Relative disease burdens of COVID-19 and seasonal influenza in New York City, February 1 - April 18, 2020

  1. Jeremy Samuel Faust
  2. Carlos del Rio

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Comparisons between the mortality burdens of COVID-19 and seasonal influenza often fail to account for the fact that the United States Centers for Disease Control and Prevention (CDC) reports annual influenza mortality estimates which are calculated based upon a series of assumptions about the underreporting of flu deaths. COVID-19 deaths, in contrast, are being reported as raw counts. In this report, we compare COVID-19 death counts to seasonal influenza death counts in New York City during the interval from February 1 - April 18, 2020. Using this approach, COVID-19 appears to have caused 21.4 times the number of deaths as seasonal influenza during the same period. We also assessed excess mortality in order to verify this finding. New York City has had approximately 13,032 excess all-cause mortality deaths during this time period. We assume that most of these deaths are COVID-19 related. We therefore calculated the ratio of excess deaths (i.e. assumed COVID-19 deaths) to seasonal influenza deaths during the same time interval and found a similar ratio of 21.1 COVID-19 to seasonal influenza deaths. Our findings are consistent with conditions on the ground today. Comparing COVID-19 deaths with CDC estimates of yearly influenza-related deaths would suggest that, this year, seasonal influenza has killed approximately the same number of Americans as COVID-19 has. This does not comport with the realities of the pandemic we see today.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.04.22.20073551: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has several limitations. First, while counted deaths are likely to be more accurate than estimated deaths, both influenza and COVID-19 deaths may either be under or overreported. In the case of COVID-19 deaths, it remains unclear who died from SARS-CoV-2 infection and who died with the infection. However, the same forces can be applied to influenza counted deaths. Second, while far lower than calculated estimates, influenza counted deaths may yet still be overestimations, as ICD codes used (J09-J11) actually permit and do not exclude COVID-19 and pneumonia (caused by other pathogens) from appearing on death certificates in which influenza was determined to be the cause of death [3]. Third, while the 13,032 excess deaths in New York City since February 1st may reasonably be attributed to COVID-19, this supposition cannot at present be explicitly proven. Equally, however, it may be that the number of COVID-related deaths is in fact greater than the number of excess deaths, as deaths from other causes, such as trauma and even heart attacks, appears to have decreased during the shelter-in-place period of the pandemic [6]. Fourth, the lower ratio of counted COVID-19 to influenza deaths calculated using CDC numbers (in lieu of NYDOH figures) likely reflects lags in COVID-19 related deaths, delays which the agency acknowledges openly. Such lags are less likely to affect influenza deaths, as the peak of the season appears to have occurred in February. Finally, influenza de...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.04.22.20073551v1 on medRxiv