Hard to Say Whether 1918 or COVID Pandemic is Worse

by Marco Cáceres
Published October 4, 2021 | Opinion
Hard to Say Whether 1918 or COVID Pandemic is Worse

There have been many articles published by the corporate media recently noting that the number of deaths in the United States surpassed 675,000 on Sept. 20, 2021. The figure is significant in that it represents the estimated number of people who died from the influenza in the country during the 1918 influenza pandemic—the most deadly disease outbreak in the U.S. until now perhaps.1 2 3 4 5 Based on data compiled by Johns Hopkins University, CNBC reported:

COVID-19 is officially the most deadly outbreak in recent American history, surpassing the estimated U.S. fatalities from the 1918 influenza pandemic.1

While this may be true in absolute terms, it is much less so relatively-speaking, given that the U.S. population in 1918 was approximately 103.2 million, compared to an estimated 333.4 million today.6 7 According to Professor Thomas Ewing, PhD of Virginia Tech University, the death rate for the 1918

pandemic was about six in every 1,000 people in the U.S., while the death rate from COVID has been about two in every 1,000 people.5

Also, John Barry, author of “The Great Influenza: The Story of the Deadliest Pandemic in History,” notes that the 1918 influenza pandemic was “much more intense, much more frightening, and the economic damage is light-years greater.”2

Still, overall, the comparison between the two historic pandemics seems reasonable. “This is the pandemic I will be studying and teaching to the next generation of doctors and public-health students,” medical historian Howard Markel, MD, PhD said.1 Some have speculated that, if anything, the COVID pandemic has been much worse in absolute terms, with Bloomberg citing one estimate of the number of U.S. deaths from the CDC as high as 830,443.2

The issue of the accuracy of the COVID death count in the U.S., however, may also apply in the opposite direction. The CDC has stated:

For over 5% of these [COVID] deaths, COVID-19 was the only cause mentioned on the death certificate. For deaths with conditions or causes in addition to COVID-19, on average, there were 4.0 additional conditions or causes per death.8

In other words, of the 675,000 COVID deaths surpassed on Sept. 20, only about 33,750 were attributable solely to COVID. The rest of deaths each had an average of four “conditions or causes” or “comorbidities” that may have been the actual cause of death. As of Sept. 12, for example, when the CDC estimated COVID deaths at 652,871, influenza and pneumonia were listed on the death certificate as “conditions contributing to deaths” a total of 306,957 times. Respiratory failure was a contributing condition 248,976 times… 8

    • Hypertensive diseases: 126,286 times
    • Diabetes: 102,952 times
    • Cardiac arrest: 79,034 times
    • Ischemic heart disease: 70,092 times
    • Adult respiratory distress syndrome: 68,936 times
    • Sepsis: 63,217 times
    • Chronic respiratory diseases: 57,255 times
    • Heart failure: 49,342 times
    • Cardiac arrhythmia: 48,117 times
    • Other diseases of the circulatory system: 42,990 times
    • Cerebrovascular diseases: 31,946 times
    • Malignant neoplasms: 31,449 times
    • Other diseases of the respiratory system: 28,596 times
    • Respiratory arrest: 13,722 times 8

So while COVID-19 was listed on the death certificates of the 675,000 cases surpassed on Sept. 20, is it accurate to say that COVID actually killed all those people? Or is it possible that the COVID death count in the U.S. may be inflated? It’s not an unreasonable question. It’s one that has been raised by many Americans during the past two years. “Is this death rate based on truth?”asked internal medicine specialist Annie Bukacek, MD of Hosanna Health Care in Kalispell, Montana. “Are the reported deaths from COVID-19 truly deaths from COVID-19?9 10

After all, dying with the SARS-CoV-2 virus that can lead to COVID symptoms is not the same as dying of the virus.

As Daniel Spitz, MD, chief medical examiner in Macomb County, Michigan said last year, “I think a lot of clinicians are putting [COVID-19] on death certificates when it might not be accurate because they died with coronavirus and not of coronavirus.”9

Minnesota state senator and family physician Scott Jensen, MD said in an interview that he had received a seven-page document from the Minnesota Department of Health “coaching” him on how to fill out death certificates. He said he felt he was being told that he didn’t have to have a “confirmed laboratory test for COVID-19 in order to make the death certificate be COVID-19.10

“The big controversy is: Do you die of COVID or with COVID?” said David Nace, MD, professor of geriatrics at the University of Pittsburgh School of Medicine.11

Suggesting there may be a problem with the math does not minimize the gravity of the pandemic. It simply highlights the difficulty in making a fair comparison between this pandemic and the one in 1918.

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