The H3N2 Flu Pandemic Of 1968-1969 Remains The Most Deadly In The US In The Past Century

Key Takeaways

Last week the number of Americans who have died from COVID-19 surpassed 100,000 making it appear more deadly than the H3N2 flu pandemic of 1968-1969 that claimed 100,000 lives according to the Centers for Disease Control (CDC).[1] A more careful examination of age-specific fatality rates, and the age distribution of the US population, indicates that the H3N2 flu had a disproportionately higher death toll than we have seen from COVID-19. Both COVID-19 and H3N2 have been especially deadly for individuals age 65 and above, but because the elderly population is substantially larger than it was in 1968, age-specific COVID-19 fatality rates remain substantially lower than the corresponding fatality rates for the H3N2 flu.

The figure below shows that while the overall US population is 65% larger today than it was in 1968, this is largely because of the substantial population differences for older age groups. Today there are only 3.7% more children (age 14 and under) but 2.7 times as many adults age 65 and above compared to 1968. Most importantly for COVID-19 fatality totals, there are currently five times as many Americans age 85 and above as there were in 1968. [2]  

The aging US population combined with the vastly higher COVID-19 fatality rates for the elderly implies that if the US population and age distribution mirrored the 1968 population, the COVID-19 death totals would be under 36,000 instead of about 104,000. The 100,000 H3N2 flu deaths in 1968-1969 are staggering when one considers that the pandemic occurred when there were fewer than 20 million Americans age 65 and above. Today there are over 52 million Americans age 65 and older, and the typical senior citizen is substantially older than in 1968. The age-specific fatality rates that resulted in 100,000 H3N2 deaths for the smaller and younger population in 1968, would have resulted in 291,385 deaths for the US population in 2020. In other words, the age-specific fatality rates of the H3N2 pandemic will continue to exceed the corresponding fatality rates of the coronavirus pandemic until COVID-19 deaths exceed 291,385.

During the H3N2 flu pandemic Americans did not engage in social distancing and there were no lockdowns. There was no internet and very few Americans would have been able to work or shop from home while sheltering in place in 1968. Consequently, a virus that is probably less deadly than the coronavirus resulted in almost three times as many fatalities per capita among the elderly as COVID-19 has claimed to date.

The extraordinary sheltering in place and social distancing measures over the past two months in the US appear to have saved many thousands of lives among elderly and vulnerable populations.[3] However, the lockdowns have come with a great economic cost; over 20 percent of the labor force has filed for unemployment insurance and many businesses may not survive the drastic reductions in travel and limitations on social gatherings that have been implemented to slow the spread of the coronavirus. 

Notes

[1] https://www.cdc.gov/flu/pandemic-resources/1968-pandemic.html

[2] Age 85 and above is the oldest age group for which the CDC reports fatalities by age.

[3] Age-specific COVID-19 fatality rates are lower than corresponding H3N2 fatality rates due to improvements in health care over the past 50 years as well as social distancing and sheltering in place. The life expectancy for individuals age 65 and above today is about 28% higher than it was in 1968.

[3]  https://www.cdc.gov/Nchs/data/statab/pop6097.pdf

[5] https://data.cdc.gov/widgets/9bhg-hcku

[6] https://www.cdc.gov/nchs/data/hus/2010/022.pdf

[7] https://www.census.gov/programs-surveys/acs/technical-documentation/table-and-geography-changes/2018/1-year.html

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Stephen G. Bronars, PhD

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