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Why COVID isn’t like the flu (yet) in one brutal graph

Chart shows weekly COVID-19 deaths compared with deaths from the flu

Since COVID first hit the U.S., some have argued that the nascent disease is no more dangerous than the flu, which sweeps the U.S. every fall and winter.

“This is a flu. This is like a flu,” former President Donald Trump insisted at a Feb. 26, 2020, press briefing, just as the virus hit the U.S. “It’s a little like a regular flu that we have flu shots for.”

While the two can present with similar symptoms—like fever, cough, fatigue, sore throat, muscle aches, and headache—and are both more likely to be fatal for the elderly and immunocompromised, the comparison falls apart when it comes to the death toll. 

One graph in particular shows just how stark the mortality difference is between the two. Flu deaths appear almost flat compared to surges in COVID deaths over the past three years. 

“We’re now trying to treat [COVID] like a seasonal influenza and it’s just not yet,” Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), recently told Fortune.

There were 1,055 COVID deaths in the U.S. two weeks ago, according to data from the U.S. Centers for Disease Control and Prevention, compared to only 4 flu deaths the same week.

COVID deaths have spiked several times over the past few years due to new variants of the virus, taking hundreds of thousands of lives annually (463,210 last year). By contrast, the flu only took an estimated 22,000 lives during the 2019-2020 season, according to the CDC

Over the past 12 years, the flu’s estimated annual death toll has been as low as 12,000, but never higher than 61,000—just an eighth of COVID’s death toll in the first year of the pandemic.

Since the earliest days of the pandemic, weekly COVID deaths have been at least 15 times that of weekly flu deaths—and sometimes as much as 811 times.

Here for the long haul

COVID’s death toll is unlikely to sink to flu levels any time soon, experts say, even though U.S. health officials have expressed hope that COVID boosters will soon become an annual occurrence, much like the flu shot.

“I think COVID deaths will continue to exceed flu deaths for a while, unless we see something new in influenza,” like a deadlier strain developing, Dr. Stuart Ray, vice chair of medicine for data integrity and analytics at Johns Hopkins Department of Medicine, recently told Fortune.

When it comes to leading causes of death in the U.S., COVID has landed as No. 3 for the last two years, while influenza and pneumonia, grouped together, have landed as No. 9, according to the CDC. 

Dr. Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security, agrees with Ray. He says COVID is likely to remain a leading cause of death in the U.S. “for the next couple of years,” as the population builds more immunity and science develops more effective tools to fight the virus—as long as the virus doesn’t evade those tools.

Eventually, the CDC will likely collapse COVID deaths into the flu and pneumonia deaths category, Adalja predicts. But he still expects COVID to have an “outsized” death toll when compared to other infectious diseases in the U.S., like the flu, for the foreseeable future.

One thing is certain, according to Adalja: Whether COVID continues to be a top killer in the U.S. and globally, or whether its fatality rate eventually sinks to that of the present-day flu, COVID is here to stay.

To think that the new virus will be stamped out, and that life will revert to like it was in 2019, is “magical thinking,” he said. 

“Not in the history of the human species have we had a new infectious disease appear that just disappears,” he said. “As long as there are humans on this planet, there are going to be COVID-19 infections on this planet.”

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