By Gary Evans, Medical Writer, Relias Media

Although there are variables by health status and age, the mortality rate of COVID-19 is about 10 times greater than a seasonal flu virus, said Anthony Fauci, MD, head of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health.

“The stated mortality overall [of COVID-19] when you look at all the data including China is about 3%. I think if you count all the cases of minimally symptomatic or asymptomatic infection, that probably brings the mortality rate down to somewhere around 1%, which means it is 10 times more lethal than the seasonal flu,” Fauci said on March 11, 2020, in testimony before the U.S. Congress. “People always say the flu does this, the flu does that. The flu has a mortality of 0.1%. This has a mortality 10 times that. That's the reason I want to emphasize we have to stay ahead of the game of preventing this.”

If prevention fails, we face a disturbing calculus using Fauci's estimates. Consider that a particularly bad flu season — take 2017-2018 as the most recent example — killed an estimated 61,000 people and caused more than 800,000 hospitalizations, the Centers for Disease Control and Prevention (CDC) reports.  On the other hand, if we look at the 2011-2012 influenza season, we find 12,000 deaths, the least over the last decade.

Based on Fauci’s 10-fold formula, we get a range of COVID-19 mortality rates extrapolated from these two influenza seasons from 120,000 to 610,000 deaths in the United States. The CDC declined to comment on such modeling estimates or clarify whether it is working on one of its own.

Regardless, Fauci’s considerable reputation and experience in infectious diseases make him an authority of these matters, and he has become the voice of calm reason in the federal response to the pandemic. As the scale of the COVID-19 pandemic is starting to become clear, public health officials face a delicate balance — they must underscore the severity of the threat without setting off panic. 

For more on this story, see the April 2020 issue of Hospital Infection Control & Prevention.