The dangers of misunderstanding the comparison between FLU and COVID-19.
There have been significant misinterpretations of the FLU death numbers. For some this has justified a "covid is not that bad" mentality. The dangers of group-think, once again.
Covid and flu can both cause viral pneumonia. Both can lead to secondary bacterial pneumonia.
But the direct death rate of each is:
Flu = 4/day
Bacterial Pneumonia = 55/day
Covid = 125/day (at CURRENT rates!)
ONS:
Most of us experience FLU as an unpleasant but rarely serious illness. This remains true for those of us working in acute medicine - we rarely see a flu pneumonia.
We do see a lot of bacterial pneumonia and now Covid pneumonia.
Where does the confusion or mis-information come from?
Sometimes its just that flu and (bacterial) pneumonia are lumped together: "20k deaths from flu and pneumonia".
Actually less than 10% are caused by FLU, the vast majority are caused by bacteria (like strep).
You may also have heard some stating flu kills between 4,000 to 20,000 people a year in the UK. These numbers come from modelling studies and are projections for a possible contributory role of Flu in other deaths, mainly bacterial pneumonia.
The hypothesis is that while flu causes only a small number of deaths, it can weaken the body and can increase the chance of death from other things...mainly bacterial pneumonia.
While this may be so (more evidence is needed), the deaths referred to are by bacterial pneumonia.
So, the modelling effectively TAKES deaths from the bacterial pneumonia column and puts them in the Flu column. The argument: take flu more seriously!
You can't of course use the same modelling to argue Covid is not that serious.
The issue is perception. We perceive flu to be relatively benign. So, if we say Covid is currently killing three times that of flu, it may not sound that bad - very few people know someone who has died of flu.
But these higher numbers quoted refer to bacterial pneumonia.
Comparisons with bacterial pneumonia cause no such perception problems. We know the number of deaths, we know the burden on health services it causes, and there is no need to use modelling or projections.
➡️On a population level, pneumonia is bad, but Covid is much worse.
At the current rates of Covid, it is TRIPLING the total number of deaths from community acquired pneumonia (includes flu and bacterial). It is likely TRIPLING the healthcare BURDEN from pneumonia both acutely and in the longer term.
The public health impact of COVID is massive!
Given some so called patriots want a French healthcare system, let’s take a look at it.
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Summary: social insurance with 95% of people taking private healthcare to cover copays. Costs £40bn per year more. Less equitable than NHS, but can turn a profit
1/10
Akin to some other European countries, France uses a social insurance based model predominantly - where employer and employee pay a means-tested insurance premium
but unlike most EU countries the French people pay a surcharge on pretty much everything they access or use
This has led to 95% of the population taking out private insurance.
This is an insurance premium (on top of the social insurance premium) that is in part based on likelihood of needing health care - older people paying more.
Some good policies but overall disappointing and a bit concerning.
A summary thread
1/x
1. There is the title: Build an NHS Fit for the Future
In one way, fair enough. Buildings are outdated and crumbling and IT is hopeless
But, Labour seems oblivious to the fact the NHS leads the world in medical and surgical care. The issue is merely access not tech upgrades.
2. "publicly owned and funded" is meaningless. Even the deranged health system of the U.S. has a publicly funded component - waiting lists are horrendous and access to treatment is very limited.
We want universal access to all available treatments - quite different!
Nuffield Trust reports this week on a massive increase in private provision
More worrying, a massive surge in people using their savings to access care
From the best health system to one of the worst in 14yrs!
Summary 🧵
The amount the NHS pays (this is our tax money) to the private sector has nearly doubled in five years…
From £1.66b to £3.1b
2/9
This is catastrophic for the future of our health system
It’s based on political targets superseding clinical ones - Managers wanting to please whoever the latest Health Sec is versus prioritising clinical needs
Urgent and primary care should be priorities not GE fodder!
3/9
My obligation is to my patients, whoever they are and wherever they live.
But I want to work in the NHS…
Selfishly speaking, I appreciate not having to say no to treatments because a patient can’t afford it..
But…
🧵 1/6
After 14 yrs of Tory rule and a cowed and complicit NHS Leadership, patients are being denied treatment due to lack of resources. It is hard to witness, day in and day out.
The very principal of the NHS - access for all - no longer exists!
2/6
So do I blame any doctor seeking work elsewhere? Absolutely not. Better to survive and help patients than to be broken by a system that makes treating patients harder and harder, in a country increasingly polarised. Staying in the NHS now can be very damaging for staff.
3/6