COVID-19 is serious but it is not the 1918–21 influenza.

The panic is upon us! As the talking heads that masquerade as news personalities rail on about travel bans and fatality rates, retail shelves go bare. We are assaulted on all sides from work to our finances to family and home as the long shadow of disease marches ever closer. We are all running scared of the COVID-19 virus that erupted in central China last fall. Of all the comparisons made to this new pandemic, the most popular is the 1918 influenza that spanned the world for three years taking an estimated 50 million lives. This death rate equaled nearly 3% of the worlds total population. Today a disease of similar fatality would take some 240 million souls. If this comparison is even close to true this is nothing to be take lightly.

We are very early in this pandemic and as such our data is skewed, being derived disproportionately from the most severe cases. So far we have seen fatality rates ranging from less than 1% to greater than 5%. Clearly if the latter is the case this will be a pandemic of a type not seen since cholera hit Europe and the new world. Fortunately these high estimates will be moderated when a full analysis of the disease is completed. Unfortunately that is only possible in the latter stages of the pandemic so for now we have to work with the data we have.

However even if the death rate of COVID is equal to that of the 1918 influenza, they are still vastly different in their outcome. In the 1918 pandemic the working class, those between 18 and 40 were the primary victims, often succuming to the disease in a very few days. Some accounts describe young healthy adults going out for a normal days work only to collapse and die by the evening.

COVID by contrast, disproportionately affects the old elderly and those with severe life compromising comorbidities. Post mortem data from Italy shows that 2/3 of the victims had at least two life compromising medical issues and the average age of death was 81 years. Here in lies the greatest difference between the to diseases.

While we can agree that losing a life to an infectious disease is tragic, it is also quite normal. Influenza takes of tens of thousand of ill and infirm each year. However, what is most important to the country at large is not how many lives are lost, but how many Life-years are being lost to each passing. In the case of 1918 influenza those lost in the prime of life lost 20–30 Life-years each. Added to the loss of life in WW1 this was a major blow to the work force world wide and probably contributed to the economic instability that ultimately lead to the Great Depression.

Although the precise data for COVID will not be known for some time, given the Italian experience the life-years lost to COVID will be on the order of 1–2 years, possibly less. Further this case fatality rate profile has minimal affect on the available workforce as severe cases under age 50 are quite rare. Certainly there will be economic effects from this virus due to the various quarantines, travel bans and suspension of events. However these will pass with the peak of the virus in 10 weeks or so. The workforce will not be permanently affected as it was in 1918.

Not that this should give us great relief. I have 13 family members in the moderate and high risk profiles for COVID, myself included. I doubt all will come through this unscathed. Still we can take some solace in the fact that this new virus, for the most part, is just speeding up the normal mortality we see throughout a normal year while sparing the lives of the young and productive.

While shocking to some, this pandemic reminds us all that we live on a capricious planet that is always searching for ways to take us out. Occasionally she hits on a good one and now we have to deal with it. After this virus passes, the vast majority of us will be okay and continue with our lives, hopefully with a bit more appreciation of the ephemeral nature of the time we have. Remember misery is not for marinading, it’s to stimulate motivation. There is a real life out there ands it’s worth living.