Covid-19 Is Nothing Like the Spanish Flu | Hacker News Reader

Covid-19 Is Nothing Like the Spanish Flu

wired.com

15 points40four5 comments

This is a really good article. Here’s the money quote, the rest of the article explains how the author investigated the problem and their best guess as to what the numbers really were.

> Both newspapers and scientific journals frequently state three facts about the Spanish flu: It infected 500 million people (nearly one-third of the world population at the time); it killed between 50 and 100 million people; and it had a case fatality rate of 2.5 percent. This is not mathematically possible. ... If the Spanish flu infected 500 million and killed 50 to 100 million, the global CFR was 10 to 20 percent. If the fatality rate was in fact 2.5 percent, and if 500 million were infected, then the death toll was 12.5 million. There were 1.8 billion people in 1918. To make 50 million deaths compatible with a 2.5 percent CFR would require at least two billion infections—more than the number of people that existed at the time.

This sounds more like confusion about definitions than anything else. If someone was an excess death attributed to the Spanish flu, they might not necessarily have ever been a "case", depending on how you define "case". For example, do you have to have been diagnosed by a doctor to be a case? etc.

Beyond that, simplistic summaries like COVID-19 is/is not like the flu seem silly and confusing. Better to just enumerate the ways that it is and isn't, and especially those ways that aren't even really known yet.

A problem that's doubly compounded by notion that the 1918 pandemic was "the flu". The 1918 H1N1 virus, like SARS-CoV-2, was a novel virus. No one had immunity. So yeah, it was "the flu", but it was flu that everyone got all at once.

It's wasn't remotely like "the flu" that we get shots for every year. That's one of a big family of endemic viruses[1] to which we all have some immunity by virtue of having had a relative at some point in the past. A bad flu season might have a strain that infects 2-5% of the population, not the 30+% we see with pandemics.

[1] Including remote descendants of the 1918 virus which still circulate!

I came to the same conclusion 2 days ago:

https://old.reddit.com/r/Wuhan_Flu/comments/fgrlwq/wikipedia...

As someone else here said. They confuse certain terminology even on Wikipedia.

I liked this article because it is a very measured and reasonable analysis, which has been very hard to come by in the last few weeks. The author goes into great detail about why/ how the numbers about the 1918 'Spanish' flu have been misconstrued, and therefore, why the 'CFR' numbers being parroted by everyone should not be trusted either.

The closing paragraph encapsulates the point nicely.

Numbers and charts convey a reassuring sense of certainty. But in the midst of an evolving crisis, that certainty is too often an illusion. A single, imprecise statistic generated more than a decade ago can suddenly proliferate, inciting panic and senseless hoarding that diverts resources from those who need them most. When experts and journalists uncritically pluck numbers from careless studies and clutch at fluctuating figures, hastily offering them up as beacons, they may do more to confuse than illuminate.

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