Much confusion has been seen in the UK media about the effects on mortality of flu and covid-19. Gareth Iacobucci separates fact from fiction in The BMJ.
Covid or flu which causes more death?
Data from the Office for National Statistics show that in England and Wales the number of deaths from influenza was 1598 in 2018 and 1223 in 2019.
Disagreements have emerged on social media because some commentators have quoted much higher figures for annual deaths from flu.
This is closer to covid death numbers, though still less, according to current trends.
Covid mortality data have also been the subject of debate.
But as The BMJ’s columnist David Oliver and the expert statistician David Spiegelhalter have pointed out, this approach has probably under-recognized the real number of deaths from covid-19, because of an initial absence of testing back in spring 2020, and because people who survived more than 28 days before dying from covid will not have been included.
Is covid more fatal?
Research published in The BMJ last December, which was based on an analysis of US Department of Veterans Affairs data on more than 3600 patients admitted to hospital with covid-19, found that, when compared with seasonal flu, covid was associated with an increased risk of extrapulmonary organ dysfunction, death, and increased health resource use, such as a fivefold higher risk of admission to intensive care and longer stays in the hospital.
The Centers for Disease Control and Prevention estimated that in the US there were 1.8 deaths from flu per 100,000 population between 1999 and 2019.
The estimated death rate from covid was 217.54 per 100,000 in the US and 206.73 per 100,000 in the UK.
The global figure for the covid-19 death rate is estimated at 279 per 100,000 population.
“This is a sixth of the life years lost to covid-19,” it noted.
Does getting flu with the covid terminal?
In Western Europe, the United Kingdom has the highest rate of covid.
It recorded 42,776 new cases on October 13th, far more than 1120 reported in France, 1277 in Spain, 1561 in Italy, and 4872 in Germany.
It is discussing lifting more restrictions, including infection control measures in general practices, and encouraging more employees to return to work.
As the country approaches winter, many medical professionals are concerned about the government’s posture.
Vaccine uptake rates in the UK
Last winter (2020-21) 80.9% of people aged over 65 in England had the flu vaccine, up from 72.4% the year before, which meant that for the first time since 2005-06 England met the 75% target set by the World Health Organization.
Uptake also rose among under 65s at risk (from 44.9% to 53%) and 2-3-year-old children (from 43.8% to 56.7%) but fell among pregnant women (from 43.7% to 43.6%).
This year, England’s flu program is aiming to reach the 85% uptake among over 65s and 75% among eligible under 65s, with the government emphasizing the importance of double protection against flu and covid while both viruses circulate.
In terms of covid vaccination, 85.6% of over 12s in the UK have had their first dose and 78.6% have had both doses.
Ninety percent of people aged 65 or older have had both doses.
But uptake is lower among younger adults.
Can both the vaccines be taken simultaneously?
Results from the ComFluCOV study have shown that administering a flu vaccine at the same time as the second dose of a covid-19 vaccine is safe.
Guidance from the UK Joint Committee on Vaccination and Immunisation says that the vaccines can be offered together “where operationally expedient” but advises that the covid-19 booster vaccine program “should not disrupt or delay deployment of the annual influenza vaccination program.”
It advises general practices to offer the covid and flu vaccines as soon as patients are eligible rather than delaying to wait for deliveries of either vaccine to administer both at the same time.
No evidence having both jabs in the same arm makes them any less effective, but many people having both together are choosing different arms to reduce soreness.
Current covid rates in the UK
The UK currently has the highest incidence of covid in western Europe.
On 13 October it recorded 42 776 new cases, much higher than 1120 in France, 1277 in Spain, 1561 in Italy, and 4872 in Germany.
It is talking about removing more restrictions, including infection control measures in general practices, and is continuing to encourage more people to return to their offices to work.
Many medical experts are concerned about the government’s stance as the country heads into winter.
In the Guardian, last week Christina Pagel, director of University College London’s Clinical Operational Research Unit, and Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, jointly wrote, “England, not for the first time, is the odd one out in Europe.”
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Source: The BMJ
