No, the flu is not more deadly than COVID

An Australian protester claims that COVID has always had a greater survival rate than influenza.

The claim is false. Experts told AAP FactCheck that the opposite is true: so far, COVID has always had a higher mortality rate than the flu.

The claim was made in a Facebook video by a man at a protest for “Australian neutrality with Russia”. In the video, a man being interviewed says: “COVID always had a survival rate greater than influenza. It is a less dangerous virus than influenza” (video mark 2min 30sec).

David Muscatello, associate professor in infectious diseases epidemiology at the UNSW Sydney, told AAP FactCheck via email: “COVID has never had a survival rate greater than flu. COVID has already killed more Australians in the first half of this year than a severe influenza season.”

There were 6651 COVID deaths in Australia from January 2022 to July 2022, but only 252 flu deaths. For the entire year of 2017, a particularly severe flu season, there were 1255 deaths due to influenza.

Prof Muscatello also pointed to the latest excess deaths figures published by the Australian Bureau of Statistics (ABS), showing that, within only the first half of this year, there were more than 13,000 excess deaths in Australia.

By contrast, “the most recent pre-pandemic year in which we saw many excess deaths for Australia was 2017, with an estimated 6,400 additional deaths for the whole year,” Prof Muscatello said, drawing upon his recent study. “In 2019, the estimate was 5,200. These were severe influenza seasons.”

Allen Cheng, professor of infectious diseases epidemiology at Monash University and director of the Infection Prevention and Healthcare Epidemiology unit at Alfred Health, also said the claim was false.

“The short answer is that COVID has always had a higher mortality than influenza, except in very young children,” he told AAP FactCheck in an email.

Prof Cheng said there had been considerable excess mortality in 2022 associated with COVID, with the virus causing at least five times as many deaths in the first half of the year as deaths attributed to the flu in 2017, “even with widespread vaccination and Omicron.”

He added: “So, even when we compare 2017 flu deaths (considered to be a particularly bad flu year) with 2022 post-vaccine and post-Omicron COVID deaths, the COVID mortality is higher in Australia.”

Prof Cheng noted many government health departments have been reporting excess mortality, which can account for deaths that may be indirectly related to the pandemic. The figures suggest that COVID mortality is “much larger than anything we have experienced before, with the exception of the 1918 influenza pandemic”.

He said mortality rates can be one of several measures, including infection-fatality rate (proportion of deaths among all infected individuals) and case-fatality rate (proportion of deaths among all confirmed cases).

These are two distinct measures but they are sometimes conflated, leading to confusion about how COVID mortality compares with influenza mortality.

“Historically, only a minority of patients with influenza were diagnosed, so the case-fatality ratio… far overestimates the true infection-fatality ratio,” Prof Cheng said.

“For COVID, many more people with infection are tested, so the case fatality is closer (but still an overestimate) to the infection fatality ratio.”

There is a risk of overestimating the true influenza IFR by only using the CFR. However, an article in The Conversation suggests the COVID CFR has still been greater than the influenza CFR in Australia since the beginning of the pandemic.

Evidence also suggests that COVID has consistently had higher mortality rates than influenza globally.

In a 2019 press release, the World Health Organization (WHO) estimated there are one billion influenza cases and 290,000 to 650,000 influenza deaths per year. By contrast, there have been at least 630,000,000 COVID cases and more than 6,580,000 COVID deaths at the time of writing – a higher proportion of deaths-to-cases than the WHO’s annual estimate for the flu, according to the Johns Hopkins Center for Systems Science and Engineering.

According to Health Feedback, which debunked a similar claim in 2021, the majority of studies found the COVID IFR was higher than that of the flu.

A December 2020 study about age-specific COVID fatality rates concluded that, while influenza mortality is usually below 0.1 per cent, the COVID IFR at the time was 0.4 per cent at age 55, 1.4 per cent at age 65, 4.6 per cent at age 75 and 15 per cent at age 85. For young adults and children, the IFR was generally below 0.01 per cent.

In the UK, the Office for National Statistics said that “annually, deaths due to COVID have been higher than those due to flu and pneumonia in any year since 1929”.

Over the course of the pandemic, a wide range of false claims about COVID and the flu have been debunked (see here, here, here, here, and here).

AAP FactCheck has also debunked claims that COVID is only slightly worse than the flu, that COVID is the flu “rebranded” and that COVID has a 99.996 per cent survival rate.

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