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

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.





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Three women, three MS journeys: How multiple sclerosis looks different for everyone

Gina, Nathalie and Helga share their reactions to being diagnosed with MS and how they stay informed and positive in the face of ever-changing symptoms.

Courtesy of Sanofi

Helga, Nathalie and Gina all have MS, and their experiences show how differently the disease can manifest.

True

It’s been 155 years since neurologist Jean-Martin Charcot gave the first lecture on a mysterious progressive illness he called “multiple sclerosis.” Since then, we’ve learned a lot. We know MS causes the immune system to attack healthy tissue, including damaging the brain and spinal cord. Resulting symptoms can be debilitating and include fatigue, blurred vision, memory problems and weakness. Huge advancements in our understanding of MS and its underlying causes, as well as treatment advances, have been made in the past few decades, but MS remains a complex and unpredictable reality for the 2.8 million+ people diagnosed around the world.

Ironically, the only real constant for people living with MS is change. There’s no set pattern or standard progression of the disease, so each person’s experience is unique. Some people with MS have mild symptoms that worsen slowly but sometimes improve, while others can have severe symptoms that drastically alter their daily lives.

All people with MS share some things in common, however, such as the need to stay informed on the ever-evolving research, find various lines of support and try to remain hopeful as they continue living with the disease.

To better understand what navigating life with MS really looks like, three women shared their MS stories with us. Their journeys demonstrate how MS can look different for different people and interestingly, how the language used to talk about the disease can greatly impact how people understand their realities.

woman with horse, woman riding horseGina loves riding her horse, Benita.Courtesy of Sanofi

Gina—Hamburg, Germany (diagnosed with relapsing multiple sclerosis in 2017)

When her youngest son was 4 months old, Gina started having problems with her eye. She’d soon learn she was experiencing optic neuritis—her first symptom of MS.

“Immediately after the diagnosis, I looked up facts on MS because I didn’t know anything about it,” Gina says. “And as soon as I knew what could really happen with this disease, I actually got scared.”

As her family’s primary income provider, she worried about how MS would impact her ability to work as a writer and editor. Her family was afraid she was going to end up in a wheelchair. However, for now, Gina’s MS is managed well enough that she still works full-time and is able to be active.

“When I tell somebody that I have MS, they often don't believe me the first time because I don't fulfill any stereotypes,” she says.

Overwhelmed by negative perspectives on living with MS, Gina sought support in the online MS community, which she found to be much more positive.

“I think it’s important to use as many positive words as you can when talking about MS.” It’s important to be realistic while also conveying hope, she says. “MS is an insidious disease that can cause many bad symptoms…that can be frightening, and you can't gloss over it, either.”

To give back to the online community that helped her so much, Gina started a blog to share her story and help others trying to learn about their diagnosis.

Though she deals with fatigue and cognitive dysfunction sometimes, Gina stays active swimming, biking, riding horses and playing with her sons, who are now 11 and 6.

Cognitive dysfunction is common in MS, with over half of people affected. It can impact memory, attention, planning, and word-finding. As with many aspects of MS, some people experience mild changes, while others face more challenges.

Gina says that while there’s still a lot of education about MS needed, she feels positive about the future of MS because there’s so much research being done.

woman in wheelchair holding medal, woman rowingNathalie is an award-winning rower with multiple international titles.Courtesy of Sanofi

Nathalie — Pennes Mirabeau, France (diagnosed with relapsing-remitting multiple sclerosis in 2002)

Nathalie was a teenager and a competitive athlete when she noticed her first symptoms of MS, but it would take four years of “limbo” before she was diagnosed.

“Ultimately, the diagnosis was more of a relief, than a shock,” she says. “Because when you have signs and you don’t know why, it’s worse than knowing, in the end, what you have.”

However, learning more about the disease—and the realities of disease progression—scared her.

“That glimpse of the future was direct and traumatic,” she says. Her neurologist explained that the disease evolves differently for everyone, and her situation might end up being serious or very mild. So, she decided to stop comparing herself to others with MS.

She said to herself, “We’ll see what happens, and you’ll manage it bit by bit.”

By 2005, Nathalie’s MS had progressed to the point of needing a wheelchair. However, that has not dampened her competitive spirit.

Nathalie began her international rowing career in 2009 and has won multiple world titles, including two Paralympic medals—silver in London and bronze in Tokyo. Now, at 42, she still trains 11 times a week. Fatigue can be a problem, and sometimes hard workouts leave her with muscle stiffness and shaking, but she credits her ongoing sports career for helping her feel in tune with her body’s signals.

“Over the years, I’ve learned to listen to my body, letting my body guide when I need to stop and take breaks,” she says.

Nathalie explains that she used to only look backwards because of the initial shock of her diagnosis. In time, she stopped thinking about what she couldn’t do anymore and focused on her future. She now lives in the following mindset: “Even when doors close, don’t miss out on those that open.” Instead of focusing on what she can’t do, she focuses on the opportunities she still has. Right now, this includes her training for the 2024 Paralympic Games in Paris, where she will compete for another rowing medal.

“I only go forward,” she says. “Well, I try, anyway…It’s easy to say, it’s not always easy to do. But that’s what I try to do.”

woman exiting water after swimming, woman with great daneHelga's Great Dane has become a helpful and beloved companion.Courtesy of Sanofi

Helga—Johannesburg, South Africa (diagnosed with relapsing multiple sclerosis in 2010)

When Helga first started having balance issues and numbness in her feet, she chalked it up to her training as a runner. But when the numbness moved to her face, she knew something was wrong. She never guessed it was MS.

“When I was diagnosed, I felt completely overwhelmed and clueless,” Helga says. “I felt that I had nowhere near enough information. I did not know anything about the disease…I had no idea that it was going to be a process of continually monitoring and adjusting your lifestyle.”

In the beginning, Helga’s symptoms developed slowly, and she didn’t appear ill to others. She was even able to run for a few years after her diagnosis, but she couldn’t do marathons anymore, and she began to fall frequently due to balance issues and right-foot dragging. Then her cognition issues became more problematic, especially in her job as a trainer in a printing company.

“My executive function, decision-making and short-term memory were affected to the point that I was eventually medically unfit for work,” she says. She stopped working in 2017.

However, she didn’t stop living life. Even though she could no longer run, she continued to swim competitively. She got a Great Dane puppy and trained him as a service dog to help her walk. She also serves as vice chair of the patient support organization Multiple Sclerosis South Africa, and she advises others who have been diagnosed to join a patient advocacy group as soon as possible to get reliable information and meet others with MS.

Helga says she is “hopeful” about the future of MS. “I must say that I am so grateful that we have all the new medications available, because my life would not be the same if it wasn't for that,” she adds.

Part of how she manages her MS is by looking at the positives.

“If I could tell the world one thing about MS, it would be that MS is an incurable disease of the nervous system, but it's also the greatest teacher of valuing your health, family, friends, and managing change in your life,” she says. “My life is diversified in a way that I never, ever thought it would, and MS has been honestly the greatest teacher.”

Each MS journey is unique – with each person impacted experiencing different struggles, successes, and feelings as they manage this unpredictable disease. But the common thread is clear – there is a critical need for information, support, and hope. We are proud to participate in World MS Day and share these incredible stories of living life while living with MS. To learn more about MS, go to https://www.sanofi.com/why-words-really-matter-when-it-comes-to-multiple-sclerosis.

MAT-GLB-2301642-v1.0-05/2023

This article was sponsored by Sanofi. Participants were compensated when applicable.

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