"A few reasons why those suggesting the coronavirus is no worse than the flu are making a false assertion."

Brief, clear and easy to understand.

Five things to tell someone who insists coronavirus is just a bad flu, by Christina Prignano (Boston Globe)

The United States is entering its fifth month since the coronavirus first appeared here and though the caseload and death toll continue to rise, there are still those who insist the virus is no more severe than a bad flu. Some protesters of virus restrictions in Massachusetts and beyond have used that argument to advocate for reopening businesses and lifting stay-at-home orders.

Here are a few reasons why those suggesting the coronavirus is no worse than the flu are making a false assertion.

1. The coronavirus is more severe than the flu, more deadly than the flu, and it appears to spread more easily

According to a CDC study, a higher percentage of older people required hospitalization during the early stages of the coronavirus pandemic compared to the early part of the previous five flu seasons. Among adults 85 and older, between about 2 to 6 people per 100,000 required hospitalization for flu, while more than 17 people per 100,000 required hospitalization for coronavirus, according to the study.

The mortality rate of coronavirus is not yet fully known. Without a solid idea of how many people have been infected, it’s not possible to reliably determine what percentage of those with the disease have died. But experts say the coronavirus is almost certainly more deadly than the flu.

Finally, according to the CDC, the coronavirus appears to be more easily transmitted from person to person than the flu. People who do not show symptoms can still be contagious and can infect others for several days before they know they are sick, if they develop symptoms at all. With influenza, people are most contagious in the days following the onset of symptoms, according to the CDC, though it’s still possible to infect others the day before symptoms begin.

2. Even with severe lockdown measures, the virus has killed nearly 70,000 Americans in just over three months

Much of the country has been in an unprecedented lockdown for several weeks. Schools are closed, and some states are only now beginning to allow people to patronize nonessential businesses. Even with those measures, tens of thousands of Americans have died since the first official coronavirus deaths in early February, overwhelming morgues and funeral service providers in New York and elsewhere.

And it could continue to get worse as states begin to reopen their economies: An internal Trump administration document obtained by the New York Times projects a daily death toll of 3,000 by June 1.

3. There’s still a lot we don’t know about how the virus behaves

— Is it airborne? We don’t know for sure. Some research suggests the virus could remain in the air even after an infected person has departed, but it remains unclear if the virus can be transmitted through aerosol particles.

— Are people who have been exposed to the virus immune from it? Probably, but it’s too early to say. “It’s a reasonable assumption that this virus is not changing very much. If we get infected now and it comes back next February or March we think this person is going to be protected," Anthony Fauci, the federal government’s top infectious disease expert, said last month. But it’s still an assumption that hasn’t yet been proven.

— Do we have a full sense of all the symptoms of the disease? We are starting to, but as doctors treat more patients, they’re finding previously unknown symptoms like the loss of smell, blood clots, and other issues.

Compare those unknowns to the flu, which has been studied for decades and whose behavior scientists can generally predict.

4. It’s true younger people are at a much lower risk of death from the coronavirus — but that doesn’t tell the whole story

Those clamoring to reopen the economy often point to statistics that show most fatal victims are older and have underlying health issues, and argue that younger people should be allowed to resume their activities. But even if you ignore the fact that young people who resume their normal lives could go on to infect vulnerable people (and you shouldn’t), younger people can get seriously ill from the disease. A CDC report in March found that among those who were hospitalized with COVID-19, 20 percent were aged 20 to 44. And the Washington Post reported recently that younger people, even if they are not suffering severe symptoms of COVID-19, are still developing blood clots that can lead to strokes.

5. There’s no proven treatment and no vaccine

A number of anti-viral drugs are being tested in hopes of finding an effective treatment for the coronavirus, and at least one has shown some early positive results. But unlike the flu, there is no treatment available that has been proven to reduce the severity or shorten the duration of COVID-19. And a vaccine is still many months away, whereas a flu vaccine is widely available every year.

Recommended COVID-19 reading: "The Great Influenza: The Story of the Deadliest Pandemic in History," by John Barry.

In 2005, just as the 7th edition of Gravity Head started (today's is #22), I came down with pneumonia. The book already on my nightstand became accompaniment to a period of forced convalescence: The Great Influenza: The Story of the Deadliest Pandemic in History, by John Barry.

Arguably this wasn't the ideal choice given the circumstances, but Barry's account of the deadly influenza pandemic's arrival at the end of World War I was and remains riveting reading. I consider it one of the most influential books I've ever read.

ON THE AVENUES: The 32 most influential books in my life.

There's also a solid American Experience documentary called "Influenza 2018," released in 1998.

Returning to Barry’s book, the opening chapters are given over to the author’s recounting of the history and development of medical science. In essence, at the dawn of the 20th century medicine had changed little for 2,000 years owing to a generalized reluctance to apply scientific methods to the theory and practice of it.

Medicine remained an obstinate realm of quackery, of humors, miasmas, and the interference of theology with science -- you know, as Donald Trump and Mike Pence still view it.

Eventually technology provided instruments such as the microscope, and daring pioneers proposed to link biology and chemistry to a potential doctor’s educational qualifications, but for the most part these innovations were ignored and the bleeding and mustard plasters continued with the full approval of society’s movers and shakers.

In fact, 19th-century American medical schools were an unvarnished joke, accepting anyone able to afford tuition irrespective of educational background. Poorly educated and barely trained doctors became increasingly discredited in America, while in Europe, researchers like Pasteur and Koch raced ahead with crucial scientific discoveries with vast implications for the future.

The balance only began to shift when a small and determined group of visionaries took advantage of a huge bequest and created Johns Hopkins as the first research university in the United States, patterning it on European lines.

Author Barry points out that these founders of Johns Hopkins proceeded with their organizational work as though in a vacuum, because American medicine’s degradation at the time was so complete that they could draw on no foundation or local experience for such an endeavor. Instead, they modeled Johns Hopkins on Europe’s research universities … and succeeded in the end.

By persevering, Barry notes, these visionaries created “a revolution from nothing.”

Following is the full text of a 2004 review by Peter Palese of Barry's classic book by The Journal of Clinical Investigation, as cited at the National Center for Biotechnology Information.

---

John M. Barry. The great influenza The epic story of the deadliest plague in history.

(2004)

The great influenza: the epic story of the deadliest plague in history is a great book. It is well conceived, well researched, and extremely well written. The appropriate audience goes beyond the interested physician, scientist, or medical student. The book will also appeal to history buffs, who will be fascinated by the dangerous mix of politics, war, and pestilence presented here. In the first third of the book, the word “influenza” rarely appears, because author John M. Barry is painting the landscape of science, medicine, and politics in the pre-World War I era. What comes to life in these pages is the sad state of US science and medicine at the time. For example, admission to US medical schools was dependent not on academic achievement, but rather on whether the applicant would pay the tuition. This changed with the Flexner Report, published in 1910 by Abraham Flexner, and with the establishment of such institutions as the Rockefeller Institute for Medical Research, ably led by Simon Flexner (brother of Abraham). As highlighted by Barry, the other major change leading to the modern era of American medicine was the founding of Johns Hopkins Medical School at the very end of the 19th century, with William Welch as the legendary force behind it. For anyone who has had the opportunity to interact with Johns Hopkins University, this introductory chapter in Barry’s book is mandatory reading.

The writing is facile and gripping at the same time, and the author does an extraordinarily good job of creating a fluent narrative from historical research. Even when Barry describes the replication of the influenza virus in the cell, the writing is easily comprehensible and convincing. He creates numerous wonderful images, such as likening the translation of a messenger RNA to reading Braille. When it comes to the actual influenza pandemic of 1918, Barry does a brilliant job. The facts of this extraordinary event are well presented and discussed. The reader is given the diverse data on the number of people who died during this pandemic; descriptions of those who did the analysis and the basis for arriving at the different numbers allow the reader to decide for him- or herself what the best estimates are. A conservative — and the most convincing — estimate is 50 million. In the context of the present world population of six billion, compared with two billion in 1918, this would translate into 150 million deaths today.

The political and military scene of 1917 as described by Barry is equally fascinating. Despite major scientific and public health advances, many of the influenza casualties resulted from uninformed and misguided decisions by military and political leaders. Hiram Johnson is quoted as saying, “The first casualty when war comes is truth.” This statement certainly remains true some eighty years later. When Barry recounts the suspicion that “German agents . . . from submarines” are suspected of having brought influenza to the United States, we can see that propaganda is not new either. Barry raises the frightening possibility that President Wilson was weakened by influenza in April 1919 and that this caused him to give in to the demands by the European allies, which resulted in the unfortunate outcome of the negotiations at Versailles.

The book is particularly powerful when it describes the actual disease and its effect on the population. The outbreak in Philadelphia must have been horrendous, with 4,597 influenza deaths in a single week. The effects of influenza in other parts of the world are described as equally harrowing. Barry quotes a report about an Alaskan village in which “ . . . it was quite impossible to estimate the number of dead as the starving dogs had dug their way into many huts and devoured the dead . . . ”

A few good things did come from this devastating pandemic. A restructuring of the country’s public health system had its beginning as a direct result of the events of 1918, and efforts were made to push for the establishment of the NIH, which became a reality about ten years later.

Overall, this book is engrossing reading, with plenty of relevance for our own time, which is threatened by natural (and/or deliberately released) emerging pathogens. It is a question not of if, but of when we will be faced with another epidemic of this magnitude. On the last page of the book, Victor Vaughan is quoted on the 1918 influenza pandemic: “Civilization could have disappeared within a few more weeks.”

Feeling poorly? You might wish to defer these two American Experience documentaries until later.

In which we learn why the online.net/locations/hospitals/silvercrest-sanatorium/">Silvercrest Sanatorium was built in the first place.

Silvercrest Sanatorium, a tuberculosis hospital in New Albany, Indiana, was later reused as a disabled children’s development center before closing in 2006. The property has since been restored as an elderly care facility.

It was tuberculosis.

The Forgotten Plague (2015) ... American Experience

By the dawn of the 19th century, the deadliest killer in human history, tuberculosis, had killed one in seven of all the people who had ever lived. The disease struck America with a vengeance, ravaging communities and touching the lives of almost every family. The battle against the deadly bacteria had a profound and lasting impact on the country. It shaped medical and scientific pursuits, social habits, economic development, western expansion, and government policy. Yet both the disease and its impact are poorly understood: in the words of one writer, tuberculosis is our "forgotten plague."

---

I originally read this account of the deadly influenza outbreak at the end of World War I in 2005 while laid up with pneumonia. This is not a course I recommend, although the book itself is a must read: The Great Influenza: The Story of the Deadliest Pandemic in History, by John Barry.

The documentary is old enough to include testimony from children who survived influenza.

Influenza 1918 (1998) ... American Experience

In September of 1918, soldiers at an army base near Boston suddenly began to die. The cause of death was identified as influenza, but it was unlike any strain ever seen. As the killer virus spread across the country, hospitals overfilled, death carts roamed the streets and helpless city officials dug mass graves. It was the worst epidemic in American history, killing over 600,000 — until it disappeared as mysteriously as it had begun.