Covid-19 overtakes 1918 Spanish flu as deadliest disease in American history | Hacker News Reader

Covid-19 overtakes 1918 Spanish flu as deadliest disease in American history

statnews.com

25 pointsPyramus67 comments

> The Spanish flu was previously the disease event that caused the biggest loss of life in the United States; the Centers for Disease Control and Prevention estimate that 675,000 Americans died during the 1918 pandemic, in waves of illness that stretched out over roughly two years in this country.

> According to STAT’s Covid-19 Tracker, Covid deaths stand at more than 675,400.

Why are we comparing raw numbers? If one disease killed 4 people in a population of 5, and another disease killed 20 people in a population of a billion, I wouldn't say the second disease is "more deadly." Not to mention life expectancy went from under 40 to above 70 in the last century, so we have way more elderly people around.

Because otherwise a car crash in a small town would be equivalent to a major terror attack in NYC, or Jack the ripper could be considered a minor offender compared to a modern day involuntary manslaughter. There is a time and place for normalized statistics, but for some situations, loss of life is something that matters.

Edit: I got the arrow of time mixed up in the jack the ripper example, but you get the idea.

No one is saying loss of life doesn't matter, but if we're wanting to figure out "which disease is deadliest," the result should help you in your answer to the question "if you had to get one of these 2 diseases, which would you rather?" Factoring in population and age is absolutely important to knowing how deadly a disease is.

There's other factors too that may bump in favor of the 1918 flu being less deadly, like the improvements with modern medicine. But JUST comparing 2 numbers is not a valuable metric on its own.

I don't know if "if you had to get one of these 2 diseases, which would you rather?" is really a meaningful question across centuries. The main treatment for Spanish flu was aspirin (!), and many previously very deadly diseases are now trivially treatable with antibiotics. The question I was thinking about is more along the lines of "how terrible an event in world history is this", and I think there it is absolutely fair to look at absolute numbers, and absolutely expected that more terrible events will happen as population increases.

>Because otherwise a car crash in a small town would be equivalent to a major terror attack in NYC

You can probably adjust for this using some sort of statistical significance test. However, without actually doing the test I'll go on a limb and say that the world's population wasn't small enough in 1918 that this phenomena (ie. n being too small) would skew the results.

World population in 1920 was presumably somewhere between 1.6bn and 2bn: https://www.worldometers.info/world-population/world-populat... so 4-5x smaller than now.

Right, but that's not small enough to make a difference. To go to the extreme, if your population size was 100, and some guy died of the flu, that's a 1% death rate! That doesn't actually mean the death rate of the flu is actually 1%, because you don't know whether that guy just happened to die because your group was unlucky, or that the death rate is 1%. As your population size gets bigger this becomes less of a problem. For instance, if your population was 1,000,000 and 10,000 died of the flu you can be fairly certain the death rate is actually 1%. With that in mind, you can intuit that the difference between between 1.6bn and 2bn (1920) and 7 billion (today) is negligible, although feel free to quantify this with actual calculations.

Ah if it’s just about significance (I thought you were arguing about rate of death being negligibly different) then agreed, little difference. In this kind of scenario, errors decrease like 1/sqrt(sample size) so quadrupling the sample size leads to halving the error (which was tiny to start off with).

If 1 out of 20 die of flu, the frequentist 1 sigma error is roughly 5% too, so same order of magnitude as the probability estimate. Different story with a hierarchical Bayesian model etc.

Or to put it another way, there is no such thing as a fraction of a human life.

An illustration of lies, damn lies, and statistics?

>Why are we comparing raw numbers?

For the clicks and eyeballs. Bigger numbers make better headlines. This is journalism 101.

So much noise, so little signal.

yeah this sounds like "top grossing movie" phenomenon. Since the movie market is always growing and there's inflation, a top grossing movie today doesn't necessarily mean it's more successful/popular. eg. if you consider avatar (2009) which grossed $2.8B and titanic (1997) which only grossed $2.2B, titanic is actually the top grossing one once you account for inflation.

> Not to mention life expectancy went from under 40 to above 70 in the last century, so we have way more elderly people around.

Yes but we also have vastly superior medical knowledge and technology and resources to draw on...but despite that it has still killed 675,400 people in the US alone.

Don't forget to account for the fact they didn't have vaccines during the 1918 pandemic.

You’re arguing that as population increases, individual lives become less important?

No, he's arguing that if you randomly shoot a gun a few times into a room, you'll probably hit more people if it has 100 people inside rather than 5. And that the gun didn't become more deadly just because the number of targets increased.

That's fair.

> Why are we comparing raw numbers?

Because it’s one of many ways to look at this disease, and any reasonably intelligent person will understand that this one comparison doesn’t tell you the whole story, but it does tell a story. The story goes into explaining this more, and also why we might not want to compare this to the 1918 pandemic itself.

I mean, the article addresses pretty much everything you mention in your comment, so I’m not sure why you bothered posting.

No mention in the article of comorbidities. This is happening likely in part because we were the fattest and sickest Americans in history even before COVID-19.

I am surprised you haven't been downvoted. People don't want to hear that they are sick and that they are in part responsible.

Really, it's astonishing how sick Americans are on average and how it isn't getting better. Now we are telling people that it is cool to be obese, that medical treatment is preferable over nutrition and life choices, that being around other people is dangerous, that binge watching is preferable to real life, and that it doesn't matter anyway because diabetes will be cured by science "just around the corner TM".

But humans can become accustomed to anything. Being overnurished and lacking nutrition is now the norm and people either don't realize it or don't care.

1) population in USA: 1918 103m vs 2020 331m

2) Spanish flu death distribution by age was totally different (mainly "young" people were dying) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734171/

So if we considere the "years lost" (life expency minus age of death multiplied by the number of cases), the spanish flue was way more impacting.

Ok, now do it by age group:

"Likewise, the mean age of the people who died in 1918 was 28, whereas with Covid, deaths are occurring mainly in the elderly, said Viboud, who works at the National Institutes of Health’s Fogerty International Center. In terms of cumulative years of life lost, the Spanish flu’s impact thus remains greater."

Does it not count when old people die?

It counts, just not as much. Go look up “quality adjusted life year”.

It depends what you're measuring. Do people live forever, perfectly healthy by default?

Not saying it shouldn't be counted but it may not end up weighing the same in policy decisions. Would you take 1000000 life years from one age group and give it to an older one? Seems wrong doesn't it? Quality of life matters and it should be balanced against the obligations to our elderly not totally subjugated.

It totally counts, but the goal posts are much easier to move when you organize things in a very specific way.

When they’re using a non diagnostic test to categorize them, yes. It doesn’t count.

It's terrifying to think what Spanish flu would do in today's world. Back then it wrecked the planet in times when almost nobody could joy-travel anywhere they wished on a whim and the world was made up of only 2 billion people.

Today, +6 billion people more and anyone can book a 30 Euro flight to snap a selfie in a different country.

You need per capita not total. The population is much larger today. This is pure clickbait.

https://www.aier.org/article/are-covid-fatalities-comparable...

Deadliest if you ignore the fact the US population 3 times bigger.

But it made you click! And that’s what’s important at the end of the day.

wow, nobody thought of that, you are a genius and a scholar, perceiving so many variables simultaneously!

(the article mentions this)

But you clicked! And that’s what’s important.

That's great, now do per capita, the population has, what, tripled since then?

>U.S. deaths make up roughly 14% of the nearly 4.7 million fatalities that have been reported worldwide in this pandemic to date, even though the country’s population comprises only about 4.2% of the global population.

Might this have something to do with testing? And are other countries using irresponsibly high PCR cycle thresholds for detection? While we're on the subject, why has the CDC recommended a lower Ct for vaccinated patients? Doesn't that just guarantee that a vaccinated patient is less likely to test positive, regardless of the efficacy of the vaccine?

>The heavy toll the pandemic has taken in the U.S. is due to the country’s inadequate response early on

Making sure to blame the previous administration, very nice. Meanwhile our numbers were comparable to many (most?) other first world countries, per capita. And this doesn't say anything about the role of testing and case reporting postmortem.

>Comparing events that happened more than a century apart has its perils. For instance, the population of the United States in 1918 was a third of what it is now. Didn't stop you from writing an irresponsibly sensationalized article, did it?

>But modern medicine is far more advanced than what was available in 1918. Now people whose lungs are under attack from Covid can be put on ventilators

I think its an open secret that the aggressive ventilator use early on in the pandemic killed more people than should have been saved.

Im getting really tired journalists opining on the pandemic, totally ignorant of the laundry list of assumptions regarding infectivity, lethality, testing sensitivity/accuracy. Two years in and its still nonstop fear porn. Meanwhile the survival rate is 99.99+, even higher if you're under 50 and not obese.

But hey, don't forget to take your third "safe and effective" booster! Even though the CDC just admitted on live television that the so called vaccine does not prevent infection or spread, consistent with multiple preprints which showed similar viral load between vaccinated and unvaccinated. But somehow we are still justified in mandates and passports...

Nothing about this pandemic makes sense anymore.

I'm mildly annoyed by journalists calling "Spanish Flu" where the 1918 Flu Pandemic had no relationship with Spain. The author could have titled the piece as "Covid-19 overtakes 1918 flu pandemic as deadliest disease in American history" and later, inside the article include some kind of note about that in that time, it was called (mistakenly) "Spanish flu".

I'm not advocating for "cancel culture" or auto-censorship but it is tiring to have to remind some users that the source of the disease was not Spain.

The way we name these things was in fact recently changed for precisely this reason. I forget where I read this, but yes, this is why it’s COVID 19 and not any of the other bad names that people tried to give it. Unfortunately, names for things in the past are harder to change, because people know it as the Spanish Flu, so even if you said the 1918 flu pandemic, you’d still have to clarify which one at this point in time.

Like the Cleveland Indians (founded in 1894)? If your thesis is true, why are they changing their name?

Effective communication is a negotiation between speaker and listener. You are welcome to refer to the 1918 flu epidemic by any name you wish. In doing so, you will be causing confusion in some number of your listeners who do not recognize that name in the way they would the more traditional "Spanish Flu."

That might be worth it to you, and over a long enough period of time, perhaps your preferred name will be more widely known, but make no mistake: it's not what most people know today.

And to your point, I already can't remember the new name of the Cleveland team. I think it started with a V?

You have to start somewhere. If a name is not a good name, society should be pushing for a change of that name. It doesn't matter if it's because racism (Cleveland Indians case) or bad taste (Spanish Flu).

You might have a good point but changing it now would just be confusing. Historically it has been called the Spanish Flu and I assume everything referencing it during that time uses the word Spanish. I think a mention of how it wasn't actually from Spain is plenty good, there's no reason to alter the name. I think it's good that everyone knows it was historically called the Spanish Flu.

In the same way that Native-Americans are not called redskins anymore, I'd expect more empathy towards Spaniards.

Are you suggesting the word Spanish is a slur? Would you like the word Redskins wiped from all history? Can I flag your comment for removal then?

Stuff like this is such a waste of time for everyone. Do you really think any significant amount of people are holding prejudice towards Spaniards because they attached a disease to their name over a century ago? I mean really, you must have better things to worry about.

I'm suggesting that calling a disease with the name of a nationality is as bad as a slur. The same can be said by calling Syphilis "the French disease".

You can flag my comment if you want, I simply don't care.

I have many things to do. However, I think that naming things in a better way is important. Calling a disease by a nationality is disgraceful.

>You can flag my comment if you want, I simply don't care.

You care enough to want the term Spanish Flu removed but you don't care about throwing the word Redskins around? At least keep the logic of your stances straight. Otherwise, people might assume you're just trying to appear progressive for social credit and you don't really care about the empathy you're claiming too.

Empathy is overrated anyway. I kinda don't care how you feel and I'm not going to base my beliefs on whether it upsets someone.

> You care enough to want the term Spanish Flu removed but you don't care about throwing the word Redskins around? At least keep the logic of your stances straight. Otherwise, people might assume you're just trying to appear progressive for social credit and you don't really care about the empathy you're claiming too.

I'm not "throwing the term Redskins" I'm making a comparison between the way of thinking of American society.

I care for empathy with all humans.

> Empathy is overrated anyway.

Only if you live in and island.

> I kinda don't care how you feel and I'm not going to base my beliefs on whether it upsets someone.

If you speak whatever you want and upsets some people, don't blame "society" or "liberals" if you are snubbed, don't get a better job, etc.

Or just stop bleeding modern society to death with endless identity politics.

I'm not sure how being more precise when calling a disease is related to "identity politics".

I'm asking for being more rigorous when naming things, not second-hand guessing like this article.

That is what is is known by. If they wrote 1918 flu pandemic more readers would be confused.

How many pandemics did happen in 1918?

It does have a relationship with Spain - because Spain was the 1st country to widely report it.

Other countries were too busy fighting over trenches in France.

No, Spain was the only country that did not censor the press. The virus did not have origin in Spanish territory. USA, Germany, Austria-Hungary, France and UK all had a strong grip on the news.

.. Yes, what I said. Spain where the only ones to report on it.

Well, hard to tell for sure, once it has been announced by the CDC that at the end of this year the PCR tests used are not a valid source anymore for Covid-19 diagnosing [1], because among other problems, those tests are not able to provide a solid identification and differentiation between Covid and other diseases, as the suddenly disappeared flu disease.

[1] https://www.cdc.gov/csels/dls/locs/2021/07-21-2021-lab-alert...

https://www.cdc.gov/csels/dls/locs/2021/08-02-2021-lab-alert...

From the link:

Is CDC retiring the CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel because it has produced inaccurate results?

No. There are no performance concerns with this test. The CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel is a highly accurate test. It has been used to successfully detect SARS-CoV-2 since February 2020.

. . .

Does the CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel confuse influenza with SARS-CoV-2?

No. The CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel does not confuse influenza with SARS-CoV-2. It is a highly accurate test that detects the presence or absence of SARS-CoV-2 viral genetic material within a patient specimen.

You see there's a logical contradiction between the two different posts right?

The first post, the lab alert from 7/21/21, withdraws the request for Emergency Use Authorization for the PCR test. The second clarification post explains why, in that the "CDC began distributing the CDC 2019 Novel Coronavirus (2019-nCOV) Real-Time RT-PCR Diagnostic Panel to fill a gap. The wide availability of other SARS-CoV-2 diagnostic tests means that the CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel is no longer filling an unmet need."

From the first post:

"In preparation for this change, CDC recommends clinical laboratories and testing sites that have been using the CDC 2019-nCoV RT-PCR assay select and begin their transition to another FDA-authorized COVID-19 test. CDC encourages laboratories to consider adoption of a multiplexed method that can facilitate detection and differentiation of SARS-CoV-2 and influenza viruses."

TL;DR

"Move on from the current PCR test. We encourage laboratories to consider adoption of a method that can facilitate detection and differentiation between SARS-Cov-2 and influenza viruses".

It's so clear that at this point I won't add anything more to conversation.

I am discontinuing the ingestion of Cherry Vanilla Coke Zero. I will need to begin my transition to another calorie-free carbonated beverage. I have been encouraged to consider adoption of a calorie-free carbonated beverage that quenches my thirst.

Am I saying that Cherry Vanilla Coke Zero does not quench my thirst? Because it does. No, the statements above only suggest that when evaluating replacements for Cherry Vanilla Coke Zero, I should choose a replacement that meets all of the same requirements.

You are clearly not the only person confused by the language, which is why they published a clarification. I will leave it as an exercise for the reader to determine whether such confusion is natural or should have been anticipated.

As the CDC points out in the clarification, the PCR test only detects SARS-CoV-2, not influenza:

"The CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel does not confuse influenza with SARS-CoV-2."

Suggesting that labs use testing methods that can differentiate between SARS-CoV-2 and influenza viruses does not equate to PCR tests not being able to differentiate between the two.

Please explain where on your page it states that the Sars test detects flu at all.

> Comparing events that happened more than a century apart has its perils. For instance, the population of the United States in 1918 was a third of what it is now. So as a percentage of the national population, the Spanish flu deaths still has the lead on Covid-19.

Everything else is done in "Deaths per 100k" isn't it? AFAIK per that metric COVID still runs behind abortions.

Suppose I go to the hospital with a stubbed toe. They test me with PCR and the test detects fragments of dead inactive virus from a month ago when my immune system defeated it. I therefore test "positive" for COVID. They give me the vaccine, which promptly kills me from a combination of stroke, heart attack, and multiple organ failure. This would be recorded as a COVID death, and I would be considered "unvaccinated". Cheating like this is a big part of why the COVID death toll is as high as it is. It's fiction.

Adverse reactions to viral vaccines are coded differently compared to COVID being an underlying cause: https://www.codingclinicadvisor.com/sites/default/files/Freq...

It's recommended that people wait a few weeks after recovering before getting the COVID vaccine, so they probably wouldn't offer it to you immediately in the hospital if you tested positive: https://www.who.int/emergencies/diseases/novel-coronavirus-2...

That's quite the claim to make. I'd love to see the verified examples you have to back it up as well as statistics on how often that happens so we can adjust the reported values to get the true number of deaths.

But I'm not going to hold my breath on you being able to actually support your statement.

What’d he claim that’s wrong?

CDC regards as unvaccinated until 2 weeks post treatment. So any acute vaccine reaction is regarded as an unvaccinated hospitalization.

> That's quite the claim to make.

Is it? What do you imagine would prevent it from happening just like I suggested? Can PCR tell the difference between live virus that's causing illness and dead virus fragments? Do the mRNA vaccines cause spike proteins to protrude out from the normally smooth walls of blood vessels, causing clotting as confirmed by D-dimer tests? Does it take 14 days for a person to be considered vaccinated after getting the jab?

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