Will This Year’s Flu Season Be a Bad One?

With COVID-19 infections still setting records, the 2020/2021 flu season is just getting underway in the Northern hemisphere. The question on many epidemiologists’ minds: Will it be worse or better than past years?

In the plus column: Community measures implemented for the coronavirus pandemic might actually have a positive impact on the spread of seasonal influenza. Towards the tail end of last season’s flu season and the beginning of the pandemic, researchers saw a precipitous decline in new flu cases, something they attributed to mitigation measures like mask wearing, social distancing and hand washing. 

Likewise, flu activity in southern hemisphere, which coincided with the coronavirus pandemic and typically mirrors the northern hemisphere season, was historically low, leading infectious disease experts like Anthony Fauci, MD, to speculate those steps were mitigating flu spread as well as COVID-19 spread.

Researchers writing in the Center for Disease Control and Preventions’ Sept. 18 Morbidity and Mortality Weekly Report suggested that if “extensive community mitigation measures continue throughout the fall, influenza activity in the United States might remain low and the season might be blunted or delayed.” 

Good news, right? But this is a big “if.” 

Flu illnesses, hospitalizations and deaths fluctuate year to year. The season typically starts in October, peaks in February and is over by May. But in some seasons, it can peak in different months, like December, January or March. 

In a given year, influenza causes between 9 and 45 million illnesses, 140,000 to 810,000 hospitalizations and 12,000 to 61,000 deaths. The amounts vary based on the effectiveness of the vaccine and the strains of the virus. For example, in 2017-2018 flu season, was one of the worst in history. The strain that year, H3N2, a subtype of the influenza A strain, was in circulation. It was more virulent than other kinds.

There are many different flu strains and they constantly evolve. In fact, the vaccine that is distributed in the U.S. is different each year based on which flu viruses are circulating. Typically, the vaccine will target three or four different types. For example, the 2020-2021 vaccine protects against four strains, including certain H1N1 and H3N2 viruses.

The bigger “if” is what happens if you get a severe case of the flu this season, even if this is a mild flu season. With coronavirus cases rising throughout the U.S., will there be bed space at hospitals, and will doctors know if you have COVID or the flu?

Even though coronavirus vaccines are on the way, experts still expect hospitalizations to continue through the beginning of 2021 — which means people who are sick with the flu will be competing against people sick with COVID-19 for medical attention. And since the symptoms of both conditions are similar, sorting out COVID from the flu may delay effective treatment. There are effective antivirals against influenza — but not COVID. 

The good news is the CDC and two companies have developed a single test that looks for flu and coronavirus infections. The tests were granted Emergency Use Authorization by the Food and Drug Administration in September, but they may not be available yet in all areas.

While we don’t know how severe this year’s flu season will be, we do know that there’s an effective tool to prevent or lessen the severity of infections. Getting a flu shot is the best way to protect yourself from the flu. Call your primary care doctor today to get your flu shot.

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