{"id":15879,"date":"2026-09-17T06:00:00","date_gmt":"2026-09-17T10:00:00","guid":{"rendered":"https:\/\/cov19longhaulfoundation.org\/?p=15879"},"modified":"2026-08-28T09:13:01","modified_gmt":"2026-08-28T13:13:01","slug":"covid-19-influenza-and-the-common-cold-how-dangerous-are-they-really","status":"publish","type":"post","link":"https:\/\/cov19longhaulfoundation.org\/?p=15879","title":{"rendered":"COVID-19, Influenza and the Common Cold: How Dangerous Are They Really?"},"content":{"rendered":"\n

John Murphy, CEO, The COVID-19 Long haul Foundation<\/p>\n\n\n\n

A comparison of the major respiratory infections\u2014and why the common cold belongs in a completely different category<\/h5>\n\n\n\n

The public discussion of respiratory infections has often become distorted by comparing diseases according to how frequently they occur rather than according to how frequently they produce serious illness or death.<\/p>\n\n\n\n

COVID-19, influenza and the common cold are all respiratory infections, but they are not equivalent diseases<\/strong>.<\/p>\n\n\n\n

The common cold is extraordinarily common and usually self-limited. Influenza is less common but substantially more capable of causing pneumonia, hospitalization and death. COVID-19 occupies a still different category: it can produce severe respiratory disease, cardiovascular and neurologic complications, hospitalization and death, although its lethality has fallen dramatically since 2020.<\/p>\n\n\n\n

The most useful comparison therefore requires examining infection frequency, hospitalization, mortality, age distribution and complications separately.<\/strong><\/p>\n\n\n\n

\n\n\n\n
The short answer<\/h5>\n\n\n\n

If the question is:<\/p>\n\n\n\n

\n

“How dangerous is COVID compared with the common cold?”<\/strong><\/p>\n<\/blockquote>\n\n\n\n

the evidence is unequivocal.<\/p>\n\n\n\n

COVID-19 is vastly more dangerous than an ordinary common cold.<\/strong><\/p>\n\n\n\n

The CDC notes that more than 200 viruses can cause colds, with rhinoviruses the most frequent cause. Most rhinovirus infections produce no symptoms or only mild illness. Adults average approximately two to three colds annually.<\/p>\n\n\n\n

By contrast, CDC estimated that during July 2024\u2013June 2025<\/strong>, SARS-CoV-2 was associated with approximately:<\/p>\n\n\n\n

    \n
  • 290,000\u2013450,000 hospitalizations<\/strong><\/li>\n\n\n\n
  • 34,000\u201353,000 deaths<\/strong><\/li>\n<\/ul>\n\n\n\n

    in the United States.<\/p>\n\n\n\n

    That places COVID in a completely different clinical category from the ordinary cold.<\/p>\n\n\n\n

    But the comparison with influenza<\/strong> is much closer.<\/p>\n\n\n\n

    \n\n\n\n
    1. The common cold<\/h5>\n\n\n\n

    The phrase “common cold” does not describe one disease or even one virus.<\/p>\n\n\n\n

    More than 200 respiratory viruses<\/strong> can cause cold symptoms. Rhinoviruses are the most frequent cause, but common human coronaviruses, adenoviruses, parainfluenza viruses, enteroviruses and other viruses can produce the same syndrome.<\/p>\n\n\n\n

    Typical symptoms include:<\/p>\n\n\n\n

      \n
    • runny nose;<\/li>\n\n\n\n
    • congestion;<\/li>\n\n\n\n
    • sneezing;<\/li>\n\n\n\n
    • sore throat;<\/li>\n\n\n\n
    • cough;<\/li>\n\n\n\n
    • headache;<\/li>\n\n\n\n
    • mild body aches;<\/li>\n\n\n\n
    • low-grade fever.<\/li>\n<\/ul>\n\n\n\n

      Symptoms usually peak within two or three days, and colds generally resolve within about a week.<\/p>\n\n\n\n

      How common?<\/h5>\n\n\n\n

      Extremely.<\/p>\n\n\n\n

      CDC estimates that American adults experience approximately two to three colds per year<\/strong>, with children experiencing even more.<\/p>\n\n\n\n

      This means that millions\u2014or potentially hundreds of millions\u2014of individual cold episodes occur annually.<\/p>\n\n\n\n

      Yet frequency should not be confused with lethality.<\/p>\n\n\n\n

      \n\n\n\n
      2. Can the common cold kill?<\/h5>\n\n\n\n

      Rarely, yes.<\/p>\n\n\n\n

      That distinction is important.<\/p>\n\n\n\n

      CDC notes that rhinovirus and other cold-causing viruses can produce serious illness, particularly in:<\/p>\n\n\n\n

        \n
      • immunocompromised individuals;<\/li>\n\n\n\n
      • people with asthma;<\/li>\n\n\n\n
      • premature infants;<\/li>\n\n\n\n
      • people with underlying disease; and<\/li>\n\n\n\n
      • people infected simultaneously with multiple respiratory viruses.<\/li>\n<\/ul>\n\n\n\n

        Complications can include:<\/p>\n\n\n\n

          \n
        • asthma exacerbations;<\/li>\n\n\n\n
        • bronchiolitis;<\/li>\n\n\n\n
        • bronchitis;<\/li>\n\n\n\n
        • pneumonia;<\/li>\n\n\n\n
        • sinusitis;<\/li>\n\n\n\n
        • otitis media;<\/li>\n\n\n\n
        • worsening COPD;<\/li>\n\n\n\n
        • worsening heart failure.<\/li>\n<\/ul>\n\n\n\n

          But there is an important epidemiological limitation:<\/p>\n\n\n\n

          The United States does not have a reliable national death count for “the common cold.”<\/strong><\/p>\n\n\n\n

          That’s because “common cold” encompasses many viruses and because death certificates generally identify the serious complication\u2014such as pneumonia, rather than “rhinovirus cold”\u2014as the proximate cause.<\/p>\n\n\n\n

          Therefore, it would be misleading to compare a precise COVID death number with an invented “common cold death rate.”<\/p>\n\n\n\n

          The correct conclusion is that ordinary rhinovirus infection is overwhelmingly a mild illness, while severe or fatal outcomes are unusual.<\/strong><\/p>\n\n\n\n

          \n\n\n\n
          3. Influenza is a different disease<\/h5>\n\n\n\n

          Influenza is much more dangerous than the common cold.<\/p>\n\n\n\n

          It can produce:<\/p>\n\n\n\n

            \n
          • viral pneumonia;<\/li>\n\n\n\n
          • secondary bacterial pneumonia;<\/li>\n\n\n\n
          • respiratory failure;<\/li>\n\n\n\n
          • myocarditis;<\/li>\n\n\n\n
          • encephalopathy;<\/li>\n\n\n\n
          • sepsis;<\/li>\n\n\n\n
          • exacerbation of heart disease;<\/li>\n\n\n\n
          • exacerbation of lung disease;<\/li>\n\n\n\n
          • hospitalization;<\/li>\n\n\n\n
          • death.<\/li>\n<\/ul>\n\n\n\n

            And unlike the common cold, influenza produces a substantial and measurable annual mortality burden.<\/p>\n\n\n\n

            CDC estimates influenza burden using mathematical models because many people with influenza are never tested and influenza-associated deaths may not have influenza recorded on the death certificate.<\/p>\n\n\n\n

            \n\n\n\n
            4. The 2024\u201325 influenza season<\/h5>\n\n\n\n

            This provides an especially useful contemporary comparison.<\/p>\n\n\n\n

            CDC classified the 2024\u201325 influenza season as high severity<\/strong>.<\/p>\n\n\n\n

            Its estimated burden was:<\/p>\n\n\n\n

            Outcome<\/th>2024\u201325 influenza<\/th><\/tr><\/thead>
            Illnesses<\/td>51 million<\/strong><\/td><\/tr>
            Medical visits<\/td>23 million<\/strong><\/td><\/tr>
            Hospitalizations<\/td>710,000<\/strong><\/td><\/tr>
            Deaths<\/td>45,000<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

            That was an unusually severe influenza season.<\/p>\n\n\n\n

            Nevertheless, influenza remained considerably less lethal than COVID was during the worst pandemic years.<\/p>\n\n\n\n

            \n\n\n\n
            5. COVID versus influenza today<\/h5>\n\n\n\n

            The comparison becomes considerably more interesting in the post-pandemic era.<\/p>\n\n\n\n

            For July 2024 through June 2025, CDC estimated:<\/p>\n\n\n\n

            COVID-19<\/h5>\n\n\n\n

            290,000\u2013450,000 hospitalizations<\/strong><\/p>\n\n\n\n

            34,000\u201353,000 deaths<\/strong><\/p>\n\n\n\n

            RSV<\/h5>\n\n\n\n

            190,000\u2013350,000 hospitalizations<\/strong><\/p>\n\n\n\n

            10,000\u201323,000 deaths<\/strong><\/p>\n\n\n\n

            Influenza during the overlapping 2024\u201325 season produced approximately:<\/p>\n\n\n\n

            710,000 hospitalizations<\/strong><\/p>\n\n\n\n

            and<\/p>\n\n\n\n

            45,000 deaths.<\/strong><\/p>\n\n\n\n

            There is therefore an important contemporary observation:<\/p>\n\n\n\n

            COVID and influenza now produce mortality burdens that can overlap substantially in a given year.<\/h5>\n\n\n\n

            COVID is no longer producing the hundreds of thousands of deaths annually seen during 2020\u201321.<\/p>\n\n\n\n

            But neither has COVID become equivalent to the common cold.<\/p>\n\n\n\n

            \n\n\n\n
            6. The extraordinary change from 2020 to the present<\/h5>\n\n\n\n

            The biggest mistake in comparing COVID today with COVID in March 2020 is assuming they are epidemiologically identical.<\/p>\n\n\n\n

            They are not.<\/p>\n\n\n\n

            The virus has changed.<\/p>\n\n\n\n

            The population has changed.<\/p>\n\n\n\n

            Medical treatment has changed.<\/p>\n\n\n\n

            Prior infection has become widespread.<\/p>\n\n\n\n

            Vaccination has produced additional immunity.<\/p>\n\n\n\n

            Antiviral treatment is available.<\/p>\n\n\n\n

            Clinicians understand severe COVID much better.<\/p>\n\n\n\n

            Consequently, the risk profile has changed enormously.<\/p>\n\n\n\n

            CDC estimates that COVID-associated deaths fell to approximately 31,000 in 2024<\/strong> based on death-certificate data, compared with hundreds of thousands during the major pandemic years.<\/p>\n\n\n\n

            The disease therefore remains serious, but its population-level mortality is now much closer to that of other major respiratory pathogens.<\/p>\n\n\n\n

            \n\n\n\n
            7. RSV belongs between influenza and the common cold\u2014but with an unusual age distribution<\/h5>\n\n\n\n

            Respiratory syncytial virus is particularly important because its danger is strongly age-dependent.<\/p>\n\n\n\n

            CDC describes RSV as the leading cause of infant hospitalization in the United States<\/strong>. It also causes substantial disease among older adults and people with risk factors.<\/p>\n\n\n\n

            During July 2024\u2013June 2025, CDC estimated:<\/p>\n\n\n\n

            190,000\u2013350,000 RSV hospitalizations<\/strong><\/p>\n\n\n\n

            and<\/p>\n\n\n\n

            10,000\u201323,000 deaths.<\/strong><\/p>\n\n\n\n

            But the age distribution differs dramatically from COVID.<\/p>\n\n\n\n

            For 2024\u201325:<\/p>\n\n\n\n

            RSV hospitalization rates<\/h5>\n\n\n\n

            Infants under 12 months:<\/p>\n\n\n\n

            1,116.7 per 100,000<\/strong><\/p>\n\n\n\n

            Adults \u226575:<\/p>\n\n\n\n

            426.9 per 100,000<\/strong><\/p>\n\n\n\n

            COVID’s highest hospitalization rate, by contrast, was among adults \u226575:<\/p>\n\n\n\n

            932.6 per 100,000.<\/strong><\/p>\n\n\n\n

            Thus, RSV is disproportionately a disease of infants and older adults<\/strong>, whereas COVID has a particularly strong mortality gradient toward older adults.<\/p>\n\n\n\n

            \n\n\n\n
            8. What about tuberculosis?<\/h5>\n\n\n\n

            Tuberculosis is fundamentally different from the respiratory viruses discussed above.<\/p>\n\n\n\n

            It is bacterial, can become chronic, can spread from person to person over prolonged periods, and without treatment can be fatal.<\/p>\n\n\n\n

            Yet in the United States its mortality burden is now far smaller than COVID or influenza.<\/p>\n\n\n\n

            CDC reports:<\/p>\n\n\n\n

            10,388 TB cases in 2024<\/strong><\/p>\n\n\n\n

            and a TB death rate of approximately:<\/p>\n\n\n\n

            0.2 deaths per 100,000 population.<\/strong><\/p>\n\n\n\n

            The latest available NCHS death count cited by CDC was 572 deaths in 2023<\/strong>.<\/p>\n\n\n\n

            So, in contemporary U.S. mortality terms:<\/p>\n\n\n\n

            COVID > influenza > RSV > tuberculosis<\/strong><\/p>\n\n\n\n

            is a reasonable broad ordering for these particular infections in recent years, although the exact ordering changes by year and the diseases affect different populations.<\/p>\n\n\n\n

            \n\n\n\n
            9. Why comparing mortality rates is harder than it appears<\/h5>\n\n\n\n

            There is an important methodological problem.<\/p>\n\n\n\n

            CDC does not<\/strong> measure every respiratory infection in the same way.<\/p>\n\n\n\n

            COVID<\/h5>\n\n\n\n

            There are extensive laboratory, hospitalization and death-certificate surveillance systems.<\/p>\n\n\n\n

            Influenza<\/h5>\n\n\n\n

            CDC uses mathematical models because testing is incomplete and influenza frequently contributes to deaths without appearing on the death certificate.<\/p>\n\n\n\n

            RSV<\/h5>\n\n\n\n

            CDC also uses statistical models to estimate outpatient visits, hospitalizations and deaths.<\/p>\n\n\n\n

            Common cold<\/h5>\n\n\n\n

            There is no comparable national mortality model encompassing all cold-causing viruses.<\/p>\n\n\n\n

            Therefore, simply placing four numbers in a table can create a false impression of precision.<\/p>\n\n\n\n

            \n\n\n\n
            10. A useful qualitative hierarchy<\/h5>\n\n\n\n

            For the average healthy adult, the respiratory infections can roughly be conceptualized this way:<\/p>\n\n\n\n

            Infection<\/th>Typical illness<\/th>Severe disease<\/th>Death<\/th><\/tr><\/thead>
            Common cold\/rhinovirus<\/strong><\/td>Usually mild<\/td>Uncommon<\/td>Very rare<\/td><\/tr>
            RSV<\/strong><\/td>Often mild in adults<\/td>Important in infants\/elderly<\/td>Significant in high-risk groups<\/td><\/tr>
            Influenza<\/strong><\/td>Often moderate\/severe<\/td>Well-established<\/td>Tens of thousands annually in severe seasons<\/td><\/tr>
            COVID-19<\/strong><\/td>Highly variable<\/td>Substantial<\/td>Tens of thousands annually currently; far higher during pandemic peaks<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

            This is a much more useful representation than saying simply that all are “respiratory viruses.”<\/p>\n\n\n\n

            \n\n\n\n
            11. COVID is particularly age-dependent<\/h5>\n\n\n\n

            Age is probably the single most important determinant of COVID mortality.<\/p>\n\n\n\n

            A young healthy adult and an 85-year-old with multiple chronic diseases do not have remotely comparable risks.<\/p>\n\n\n\n

            The same principle applies to influenza and RSV, but the age-risk curves differ.<\/p>\n\n\n\n

            COVID mortality became extraordinarily concentrated among older adults during the pandemic.<\/p>\n\n\n\n

            Influenza likewise disproportionately affects older adults: CDC estimates that people \u226565 accounted for 71% of influenza deaths during the 2024\u201325 season<\/strong>.<\/p>\n\n\n\n

            RSV has the additional distinctive burden of severe disease in infants.<\/p>\n\n\n\n

            The common cold generally produces mild disease across the population, although exceptions occur in medically vulnerable people.<\/p>\n\n\n\n

            \n\n\n\n
            12. COVID is not “just a cold”<\/h5>\n\n\n\n

            This statement is supported by the clinical data.<\/p>\n\n\n\n

            The common cold generally remains an upper-respiratory illness.<\/p>\n\n\n\n

            COVID can involve:<\/p>\n\n\n\n

              \n
            • the lungs;<\/li>\n\n\n\n
            • cardiovascular system;<\/li>\n\n\n\n
            • nervous system;<\/li>\n\n\n\n
            • kidneys;<\/li>\n\n\n\n
            • vascular system;<\/li>\n\n\n\n
            • gastrointestinal system;<\/li>\n\n\n\n
            • immune system.<\/li>\n<\/ul>\n\n\n\n

              And some patients develop persistent symptoms after the acute infection.<\/p>\n\n\n\n

              That difference alone places COVID in a fundamentally different clinical category.<\/p>\n\n\n\n

              CDC specifically distinguishes SARS-CoV-2 from the viruses that cause ordinary colds, noting that SARS-CoV-2 can produce severe disease, hospitalization and death.<\/p>\n\n\n\n

              \n\n\n\n
              13. But COVID is also not perpetually a 2020-level threat<\/h5>\n\n\n\n

              This is equally important.<\/p>\n\n\n\n

              Current CDC surveillance shows COVID activity at relatively low levels nationally as of August 2026, although activity has begun increasing in some areas. Influenza activity remains low and RSV activity is very low nationally.<\/p>\n\n\n\n

              Therefore, the phrase “COVID is dangerous”<\/strong> is incomplete without specifying:<\/p>\n\n\n\n

              When?<\/strong><\/p>\n\n\n\n

              Which variant?<\/strong><\/p>\n\n\n\n

              Which age group?<\/strong><\/p>\n\n\n\n

              What underlying medical conditions?<\/strong><\/p>\n\n\n\n

              Previous infection?<\/strong><\/p>\n\n\n\n

              Vaccination status?<\/strong><\/p>\n\n\n\n

              Treatment availability?<\/strong><\/p>\n\n\n\n

              The COVID risk in March 2020 cannot simply be substituted for the COVID risk in August 2026.<\/p>\n\n\n\n

              \n\n\n\n
              14. The most revealing comparison: deaths per year<\/h5>\n\n\n\n

              A rough contemporary comparison illustrates the point.<\/p>\n\n\n\n

              United States<\/h5>\n\n\n\n

              COVID-19, July 2024\u2013June 2025:<\/strong><\/p>\n\n\n\n

              34,000\u201353,000 estimated deaths.<\/p>\n\n\n\n

              Influenza, 2024\u201325:<\/strong><\/p>\n\n\n\n

              45,000 estimated deaths.<\/p>\n\n\n\n

              RSV, July 2024\u2013June 2025:<\/strong><\/p>\n\n\n\n

              10,000\u201323,000 estimated deaths.<\/p>\n\n\n\n

              Tuberculosis, 2023:<\/strong><\/p>\n\n\n\n

              572 deaths.<\/p>\n\n\n\n

              Common cold:<\/strong><\/p>\n\n\n\n

              No reliable national death estimate encompassing all cold viruses.<\/p>\n\n\n\n

              This produces a striking conclusion:<\/p>\n\n\n\n

              Today, COVID and influenza can be of comparable magnitude as causes of death in the United States.<\/h5>\n\n\n\n

              But:<\/p>\n\n\n\n

              Neither is remotely comparable to the ordinary common cold.<\/h5>\n\n\n\n
              \n\n\n\n
              15. COVID versus the common cold: the practical answer<\/h5>\n\n\n\n

              Suppose 1,000 otherwise healthy adults acquire:<\/p>\n\n\n\n

              Rhinovirus\/common cold<\/h5>\n\n\n\n

              The overwhelming majority will recover without medical intervention.<\/p>\n\n\n\n

              A small minority may experience complications, particularly those with asthma or other vulnerabilities.<\/p>\n\n\n\n

              COVID<\/h5>\n\n\n\n

              The overwhelming majority will also recover.<\/p>\n\n\n\n

              But a materially larger fraction can develop:<\/p>\n\n\n\n

                \n
              • pneumonia;<\/li>\n\n\n\n
              • hypoxemia;<\/li>\n\n\n\n
              • hospitalization;<\/li>\n\n\n\n
              • thrombotic complications;<\/li>\n\n\n\n
              • cardiac complications;<\/li>\n\n\n\n
              • neurologic complications;<\/li>\n\n\n\n
              • or persistent post-infectious symptoms.<\/li>\n<\/ul>\n\n\n\n

                The difference is therefore not that every COVID infection is dangerous<\/strong>.<\/p>\n\n\n\n

                It is that the probability distribution has a substantially heavier severe-disease tail.<\/strong><\/p>\n\n\n\n

                That is the most scientifically accurate way to describe the difference.<\/p>\n\n\n\n

                \n\n\n\n
                16. The pandemic changed the question<\/h5>\n\n\n\n

                During 2020 and 2021 the question was:<\/p>\n\n\n\n

                \n

                “How dangerous is this new virus?”<\/strong><\/p>\n<\/blockquote>\n\n\n\n

                The answer was: extraordinarily dangerous compared with ordinary seasonal respiratory viruses.<\/strong><\/p>\n\n\n\n

                In 2026, the more appropriate question is:<\/p>\n\n\n\n

                \n

                “How dangerous is SARS-CoV-2 now, for this particular person, compared with other circulating respiratory viruses?”<\/strong><\/p>\n<\/blockquote>\n\n\n\n

                That answer is more complicated.<\/p>\n\n\n\n

                For an elderly person with multiple medical conditions, COVID remains a significant threat.<\/p>\n\n\n\n

                For a healthy young adult, the absolute risk of death is vastly lower.<\/p>\n\n\n\n

                For an infant, RSV may represent a greater hospitalization threat than COVID.<\/p>\n\n\n\n

                For the average healthy adult with an ordinary cold, rhinovirus remains overwhelmingly benign.<\/p>\n\n\n\n

                \n\n\n\n
                Bottom line<\/h5>\n\n\n\n

                The evidence supports a hierarchy that is substantially different from the rhetoric used during the most intense years of the pandemic:<\/p>\n\n\n\n

                Common cold \u2192 usually trivial<\/strong><\/p>\n\n\n\n

                RSV \u2192 potentially serious, particularly infants and elderly<\/strong><\/p>\n\n\n\n

                Influenza \u2192 substantial annual morbidity and mortality<\/strong><\/p>\n\n\n\n

                COVID-19 \u2192 still a major respiratory pathogen, with current mortality roughly comparable to severe influenza seasons, but dramatically less dangerous at the population level than during 2020\u201321<\/strong><\/p>\n\n\n\n

                And the most important comparison is this:<\/p>\n\n\n\n

                \n

                COVID is not the common cold. But present-day COVID is also not the same epidemiological threat that Americans faced in March 2020.<\/strong><\/p>\n<\/blockquote>\n\n\n\n

                The data show a disease whose severity has changed profoundly over time. CDC’s current surveillance confirms that COVID, influenza and RSV are now all part of an ongoing respiratory-virus landscape rather than the extraordinary single-pathogen emergency of early 2020.<\/p>\n\n\n\n

                Table 1. Current U.S. burden of major respiratory infections<\/h5>\n\n\n\n
                Infection<\/th>Approx. U.S. illnesses\/year<\/th>Hospitalizations<\/th>Deaths<\/th>Principal high-risk groups<\/th><\/tr><\/thead>
                COVID-19<\/strong><\/td>Very large; difficult to estimate precisely<\/td>290,000\u2013450,000<\/strong>\u00b9<\/td>34,000\u201353,000<\/strong>\u00b9<\/td>Older adults, immunocompromised, chronic disease<\/td><\/tr>
                Influenza<\/strong><\/td>51 million<\/strong>\u00b2<\/td>710,000<\/strong>\u00b2<\/td>45,000<\/strong>\u00b2<\/td>\u226565, young children, pregnancy, chronic disease<\/td><\/tr>
                RSV<\/strong><\/td>Millions<\/td>190,000\u2013350,000<\/strong>\u00b9<\/td>10,000\u201323,000<\/strong>\u00b9<\/td>Infants, \u226575, chronic disease<\/td><\/tr>
                Common cold<\/strong><\/td>Hundreds of millions of episodes<\/td>Very uncommon<\/td>No reliable national estimate<\/strong><\/td>Immunocompromised, infants, chronic lung disease<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                Sources:<\/strong>
                \u00b9 CDC, July 2024\u2013June 2025 respiratory-virus burden estimates.
                \u00b2 CDC, 2024\u201325 influenza burden estimates.<\/p>\n\n\n\n

                \n\n\n\n
                Table 2. COVID mortality compared with influenza over time<\/h5>\n\n\n\n
                Year\/season<\/th>COVID deaths, U.S.<\/th>Influenza deaths, U.S.*<\/th>Interpretation<\/th><\/tr><\/thead>
                2020<\/strong><\/td>~385,000<\/td>Exceptionally low<\/td>COVID pandemic; influenza circulation collapsed<\/td><\/tr>
                2021<\/strong><\/td>416,893<\/strong><\/td>~20,000<\/td>COVID mortality vastly exceeded influenza<\/td><\/tr>
                2022<\/strong><\/td>186,552<\/strong><\/td>~19,000\u201321,000<\/td>COVID still substantially greater<\/td><\/tr>
                2023<\/strong><\/td>49,932<\/strong><\/td>~21,000<\/td>Difference narrowed substantially<\/td><\/tr>
                2024<\/strong><\/td>31,426<\/strong><\/td>~20,000\u201330,000<\/td>Comparable order of magnitude<\/td><\/tr>
                2024\u201325 season<\/strong><\/td>~34,000\u201353,000\u00b9<\/td>45,000\u00b2<\/strong><\/td>Similar current annual mortality<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                *Influenza figures are CDC modeled estimates and therefore should not be interpreted as directly equivalent to death-certificate COVID counts.<\/p>\n\n\n\n

                Table 3. Hospitalization burden by age<\/h5>\n\n\n\n

                CDC’s 2024\u201325 respiratory-virus surveillance illustrates the dramatically different age distributions.<\/p>\n\n\n\n

                Age<\/th>COVID hospitalization rate<\/th>RSV hospitalization rate<\/th>Influenza hospitalization rate<\/th><\/tr><\/thead>
                <1 year<\/strong><\/td>Lower than older adults<\/td>1,116.7\/100,000<\/strong><\/td>High<\/td><\/tr>
                1\u20134 years<\/strong><\/td>Lower<\/td>Substantial<\/td>Substantial<\/td><\/tr>
                5\u201317 years<\/strong><\/td>Low<\/td>Low<\/td>Moderate<\/td><\/tr>
                18\u201349 years<\/strong><\/td>Moderate<\/td>Low<\/td>Moderate<\/td><\/tr>
                50\u201364 years<\/strong><\/td>Higher<\/td>Increasing<\/td>Higher<\/td><\/tr>
                65\u201374 years<\/strong><\/td>High<\/td>High<\/td>High<\/td><\/tr>
                \u226575 years<\/strong><\/td>932.6\/100,000<\/strong><\/td>426.9\/100,000<\/strong><\/td>Very high<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                The important observation is that RSV has an unusually high hospitalization burden in infants<\/strong>, whereas COVID and influenza have particularly large burdens among older adults.<\/p>\n\n\n\n

                \n\n\n\n
                Table 4. Relative clinical severity<\/h5>\n\n\n\n
                Characteristic<\/th>Common cold<\/th>Influenza<\/th>RSV<\/th>COVID-19<\/th><\/tr><\/thead>
                Usually mild<\/td>Yes<\/strong><\/td>Often<\/td>Often<\/td>Often<\/td><\/tr>
                Pneumonia<\/td>Rare<\/td>Well recognized<\/td>Well recognized<\/td>Important complication<\/strong><\/td><\/tr>
                Hospitalization<\/td>Very uncommon<\/td>Significant<\/td>Significant<\/td>Significant<\/td><\/tr>
                Respiratory failure<\/td>Very rare<\/td>Possible<\/td>Possible<\/td>Well documented<\/strong><\/td><\/tr>
                Death<\/td>Extremely rare<\/td>Thousands\u2013tens of thousands\/year<\/td>Thousands\/year<\/td>Tens of thousands\/year currently<\/td><\/tr>
                Severe disease in elderly<\/td>Uncommon<\/td>Yes<\/strong><\/td>Yes<\/strong><\/td>Yes<\/strong><\/td><\/tr>
                Severe disease in infants<\/td>Uncommon<\/td>Yes<\/td>Especially important<\/strong><\/td>Less prominent than RSV<\/td><\/tr>
                Long-term post-infectious illness<\/td>Uncommon<\/td>Possible<\/td>Uncommon<\/td>Well documented<\/strong><\/td><\/tr>
                Major cardiovascular complications<\/td>Unusual<\/td>Possible<\/td>Unusual<\/td>Documented<\/strong><\/td><\/tr>
                Neurologic complications<\/td>Uncommon<\/td>Possible<\/td>Uncommon<\/td>Documented<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
                \n\n\n\n
                Table 5. The most important distinction: risk is highly age-dependent<\/h5>\n\n\n\n

                A population-wide mortality figure can be misleading because the risk of dying from respiratory infection is not evenly distributed across the population<\/strong>.<\/p>\n\n\n\n

                Population<\/th>Common cold<\/th>Influenza<\/th>RSV<\/th>COVID-19<\/th><\/tr><\/thead>
                Healthy children<\/td>Very low risk<\/td>Low<\/td>Low\u2013moderate<\/td>Low<\/td><\/tr>
                Healthy young adults<\/td>Very low<\/td>Low<\/td>Low<\/td>Low<\/td><\/tr>
                Middle-aged adults<\/td>Very low<\/td>Moderate<\/td>Moderate<\/td>Moderate<\/td><\/tr>
                Adults \u226565<\/td>Low<\/td>High<\/strong><\/td>High<\/strong><\/td>High<\/strong><\/td><\/tr>
                Adults \u226575<\/td>Low<\/td>Very high<\/strong><\/td>Very high<\/strong><\/td>Very high<\/strong><\/td><\/tr>
                Immunocompromised<\/td>Higher complication risk<\/td>High<\/td>High<\/td>High<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                This is why statements such as “COVID has a 0.X% mortality rate”<\/strong> are inadequate without specifying the population.<\/p>\n\n\n\n

                \n\n\n\n
                Table 6. COVID mortality at the height of the pandemic versus today<\/h5>\n\n\n\n
                Measure<\/th>2020\u201321<\/th>2024\u201325<\/th><\/tr><\/thead>
                COVID deaths<\/td>Hundreds of thousands\/year<\/strong><\/td>~34,000\u201353,000\/year<\/strong><\/td><\/tr>
                Population immunity<\/td>Minimal initially<\/td>Extensive<\/td><\/tr>
                Prior infection<\/td>Limited initially<\/td>Widespread<\/td><\/tr>
                Vaccination<\/td>Unavailable initially<\/td>Available<\/td><\/tr>
                Effective antivirals<\/td>Limited<\/td>Available<\/td><\/tr>
                Clinical experience<\/td>Minimal<\/td>Extensive<\/td><\/tr>
                ICU treatment protocols<\/td>Rapidly evolving<\/td>Established<\/td><\/tr>
                Mechanical ventilation<\/td>Used much more frequently<\/td>Used less frequently<\/td><\/tr>
                Mortality<\/td>Extremely high<\/strong><\/td>Much lower<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                This table is perhaps the most important one for interpreting the entire COVID debate.<\/p>\n\n\n\n

                “COVID” in 2020 and “COVID” today are not epidemiologically equivalent situations.<\/strong><\/p>\n\n\n\n

                \n\n\n\n
                Table 7. COVID versus the common cold<\/h5>\n\n\n\n
                Question<\/th>Common cold<\/th>COVID-19<\/th><\/tr><\/thead>
                Caused by one virus?<\/td>No<\/strong>\u2014many viruses<\/td>Yes<\/strong>\u2014SARS-CoV-2<\/td><\/tr>
                Most infections mild?<\/td>Yes<\/strong><\/td>Yes<\/td><\/tr>
                Can cause pneumonia?<\/td>Rare<\/td>Yes<\/strong><\/td><\/tr>
                Can cause respiratory failure?<\/td>Very rare<\/td>Yes<\/strong><\/td><\/tr>
                Can require ICU care?<\/td>Extremely uncommon<\/td>Yes<\/strong><\/td><\/tr>
                Can cause death?<\/td>Extremely rare<\/td>Yes<\/strong><\/td><\/tr>
                Large annual mortality burden?<\/td>No reliable estimate; extremely small<\/td>Yes<\/strong><\/td><\/tr>
                Can cause persistent symptoms?<\/td>Occasionally<\/td>Yes\u2014Long COVID<\/strong><\/td><\/tr>
                Significant mortality among elderly?<\/td>Very unusual<\/td>Yes<\/strong><\/td><\/tr>
                Vaccines available?<\/td>No<\/td>Yes<\/strong><\/td><\/tr>
                Antiviral treatment available?<\/td>No routine antiviral<\/td>Yes for selected high-risk patients<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
                \n\n\n\n
                Table 8. A useful hierarchy of respiratory-virus danger<\/h5>\n\n\n\n

                For the average person<\/strong>, a reasonable qualitative hierarchy is:<\/p>\n\n\n\n

                Level<\/th>Infection<\/th>General assessment<\/th><\/tr><\/thead>
                1 \u2014 Very low<\/strong><\/td>Common cold\/rhinovirus<\/td>Usually self-limited<\/td><\/tr>
                2 \u2014 Low to moderate<\/strong><\/td>RSV in healthy adults<\/td>Usually mild, but important exceptions<\/td><\/tr>
                3 \u2014 Moderate to high<\/strong><\/td>Influenza<\/td>Significant hospitalization and mortality<\/td><\/tr>
                4 \u2014 Moderate to high today<\/strong><\/td>COVID-19<\/td>Substantial hospitalization and mortality, particularly in older\/high-risk people<\/td><\/tr>
                5 \u2014 Exceptional historical period<\/strong><\/td>COVID-19, 2020\u201321<\/td>Extraordinary mortality and health-system disruption<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                The final distinction is important: current COVID should not be characterized using the mortality experience of the first pandemic waves.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

                John Murphy, CEO, The COVID-19 Long haul Foundation A comparison of the major respiratory infections\u2014and why the common cold belongs in a completely different category The public discussion of respiratory […]<\/p>\n","protected":false},"author":2,"featured_media":15891,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[95,761,149,1091,974,607,608],"tags":[],"class_list":["post-15879","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-common-cold","category-concerns","category-epidemiology","category-influenza","category-vaccine-long-term-safety","category-vaccine-news","category-vaccine-safety"],"_links":{"self":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/15879","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=15879"}],"version-history":[{"count":5,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/15879\/revisions"}],"predecessor-version":[{"id":15890,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/15879\/revisions\/15890"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/media\/15891"}],"wp:attachment":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=15879"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=15879"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=15879"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}