How many times have you heard someone say "The flu kills people too."  As a reason for criticizing the reaction to COVID19?  Comparisons between COVID19 and the flu are often drawn; even we discussed the new virus in the context of the flu when it first started to break.  But it quickly became apparent that that was not appropriate.  
As we moved through the year gaining more data and a greater perspective it's become even clearer that the two diseases cannot be likened. 
That's the topic of this week's healthcare triage.
*intro music*
Before we get started; I'm Tiffany.  I usually work behind the scenes where I do scripts, and I've cohosted some of the Q and A videos.  But today I'm filling in as a host for Aron and I'm excited to hang out with you guys. 
So let's begin with the similarities between the flu and COVID19.  Both of these are contagious respiratory illnesses that share several common symptoms.  These symptoms include but are not limited to fever, cough, difficulty breathing, fatigue, and body aches.  Both illnesses can result in complications such as pneumonia, respiratory failure, and sepsis.  Both diseases can range form mild to severe, and both can be fatal.
And now for the differences. We'll start with some of the easy ones.  Each illness is caused by a different virus; COVID19 is caused by the virus SARS-CoV-2 whereas the flu is mainly caused by Influenza A and B viruses.  In terms of symptoms, loss of taste and/or smell is common to COVID19 but not to the flu.  How long the symptoms show up after a person is infected; AKA the Incubation Period also differs between the two.  Flu symptoms generally appear one to four days after infection, whereas that time frame extends from two to fourteen days following infection with COVID19.  It's also possible that COVID19 is contagious for a longer period than the flu, but data on this is still forthcoming.  
Both diseases represent more risk for certain groups of people, like the elderly or those with certain underlying medical conditions, but they appear to affect the young differently.  Young children are at higher risk for severe complications from the flu; though school age children with COVID are at higher risk of a rare complication called Multi System Inflamitory Syndrome in children.
And obviously, there are differences right now in treatment that will hopefully level out as time goes on.  There are of course, approved antiviral drugs and a vaccine for the flu; whereas right now we've got a few potential treatments and vaccines in the pipeline for COVID19 but nothing solid just yet.
The differences that matter the most about COVID19, at least in terms of public heath, are; one, how contagious it is, and two, how much higher its case fatality ratio is.  Meaning the proportion of infected people who end up dying.
The R not for the flu is somewhere around 1.3 whereas the data so far indicate that the R not for COVID is likely somewhere between two and three.  So that means that someone infected with the flu will go on to infect an average of 1.3 people; whereas someone with COVID may go on to infect an average of two to three people.  And that means it can spread a lot faster!
And then there's fatality.  Yes, people die from the flu every year, but, take a look at these numbers.
In the last ten years, the number of estimated deaths during the worst flu season in the US was just over 61,000.  Since the new coronavirus came to the United States, we've seen over 230,000 deaths.  It took the last six flu seasons to kill almost as many people in the US as the new coronavirus has killed since it arrived here.  And this is with everything we're doing!  Masking, socially distancing, isolating, and quarantining.  Do we actually need to say anything to reinforce that difference?
This, of course, does not mean that the flu isn't something to worry about.  In fact Aron is known for complaining about people not taking the flu seriously enough.  It can cause a lot of serious complications; some of them long term.  You should really take advantage of the flu vaccine.  
But, this leads me to another issue with comparing these two illnesses.  At least the flu is the devil we know.  We have a vaccine, we have some natural immunity, we have some approved treatments, and we have a handle on it's pattern, so we can prepare for it every year.  
We're working toward all that with COVID but we don't have it yet.  And we certainly didn't have any of it when the virus hit.  All of this means that if we had gone on with things as normal when COVID hit, or if we try to go on with things as normal even now the outcome would not be life as normal with the flu.  
Because it is not the flu.
Hey!  Did you enjoy this episode; you might enjoy this previous episode about vitamin D and COVID19.  And of course we'd love it if you liked and subscribed down below.  And maybe even head over to patreon.com/healthcaretriage where you can help support the show during this global pandemic.  We'd especially like to thank our research associates James Glasgow,  Joe Sevits, Josh Gister and Michael Chinn.  And of course our Surgeon Admiral Sam