COVID-19: Did the Spanish Flu kill “an estimated 2 to 3 percent of those infected”?

Within the past few weeks, as the COVID-19 pandemic spread across the world, commenters in news media have propagated a meme that’s now firmly embedded in the public consciousness. It’s best summed up in an article in Vox that’s typical of the trend, “Did the coronavirus get more deadly? The death rate, explained.”1 The Vox article states that the global COVID-19 CFR is “even worse than the Spanish flu pandemic (which killed an estimated 2 to 3 percent of those infected).” A New York Times article2 from about the same time soberly contrasts the Spanish Flu with the current pandemic, but it makes a similar claim, “The 1918 flu pandemic, thought to be the deadliest in human history, killed at least 50 million people worldwide… With a case fatality rate of at least 2.5 percent, the 1918 flu was far more deadly than ordinary flu, and it was so infectious that it spread widely, which meant the number of deaths soared.”

Can you spot the problem?

If the Spanish Flu killed 50 million people (as is widely reported)[note] and had a case fatality rate of 2.5%, then no less than 2 billion were infected….which is greater than the global population of 1.8 billion in 1918.This is even more problematic given that the Spanish Flu is estimated to have infected 500 million people. The transparently false claim about the Spanish Flu’s case fatality rate has led to articles with breathless headlines like “According to the WHO, Coronavirus Is WORSE Than the Spanish Flu … Which Killed Tens of Millions of People.”5

Thankfully, Ferris Jabr noticed this bizarre discrepancy. His article on Wired, “Covid-19 Is Not the Spanish Flu6 offers a deep dive into how this viral, erroneous factoid came to be.


Note: Spreeuwenberg et al. (2018, 2019) argue convincingly that the global Spanish flu death toll was much lower (approximately 17 million), and that estimates over 25 million are “not realistic” based on exhaustive analysis showing that expectations of concomitant population declines are contradicted by existing records and flu mortality dynamics.7,8

[1] Belluz J. “Did the coronavirus get more deadly? The death rate, explained.” Vox. March 11, 2020. Retrieved March 24, 2020.

[2] Kolata G. “Coronavirus Is Very Different From the Spanish Flu of 1918. Here’s How.” New York Times. March 9, 2020. Retrieved March 24, 2020.

[3] Roser M. “The Spanish flu (1918-20): The global impact of the largest influenza pandemic in history.” Our World in Data. March 4, 2020. Retrieved March 24, 2020.

[4] “Influenza (Flu): 1918 Pandemic” CDC. March 20, 2019. Retrieved March 24, 2020.

[5] Smith Y. “According to the WHO, Coronavirus Is WORSE Than the Spanish Flu … Which Killed Tens of Millions of People” Naked Capitalism. March 4, 2020. Retrieved March 24, 2020.

[6] Jabr F. “Covid-19 Is Not the Spanish Flu” Wired. March 13, 2020. Retrieved March 24, 2020.

[7] Spreeuwenberg P, Kroneman M, Paget J. Reassessing the Global Mortality Burden of the 1918 Influenza Pandemic. American Journal of Epidemiology. 2018;187(12):2561-2567. doi:10.1093/aje/kwy191

[8] Spreeuwenberg P, Kroneman M, Paget J. THE AUTHORS REPLY. American Journal of Epidemiology. 2019;188(7):1405-1406. doi:10.1093/aje/kwz041

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