Just in time for a COVID surge, experts bracing for harsher flu season

In this Jan. 23, 2020, photo, a syringe with influenza vaccine inside heads for its mark during a flu vaccination at Eastfield College in Mesquite, Texas.

By Hannah Wyman

Pittsburgh Post-Gazette

With less than 50 days until the start of fall, medical experts anticipate this year’s flu season harshly intersecting with the ongoing COVID-19 pandemic.

Influenza cases typically increase in the fall, but last season, Pennsylvania saw fewer cases than usual due to the efforts taken to combat the spread of COVID-19, according to the Pennsylvania Department of Health, whose data includes positive flu tests using multiple methodologies.

In the most recent flu season — late September to May — the Health Department reported 3,664 laboratory-confirmed influenza cases. The season before that saw 130,900 cases.

Now, months later, concerns over the coronavirus remain, as the delta variant of the virus has caused a surge in cases.

But unlike last year, when most mitigation efforts were firmly in place, students are returning to school, workplaces are transitioning back to in-person operations, and much of America — despite increasing mandates — is going maskless.

Those factors coupled with a seasonal rise in flu cases are cause for concern, said John Cordier, CEO of ​​Epistemix, a company that simulates epidemics.

“Because the flu hasn’t been able to be in circulation like it normally would, there’s less natural immunity to the flu,” Mr. Cordier said. “There will be more flu cases this year than last year, and there also could be more flu cases this year than in 2019 or 2018 because there’s less of that natural immunity if all the mitigation factors are lifted.”

Based on models and simulations, Mr. Cordier said, the same could happen with COVID-19 cases this fall without mitigations in place.

“With kids going back to school, people going back to work from September through the end of the year, there could be up to five times as many COVID cases as there was last year during the fall at its peak,” he said.

Dr. Richard Zimmerman, a professor at the University of Pittsburgh’s School of Medicine, said we will see a more aggressive influenza season that will affect greater numbers.

Three different viruses — human metapneumovirus (HMPV), influenza (types A and B) and respiratory syncytial virus (RSV) — disappeared last winter due to COVID-19 precautions. Dr. Zimmerman expects them to “come back and bite us” this year.

He said doctors already are seeing cases of RSV, a respiratory infection, earlier in the year than usual.

“We’re going to see three respiratory viruses come back and COVID hit at the same time,” Dr. Zimmerman said. “My guess is that schools reopening will increase the spread, and a fraction of the population that is unprotected [will also increase spread],” Dr. Zimmerman said. “We may see this in October, later September, it’s very possible.”

Despite an expected rise in COVID-19 and influenza case counts, Mr. Cordier said there should be fewer COVID-19 deaths, thanks to 70% of the adult population having received at least one dose of the vaccine, as well as mitigation efforts.

“The mitigation factors for COVID are the same as the mitigation factors for the flu, and until we get COVID under control, we don’t really want that double epidemic happening [with] flu going way up and COVID going up,” Mr. Cordier said. “That could provide almost a perfect storm to overwhelm hospitals, and that’s what we want to avoid.”

Public officials continue to advocate for preventative measures — hand-washing, mask-wearing, social distancing and vaccinations.

“This will be the second year where both flu and COVID-19 pose a threat to individuals,” said Maggi Barton, the Pennsylvania Department of Health’s deputy press secretary. “When we finished off the last flu season, which was one of the mildest flu seasons on record for Pennsylvania, we shared that this stark difference was a testament to effective COVID-19 mitigation efforts that also prevent the flu.”

At a COVID-19 briefing on Wednesday, Allegheny County Health Director Dr. Debra Bogen said she couldn’t predict the severity of the flu season but noted that there are ways to minimize infections.

“We know from last year that wearing masks really does prevent the spread of all respiratory infections, so you can wear masks during cold and flu season. And we know that vaccines are very effective, so I encourage everyone to start planning for their flu shots, which will become available within the next couple of weeks,” Dr. Bogen said. “I hope that there will be a big push to get flu vaccines again this year like there was last year.”

Last season, the nation distributed a record number of more than 193 million flu shots, according to the Centers for Disease Control and Prevention.

Walgreens pharmacy spokesperson Alexandra Brown said its flu vaccine supply is in line with last season.

“While the severity of this flu season is uncertain, getting a flu shot remains a critical preventive measure as the COVID-19 pandemic continues and various regions of the country reopen, increasing risk of both COVID-19 and flu circulating at the same time and overburdening the health care system,” Ms. Brown said.


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