For decades, the U.S. Centers for Disease Control and Prevention has warned about the deadliness of seasonal influenza, but their estimates of annual flu deaths may have been heavy-handed.
In recent years, the promotion of annual influenza vaccination has also been strong, with officials suggesting it’s the best way to stay safe during flu season in the U.S. Much of the push for vaccination is based on the CDC’s estimates of flu illnesses and deaths, which now appear questionable.
“CDC uses the estimates of the burden of influenza in the population and the impact of influenza vaccination to inform policy and communications related to influenza,” the agency writes on their website.1
Their estimates are based on a mathematical model created from survey results, using surveillance data, outbreak field investigations and proportions of people seeking health care.2 According to the CDC’s estimates, “Seasonal flu is a serious disease that causes millions of illnesses, hundreds of thousands of hospitalizations, and tens of thousands of deaths every year in the United States.”3
Now that COVID-19 is in focus, however, and people are drawing comparisons between the number of COVID-19 deaths and the number of annual influenza deaths, researchers are turning to actual death counts, which has revealed that the CDC’s flu death estimates have been too high.
CDC Flu Death Estimates Nearly Six Times Too High
The CDC’s estimated burden of influenza deaths from 2010 through 2019 range from a low of 12,000 to a high of 61,000 per year.4 During the 2019 to 2020 flu season, the CDC’s preliminary burden of disease estimates put flu deaths at 24,000 to 62,000,5 with estimates that between 29,000 and 59,000 had already died from influenza by mid-March.6
Yet, an article published in JAMA Internal Medicine by Drs. Jeremy Faust of Harvard Medical School and Carlos del Rio of Emory University School of Medicine, tells a different story.7 They wrote:
“As of early May 2020, approximately 65,000 people in the U.S. had died of coronavirus disease 2019 (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This number appears to be similar to the estimated number of seasonal influenza deaths reported annually by the Centers for Disease Control and Prevention (CDC).
This apparent equivalence of deaths from COVID-19 and seasonal influenza does not match frontline clinical conditions, especially in some hot zones of the pandemic where ventilators have been in short supply and many hospitals have been stretched beyond their limits.
… Yet public officials continue to draw comparisons between seasonal influenza and SARS-CoV-2 mortality, often in an attempt to minimize the effects of the unfolding pandemic.”
Comparing COVID-19 deaths and flu deaths is not an accurate comparison, however, due to the fact that COVID-19 deaths are counted while flu deaths are estimated. According to the article, the CDC’s estimates of flu deaths between 2013-2014 and 2018-2019 ranged from 23,000 to 61,000. However, the counted flu deaths during that same period were between 3,448 and 15,620 yearly.
“On average, the CDC estimates of deaths attributed to influenza were nearly six times greater than its reported counted numbers,” the researchers stated.
CDC Estimates ‘Substantially Overstate’ Number of Flu Deaths
For instance, there were 15,455 COVID-19 deaths counted during the week ending April 21, 2020, and 14,478 such deaths the week before it. But during the peak influenza season week from the 2013-2014 to 2019-2020 flu seasons, counted flu deaths ranged from 351 to 1,626.8
“These statistics on counted deaths suggest that the number of COVID-19 deaths for the week ending April 21 was 9.5-fold to 44.1-fold greater than the peak week of counted influenza deaths during the past seven influenza seasons in the U.S., with a 20.5-fold mean increase,” the researchers wrote, adding:
“From our analysis, we infer that either the CDC’s annual estimates substantially overstate the actual number of deaths caused by influenza or that the current number of COVID-19 counted deaths substantially understates the actual number of deaths caused by SARS-CoV-2, or both.
… Directly comparing data for 2 different diseases when mortality statistics are obtained by different methods provides inaccurate information. Moreover, the repeated failure of government officials and others in society to consider these statistical distinctions threatens public health. Government officials may rely on such comparisons, thus misinterpreting the CDC’s data …”9
The researchers used this data to suggest that comparisons between COVID-19 and flu deaths are misleading and undermining officials’ ability to determine the true public health threat of the pandemic, but another question is, has the threat of the flu season been overstated?
How Many Are Really Dying From Flu?
Given the significant discrepancies between the CDC’s estimated flu deaths and the actual counts, and if there are as few as 3,448 to 15,620 flu deaths annually, have we been talked into flu vaccines all these years for no reason?
While it’s true that influenza is a highly infectious airborne disease that can be deadly, controversy exists over the use of annual influenza vaccines, commonly known as flu shots, for its prevention, and this becomes even more controversial if we’ve been misled about the actual number of deaths.
It’s already known that more than 80% of the respiratory infections that occur during flu season are not actually caused by type A or type B influenza but, rather, by influenza-like illness.10 A flu shot, therefore, will do nothing to prevent such illness.
Nonetheless, U.S. Surgeon General Dr. Jerome Adams has gone so far as to say that getting vaccinated against influenza is a "social responsibility," as it "protects others around you, including family, friends, co-workers and neighbors."11
But is that actually true? On the contrary, research published in 2018 found that repeated annual flu vaccinations may do little to protect your community, as people who receive the seasonal flu shot and then contract influenza excrete infectious influenza viruses through their breath, meaning vaccinated individuals can indeed spread influenza.12
Further, while influenza can indeed be deadly in rare cases, what most health experts fail to tell you is that these deaths are typically the result of secondary infections, such as pneumonia and sepsis, not the flu virus itself. And the flu vaccine is notoriously ineffective among certain groups, including high-risk seniors.
In fact, while turning 65 was associated with a significant increase in the rate of seasonal influenza vaccination, one study revealed “no evidence indicated that vaccination reduced hospitalizations or mortality among elderly persons.”13
In short, your chances of getting influenza after vaccination are still greater than 50/50 in any given year. According to CDC data, for example, the 2017-2018 seasonal influenza vaccine's effectiveness against "influenza A and influenza B virus infection associated with medically attended acute respiratory illness" was just 36%.14
CDC Methodology Challenged
In an email exchange with HealthLeaders, Faust, one of the researchers of the featured study, said that while the CDC has stated flu deaths are actually underestimated, he doesn’t believe this to be the case:15
"The CDC believes that flu counts are underestimated at several points in the healthcare system. But if that were true, we’d see increases in overall death counts in bad flu seasons. We simply don’t observe that … the assumptions it make[s] are simply not supported by reality. If they were, again we would see more ‘all cause’ deaths in bad flu seasons. That does not occur."
What’s more, according to HealthLeaders, “Faust said it's possible that CDC is reporting larger numbers of influenza deaths in the hopes of encouraging the public to use better hygiene and get flu shots.”16 It’s also possible that if the CDC actually counted flu deaths and recorded them accurately, the death count may be even lower. This is especially true if the underlying cause of death is reported. Faust wrote:17
"If official documents are only 'allowed' to count one cause of death, that means the yearly total of deaths in the United States needs to add up to 2.5 million. In that regime, medical examiners would have to choose between causes of death … For those dying of flu after a three-year battle with cancer? I’d give cancer the credit.”
COVID-19 Deaths Have Bottomed Out
At this point in time, it’s also unknown how many people have died from COVID-19. From problems with testing to attributing deaths from other causes to COVID-19, it’s likely the death toll is not accurate. Mortality statistics are likely being skewed by counting people who die from other conditions as COVID-19 deaths. According to epidemiologist Dr. John Ioannidis of Stanford University:18
“What we do know, however, is that the vast majority of people who die with a COVID-19 label have at least one and typically many other comorbidities. This means that often they have other reasons that would lead them to death. The relative contribution of COVID-19 needs very careful audit and evaluation of medical records.”
Meanwhile, data show that the COVID-19 fatality rate for those under the age of 45 is “almost zero,” and between the ages of 45 and 70, it’s somewhere between 0.05% and 0.3%.19
Data from the CDC also show a stark drop in COVID-19 deaths based on provisional death counts, which are based on death certificate data received and coded by the National Center for Health Statistics.20
Overall, the percentage of deaths attributed to pneumonia, influenza or COVID-19 has declined for 12 weeks in a row,21 but even as all indications suggest COVID-19 deaths have bottomed out, the push for a fast-tracked COVID-19 vaccine continues.
What to Remember Come Flu Season
The fear-mongering about a possible second wave of COVID-19 deaths in conjunction with flu season has already started in the media. Rather than succumbing to the fear of what have turned out to be, in the case of influenza, overinflated death estimates, take action to bolster your immune system against infectious diseases of all kinds.
Clinical trials using vitamin D against COVID-19 are currently underway,22 but we don't need to wait for results to know that vitamin D optimization is a good idea, not only for COVID-19 but also for influenza.
I recommend that everyone optimize your vitamin D this summer, before flu season. The optimal blood level for health and disease prevention is between 60 ng/mL and 80 ng/mL. (In Europe, the measurements you're looking for are 150 to 200 nmol/L and 100 nmol/L respectively.) However, even getting above 30 ng/mL (75 nmol/L) may dramatically reduce your risk of serious infection and death, and doing so is both easy and inexpensive.
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