Flu Deaths Have Dropped Dramatically, Thanks to COVID-19 Prevention Efforts

Story by Korin Miller •

The flu is back this winter, along with other illnesses

Flu season, which runs from October through May, usually results in millions of infections and thousands of deaths.

Doctors explain how COVID-19 prevention efforts have diminished flu-related deaths in the past.

RSV and COVID-19 are dominating headlines right now, but there’s another potentially serious illness simmering in the background: the flu. People have written off the flu in the past, but doctors say that’s a mistake. “Prior to COVID-19, the flu was the most deadly respiratory virus we saw each year in the U.S.,” says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. “Now, COVID is an estimated five times more lethal.”


Flu activity remains low for the 2022-2023 season due to COVID-19 prevention efforts. But how many people die from the flu each year? Doctors explain.© Helin Loik-Tomson - Getty Images

But with all of the warnings about the flu being deadly, how many people die from the flu each year? Caveat: It’s hard to come by exact numbers, but there are estimates. Here’s the deal.

How many people die from the flu each year?

The answer is slightly complicated: The Centers for Disease Control and Prevention (CDC) doesn’t have an exact count of the number of people who die from influenza each year. Instead, the federal agency develops estimates based on rates of confirmed hospitalizations from the flu.

For that reason, it’s difficult to compare flu deaths with those of COVID-19, which are actual documented deaths, says Dr. Russo. “COVID deaths have been very specific—you have to have a positive COVID test for it to be attributable to COVID,” he says.

According to preliminary estimates from the CDC, 25,000 people died from flu in the 2019-2020 flu season. There were no estimates for the 2020-2021 season due to “minimal influenza activity,” the CDC says, and it’s estimated that 5,000 people died from the flu last year.

The number of flu deaths varies by season, though. In the 2018-2019 season, an estimated 52,000 people died of the flu, per CDC data.

And, of course, COVID-19 has screwed things up a bit. Flu death estimates traditionally incorporated pneumonia cases and “COVID has made that challenging” given that people can also die of pneumonia caused by COVID-19, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. “Many times in the past, death certificates would simply say ‘pneumonia’” if someone died from pneumonia caused by the flu, Dr. Adalja says.

“The CDC knows that they need to make adjustments to the way influenza deaths are tracked now—they just haven’t figured out what that should be,” Dr. Adalja says.

Why can the flu be so deadly?

The flu is a contagious respiratory illness that’s caused by influenza viruses that infect the nose, throat, and lungs, the CDC explains. There are two main types—influenza A and B—that regularly circulate each year. While plenty of people get the flu, have a miserable period of illness, and then recover, others can actually die of the virus.

“Influenza is a respiratory virus that has the ability to kill at a very high rate, even in the modern era,” Dr. Adalja says. “In severe cases, it causes pneumonia that can be complicated with a secondary bacterial infection.”

Other possible serious complications triggered by the flu, per the CDC, can include:
inflammation of the heart (myocarditis)
inflammation of the brain (encephalitis)
inflammation of the muscle tissues (myositis, rhabdomyolysis)
multi-organ failure (like respiratory and kidney failure)
Sepsis, a life-threatening response to an infection

Who is most at risk of dying from the flu?

The CDC has a list of people who are at a higher-than-average risk of getting seriously ill with the flu and even dying of it:
Adults 65 and up
Pregnant people
Young children
Young children with neurological disease

Certain health conditions can also put people at a higher risk of severe flu, the CDC says, including:
Asthma
Heart disease and stroke
Diabetes
HIV/AIDS
Cancer
Chronic kidney disease

“The flu tends to kill people at the extremes of age: very young and very old,” Dr. Adalja says. “The very young and the old may have very low physiological reserve when it comes to fighting influenza off.”

How many total flu-related deaths are expected for the 2022-2023 season?

The CDC releases estimates on flu cases and deaths each year. Right now, the agency estimates that between 730 and 2,100 people have died of the flu from Oct. 1 through Oct. 29—and the season has just started.

Still, the same disease-prevention practices we’ve mastered to slow the spread of COVID-19 can also impact impacted flu transmission, says David Cennimo, M.D., assistant professor of medicine-pediatrics infectious disease at Rutgers New Jersey Medical School. While flu rates are higher than last year’s low numbers, they’re still lower than your average flu season. That’s “a byproduct” of efforts like masking, hand-washing, and social distancing, Dr. Cennimo says.

How to protect yourself from the flu

If you haven’t already gotten your flu shot, William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine, recommends doing it ASAP, as it takes time to build immunity. Flu season continues through May, after all. “It’s still not too late to get vaccinated,” he says.

Since there’s no hard and fast data on how many people die from the flu each year, it can be tricky to calculate how much getting the flu shot protects you from death, Dr. Russo says. “We do know that dying from the flu is much less likely if you’ve been vaccinated than if you don’t get the vaccine,” he says. “Certainly, the more vulnerable you are, the greater benefit the vaccine in decreasing the likelihood of a bad outcome.”

The following precautions can also protect you from the flu, per the CDC:

Avoid close contact with people who are sick.

Wash your hands often with soap and water for at least 20 seconds.

If soap and water aren’t available, use an alcohol-based hand sanitizer.

Avoid touching your eyes, nose, and mouth.

Clean and disinfect high-touch surfaces and objects.

Methods that help prevent the spread of COVID-19, like wearing a mask in crowded indoor spaces when flu cases are high in your area can also help you prevent a cold, flu, RSV, and other respiratory illnesses, Dr. Russo says.

If you suspect you may have the flu, Dr. Adalja recommends contacting your doctor ASAP or visiting your local urgent care clinic. “Have a low threshold to be tested and prescribed an antiviral,” he says. Medications like oseltamivir (Tamiflu) work best when they’re taken soon after you develop symptoms, he points out, so timing is important.