This Year’s Flu Season: Repeat of Last Year or a ‘Twindemic?’


Nov. 19, 2021 — Cases of the flu, that after annual viral intruder that was often the nation’s worst annual well being disaster, is displaying indicators of waking up once more this fall.

But, consultants say, it’s far too early to say if the nation may have a traditional – i.e., dangerous – flu season or a repeat of final yr, when the flu all however disappeared amid the COVID-19 pandemic.

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This flu season is beginning out extra just like the seasons earlier than the pandemic. About 2% of all visits to medical doctors and outpatient clinics by Nov. 13 had been flu or flu-like sicknesses, in comparison with about 1.4% a yr in the past, the CDC says. Cases to date are being counted within the tons of – 702 by Nov. 13.

Still, whereas circumstances are low, they’re rising, the company says. The unfold of flu is already excessive in New Mexico and average in Georgia. The remainder of the nation is seeing little exercise, based on the CDC.

This time final yr, circumstances of flu, hospitalizations and deaths had been down dramatically, regardless of fears {that a} drastic ”twindemic” could occur if cases of COVID-19 and influenza increased greatly, and in tandem. The comparisons of last year’s flu season statistics to previous years are startling — in a good way.

In the 2019-2020 season, more 22,000 people in the U.S. died from flu; last year, deaths decreased to about 700 for the 2020-2021 season.

So, what might happen this year? Will flu be a no-show once again? Several top experts say it’s complicated:

  • “It’s a sizzling query and I’d love to provide you a concrete reply. But everyone seems to be having bother predicting.” — Stuart Ray, MD, professor of medicine and infectious disease specialist at Johns Hopkins Medicine in Baltimore.
  • “It’s very exhausting to foretell precisely the place the flu season will land. What appears to be the case is that will probably be worse than final yr, however it’s unclear whether or not or not will probably be an extraordinary flu season.” — Amesh Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security.
  • “There will likely be flu, however I am unable to let you know how dangerous will probably be.” We do know that flu will be back.” — William Schaffner, MD, infectious illness specialist and professor of preventive drugs at Vanderbilt University Medical Center in Nashville.

Already, Schaffner says, “we’re starting to listen to about some outbreaks.”

One outbreak triggering concern is at the University of Michigan, Ann Arbor, where 528 flu cases have been diagnosed at the University Health Service since Oct. 6. The CDC sent a team to investigate the outbreak. Florida A&M University and Florida State University have also seen large outbreaks this month.

Outbreaks on college campuses are not surprising, Schaffner said. “That’s a inhabitants that’s under-vaccinated,” he says, and students are often in close quarters with many others. University of Michigan officials said 77% of the cases are in unvaccinated people.”

Predictions about this yr’s flu season additionally should take into consideration that masks carrying and social distancing that had been widespread final yr, however have grow to be much less widespread or generally nonexistent this yr.

Despite uncertainty about how this yr’s flu season will play out, a number of modifications and advances in play for this yr’s flu season are aimed toward preserving sickness low.

  • The composition of the vaccines has been up to date — and every vaccine targets 4 viruses anticipated to flow into.
  • The flu vaccine and the COVID vaccines may be given on the identical time.
  • The CDC has up to date steering for timing of the flu vaccine for some folks.
  • A brand new dashboard is monitoring flu vaccination charges nationwide, and the CDC has an schooling marketing campaign, fearing the significance of the flu vaccine has taken a again seat with the eye largely on COVID and its vaccine for the reason that pandemic started.

What’s in This Year’s Vaccine?

This yr, all of the flu vaccines within the U.S. are 4 element (quadrivalent) photographs, meant to guard towards the 4 flu viruses most certainly to unfold and trigger illness this season.

The FDA’s Vaccines and Related Biological Product Advisory Committee (VRBPAC) selects the precise viruses that every yr’s vaccine ought to goal. To choose, they take into consideration surveillance information with particulars about latest influenza cultures, responses to the earlier yr’s vaccines and different data.

Both the egg-based vaccines and the cell- or recombinant-based vaccines will goal two influenza A strains and two influenza B strains. Options embody injections or a nasal spray.

Several of the formulation are accredited to be used in these age 65 and up, together with a high-dose vaccine and the adjuvanted flu vaccine. The purpose of every is to create a stronger immune response, as folks’s immune techniques weaken with age. However, the CDC cautions folks to not delay the vaccination whereas ready for the high-dose or adjuvanted. Getting the vaccine that is out there is the most effective factor to do, consultants say.

Vaccine Timing

In normal, September and October had been good occasions for flu vaccinations, the CDC says. While it is very best to be vaccinated by the top of October, it nonetheless recommends vaccinating later than that reasonably than skipping it.

Even if you’re unvaccinated in December or January, it is nonetheless a good suggestion to get it then, Schaffner agrees. You would nonetheless get some safety, he says, since ”for essentially the most half within the U.S., flu peaks in February.” But he stresses that earlier is better.

While children can get vaccinated as soon as doses are available — even July or August — adults, especially if 65 and older, because of their weakened immune systems, should generally not get vaccinated that early. That’s because protection will decrease over time and they may not be protected for the entire flu season. But, early is better than not at all, the CDC says.

Some children ages 6 months to 8 years may need two doses of flu vaccine. Those getting vaccinated for the first time need two doses (spaced 4 weeks apart). Others in this age group who only got one dose previously need to get 2 doses this season.

Early vaccination can also be considered for women in the third trimester of pregnancy, because the immunization can help provide protection to their infants after birth. Infants can’t be vaccinated until age 6 months.

Two Arms, Two Vaccines

With millions of Americans now lining up for their COVID-19 boosters, experts urge them to get the flu vaccine at the same time. It’s acceptable to get both vaccines the same day, experts agree.

“You can [even] do 2 in a single arm, spaced by an inch,” says L.J. Tan, PhD, chief policy and partnership officer, Immunization Action Coalition, an organization devoted to increasing immunization rates. “We co-administer vaccines to children all of the time.”

And, Tan says, ”the flu vaccine is not going to amplify any reaction you would have to the COVID vaccine.”

Tracking Vaccinations

According to the CDC National Flu Vaccination Dashboard, about 162 million doses of flu vaccine have been distributed as of Nov. 5.

It expects about 58.5% of the inhabitants to get a flu shot this season, up from about 54.8% final season.

Undoing the ‘Flu Isn’t Bad’ Thinking

One widespread false impression, particularly from mother and father, is that ”the flu will not be dangerous, it does not trigger critical issues,” says Flor M. Munoz, MD, MSc, medical director of transplant infectious diseases at Texas Children’s Hospital in Houston.

“Flu by itself may be critical,” she says. And now, with COVID, she says, ”we do worry. If someone got both infections, they could get quite sick.”

Among the potential problems in children, particularly these below 5 years, are pneumonia, dehydration, mind dysfunction and sinus and ear infections.

The vaccine for flu, like for COVID, is not good, she additionally tells mother and father. “In a good year, it gives 60 to 70% protection. ” But it may be a lot much less protecting than that, too. Even so, “if you get vaccinated and still get the flu, you will have milder illness.”

Anti-Virals to the Rescue

When flu signs — fever, cough, sore throat, runny nostril, physique aches, complications, chills and fatigue — seem, anti-viral therapies can reduce the time you might be sick by a few day, based on the CDC. They can be found solely by prescription and work finest when began inside 2 days of turning into sick with flu.

Four antiviral medicine to deal with flu are FDA-approved, together with:

  • Oseltamivir phosphate (generic or as Tamiflu)
  • Zanamivir (Relenza)
  • Peramivir (Rapivab)
  • Baloxavir marboxil (Xofluza)

Depending on the drug and technique of administration, the medicine are given for 1 to five days, typically, however generally longer than 5 days.

Track Local Flu Rates

Ray of Johns Hopkins suggests preserving an eye on how widespread flu is in your neighborhood, simply as we have gotten used to monitoring COVID charges, after which taking precautions comparable to masking up and social distancing. “Maybe we are a little more nimble now in responding to risk,” he says, given the follow gotten with COVID.

He says adapting these habits in responding to flu outbreaks could be useful—and extra pure for most individuals than up to now. ”I don’t assume it was traditional ever, 3 years in the past, to see folks out in masks when flu charges had been excessive.”

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