In 1918 and 1919, influenza killed an estimated 675,000 Americans. That pandemic came to be known as the mother of all pandemics.
On September 20, 2021, the number of Americans who've died of COVID-19 surpassed that number, according the Johns Hopkins University COVID Tracker, becoming the deadliest disease event in American history.
Yet millions of Americans are refusing their vaccines, and a top San Antonio doctor has warned that the COVID death toll could climb much higher this winter.
Dr. Robert Leverence is the Chief Medical Officer for UT Health Physicians in San Antonio. He said a recent model from the Institute for Health Metrics and Evaluation has him concerned about the potential for another COVID surge this winter that could be worse than last winter's deadly surge, even though Americans now have access to safe, effective, free vaccines. There are a couple of reasons for that.
First, children are attending school in-person this year.
"That's different this year, right? We have 20% of our population, mostly unvaccinated, mingling five days a week," Leverence said.
Even with the delta variant, children don't seem to get as sick with COVID as do other age groups, but Leverence said if more children get sick, more people in higher risk groups will also get sick.
"(Children) certainly act as a reservoir, and can readily spread it to parents, uncles, aunts, and grandparents," Leverence pointed out.
Another factor contributing to his concern is the nature of the current delta COVID surge. Last winter's deadly surge built on the numbers of the 2020 summer surge. That surge, Leverence said, acted as a springboard for the much more deadly winter surge. If the pandemic follows the same pattern this winter, it could boost COVID case numbers beyond what the nation experienced during the winter of 2020-2021.
"This summer surge was not only higher than last year's summer surge, but it was also later in the summer," Leverence said. "So we can anticipate the tail to this surge will last well into the early winter, and it could very well function as a biological platform to the winter lift at the beginning of that surge."
What might that look like? Leverence said if large numbers of people remain unvaccinated, the IHME model looks bad.
"We're likely to have multiple, significant, one or two month long surges in different regions throughout the country," Leverence said. "When added all up, will lead to a sustained hospitalization rate, a sustained death rate throughout the country through the new year."
Leverence said this could also be complicated by flu season.
"There's a good chance that we're going to see a standard or worse than standard flu season this year, because it's been pent up, we did not have a flu season last year because we children weren't gathering and people in general weren't gathering and people were wearing their masks, whereas that's not the case this year," Leverence said.
The San Antonio doctor said another winter surge of COVID could be prevented if more people would get fully vaccinated against the disease. Vaccine hesitancy frustrates him, especially now that the number of dead from COVID has surpassed the number of dead from the 1918 pandemic.
"This COVID pandemic is the worst crisis in terms of life loss that this country has ever experienced," Leverence said. "More than any prior war or prior pandemic. More than the Civil War or the Spanish flu."
Leverence thinks Americans are, in many ways, isolated from the true toll of the disaster.
"You look out your window, and no one's chasing you with a bayonet, and you watch TV and there's no images of tanks or war planes," Leverence said. "People are not dying in droves in their homes like they were during the 1918 flu. So things look pretty good outside."
That's deceptive, Leverence said, and may be causing complacency in many of the vaccine hesitant.
"We all have a false sense of reassurance that things really aren't so bad when in fact, again, this is the worst crisis in terms of life loss that this nation has ever suffered," Leverence said.
To avoid another deadly winter COVID surge, Leverence urged everyone who is eligible for the vaccine to put their hesitance aside and get their shots.