As the country suffered a severe devastation from coronavirus cases, the phones at Old Dominion Pediatrics in Virginia rang off the hook. Callers with infected family members sought advice on ways to quarantine at home so others would not get sick.
But no one asked about the flu.
And the results Eric Freeman saw showed that dozens of his patients had the coronavirus, but almost no one tested positive for flu.
“COVID was currently just the dominant viral pathogen, and it really did not allow enough flu to adequately populate,” Freeman said in an interview Monday. “I haven’t had a quick flu test in my office since my Thanksgiving.”
Public health experts, general practitioners and pediatricians have been warning for months that an increase in coronavirus cases during the winter months will be exacerbated by a typical flu season, killing tens of thousands of Americans annually. But a funny thing happened in the midst of a global health pandemic: flu season was effectively canceled.
Data from the Centers for Disease Control and Prevention (CDC) show that only 1,893 Americans tested positive for the flu virus this year, between clinical lab results and public health labs. By this time, more than 290,000 people had tested positive for flu.
The CDC reported in August that 198 children had died from flu-related causes during the past flu season, a record high. So far this year, only one child has died, the lowest score since records began in 2004.
‘You would never think it would be a silver lining [pandemic]”But it’s about as close to a silver lining as there was,” said Peter Hotez, a pediatrician and dean of the National School of Tropical Medicine at Baylor College. “It’s what wearing masks and social distance and probably reduced the personal classes [does]. ”
Less than 1 in every 1,000 hospitalizations this year was for flu, a seventh percent of the percentage recorded in the last flu season with low severity in 2011-2012.
U.S. health officials and vaccinators are usually picking up important tips about the upcoming flu season of viruses that begin circulating in the Southern Hemisphere during the winter months, our summer months.
But even as officials sounded the alarm about the possibility of a double season of respiratory illnesses, governments in Australia, Chile and South Africa reported that flu circulation was lower than normal. The viral curves in those three countries started to decline much faster than in previous seasons as new closures and restrictions were introduced.
‘During the last twelve months, with the exception of some countries in West Africa and some countries in Southeast Asia, no one has had a flu season. And it’s in countries that close really strictly, it’s in countries that may not have closed so tightly. It confuses me a bit, ” said Richard Webby, director of the World Health Organization’s WHO Collaborative Center for Animal and Bird Flu Ecology. Jude Children’s Research Hospital.
The same apparently happened in the United States. Influenza is less transmissible than the SARS-CoV-2 virus that causes COVID-19, which means that masks and social distances are likely to have a greater impact on the total number of flu cases than on the coronavirus. School closures meant that one of the most fertile vectors of person-to-person transmission had to be hampered.
“Young children and schools are very important players when we talk about the transmission of flu in the community,” Webby said. “Because many schools are not open, or that the controls are actually in schools, it has had a huge impact on the outbreak of flu.”
And according to Freeman, parents have taken to heart the warnings from public health officials that their children should get a flu shot. Although final data on influenza vaccination acceptance rates for months will not be known, Freeman said vaccination acceptance rates in his practice, just south of Richmond, United States, were significantly higher than in previous years.
‘It was one of the best years I’ve had in 15 years to get vaccinated against the flu. This year, parents were definitely engaged, very enthusiastic, ”Freeman said. “It was at a point where I could not keep flu vaccines on my shelves.”
Apparently nothing was easy about the coronavirus pandemic, and some experts have warned that even the least damaging flu season recorded could bring some downsides. A typical flu season provides clues about the strain that will be prevalent next year, which then gives vaccine manufacturers the ability to customize next year’s shots for a specific strain. Without the knowledge, it can be more difficult to produce a vaccine that matches next year’s strain.
“There is not enough information about the circulating virus in the world,” said Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine in Mount Sinai. ‘Because there is so little flu spread, we do not know exactly which strains, which variants are currently circulating. This creates problems with the development of the vaccine and whether it should be updated or not. ”
David Wentworth, head of the virology, surveillance and diagnosis branch of the CDC’s Influenza Division, said the WHO’s global influenza and response system is still testing between 50,000 and 100,000 samples a week to identify dominant strains.
“The reduced number of positive samples has made it more challenging to identify the optimal vaccine viruses for each of the four main groups of influenza viruses included in most influenza vaccines for the 2021-22 influenza season, but it should be noted that the choice and recommendation of vaccine viruses is not just based on flu viruses that are currently circulating, ”Wentworth said in an email.
The identification of the next strain is also dependent on genetic sequencing of current strains, serology studies after vaccination to indicate which strains may break out next year, forecasts of models and efficacy studies.
The lack of increase in flu infections reduced a crippling strain on the health care system at the height of the pandemic, when more than 100,000 Americans were treated for COVID-19 in hospitals across the country. And the United States still records a large number of deaths that, according to the CDC, are flu-like illnesses, although the vast majority in this case are due to COVID-19.
The flu will not go away, and health officials are constantly monitoring concerned strains that could become the next threat to human health – the WHO said in January it was looking at an outbreak of H5N6 in China, H1N1 cases in China and the Netherlands , H1N2 in Brazil and H3N2 in a child in Wisconsin.
But the success of keeping flu this year, doctors hope, will increase acceptance of the vaccine that appears in late summer and early fall.
‘This [mitigation] measures really work to reduce the spread of infectious viruses that are respiratory, ”said Garcia-Sastre. “I do not think we will reduce the cases enough to completely prevent the spread of the virus.”