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Why Flu Season Is Especially Severe This Year

Kelsey Tyler

Inflation and supply chain issues are the big worries du jour, but just one year ago many of us were gripped with anxiety about something else: the possibility of a “twindemic,” or a surge in COVID-19 cases alongside a severe flu season.

To the surprise of many, this didn’t happen. So, as we roll into our second pandemic-era flu season — a period that spans roughly October through May — you may not know what to expect. Below, we cover everything you need to know. 

The state of the flu-nion

Before diving into the specifics of the 2021-2022 flu season, it’s important to first cover the basics. The influenza virus comes in a few distinct forms. Influenza A and B are the primary types that appear during flu season each year. 

What’s more, strains of the flu are constantly evolving — which means researchers frequently adapt flu vaccines. They use data from early cases of the flu to predict which strains will be dominant each year, and develop the shot from there. Distribution starts as early as August. 

Typically, the vaccine reduces an individual’s flu risk by 40-60 percent, and significantly lessens the chance of being hospitalized or dying from the flu.  However, it’s common for less than half of Americans to get the shot. (Why? Many underestimate the value of the vaccine and overestimate its potential risks and side effects.) 

“In the last three influenza seasons, overall vaccination rates hovered only in the 50th percentile for Americans,” says Dr. Susan Donelan, Medical Director of the Healthcare Epidemiology Department at Stony Brook Medicine. 

Last winter, despite pretty average vaccination rates, the flu nearly disappeared. During a typical flu season, about a third of people who contract some sort of respiratory virus have the flu. But last year, only 0.2% of respiratory specimens collected in U.S. clinical labs tested positive for the flu.

And while researchers found an average of 8 percent of the population gets the flu during moderately serious flu seasons, less than 1 percent had it last year. 

Given such a turn of events, can we expect things to be equally chill in the next few months? Well, we can’t ever predict the future — but unfortunately, experts say many of the signs point to no. 

The forecast

“While I don’t have a crystal ball, I think we’re certainly at a higher risk of a difficult influenza season this year compared to last,” Dr. Donelan says. Shoshana Fishbein, Communications Director of the nonprofit Families Fighting Flu, echoes her, noting that we’re already seeing more flu activity this fall compared to last year.

There are a few reasons driving this likely uptick: 

  • Normal life is resuming. With COVID-19 vaccinations now widely available, we’re returning to our pre-pandemic behaviors in many areas. Adults are returning to the office; Kids are returning to school; And international travel is occurring more often. At the same time, we’re also dropping many pandemic-era health precautions. “The likely reason the flu didn’t spread last year is because of masks and social distancing. Now, people have become complacent,” says Fishbein. Combined, these two factors create conditions that are ripe for an influenza resurgence.
  • After COVID-19, the flu seems minor. COVID-19 has a higher mortality rate than the flu. While the world shut down for the coronavirus, it’s never been as drastically impacted by the flu (that is, since 1918). After months of pandemic anxiety, many aren’t quite as worried about the flu now that they have their COVID-19 vaccines. “Sadly, preliminary data shows that flu vaccinations are lower this year than they were last year,” says Fishbein.
  • We have less population-level immunity because of last year’s anomalous season. In a typical year, there are tens of millions of cases of the flu. The general population develops some immunity through exposure to any flu strains circulating. “People have lost a year of being exposed and developing some protective immunity,” says Donelan. “We need to be prepared for the worst.” 

In all, there’s strong reason to believe we won’t get another year off from influenza. Experts say this is especially concerning given that the COVID-19 pandemic isn’t over quite yet. 

“We’re still faced with COVID-19 cases, as well as the Delta variant being highly transmissible, ” says Donelan, explaining why a “twindemic” could still be in the cards. “With more and more people getting vaccinated, this potential is lower than it would have been at the height of the pandemic, but parts of the country with low vaccination rates are currently seeing an uptick in cases. This is a concerning development as we enter flu season, since a simultaneous spike in both COVID-19 and the flu could overload our hospital system.”

There’s also the risk of people contracting both viruses at once. Whether it’s a breakthrough case or a result of being unvaccinated, it’s entirely possible for someone with COVID-19 to get the flu at the same time. 

Staying healthy

There are concrete things you can do right now to ensure that you and your loved ones are braced for a potentially severe flu season.

“​​The resurgence of influenza activity is likely inevitable,” says Dr. Gregg Sylvester, Chief Medical Officer at Seqirus, one of the largest manufacturers of flu vaccines. “With the path of the COVID-19 pandemic still unknown, it’s important for us to control what we can and mitigate the impact of the flu.”

Check out some tips and tricks below: 

  • Get a flu shot. The CDC recommends that pretty much everyone six months and older gets a flu shot. People in populations most likely to be hospitalized or die from the flu, including those who are pregnant, under 5, over 65, or have chronic conditions, should get vaccinated. However, Fishbein emphasizes, “vaccination is a team sport that performs best when everyone plays the game. Even if you’re not at risk of serious flu complications, get vaccinated to protect others who are more vulnerable.” Find your closest flu shot site here
  • Get tested. A lot of us are accustomed to getting a COVID-19 test when we have cold- or flu-like symptoms. Now that we’re in flu season, you should add an influenza test to your order. “There are combination flu and COVID-19 tests that use one swab to test for both viruses,” says Fishbein. “They can be accessed in a medical office or an at-home kit.” 
  • Remember that the flu is serious. After dealing with COVID-19, it’s easy to dismiss the flu. Don’t. In a typical year, tens of thousands of Americans die from influenza, and while you may not be at high risk for a severe case, you probably know someone who is (plus, having the flu is pretty horrible for anyone). To avoid catching the flu, wash your hands frequently, stay home if you feel sick and wear your mask when it makes sense. 

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