Comparing COVID-19 and the Flu: Exploring Risk Perception and Public Health Response

Differences in the perception of risk, how our response to COVID-19 may have reduced the impact of this year’s flu season

How our response to COVID-19 may have reduced the impact of this year’s flu season

By Frankie Wood-Black, Ph.D., REM, Principal, Sophic Pursuits

Frankie Wood-Black

Since January, the world has been focused on what was initially referred to as the "novel coronavirus." It was a virus that was new. It behaved differently. It easily spread. Not much was known and even though a significant amount of research and attention has been paid to the virus, there is still a great deal unknown about it. This virus appeaared, at least for the Northern Hemisphere, during the same time as something more familiar was making its rounds, the regular seasonal influenza or flu. Thus, it was understandable that individuals would begin to make comparisons.

Humans function by making comparisons. We analyze our world based upon prior experience. When we are presented with something new, humans will tend to view the new situation in the context of prior events or situations experienced. Additionally, our prior experience also influences how we view risk.

Risk is an interesting concept, and depending upon your source generally means the chance of injury or loss. Risk is related to danger. As this new virus came upon the world's stage, our view of the virus was colored by our prior experience and our perception of the potential risk of harm to this new virus.

As the virus spread, recommendations were put forth:  wash your hands frequently, guidelines for how to cover your cough, and how to protect yourself. These guidelines were nothing new. We hear them every year during flu season. The only one not included was to get your vaccination because there is no current vaccination for the virus. This, of course, frames our perception of the risk. But then things changed.  Systems became overwhelmed.  This new virus was easily spread.  The news was filled with more and more information about it.  An individual's perception of risk increased, and justifiably so, as we listen to the experts convey information.

It should be noted that an individual's perception of risk changes based upon experience and whether or not they think they can control the risk. For example, according to the 2018 National Safety Council “odds of dying”, an individual has a 1 in 106 chance of dying in a car crash versus odds too low to calculate (at least in 2018) of dying in an airplane crash.  Yet, many individuals will not fly due to a perceived level of increased risk.  Those that study an individual’s perception of risk indicate that individuals are about 1000 times more likely to take on a voluntary risk, such as driving, over an involuntary one. Similarly, the risk from an unknown is going to be perceived to be greater than that of something which is known. It will influence our response.  And, while our response to COVID-19 has been justified by data gathered and what we have seen in communities impacted by this virus, a nagging question arises; would we have viewed the seasonal influenza in the same way?

Because of this focus on the unknown, and challenges to health care infrastructure, the focus on the familiar has been overshadowed.  For many, the tracking of the spread of COVID-19 has become a daily occurrence. Organizations have built public health dashboards.  We follow the numbers just as we follow the stock market.  Yet, the familiar has been progressing, the flu season has been marching on with significant numbers and impacts.

Yes, this is a what-if question.  Looking at this year's flu season, an unsettling picture emerges. This year the CDC estimates that there have been 39 million illnesses, 410,000 hospitalizations and 24,000 deaths from the flu. The mortality rate, published on the flu dashboard, states that "the percentage of deaths attributed to pneumonia and influenza is 10.0% above the epidemic threshold of 7.1%." This year's flu season is at "epidemic" rates. 

A side by side comparison of this year's flu and COVID-19, shows that the seasonal flu has a 68.2 per 100,000  hospitalization rate while at this point in time COVID-19 has a 12.3 per 100,000 rate.  These numbers are impacted by the quarantine measures prompted by COVID-19, and we know that those same measures can limit the spread of influenza. Thus, while it is speculation, there is a valid question, "What would the flu season have looked like without the influence of the measures taken for COVID-19?" And, because of our perception of the risk associated with the familiar, would the same types of restrictions been put into place because of the risk in the numbers associated with the flu?  One might suggest, it could have been the pandemic that never was.

The opinions expressed in this article are the author's own and do not necessarily reflect the view of their employer or the American Chemical Society.

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