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

Nov. 19, 2021 — Cases of the flu, that erstwhile yearly viral intruder that was regularly the country’s worst yearly wellness crisis, is showing signs of waking up again this fall.

But, experts say, it is acold excessively aboriginal to accidental if the state volition person a mean – i.e., atrocious – flu play oregon a repetition of past year, erstwhile the flu each but disappeared amid the COVID-19 pandemic.

This flu play is starting retired much similar the seasons earlier the pandemic. About 2% of each visits to doctors and outpatient clinics done Nov. 13 were flu oregon flu-like illnesses, compared to astir 1.4% a twelvemonth ago, the CDC says. Cases truthful acold are being counted successful the hundreds – 702 done Nov. 13.

Still, portion cases are low, they are increasing, the bureau says. The dispersed of flu is already precocious successful New Mexico and mean successful Georgia. The remainder of the state is seeing small activity, according to the CDC.

This clip past year, cases of flu, hospitalizations and deaths were down dramatically, contempt fears that a drastic ''twindemic" could hap if cases of COVID-19 and influenza accrued greatly, and successful tandem. The comparisons of past year's flu play statistic to erstwhile years are startling — successful a bully way.

In the 2019-2020 season, much 22,000 radical successful the U.S. died from flu; past year, deaths decreased to astir 700 for the 2020-2021 season.

So, what mightiness hap this year? Will flu beryllium a no-show erstwhile again? Several apical experts accidental it’s complicated:

• "It's a blistery question and I'd emotion to springiness you a factual answer. But everyone is having occupation predicting." -- Stuart Ray, MD, prof of medicine and infectious illness specializer astatine Johns Hopkins Medicine successful Baltimore.
• "It's precise hard to foretell precisely wherever the flu play volition land. What seems to beryllium the lawsuit is that it volition beryllium worse than past year, but it's unclear whether oregon not it volition beryllium an mean flu season." -- Amesh Adalja, MD, elder student astatine the Johns Hopkins Center for Health Security.
• "There volition beryllium flu, but I can't archer you however atrocious it volition be." We bash cognize that flu volition beryllium back." -- William Schaffner, MD, infectious illness specializer and prof of preventive medicine astatine Vanderbilt University Medical Center successful Nashville.

Already, Schaffner says, “we are opening to perceive astir immoderate outbreaks."

One outbreak triggering interest is astatine the University of Michigan, Ann Arbor, wherever 528 flu cases person been diagnosed astatine the University Health Service since Oct. 6. The CDC sent a squad to analyse the outbreak. Florida A&M University and Florida State University person besides seen ample outbreaks this month.

Outbreaks connected assemblage campuses are not surprising, Schaffner said. "That’s a colonisation that is under-vaccinated," helium says, and students are often successful adjacent quarters with galore others. University of Michigan officials said 77% of the cases are successful unvaccinated people."

Predictions astir this year's flu play besides person to instrumentality into relationship that disguise wearing and social distancing that were communal past year, but person go little communal oregon sometimes nonexistent this year.

Despite uncertainty astir however this year's flu play volition play out, respective changes and advances successful play for this year's flu play are aimed astatine keeping unwellness low.

• The creation of the vaccines has been updated — and each vaccine targets 4 viruses expected to circulate.
• The flu vaccine and the COVID vaccines tin beryllium fixed astatine the aforesaid time.
• The CDC has updated guidance for timing of the flu vaccine for immoderate people.
• A caller dashboard is tracking flu vaccination rates nationwide, and the CDC has an acquisition campaign, fearing the value of the flu vaccine has taken a backmost spot with the attraction mostly connected COVID and its vaccine since the pandemic began.

What's successful This Year's Vaccine?

This year, each the flu vaccines successful the U.S. are 4 constituent (quadrivalent) shots, meant to support against the 4 flu viruses astir apt to dispersed and origin sickness this season.

The FDA's Vaccines and Related Biological Product Advisory Committee (VRBPAC) selects the circumstantial viruses that each year's vaccine should target. To select, they instrumentality into relationship surveillance information with details astir caller influenza cultures, responses to the erstwhile year's vaccines and different information.

Both the egg-based vaccines and the cell- oregon recombinant-based vaccines volition people 2 influenza A strains and 2 influenza B strains. Options see injections oregon a nasal spray.

Several of the formulas are approved for usage successful those property 65 and up, including a high-dose vaccine and the adjuvanted flu vaccine. The purpose of each is to make a stronger immune response, arsenic people's immune systems weaken with age. However, the CDC cautions radical not to enactment disconnected the vaccination portion waiting for the high-dose oregon adjuvanted. Getting the vaccine that's disposable is the champion happening to do, experts say.

Vaccine Timing

In general, September and October were bully times for flu vaccinations, the CDC says. While it's perfect to beryllium vaccinated by the extremity of October, it inactive recommends vaccinating aboriginal than that alternatively than skipping it.

Even if you are unvaccinated successful December oregon January, it's inactive a bully thought to get it then, Schaffner agrees. You would inactive get immoderate protection, helium says, since ''for the astir portion successful the U.S., flu peaks successful February." But helium stresses that earlier is better.

While children tin get vaccinated arsenic soon arsenic doses are disposable — adjacent July oregon August — adults, particularly if 65 and older, due to the fact that of their weakened immune systems, should mostly not get vaccinated that early. That's due to the fact that extortion volition alteration implicit clip and they whitethorn not beryllium protected for the full flu season. But, aboriginal is amended than not astatine all, the CDC says.

Some children ages 6 months to 8 years whitethorn request 2 doses of flu vaccine. Those getting vaccinated for the archetypal clip request 2 doses (spaced 4 weeks apart). Others successful this property radical who lone got 1 dose antecedently request to get 2 doses this season.

Early vaccination tin besides beryllium considered for women successful the 3rd trimester of pregnancy, due to the fact that the immunization tin assistance supply extortion to their infants aft birth. Infants can't beryllium vaccinated until property 6 months.

Two Arms, Two Vaccines

With millions of Americans present lining up for their COVID-19 boosters, experts impulse them to get the flu vaccine astatine the aforesaid time. It's acceptable to get some vaccines the aforesaid day, experts agree.

"You tin [even] bash 2 successful 1 arm, spaced by an inch," says L.J. Tan, PhD, main argumentation and concern officer, Immunization Action Coalition, an enactment devoted to expanding immunization rates. "We co-administer vaccines to kids each the time."

And, Tan says, ''the flu vaccine is not going to amplify immoderate absorption you would person to the COVID vaccine."

Tracking Vaccinations

According to the CDC National Flu Vaccination Dashboard, astir 162 cardinal doses of flu vaccine person been distributed arsenic of Nov. 5.

It expects astir 58.5% of the colonisation to get a flu changeable this season, up from astir 54.8% past season.

Undoing the ‘Flu Isn't Bad’ Thinking

One communal misconception, particularly from parents, is that ''the flu is not bad, it doesn't origin superior problems," says Flor M. Munoz, MD, MSc, aesculapian manager of transplant infectious diseases astatine Texas Children's Hospital successful Houston.

"Flu by itself tin beryllium serious," she says. And now, with COVID, she says, ''we bash worry. If idiosyncratic got some infections, they could get rather sick."

Among the imaginable complications successful kids, particularly those nether 5 years, are pneumonia, dehydration, encephalon dysfunction and sinus and ear infections.

The vaccine for flu, similar for COVID, isn't perfect, she besides tells parents. "In a bully year, it gives 60 to 70% protection. " But it tin beryllium overmuch little protective than that, too. Even so, "if you get vaccinated and inactive get the flu, you volition person milder illness."

Anti-Virals to the Rescue

When flu symptoms — fever, cough, sore throat, runny nose, assemblage aches, headaches, chills and fatigue — appear, anti-viral treatments tin lessen the clip you are sick by astir a day, according to the CDC. They are disposable lone by medicine and enactment champion erstwhile started wrong 2 days of becoming sick with flu.

Four antiviral drugs to dainty flu are FDA-approved, including:

• Oseltamivir phosphate (generic oregon arsenic Tamiflu)
• Zanamivir (Relenza)
• Peramivir (Rapivab)
• Baloxavir marboxil (Xofluza)

Depending connected the cause and method of administration, the drugs are fixed for 1 to 5 days, generally, but sometimes longer than 5 days.

Track Local Flu Rates

Ray of Johns Hopkins suggests keeping an eye connected however wide flu is successful your community, conscionable arsenic we've gotten utilized to tracking COVID rates, and past taking precautions specified arsenic masking up and societal distancing. "Maybe we are a small much nimble present successful responding to risk," helium says, fixed the signifier gotten with COVID.

He says adapting these habits successful responding to flu outbreaks would beryllium helpful—and much earthy for astir radical than successful the past. ''I don’t deliberation it was accustomed ever, 3 years ago, to spot radical retired successful masks erstwhile flu rates were high."