Is COVID no more dangerous than flu? – the expert’s view from respiratory specialist Dr Tim Whitmore

Every time we post a story on COVID, we get a variety of comments from readers, some claiming COVID is no worse than the annual flu many of us are used to, and some even saying COVID is little worse than a bad cold and more people die of flu every year than COVID.

We’re no experts, of course, but we know a man who is – Dr Tim Whitmore is a Respiratory and Infectious Diseases Specialist who has just posted an excellent explainer on the Hawkesbury Hospital website, which we re-publish here.

What are the key differences between COVID-19 and influenza?

Both COVID-19 and influenza are respiratory viruses and are rapidly transmissible between humans.

The main differences are the rate of mutation and the severity.

We always gripe that we have to have a new flu booster every year. The reason for this is due to influenza’s very high rate of mutation, whereby each year, we try and match the strain in the vaccine.

Dr Tim Whitmore

Part of the issue with COVID-19 is the reduced immunity in the local population.

Obviously they both have variable severity, but a key difference is that, unlike the flu, we do not have background immunity to COVID-19, nor treatment options.

Are there any key differences between the symptoms?

Not really. The key thing we look at with COVID-19 is the total loss of smell – anosmia – as the initial presentation, which is fairly unique to COVID-19.

Generally speaking from a symptom point of view, you can’t tell them apart.

With that in mind, if you have any symptoms, go and get a COVID-19 test and isolate until you get a negative result.

Are the same people at high risk of contracting influenza and COVID-19?

Yes. The same high-risk groups (pregnant women, the elderly and anyone who is immunocompromised or has pre-existing respiratory issues) are just as at risk of getting COVID-19 as they are with the flu.

The surprise is that we are seeing much worse outcomes in younger people with COVID-19 than we do with influenza, with some ending up in ICU, however, the high-risk groups naturally carry more concern.

What about comparing the amount of Australians that die from influenza every year to COVID-19?

We’ve had minimal deaths in Australia from influenza since June 2020 which shows that self-distancing and social isolation – the imposed precautions put in place when the pandemic hit – does protect against most viruses.

In looking at the annual deaths from influenza in Australia pre-COVID-19, it does fluctuate each year based on the strains and how well the vaccine matches the flu strain.

In 2016, we had 273 deaths from the flu. In 2017, we had 1181, down to 148 in 2018, back up to just under 1000 in 2019.

“We’ve already seen more than double the number of deaths, let alone the number of cases, of COVID-19 since the pandemic began in comparison to the flu.”

This is due to us not fully understanding the virus and not having access to the vaccine until early 2021. In saying this, the flu is not to be underestimated.

Is it still necessary to get the flu vaccination each year?

Yes, for two reasons – the same two reasons to get fully vaccinated against COVID-19 (double dose and booster).

1. Self interest

The flu kills people. All high-risk groups, including the elderly, pregnant women and anyone who is immunocompromised, should absolutely have an influenza vaccination every year.

Generally speaking, the risk of severe illness is much lower in young adults but my advice is everyone should have the vaccination.

2. Public interest

Anyone who works in health care should be immunised not only to protect themselves, but to reduce the risk of them spreading it to the patients or clients in their care.

That includes aged care, hospitals and home services, people delivering care in the community, and others at risk of spreading it.

Dr Tim Whitmore is a respiratory and infectious diseases specialist with a particular interest in tuberculosis, non-tuberculous mycobacterial disease, complex fungal infections, and management of infections associated with immunocompromised hosts. Dr Whitmore currently works at the Anita Clayton Centre as a Respiratory and Infectious Diseases Physician for management of tuberculosis and M leprae infections. He also works at Royal Perth Hospital as a Respiratory Physician, and at St John of God Subiaco Hospital and Respiratory West as a Respiratory and Infectious Diseases Physician providing inpatient and outpatient care.

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