COVID-19 compared to the H1N1 Virus

There has been considerable discussion about comparing the current virus to the 1918 Influenza pandemic. There also has been a lot of misinformation. In 1918 the Spanish flu terminated the lives of an estimated 35 million folks. Despite the name, the H1N1 virus started in Kansas. At the time, no one knew how it was transmitted, and there were no NPIs (Non-Pharmaceutical Interventions) in place. Items like social distancing, closing establishments based on group settings, contact tracing, and other measures were not even considered. Our ability to provide testing and track the sources of the virus was extremely limited. About 35% of all people living at the time contracted the virus, and the mortality rate was estimated at 2%. If our current NPI, testing, and tracking procedures been in place at the time, there is no doubt that the number of cases would have been just a small fraction of what occurred.

We really do not know the actual mortality rate of COVID19. The reported rate in the U.S. is 6%, but that is not accurate. The best estimate based on countries that have done a better job on testing is that it is about 2% or about the same as the Spanish Flu. This is about twenty times the mortality rate of the common flu at .09% (a bit under one in a thousand will die from the flu.)

What is alarming is that, as of May 2020, the USA has 4.5% of the world’s population but almost 29% of the COVID19 related deaths. We can learn a lot from studying both the countries that are doing a better job as well as those few that are doing worse.