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School closures likely played a role in stopping the spread of the flu this winter. via Getty Images David L. Ryan / The Boston Globe
What Strain Of Flu Is Going Around Right Now
Brian Resnick is the science and health editor and co-creator of Unexplainable, the podcast about unanswered questions in science. Brian was previously a reporter for the National Journal.
Covid 19 And Flu: Influenza Has Killed One Child So Far This Flu Season
The sum total of all mask-wearing, distancing, workplace closures and other measures, while flawed, was not enough to stop the Covid-19 outbreak. But there’s one more glimmer of hope: This season has been enough to almost eradicate the flu.
The Centers for Disease Control and Prevention (CDC) says that as of January 30, there were only 1,316 positive cases of flu in its clinical surveillance network since September. This time last year, it had recorded 129,997 positive cases of flu in the same time period.
Part of the decline may be due to people not coming in and being tested for the flu or staying home for fear that their symptoms could be a Covid-19 infection. But researchers believe the decline in actual cases is real and significant.
It’s not just confirmed cases that have dropped. The CDC’s syndromic surveillance system, which tries to track the disease according to people presenting to clinics with symptoms, has historically shown low flu levels.
About This Year’s Flu
Number of confirmed flu samples in the CDC surveillance network. These numbers are more of a snapshot of the seasonal trend; It is not intended to be an exact number of everyone who has the flu in any given season. Tim Ryan Williams
Last flu season, the CDC estimated that the virus was responsible for “38 million illnesses, 18 million medical visits, 405,000 hospitalizations and 22,000 deaths.”
Seema Lakdawala, a flu researcher at the University of Pittsburgh, says flu trends this year mean “we’ve found a way to potentially reduce tens of thousands of deaths each year.”
The good news is that we’ve seen how effective our collective behavior can be in reducing the flu burden. And with that experience, we can be better prepared to stop a future flu epidemic.
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Warning: Since people won’t get the flu this year, that means more people will get the flu next year. Children are particularly vulnerable to catching the flu, and next year there will be more children than ever who have never contracted the flu in their lives. This will also make them more likely to spread. Some adults may also be more vulnerable to catching the flu next year. The immunological memory of the virus fades over time, and by the time the next flu season begins, it will be a year since most adults last got a flu shot.
To reduce the overall burden of future flu seasons, we need to remember some of what we learned during the pandemic. It will not be sustainable to continue all Covid-19 measures after the pandemic subsides. However, we should spend some time thinking carefully about what changes should be permanent.
This flu season, more or less, didn’t really happen. Not entirely surprising: During the southern hemisphere flu season last year (occurring in the northern summer from May to September), cases and deaths also declined.
“Until a few weeks ago, I didn’t feel like I was out of danger yet,” says Shweta Bansal, an epidemiologist and biologist at Georgetown University. But now that we’re in February, you usually feel like a flu wave isn’t coming when flu season is at its peak in the US. And it’s not just the flu: other respiratory viruses other than rhinoviruses have also dropped significantly.
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This is a huge relief: At the beginning of the pandemic, scientists were very concerned about the pressure on our health systems should the flu spread widely with covid-19. Quiet flu season means more hospital beds and equipment are available for Covid-19 patients, and healthcare workers treating these patients are under less pressure than in a typical flu year.
The researchers don’t think the sharp declines are due to more people getting the flu shot this year. “Vaccination helps, but there’s absolutely no way that increased vaccination alone is responsible for it,” says Harvard epidemiologist Stephen Kissler. Yes, flu vaccine intake has increased (around 15.5 million more doses), but that doesn’t explain what happened to the flu. (The flu is also most commonly transmitted through contaminated surfaces. So routine surface cleaning can be hygiene theater when it comes to Covid-19, but it can be helpful when it comes to flu.)
What is responsible? “As far as I can tell, the most coherent explanation is that wearing a mask and keeping distance actually works,” Kissler says.
We go back to something that scientists said at the beginning of the pandemic: Covid-19 is much, much worse than seasonal flu because it is more contagious.
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Scientists identify the spread of a disease with a number called R0 (pronounced r-naught). The number defines how many new cases each disease case produces, on average. For seasonal flu, R0 is between 1 and 2. It is more likely to be between 2 and 3, if not slightly higher for Covid-19.
Our collective actions have brought the effective R number for Covid-19 down to just over 1. As long as the R number is greater than 1, the virus will continue to spread. But when it comes to the flu, all that collective action pushed the flu’s effective R below 1.
For Kissler, this is textbook epidemiology: “Anything that is less contagious [than Covid] but spreads similarly will be brought well below the R threshold of 1 and immediately destroyed.” “.
We can feel good that our efforts put an end to the flu. Less of a burden to deal with during an already difficult year. But there are also some optimistic outcomes for the future. Let’s say you have another pandemic respiratory virus, but slightly less contagious than Covid-19. This epidemic will likely stop if we bring in the same collective action force as now to contain the new virus.
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Scientists do not know exactly which Covid-19 public health steps contributed the most to the decline in flu cases. But they are suspects. “The biggest difference is the lack of travel, the closing of schools, and the absence of distancing and wearing a mask,” says Helen Chu, a doctor and epidemiologist at the University of Washington who studies flu.
It is difficult to say for certain which contributed more. “The flu makes children disproportionately sick or hospitalized, so things like school closures have a bigger impact on flu than SARS-CoV-2,” Chu says.
But then she said, “I can’t imagine school closures working best because so many places have managed to keep schools open and still have the flu: Australia, for example. They still kept schools open and didn’t get the flu.”
While scientists don’t currently know how much each intervention has contributed to the flu decline this year, they see opportunities to learn more.
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“I hope someone in the United States looks at this and tries to unpack this by state, because there are many regional differences in acceptance of mask-wearing, social distancing, and school closures,” Chu says. Perhaps these differences in policy and behavior can be linked to cold or flu outcomes to better understand what works.
There is something that will help even more: Scientists will monitor what happens when Covid-19 measures are lifted. “We’re going to start to see the flu and other respiratory viruses circulating,” says Kissler.
So scientists can potentially see what restrictions and behavioral changes lead to further resurgence of respiratory viruses.
We can use the pandemic to think about how society might change to prevent more of these infections and deaths in the future. “Seasonal flu viruses remain a huge public health burden,” says Lakdawala. This will continue to apply after the pandemic is over and to address this we need to remember some lessons from the pandemic.
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For example, if you were exposed to someone who had the flu or a cold in the past, you wouldn’t think anything of it. In the future, post-pandemic, I would consider not meeting friends or going to the office after an exposure (flu has a shorter incubation period than covid-19, so you probably don’t need to quarantine that long). ). only up to four days). And I would make sure to wear a mask
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