Dr. Nicole Ascanio, aspireMD

It’s hard to believe it has been about a year since the pandemic really took hold in the US. We might not be out of the woods yet, but I do believe we are starting to see the beginning of a return to normal life now that vaccine rollout is picking up and warmer months are here. One interesting and positive thing to come from the COVID-19 pandemic is a historic 2020-2021 flu season. Flu season usually spans from October to March and 10 million to 45 million people in the US get infected each year including 10,000 to 60,000 deaths depending on severity. The very young and the very old are at highest risk of severe influenza infection and death, but I have seen otherwise healthy people of all ages die from influenza every year. As of 3/13/21, there have only been 1,561 confirmed influenza cases in the US. This is staggering. We have essentially “missed” an entire flu season. This lends itself to the a few questions…. why did this happen while so many people were still getting COVID and can this be the new norm?

There are a few answers to the question why: 

• The influenza virus is less contagious than the virus that causes COVID-19. It is similarly spread from respiratory droplets but takes a larger exposure to infect someone. This means that the things we are doing to prevent COVID-19 infection (more handwashing, masks, social distancing, not gathering indoors in large groups, etc) work even better to prevent influenza.
• People are actually staying home when they are sick. In years past, it was more common than not to go to work, school, daycare, or social events when you had mild viral symptoms. People were always told to “stay home if sick” but this was rarely followed if someone had a little runny nose, cough, or sore throat. The pandemic has caused (forced?) people to follow this advice, and it works. Workplaces have also had to become far more accommodating to those employees with viral symptoms staying home.
• When you get infected with the influenza virus, your symptoms appear rather quickly – usually within a day or two. This helps eliminate the longer period of viral spreading prior to symptom onset that we see with COVID-19.
• School closures/remote learning, less travel/airport traffic, and fewer large social gatherings have kept all sorts of viruses from spreading like they normally would.
• Influenza survives better on surfaces than COVID-19. The pandemic has dramatically changed how people clean and sanitizes their homes and workspaces which has indirectly combated the flu.
• An unprecedented number of people got the flu vaccine this year. 15.5 million more this season than last.

Can we keep the burden of influenza illness and death low in the future (without going into lockdown)? Yes. 

•  In the post-pandemic world, it (should) be much easier to actually stay home when sick. Work should no longer be viewed as universally “critical” when an employee is sick.
• Masking when travelling, shopping, working, and gathering during flu season won’t be required, but will be a much more common and acceptable practice
• Close exposure to someone who has the flu should prompt someone to stay home for a few days to ensure they do not have it and spread it.
• Workplaces have adapted well to remote opportunities and this will likely continue

As always, the best protection you have against a serious influenza infection is to get your flu shot early in the season.