In England, COVID is now less deadly than the flu. But what about in the U.S.?
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When it comes to COVID-19, what happens in the United Kingdom rarely stays in the United Kingdom — and that, in turn, rarely bodes well for the rest of the world.
But the latest coronavirus news out of the U.K. might be just the opposite: a sign of hope as the United States and other countries try to put the winter’s enormous Omicron wave behind them and transition into a less disruptive and dangerous phase of the pandemic.
For the first time, a person who catches COVID in England has a lower chance of dying than someone who catches the flu, according to a new analysis by the London-based Financial Times — regardless of how old the individual is.
The authors attribute this encouraging milestone to both “high levels of immunity [in England] and the reduced severity of the Omicron variant,” a reminder that COVID-19’s declining lethality is largely dependent on vaccination and booster rates, exposure to earlier versions of the virus and the intrinsic properties of today’s dominant variant. They also warn that waning immunity, new variants and different levels of vaccination in different countries could change this equation for the worse.
The current trend, however, is clear. At the start of the pandemic — as well as at the peak of last winter’s U.K. Alpha wave, before mass vaccination — COVID-19 was killing more than 1,000 of every 100,000 Britons it infected, making it at least 20 times more lethal than influenza.
But by charting England’s infection fatality ratio (IFR) over time, the paper found that today, just 35 of every 100,000 Omicron infections are resulting in death — less than the 40 deaths that result from every 100,000 flu infections.
On Twitter, Financial Times data journalist John Burn-Murdoch explained the shift.
“Mass vaccination reduced the infection fatality ratio (IFR) by 11x, boosters did some more, then Omicron cut it another 4x,” Burn-Murdoch wrote. “Infection-acquired immunity has also played an important role in building immunity, but … vaccination was by far the biggest driver.”
All in all, “a COVID infection [in England] is around 40x less likely to result in death now than it was in January 2021, at the height of the Alpha wave, before vaccines,” he added.
Crucially, older, more vulnerable Britons are benefiting the most from COVID’s plummeting lethality. In mid-2020, for instance, COVID was nearly 18 times more lethal than the flu for people over 60; today — again, for the first time — it’s actually less lethal for them, by about 10 percent.
A similar pattern holds for younger Britons as well. In 2020, COVID’s IFR among those in their 30s was about 3.4 times higher than the flu’s; among those in their 40s, it was about 7.4 times higher. Today, it’s about 70 percent lower across the board. Among even younger English people — who only ever faced a slightly elevated risk of death from COVID by comparison with the flu — the risk is now between 60 and 90 percent lower, according to the Financial Times’ calculations.
Does this mean COVID-19 is “just a flu,” as so many pandemic minimizers have repeatedly claimed over the last two years? Hardly. For one thing, COVID has managed to kill nearly 1 million Americans in that time; the flu typically kills fewer than 50,000 Americans a year (and was responsible for the deaths of as few as between 500 and 2,000 per year during the pandemic, according to Centers for Disease Control and Prevention estimates). The very immunity that has now reduced COVID to a flulike threat has come at a tragic cost.
It’s also possible that the United States’ lower vaccination rate among the elderly and its much lower booster rate — about half the U.K.’s — leaves vulnerable U.S. residents far more exposed to severe illness and death than their British counterparts. During the Omicron wave, the U.S. death rate peaked at twice the U.K.’s. The Financial Times’ analysis applies only to England, one of the four countries that make up the U.K.
Meanwhile, COVID spreads a lot faster and more easily than the flu, meaning that it can still produce a lot more infections. Two viruses may be equally lethal on an individual level, but if one infects a lot more individuals, it will kill a lot more individuals. A small percentage of a really big number is still a big number. That largely explains why this winter’s overall death toll in England from respiratory illness was still 50 percent higher than during a typical flu season.
The good news, however, is that last winter’s death toll was instead seven times higher than during a typical flu season. That’s real progress.
As a result, both the U.K. and the U.S. have largely lifted their remaining mask and vaccine requirements. Social gathering is increasing. Offices are reopening. Life is returning to normal.
Yet risks remain. Billions of people worldwide are still unvaccinated — and as Professor Julian Hiscox, chair of infection and global health at Liverpool University, told the Financial Times, “all of this could be academic if a new variant comes along.”
That’s why experts say it’s imperative to prepare for the worst now, during the springtime lull, by expanding surveillance, updating vaccines, securing therapeutics, improving ventilation and stockpiling masks and tests — not to mention readying people to shift back into pandemic mode if a more evasive or deadly version of the virus emerges. The fact that both Democrats and Republicans in Congress refused earlier this week to fund such precautionary measures does not bode well.
But even if Omicron is the last major coronavirus variant, the road ahead is not likely to be a smooth ride. An estimated 7 million Americans are immunocompromised, no children under 5 have been vaccinated and “long COVID” looms as a real concern.
Right now, COVID-positive hospitalizations are rising in the U.K. across age groups and regions, due in part to the spread of Omicron’s more infectious BA.2 subvariant, and in part, due to increased socializing.
“Pandemic precautions such as avoiding public transport, working remotely, staying away from big social gatherings and mass events, are all now at their lowest point since March 2020, and still falling,” Burn-Murdoch wrote on Twitter. “The result is we now have more close contacts than at any time in the last two years, and we’re also taking fewer precautions with those contacts. So we shouldn’t be surprised that the virus is still getting around!”
Fortunately, “more of the increase” in patients testing positive “is coming from people who are not being treated primarily for COVID, i.e those who have mild or no symptoms,” according to Burn-Murdoch — at least for now.
The U.S. could see a similar uptick in the months ahead. Barring a new variant or a new surge, however, the question going forward is whether we’ve finally arrived at the point where a modest rise in patients testing positive is a risk we can “live with” — much as we live with the flu.
