What Was More Deadly for New Yorkers – COVID-19 or the 1918 Flu?

THURSDAY, Aug. 13, 2020 (HealthDay News) -- New York City residents have seen their fair share of health crises over the past century, but a new study finds that this year's COVID-19 pandemic may have been more deadly than even the killer flu outbreak of 1918.

Crunching the numbers from New York City during the worst two months of the 1918 flu epidemic (October-November of that year) and the two months encompassing the height of this year's COVID-19 outbreak (March 11- May 11), researchers said the latter may have been the more lethal.

After accounting for historical changes in public hygiene and medical care, "the relative increase [in NYC deaths] during early COVID-19 period was substantially greater than during the peak of the 1918 H1N1 influenza pandemic," said a team of researchers reporting Aug. 13 in the journal JAMA Network Open.

The research was led by Dr. Jeremy Faust, from the department of emergency medicine at Brigham and Women's Hospital in Boston. He and his colleagues pored over statistics on New York deaths gathered between 1914 and 1918 by the U.S. Centers for Disease Control and Prevention, and compared them to numbers compiled by the NYC Department of Health and Mental Hygiene for 2020, as well as U.S. Census Bureau data for the city for 2017-2020.

Faust's group found that during the two "peak" pandemic months of 1918, about 31,600 New Yorkers perished from any cause, out of a total population of 5.5 million. In 2020, during the peak two months of the SARS-CoV-2 pandemic, the rate was smaller -- about 33,500 deaths in a population of almost 8.3 million.

But those numbers don't tell the full story, Faust's team noted. That's because New Yorkers' "baseline" odds for death in 1918 from any cause were more than double what they are today.

So when the researchers factored out "improvements in hygiene and modern achievements in medicine, public health and safety" occurring over the past century, COVID-19 actually hit New Yorkers harder compared to the 1918 pandemic, based on death rates.

In fact, because of modern lifesaving technologies and drugs, "it is unknown how many deaths due to SARS-CoV-2 infection have been prevented," the study authors said.

They believe their findings hold a lesson for Americans wondering if lockdowns and mask orders were lifted too soon, as the country experiences the highest numbers of COVID-19 cases and deaths in the world.

A "prudent" return to such measures could "prevent the exhaustion of essential supplies of lifesaving resources in the coming weeks and beyond," Faust and his colleagues believe.

Dr. Robert Glatter witnessed the ravages of the pandemic firsthand in his role as an emergency physician at Manhattan's Lenox Hill Hospital. Responding to the new study, he said, "What's clear is that excess deaths related to COVID-19 in 2020 or the Spanish flu in 1918 significantly added to the overall number of deaths during both pandemics."

Glatter concurred with the study authors that "in order to reduce ongoing deaths and morbidity, we need to consider reinstituting or extending shutdowns in areas that continue to experience high cases, increasing hospitalizations and escalating deaths."

Dr. Eric Cioe-Pena, who directs global health for Northwell Health in Great Neck, N.Y., agreed. Reading over the new study, he called it "a reminder of just how bad this [COVID] pandemic is and how swiftly this virus can kill."

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.