • #24
  25. MichaelKennedy Inactive
    MichaelKennedy
    @MichaelKennedy

    Kozak (View Comment):

    Stina (View Comment):

    Kozak (View Comment):
    I find it hysterical that suddenly, old people dying in large numbers is socially acceptable.

    It has always been socially acceptable until modern medicine has devised such incredible measures to make immortality a convincing illusion.

    Old people dying has been with us since Adam.

    Sure thing. Everybody dies. Some younger.

    So you’re good with the death panels right?

     

    The “death panels” are another thing altogether.  It was about denying all but compassionate (hospice) care to those over 75. The author was Ezekiel Emanuel, brother of Rahm and alleged “ethicist.”

    https://en.wikipedia.org/wiki/Ezekiel_Emanuel

    • #25
  26. MichaelKennedy Inactive
    MichaelKennedy
    @MichaelKennedy

    Jerry Giordano (Arizona Patrio… (View Comment):

    Kozak (View Comment):

    The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    5-10% end up in the ICU with a prolonged stay.

    Kozak, I should have asked specifically about this. With the second figure, do you mean that 5-10% of hospitalized cases end up in the ICU, or 5-10% of total cases?

    All of these projections ignore therapy, which is rapidly becoming practical.  Hydroxychloroquine has been around since WWII and it is widely used for Rheumatoid arthritis and Lupus. My wife, who has taken it for years, is probably protected in spite of her  High IGE Immunodeficiency.  Production of that drug should be ramped up rapidly as I expect it will be. Remdesivir is more investigational but is undergoing a trial now.  In the New England Journal case report, it resolved a case that was serious, pending respirator, in 24 hours.

    • #26
  27. Kozak Member
    Kozak
    @Kozak

    Misthiocracy ingeniously (View Comment):

    Kozak (View Comment):

    The vast majority of people who get the flu do not even need to see a doctor. Like 90%. Complete waste of their money…

    …The Covid infection hospitalizes about 10-15 % of those with confirmed infections.

    You do realize those are about the same numbers for both diseases, right?

    Uh No.

    Influenza 2017-18

    45million symptomatic cases.

    21 million doctor visits = 46%

    810,000 hospitalizations = 1.8%

    61000 deaths = 0.13%

    Disease Burden of Influenza CDC

    • #27
  28. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    Kozak (View Comment):
    Both the death panels and the ” can’t close down the economy” argument are based on the notion that the elderly are expendable because, well old.

    I believe the latter argument is based on the idea that a strong economy is necessary to save lives in the future.

    • #28
  29. E. Kent Golding Moderator
    E. Kent Golding
    @EKentGolding

    Stad (View Comment):

    The cynic in me thinks governments at all levels are flexing their muscles to see how much control we will accept when an emergency is declared.

    No offense,  but why do you think you are a cynic rather than an astute observer?

    • #29
  30. E. Kent Golding Moderator
    E. Kent Golding
    @EKentGolding

    Saint Augustine (View Comment):

    Kozak (View Comment):
    Both the death panels and the ” can’t close down the economy” argument are based on the notion that the elderly are expendable because, well old.

    I believe the latter argument is based on the idea that a strong economy is necessary to save lives in the future.

    Shutting down the economy is going to kill more people than coronavirus.    Gotta wonder — did all the people panicking about coronavirus get vaccinated for the flu ?    I get a flu shot every year because I don’t want to die unnecessarily early,  but I accept I will die sometime.

    Remember when  “Live Free or Die” was an American slogan?    Now we are giving up our freedom as quickly as we can in a vain hope to live forever.

    • #30
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