Analysis: COVID-19 mortality on par with peak of 1918 pandemic

The spike in deaths in New York during the early days of COVID-19 was on par with the death toll of the 1918 flu pandemic, according to an analysis published Thursday.

The analysis, published in the medical journal JAMA Open Network, found that the mortality associated with COVID-19 during the early phase of the New York City outbreak was comparable to the peak mortality observed during the 1918 pandemic.

During the peak of the 1918 H1N1 influenza outbreak in New York City, there were a total of 31,589 all-cause deaths, compared to the 33,465 tallied in the 61 days after the first death on March 11 of this year, according to the analysis.

The H1N1 pandemic killed approximately 50 million people worldwide, including 675,000 in the U.S. The COVID-19 pandemic has killed more than 750,000 people worldwide, including at least 166,000 in the U.S., according to Johns Hopkins University data.

In 1918, New York City had 5.5 million residents, and experienced a mortality rate of about 287 deaths per 100,000 person-months, the measure of people over a given length of time.

However, the COVID-19 outbreak has seen a higher increase in the number of “excess deaths,” which are the difference between the actual numbers of deaths and expected numbers of deaths during the same time periods.

Modern medicine means New York’s overall baseline mortality rate is less than half that of the early 20th century.

“Because baseline mortality rates from 2017 to 2019 were less than half that observed from 1914 to 1917 (owing to improvements in hygiene and modern achievements in medicine, public health, and safety), the relative increase during early covid-19 period was substantially greater than during the peak of the 1918 H1N1 influenza pandemic,” the authors wrote.

The authors said that public officials don’t have a frame of reference for the sheer magnitude of the COVID-19 pandemic.

“We believe that our findings may help officials and the public contextualize the unusual magnitude of the COVID-19 pandemic, leading to more prudent policies that may help to decrease transmission,” the authors wrote.