Every Picture Tells a Story: COVID vs. the Flu

Former President Trump said, “we have learned to live with it [COVID-19], just like we are learning to live with Covid, in most populations far less lethal!!!” before he recanted that statement with Bob Woodward, saying he knew it was "more deadly than even your strenuous flu." The morbidity and mortality of COVID have indeed changed over time; a recent study helps define whether COVID is becoming a new seasonal influenza.

In the bad old days, studies suggested that if hospitalized with COVID vs. seasonal influenza, your chance of dying was fivefold greater – a number guaranteed to catch your attention. But times change, as does the current COVID variant of concern. A study of hospitalized patients in the VA system for this influenza season details the changes.

We do not have a denominator for how many individuals were not admitted to the hospital, so the study simply considers, as an outcome, those sufficiently ill to require hospitalization. [1]

  • 8,996 hospitalizations for COVID with a 30-day mortality of 5.98%
  • 2,403 hospitalizations for influenza with a 30-day mortality of 3.16%

  • Roughly 55% were fully vaccinated for COVID-19 and 60% for seasonal influenza. The unvaccinated fared more poorly in both instances. Influenza vaccination with not as protective, with a 0.09% reduction in mortality compared with COVID vaccination, with an absolute decrease of 2.57%. For those who like bigger numbers, the relative reduction for influenza vaccination was 2.3% for influenza and 29.3% for COVID vaccination

The mortality from COVID-19 continues to diminish, inching closer to what we might now claim were former President Trump’s prophetic words. These changes are multifactorial, a changing foe, a vaccine that reduces, at a minimum, mortality, and better hospital care. The deaths from seasonal influenza that has been with us much longer show no continued improvement and may reflect the best we can do with these foes.


[1] These are VA patients, so overwhelmingly (95%) male

Source: Risk of Death in Patients Hospitalized for COVID-19 vs Seasonal Influenza in Fall-Winter 2022-2023 JAMA DOI: 10.1001/jama.2023.5348