People are comparing COVID-19 deaths to the flu. Here's why it doesn't work.

As countries around the world pay rapt attention to the rising number of confirmed coronavirus cases and deaths from COVID-19, some confusion about the mathematics of it all keep floating around.

I've seen countless comments from people who say things like:

"The virus has only killed 20,000 people. The seasonal flu kills 60,000 people each year and we don't shut the country down for that!"

"Far more Americans die of flu/cancer/heart disease/etc. than will die from COVID-19 this year. Why aren't we shutting down the economy for those things?"


The idea that the coronavirus isn't markedly different or worse than the seasonal flu got an early hold in some people's consciousness when the virus first emerged. Part of the problem is that the virality and mortality of the virus hasn't been totally clear. Even Dr. Fauci and colleagues wrote an editorial published February 28 in the New England Journal of Medicine stating that the coronavirus death rates "may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza."

However, with a novel virus, things change quickly and experts' knowledge and understanding change along with it. As we saw numbers begin to emerge from around the world, it became clear that this virus is more contagious and far deadlier than the seasonal flu. Dr. Fauci stated in an interview with Trevor Noah on March 26 that the coronavirus was actually at least twice as contagious and ten times as deadly as the seasonal flu. Though death rates vary widely by country so far, and we won't have a clear picture of that rate for quite some time, it's clear that this isn't your average flu.

Additionally, normal flu seasons vary in severity, but the flu is largely a known quantity. We know there will be flu strains, and epidemiologists construct a vaccine each year based on their most informed guess as to which strains will be circulating the most. So we have vaccines and we have treatments to lessen flu severity, such as Tamiflu. And since flu-related deaths happen fairly evenly throughout flu season, our hospital system doesn't get overwhelmed by them.

Let's hold that thought about overwhelmed hospitals while we look at the other comment about various causes of death.

Yes, based on the numbers of deaths we've seen so far, more Americans die of things other than coronavirus each year. But there are some big "buts" here. Most of those causes of death are not communicable diseases. If shutting down the country for a period of time was guaranteed to save people's lives from heart disease or cancer, I'm sure we'd do that. But we are already doing what we can to try to reduce deaths from things like heart disease, cancer, car accidents, and the seasonal flu.

A viral pandemic gone unchecked is an entirely different beast. We have been watching both the case numbers and the death numbers rise dramatically, even after enacting social distancing and locking down the country.

This chart shows a daily visualization of the increase in COVID-19 deaths in the U.S. compared to the average daily deaths from various causes from March 1 to April 18, 2020. GIve it 10 seconds or so, since the virus deaths start off slow, but then really start really taking off after March 20.

By April 8, you can see that the virus's daily death toll overtakes every other cause of death in America.

This is called exponential growth. I've seen people say that coronavirus has killed 20,000 Americans in four months, making it sound like it was an average of 5,000 per month, but that's not how this works. In January, we had no deaths. In February, just a few. By March 26, we had 1,000. Less than 3 weeks later, we're at around 22,000. That's what we mean by exponential growth. No other cause of death does that.

And again, this is with mitigation measures in place for the past month. Imagine what it would look like if we'd kept up business as usual during the past few weeks and let the virus spread unchecked. This kind of exponential growth in deaths is exactly why nations around the globe have shut down businesses and enacted social distancing guidelines.

This is not the seasonal flu. We don't have a vaccine for this. We don't have a cure for this. We don't even have a sure-fire, reliable treatment for this.

The problem is that people see that numbers are not exploding as much as some models indicated they would and think "Oh, this has all been overblown!" They're only seeing some overwhelmed hospitals in select areas and think that means all of the widespread preparations and shutdowns weren't necessary. But that notion ignores the fact that the initial models provided an estimate for what would happen if we didn't shut the country down, which was an absolutely catastrophic outcome with millions of deaths. Without these "extreme" measures, the death toll would be far higher, and more hospitals would be out of beds and ventilators. And it's hard to predict beforehand where a big outbreak might spring up.

And we're not even close to out of the woods yet. Our case and death numbers are still climbing, though experts indicate that we may be at a peak where we might plateau for a while.

But the bottom line is that this virus is not like something we've seen before. The death numbers we've seen so far can't be compared to anything else. And we need to keep on doing what we're doing to keep those exponential numbers under control.





Connections Academy

Wylee Mitchell is a senior at Nevada Connections Academy who started a t-shirt company to raise awareness for mental health.

True

Teens of today live in a totally different world than the one their parents grew up in. Not only do young people have access to technologies that previous generations barely dreamed of, but they're also constantly bombarded with information from the news and media.

Today’s youth are also living through a pandemic that has created an extra layer of difficulty to an already challenging age—and it has taken a toll on their mental health.

According to Mental Health America, nearly 14% of youths ages 12 to 17 experienced a major depressive episode in the past year. In a September 2020 survey of high schoolers by Active Minds, nearly 75% of respondents reported an increase in stress, anxiety, sadness and isolation during the first six months of the pandemic. And in a Pearson and Connections Academy survey of US parents, 66% said their child felt anxious or depressed during the pandemic.

However, the pandemic has only exacerbated youth mental health issues that were already happening before COVID-19.

“Many people associate our current mental health crisis with the pandemic,” says Morgan Champion, the head of counseling services for Connections Academy Schools. “In fact, the youth mental health crisis was alarming and on the rise before the pandemic. Today, the alarm continues.”

Mental Health America reports that most people who take the organization’s online mental health screening test are under 18. According to the American Psychiatric Association, about 50% of cases of mental illness begin by age 14, and the tendency to develop depression and bipolar disorder nearly doubles from age 13 to age 18.

Such statistics demand attention and action, which is why experts say destigmatizing mental health and talking about it is so important.

“Today we see more people talking about mental health openly—in a way that is more akin to physical health,” says Champion. She adds that mental health support for young people is being more widely promoted, and kids and teens have greater access to resources, from their school counselors to support organizations.

Parents are encouraging this support too. More than two-thirds of American parents believe children should be introduced to wellness and mental health awareness in primary or middle school, according to a new Global Learner Survey from Pearson. Since early intervention is key to helping young people manage their mental health, these changes are positive developments.

In addition, more and more people in the public eye are sharing their personal mental health experiences as well, which can help inspire young people to open up and seek out the help they need.

“Many celebrities and influencers have come forward with their mental health stories, which can normalize the conversation, and is helpful for younger generations to understand that they are not alone,” says Champion.

That’s one reason Connections Academy is hosting a series of virtual Emotional Fitness talks with Olympic athletes who are alums of the virtual school during Mental Health Awareness Month. These talks are free, open to the public and include relatable topics such as success and failure, leadership, empowerment and authenticity. For instance, on May 18, Olympic women’s ice hockey player Lyndsey Fry will speak on finding your own style of confidence, and on May 25, Olympic figure skater Karen Chen will share advice for keeping calm under pressure.

Family support plays a huge role as well. While the pandemic has been challenging in and of itself, it has actually helped families identify mental health struggles as they’ve spent more time together.

“Parents gained greater insight into their child’s behavior and moods, how they interact with peers and teachers,” says Champion. “For many parents this was eye-opening and revealed the need to focus on mental health.”

It’s not always easy to tell if a teen is dealing with normal emotional ups and downs or if they need extra help, but there are some warning signs caregivers can watch for.

“Being attuned to your child’s mood, affect, school performance, and relationships with friends or significant others can help you gauge whether you are dealing with teenage normalcy or something bigger,” Champion says. Depending on a child’s age, parents should be looking for the following signs, which may be co-occurring:

  • Perpetual depressed mood
  • Rocky friend relationships
  • Spending a lot of time alone and refusing to participate in daily activities
  • Too much or not enough sleep
  • Not eating a regular diet
  • Intense fear or anxiety
  • Drug or alcohol use
  • Suicidal ideation (talking about being a burden or giving away possessions) or plans

“You know your child best. If you are unsure if your child is having a rough time or if there is something more serious going on, it is best to reach out to a counselor or doctor to be sure,” says Champion. “Always err on the side of caution.”

If it appears a student does need help, what next? Talking to a school counselor can be a good first step, since they are easily accessible and free to visit.

“Just getting students to talk about their struggles with a trusted adult is huge,” says Champion. “When I meet with students and/or their families, I work with them to help identify the issues they are facing. I listen and recommend next steps, such as referring families to mental health resources in their local areas.”

Just as parents would take their child to a doctor for a sprained ankle, they shouldn’t be afraid to ask for help if a child is struggling mentally or emotionally. Parents also need to realize that they may not be able to help them on their own, no matter how much love and support they have to offer.

“That is a hard concept to accept when parents can feel solely responsible for their child’s welfare and well-being,” says Champion. “The adage still stands—it takes a village to raise a child. Be sure you are surrounding yourself and your child with a great support system to help tackle life’s many challenges.”

That village can include everyone from close family to local community members to public figures. Helping young people learn to manage their mental health is a gift we can all contribute to, one that will serve them for a lifetime.

Join athletes, Connections Academy and Upworthy for candid discussions on mental health during Mental Health Awareness Month. Learn more and find resources here.

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