Can the flu mortality be as high as covid-19 in some countries?

Question

According to this

Up to 650,000 people die of respiratory diseases linked to seasonal flu each year

This marks an increase on the previous global estimate of 250 000 – 500 000, which dates from over ten years ago and covered all influenza-related deaths, including cardiovascular disease or diabetes. The new figures of 290 000 – 650 000 deaths are based on more recent data from a larger, more diverse group of countries, including lower middle income countries, and exclude deaths from non-respiratory diseases.

And according to this,

How does new coronavirus compare to the flu

The death rate from seasonal flu is typically around 0.1% in the U.S., according to news reports

Now for covid-19 worldwide, in 8 months deaths were over 800,000 worldwide

Coronavirus update

and the death rate according to this is between 0,5 to 1%

How deadly is the coronavirus

But in Argentina, according to this source which supposedly cites the Ministery of Health,

Around 32,000 persons die each year by flu and pneumonia

In 2018 around 32,000 persons died by flu and pneumonia in Argentina

This figure is amazingly high considered Argentina is #11 in number of covid-19 cases worldwide and it had in 6 months less than 10,000 deaths.

Coronavirus in Argentina

Here you could think, well, they say flu and pneumonia and there are other causes for pneumonia aside Influenza, but the article also says,

The flu is caused by the virus Influenza and it has in all its kinds a mortality of around 0,5%.

(I'm assuming he's talking about Argentina since he's the director of an infectologist institution in Argentina)

This would be (for Argentina) practically the same death rate for flu than for covid-19. Can this be possible? Can this be confirmed or refuted by other sources?

Answer 1

It's possible your news source confused deaths with hospitalizations, confused the cause of death, or that 2018 was particularly bad flu year in Argentina (but I rather doubt that).

Peer-reviewed, albeit older publications put the flu mortality figures much lower:

During 2002–2009, we estimated that influenza contributed to an average of approximately 2000–9000 deaths and 8000–23,000 hospitalizations in Argentina

And broken down by month

Also they don't find the mortality substantially different from other American countries:

our mortality rates are similar to those estimated in Argentina during 1992–1999, in neighboring Brazil, and in the United States

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I do see in a more recent paper some criticism that that older one may underestimate influenza...

Several countries, including Argentina, Chile, and many Central American countries, have used virologic surveillance data to attribute hospitalizations to influenza, as we did in this analysis, but used a smaller subset of “pneumonia and influenza” ICD-10 hospital discharge codes, rather than all respiratory hospitalizations [7, 10, 36]. Using “pneumonia and influenza” hospitalizations likely under-estimated the true respiratory hospitalization burden from influenza, because patients with influenza can present with a wide spectrum of clinical respiratory symptoms, including exacerbations of chronic respiratory conditions [22, 37–40]. Our approach of using all respiratory codes, therefore, generated higher rates compared to the published rates using only “pneumonia and influenza” codes and are likely more inclusive and reflective of the full breadth of conditions seen in patients with influenza.

Howerver, this more rencet paper doesn't estimate mortality, only incidence, and even for that they don't give per-country estimates, except as a (badly colord) heat map, on which (to my eye) Argentina seems to have between 10,000 and 50,000 hostpitalized cases (per year).

So it's possible that the ministry (cited as sourcein that newspaper) changed their methodology, but even given this putative revised methodology, death exceeding hospitalizations seems fairly implausible.