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Covid and flu: what do the numbers tell us about morbidity and deaths?

BMJ 2021; 375 doi: (Published 14 October 2021) Cite this as: BMJ 2021;375:n2514
  1. Gareth Iacobucci
  1. The BMJ

Much confusion has been seen in the UK media about the effects on mortality of flu and covid-19. Gareth Iacobucci separates fact from fiction

Are there more deaths from flu than from covid?

Data from the Office for National Statistics show that in England and Wales the number of deaths from influenza was 1598 in 2018 and 1223 in 2019.1 This is way below the annual deaths from covid-19, which at the current rate of around 800 deaths a week in England and Wales equates to more than 40 000 a year.2

Disagreements have emerged on social media because some commentators have quoted much higher figures for annual deaths from flu.3 The reason for the discrepancy, as highlighted by the health systems researcher Dan Goyal,4 is that flu and pneumonia deaths are often reported together, including by the ONS itself. When pneumonia deaths are included with flu, the number would be 29 516 in 2018 and 26 398 in 2019. This is obviously closer to covid death numbers, though still less, according to current trends.

Covid mortality data have also been the subject of debate. Through the pandemic some datasets, including Public Health England’s, have included all deaths from any cause within 28 days of a positive covid test. Some sceptics have argued that this approach has overestimated the number of people dying from covid-19. But as The BMJ’s columnist David Oliver and the expert statistician David Spiegelhalter have pointed out,56 this approach has probably under-recognised the real number of deaths from covid-19, because of an initial absence of testing back in spring 2020, and because people who survived more than 28 …

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