Why isn't there a shortage of hospital resources during a typical flu season?

Because the media only hypes up the flu season in September and October to scare people into getting their flu shot.

I suspect it's spread out over a longer period, so health services can cope, rather than a peak of a month, but I may be wrong.

800,000 Americans hospitalized with the flu each year.

No stories of hospitals being overwhelmed.

Covid -- hard to get a hard number but surely no more than 20k to 30k hospitalized in Amercia so far.

All sorts of stories of hospitals being overwhelmed.

gilt wrote:

I'm trying to understand how the coronavirus pandemic is different from a typical flu outbreak in terms of resources.

During a standard flu season, ~ 36,000 people die in the US. I would expect that all of these people would be in hospitals. Wouldn't this overwhelm the hospitals?

This crisis is basically an IQ test given to everyone. Your results are in.

You think the flu comes as a surprise every year?

Giles Corey wrote:

800,000 Americans hospitalized with the flu each year.

No stories of hospitals being overwhelmed.

Covid -- hard to get a hard number but surely no more than 20k to 30k hospitalized in Amercia so far.

All sorts of stories of hospitals being overwhelmed.

The number is closer to 400,000 being hospitalized each year. 800,000 is the extreme end of the range not often seen.

This season, there were 310,000 hospitalizations as of 3/5.

Now, flu season is Oct 1 - Mar 31, but a only a small percentage of cases occur in Oct & Nov. But nevertheless, flu season is a fairly consistent wave that is understood and planned for. Generally, the average flu stay is 4.3 days.

So, let’s do some math. Of the 400,000 flu cases, 90% occur across Dec to Mar. That’s 360,000 hospitalizations in 120 days. That’s 3,000 per day. So for example, last week, the flu would have created the need for (21,000 x 4.3) 90,300 days of hospitalized care across the country.

The average Covid 19 stay is about twice that (8.0). There were (estimated) 25,000 Covid hospitalizations last week, generating the need 160,000 days of hospitalized care.

So, not only is Covid acutely more taxing than the flu, that’s just half the story. The other half of the story is that flu hospitalizations still exist. So, these aren’t cases generated in a vacuum, these people are going to hospitals that already have beds taken by the flu.

So, in summary, last week alone would there was a more than 2x need to support respiratory patients and this upcoming week looks like it might be 5x or more if the growth continues. Hospitals don’t have exponentially large staffs.

Because. This. Isn’t. Just. A. Bad. Flu.

It’s much worse.

Repeat that as necessary until it sinks in.

Signed,

A frustrated physician

+1

+2. Really great post. And add that corona epicenters like NYC are seeing even larger relative surges.

GOML wrote:

Because. This. Isn’t. Just. A. Bad. Flu.

It’s much worse.

Repeat that as necessary until it sinks in.

Signed,

A frustrated physician

I'm trying to understand this Covid concern and it's comparison to the common flu. So, in the past, when I have have the common flu I have experienced fever, fatigue, body aches, vomiting, diarrhea, and sometimes all of those at the same time. I have never gone to the hospital for the common flu, so I have never been counted statistically. With this most recent Covid 19, I hear of numerous people who are infected and they have no, or little symptoms, so I'm guessing the number of people who currently are infected is way higher than the numbers we are receiving as being reported. Yet, I'm guessing there are very few Covid 19 deaths that aren't be reported, and wonder how many common flu deaths are now being counted as Covid 19 deaths?

What am I missing and help me understand why this is so much worse than the common flu? Not trolling, just honestly don't understand why this virus is so much worse than other viruses?

+3 great post

This would be interesting to find out since Covid 19 started during the regular flu season . And how many of the flu patients who came into the hospital were also infected by the Corona ? Which could have speed up the severe rate of the conditions?

Lots to think about since the testing of the Covd 19 has just began...also will it slow down once the flu season is over or will we be able to see clearer numbers of the virus?

Tribe wrote:

+2. Really great post. And add that corona epicenters like NYC are seeing even larger relative surges.

Right. Remember this is a novel virus. Typical flu spreads slowly because so many people are immune from a previous exposure. This Covid-19 really takes over an area. My county still doesn't have a single case.

The other factor is that with COVID, a higher % of patients need ICU beds and, particularly, ventilators -- and need them for much longer (2 to 3x times). That is the real bottleneck.

About to head out the door for a run. I appreciate your thoughtful response. I will try to address your points one-by-one when I return.

Tribe wrote:

best post ever wrote:

+1

+2. Really great post. And add that corona epicenters like NYC are seeing even larger relative surges.

+4. Thank you for your succinct answer. This is what I was looking for (other posters' snide replies be damned)

Help me to understand wrote:

Yet, I'm guessing there are very few Covid 19 deaths that aren't be reported, and wonder how many common flu deaths are now being counted as Covid 19 deaths?

I’m not sure what it’s like in the U.S., but in the Netherlands and Germany this is actually the opposite of what’s happening. You can’t count someone as a Corona victim unless they get tested positive. Based on a number of stories from GP and my own brother (also GP), about 2 out of 3 their patients who die from Corona, are not counted as Corona deaths. They die too fast to get tested, or they already had health issues beforehand and decide to not get treated at the hospital and doctors help them pass peacefully in their home.

My brother mentioned that a lot of people remember how they must’ve gotten the virus. They decided to have coffee with friends, go to the market, etc even though they were told not to. Some of these people are now dying and know that they would’ve been fine if they had stayed home. That must be a difficult realization.

I understand it’s difficult to see the “big deal” based on raw numbers, but if you look at the reaction of people who work in this field, you will know that it is a crisis and really can’t be called “just a flu.”

Right now the protocol for respiratory diseases in hospitals is to do a flu test before anything else. If someone tests positive for the flu no Covid test is given. Because of this you will likely see people who are actually infected with both the flu and covid only being registered as a flu death.

In terms of how yearly cases of the flu are calculated. The yearly flu deaths are more of a statistical/modeling exercise than they’re an actual count. Each year epidemiologists will look at the number of deaths that occur during flu season versus the number of deaths for previous years paired with data on the number of deaths in hospitals. Based on previous data of how many cases there typically are in the community per death recorded an estimate of the number of yearly flu cases is calculated.

So when you have a case of the flu that doesn’t require hospitalization it will not be recorded but your case and others like it are accounted for in the models estimates of flu cases.

I would imagine most covid deaths are being captured in the US but you’re right about the number of confirmed cases being significantly lower than reality. After this pandemic is over we will have a better understanding of what percentage of cases are asymptomatic and we will be able to make rough estimates of how many cases there actually were.

I would be more than happy to help out with any other questions.

-your neighborhood infectious disease epidemiologist

I concur with this. Also the Covid19 puts people in the hospital for much longer than regular flu. They could be there for weeks.

For the sake of fairness, Seattle doesn't have overwhelmed hospitals yet.