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How Does the Coronavirus Compare With the Flu? How Does the Coronavirus Compare With the Flu?
(8 days later)
As coronavirus infections began appearing across the United States, in cities from Seattle to New York, Americans wondered how to measure this new threat against a more familiar foe: influenza.As coronavirus infections began appearing across the United States, in cities from Seattle to New York, Americans wondered how to measure this new threat against a more familiar foe: influenza.
President Trump, a self-described germophobe, has said he was amazed to learn that tens of thousands of Americans died from the flu each year. On several occasions, Mr. Trump has accused the news media and Democrats of exaggerating the dangers of the coronavirus.President Trump, a self-described germophobe, has said he was amazed to learn that tens of thousands of Americans died from the flu each year. On several occasions, Mr. Trump has accused the news media and Democrats of exaggerating the dangers of the coronavirus.
“The flu kills people,” Mick Mulvaney, the acting White House chief of staff, said in February. “This is not Ebola. It’s not SARS, it’s not MERS. It’s not a death sentence.”“The flu kills people,” Mick Mulvaney, the acting White House chief of staff, said in February. “This is not Ebola. It’s not SARS, it’s not MERS. It’s not a death sentence.”
To many public health officials, that argument misses the point.To many public health officials, that argument misses the point.
Yes, the flu is terrible — that’s exactly why scientists don’t want another contagious respiratory disease to take root. If they could stop the seasonal flu, they would. But there may yet be a chance to stop the coronavirus, or at least slow its spread.Yes, the flu is terrible — that’s exactly why scientists don’t want another contagious respiratory disease to take root. If they could stop the seasonal flu, they would. But there may yet be a chance to stop the coronavirus, or at least slow its spread.
In many ways, the flu is the best argument for throwing everything at the coronavirus. Here’s a closer look at the similarities and differences.In many ways, the flu is the best argument for throwing everything at the coronavirus. Here’s a closer look at the similarities and differences.
The coronavirus seems to be more deadly than the flu — so far.The coronavirus seems to be more deadly than the flu — so far.
On average, seasonal flu strains kill about 0.1 percent of people who become infected. The 1918 flu had an unusually high fatality rate, around 2 percent. Because it was so contagious, that flu killed tens of millions of people.On average, seasonal flu strains kill about 0.1 percent of people who become infected. The 1918 flu had an unusually high fatality rate, around 2 percent. Because it was so contagious, that flu killed tens of millions of people.
Early estimates of the coronavirus death rate from China were about 2 percent. But a later report on 1,099 cases from many parts of China, published in The New England Journal of Medicine, found a lower rate: 1.4 percent.Early estimates of the coronavirus death rate from China were about 2 percent. But a later report on 1,099 cases from many parts of China, published in The New England Journal of Medicine, found a lower rate: 1.4 percent.
In a recent speech, Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, asserted that the global case fatality rate for people infected with coronavirus was 3.4 percent, a startling figure.In a recent speech, Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, asserted that the global case fatality rate for people infected with coronavirus was 3.4 percent, a startling figure.
W.H.O. officials later clarified that Dr. Tedros’s figure was a crude “snapshot” based on incomplete data and heavily skewed by the intensity of the initial outbreak in Wuhan, China.W.H.O. officials later clarified that Dr. Tedros’s figure was a crude “snapshot” based on incomplete data and heavily skewed by the intensity of the initial outbreak in Wuhan, China.
The true death rate could turn out to be similar to that of a severe seasonal flu, below 1 percent, according to an editorial published in the journal by Dr. Anthony S. Fauci and Dr. H. Clifford Lane, of the National Institute of Allergy and Infectious Diseases, and Dr. Robert R. Redfield, director of the Centers for Disease Control and Prevention. But more recently, Dr. Fauci has cited the 1 percent estimate, emphasizing that it is 10 times the death rate from seasonal flu.The true death rate could turn out to be similar to that of a severe seasonal flu, below 1 percent, according to an editorial published in the journal by Dr. Anthony S. Fauci and Dr. H. Clifford Lane, of the National Institute of Allergy and Infectious Diseases, and Dr. Robert R. Redfield, director of the Centers for Disease Control and Prevention. But more recently, Dr. Fauci has cited the 1 percent estimate, emphasizing that it is 10 times the death rate from seasonal flu.
Even a disease with a relatively low death rate can take a huge toll if enormous numbers of people catch it. As of Friday, there were more than 135,000 coronavirus cases and nearly 5,000 deaths. In the United States, there have been more than 1,200 coronavirus cases and about 36 deaths.Even a disease with a relatively low death rate can take a huge toll if enormous numbers of people catch it. As of Friday, there were more than 135,000 coronavirus cases and nearly 5,000 deaths. In the United States, there have been more than 1,200 coronavirus cases and about 36 deaths.
But because of the lack of testing capacity in the United States, the true case count and number of deaths are not known for sure.But because of the lack of testing capacity in the United States, the true case count and number of deaths are not known for sure.
So far, the new coronavirus seems to be more contagious than most strains of the flu, and roughly as contagious as strains that appear in pandemic flu seasons.So far, the new coronavirus seems to be more contagious than most strains of the flu, and roughly as contagious as strains that appear in pandemic flu seasons.
Each person with the coronavirus appears to infect 2.2 other people, on average. But the figure is skewed by the fact that the epidemic was not managed well in the beginning, and infections soared in Wuhan and the surrounding province. As an epidemic comes under control, the reproduction number, as it’s called, will fall.Each person with the coronavirus appears to infect 2.2 other people, on average. But the figure is skewed by the fact that the epidemic was not managed well in the beginning, and infections soared in Wuhan and the surrounding province. As an epidemic comes under control, the reproduction number, as it’s called, will fall.
By comparison, the figure for the seasonal flu is roughly 1.3. The reproduction number for the flu of 1918 was about the same as that of the new coronavirus, perhaps higher, but that was before modern treatments and vaccines were available.By comparison, the figure for the seasonal flu is roughly 1.3. The reproduction number for the flu of 1918 was about the same as that of the new coronavirus, perhaps higher, but that was before modern treatments and vaccines were available.
In both flu and the illness caused by the coronavirus, people may be contagious before symptoms develop, making it difficult or even impossible to control the spread of the virus. Nobody knows yet how many people infected with the coronavirus have only very mild symptoms or none at all.In both flu and the illness caused by the coronavirus, people may be contagious before symptoms develop, making it difficult or even impossible to control the spread of the virus. Nobody knows yet how many people infected with the coronavirus have only very mild symptoms or none at all.
People who are older than 60, or have a weakened immune system or chronic illnesses like lung disease, heart disease or diabetes, have the highest risk of becoming severely ill if they contract the coronavirus or the flu. Each underlying illness adds to the risk.People who are older than 60, or have a weakened immune system or chronic illnesses like lung disease, heart disease or diabetes, have the highest risk of becoming severely ill if they contract the coronavirus or the flu. Each underlying illness adds to the risk.
Many people in the United States have an increased risk of becoming seriously ill if they are infected: about 60 percent of adults have at least one underlying health condition, and 40 percent have two or more underlying conditions. Approximately 25 million have diabetes, which can lower immunity.Many people in the United States have an increased risk of becoming seriously ill if they are infected: about 60 percent of adults have at least one underlying health condition, and 40 percent have two or more underlying conditions. Approximately 25 million have diabetes, which can lower immunity.
Death rates among men infected with the coronavirus in China, particularly those in their late 40s and older, have exceeded those among women, a pattern not seen in the seasonal flu. The reason for the discrepancy is not known, although Chinese men do smoke more, often resulting in compromised lung function.Death rates among men infected with the coronavirus in China, particularly those in their late 40s and older, have exceeded those among women, a pattern not seen in the seasonal flu. The reason for the discrepancy is not known, although Chinese men do smoke more, often resulting in compromised lung function.
There seems to be another important difference: The flu appears far more dangerous to children, particularly very young ones, who can become severely ill. Children infected with the new coronavirus tend to have mild or no symptoms.There seems to be another important difference: The flu appears far more dangerous to children, particularly very young ones, who can become severely ill. Children infected with the new coronavirus tend to have mild or no symptoms.
The flu is also especially dangerous for pregnant women, who can become severely ill from it. Whether the new coronavirus poses as serious a threat to pregnant women is not known.The flu is also especially dangerous for pregnant women, who can become severely ill from it. Whether the new coronavirus poses as serious a threat to pregnant women is not known.
Not everyone who becomes seriously ill fits the high-risk profile. In every infectious disease outbreak, there are unexplained cases that defy the statistics, such as severe illness striking a young, healthy person who would have been expected to become just mildly sick. The physician in China who was penalized for alerting colleagues to the outbreak there, Dr. Li Wenliang, died from the disease at age 34.Not everyone who becomes seriously ill fits the high-risk profile. In every infectious disease outbreak, there are unexplained cases that defy the statistics, such as severe illness striking a young, healthy person who would have been expected to become just mildly sick. The physician in China who was penalized for alerting colleagues to the outbreak there, Dr. Li Wenliang, died from the disease at age 34.
In the current season, there have been at least 34 million cases of flu in the United States, 350,000 hospitalizations and 20,000 flu deaths, according to the C.D.C. Hospitalization rates among children and young adults this year have been unusually high.In the current season, there have been at least 34 million cases of flu in the United States, 350,000 hospitalizations and 20,000 flu deaths, according to the C.D.C. Hospitalization rates among children and young adults this year have been unusually high.
There would be even more illnesses and deaths if there were no flu vaccine. Most people recover in less than two weeks, and sometimes in just days.There would be even more illnesses and deaths if there were no flu vaccine. Most people recover in less than two weeks, and sometimes in just days.
By contrast, at least 90,000 people in the United States have been infected with the new coronavirus by late March, and there have been at least 1,400 deaths. There are no treatments or vaccines for the coronavirus, only supportive care for infected people.By contrast, at least 90,000 people in the United States have been infected with the new coronavirus by late March, and there have been at least 1,400 deaths. There are no treatments or vaccines for the coronavirus, only supportive care for infected people.
Most cases of coronavirus infection are not severe, but some people do become quite sick. Data from the largest study of patients to date, conducted in China, suggests that of coronavirus patients receiving medical attention, 80 percent had mild infections, about 15 percent had severe illnesses, and 5 percent were critical. (But many of the mild infections included patients with pneumonia, experts later learned.)Most cases of coronavirus infection are not severe, but some people do become quite sick. Data from the largest study of patients to date, conducted in China, suggests that of coronavirus patients receiving medical attention, 80 percent had mild infections, about 15 percent had severe illnesses, and 5 percent were critical. (But many of the mild infections included patients with pneumonia, experts later learned.)
The first symptoms, fever and cough, are similar to that of the flu, so the diseases can be hard to tell apart without a test to identify the virus. Pneumonia is common among coronavirus patients, even among those whose cases are not severe.The first symptoms, fever and cough, are similar to that of the flu, so the diseases can be hard to tell apart without a test to identify the virus. Pneumonia is common among coronavirus patients, even among those whose cases are not severe.
Experts think there may also be many people with no symptoms at all, or such mild ones that they never bother to seek medical attention. Because those cases have not been counted, it’s not possible now to know the real proportion of mild versus severe cases.Experts think there may also be many people with no symptoms at all, or such mild ones that they never bother to seek medical attention. Because those cases have not been counted, it’s not possible now to know the real proportion of mild versus severe cases.
Antibody tests, which can determine whether someone has ever been infected, may eventually help to establish how many people had mild or asymptomatic coronavirus infections.Antibody tests, which can determine whether someone has ever been infected, may eventually help to establish how many people had mild or asymptomatic coronavirus infections.
Updated June 24, 2020
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
After viral infections, people generally develop antibodies in their blood that will fight off the virus and protect them from contracting it again. It’s reasonable to assume that people who have had the new coronavirus will become immune to it.After viral infections, people generally develop antibodies in their blood that will fight off the virus and protect them from contracting it again. It’s reasonable to assume that people who have had the new coronavirus will become immune to it.
But it is not known how long that immunity will last. With other coronaviruses, which cause the common cold, immunity can wane.But it is not known how long that immunity will last. With other coronaviruses, which cause the common cold, immunity can wane.
There are vaccines for the seasonal flu, of course, and these induce at least some immunity to influenza.There are vaccines for the seasonal flu, of course, and these induce at least some immunity to influenza.
There is no approved antiviral drug for the coronavirus, though several are being tested. Doctors can recommend only the usual remedies for any viral illness: rest, medicine to reduce pain and fever, and fluids to avoid dehydration.There is no approved antiviral drug for the coronavirus, though several are being tested. Doctors can recommend only the usual remedies for any viral illness: rest, medicine to reduce pain and fever, and fluids to avoid dehydration.
Coronavirus patients with pneumonia may also need oxygen, and a ventilator if breathing trouble worsens.Coronavirus patients with pneumonia may also need oxygen, and a ventilator if breathing trouble worsens.
For the flu, however, there are four prescription medicines. All work best if they are taken within a day or two of when symptoms start.For the flu, however, there are four prescription medicines. All work best if they are taken within a day or two of when symptoms start.
They’re not miracle cures: They can lessen the severity of the illness and shorten its course by a day or so, and they may lower the risk of serious complications.They’re not miracle cures: They can lessen the severity of the illness and shorten its course by a day or so, and they may lower the risk of serious complications.
The drugs are also recommended for people who have been exposed to a flu patient, to try to prevent the illness.The drugs are also recommended for people who have been exposed to a flu patient, to try to prevent the illness.
The flu, like the coronavirus illness, can also cause pneumonia and breathing trouble. Anyone who becomes short of breath needs medical attention quickly.The flu, like the coronavirus illness, can also cause pneumonia and breathing trouble. Anyone who becomes short of breath needs medical attention quickly.
An experimental vaccine for the coronavirus may be ready for safety testing in humans soon, but will take much longer, at least a year or two, to become available for widespread use — if it works.An experimental vaccine for the coronavirus may be ready for safety testing in humans soon, but will take much longer, at least a year or two, to become available for widespread use — if it works.
Flu vaccines, on the other hand, are widely available and generally 40 percent to 60 percent effective, which means they will reduce cases by that amount in a population that has been vaccinated, compared with one that has not.Flu vaccines, on the other hand, are widely available and generally 40 percent to 60 percent effective, which means they will reduce cases by that amount in a population that has been vaccinated, compared with one that has not.
The vaccine for the current season falls into that range, according to the C.D.C., which said in February that people who have not been vaccinated should still get the shot, because the flu season is ongoing.The vaccine for the current season falls into that range, according to the C.D.C., which said in February that people who have not been vaccinated should still get the shot, because the flu season is ongoing.
Experts have been urging people to get the flu shot for all the usual reasons. But now there’s another: As the coronavirus spreads in the United States, hospitals will need all the beds, equipment and staff they can muster.Experts have been urging people to get the flu shot for all the usual reasons. But now there’s another: As the coronavirus spreads in the United States, hospitals will need all the beds, equipment and staff they can muster.
It will be important not to have those resources taken up by patients with flu that could have been prevented.It will be important not to have those resources taken up by patients with flu that could have been prevented.
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Mr. Trump has said repeatedly that the coronavirus will retreat as weather warms, just as influenza does. In fact, because this is a new virus, there is no information about how the weather might affect it.Mr. Trump has said repeatedly that the coronavirus will retreat as weather warms, just as influenza does. In fact, because this is a new virus, there is no information about how the weather might affect it.
Even if the virus were to diminish in the spring, it might rebound later in the fall, as the weather cools. This is a pattern often seen in severe flu seasons.Even if the virus were to diminish in the spring, it might rebound later in the fall, as the weather cools. This is a pattern often seen in severe flu seasons.
Containment is becoming less likely, because of the contagiousness of the virus, the possibility that people can spread it before they have symptoms and the increasing number of outbreaks around the world.Containment is becoming less likely, because of the contagiousness of the virus, the possibility that people can spread it before they have symptoms and the increasing number of outbreaks around the world.
Cases in California, New York, Oregon and Washington State without known links to overseas travel indicate the new coronavirus has already begun to circulate.Cases in California, New York, Oregon and Washington State without known links to overseas travel indicate the new coronavirus has already begun to circulate.
Reporting was contributed by Gina Kolata and Knvul Sheikh.Reporting was contributed by Gina Kolata and Knvul Sheikh.