Dr. Daniel Solomon was not only afraid of a bad flu season. While the coronavirus was still circulating, he was afraid of even a normal flu season.
“I was worried about overwhelming our hospital capacity,” he says. “Our ICUs are running on a thin margin, and I was concerned that if there is an additional surge of flu, we just do not have the means to care for patients.”
Solomon is a doctor on infectious diseases at Brigham and Women’s Hospital, where he and colleagues review flu numbers at weekly meetings.
“And we say ‘Is there already flu activity?’ And we always hear ‘No.’ week after week, so it was incredibly soft, “he says.” And there is this prevailing feeling of surprise and relief that we are not experiencing a simultaneous epidemic of flu and COVID. “
In the fall, public health experts in Boston and beyond feared the prospect of such a ‘twindemie’. Now it is becoming increasingly clear that it was, fortunately, the flu season that was not yet over.
Federal flu cards use a traffic light color scheme – green if flu is low, yellow if it is medium and red if it is high. Here in Massachusetts and across the country, the maps will normally appear very yellow and red by February. But this year they are pure green.
And it’s not just flu that’s bad. Dr. Eileen Costello, head of outpatient pediatrics at Boston Medical Center, says these are other viruses as well.
“We have seen dramatically lower flu and respiratory sensory viruses this year, which is a viral infection of babies and very young children that we see,” she says. ‘It’s the meat and potatoes of every pediatric practice in America, and we are not seeing it at all this year.
In fact, the “flu season has not yet begun”, says Dr. Lynnette Brammer of the Centers for Disease Control & Prevention.
She will know. She is the country’s leading flu detector and says it is the mildest season since the current detection system began in 2009.
“I hate to go with myself, but this is my 30th flu season in the flu section. I think I can pretty safely say it’s definitely the lowest flu season I’ve ever seen,” she says.
Many factors appear to be. “Clearly, mitigation measures are in place to slow down the COVID pandemic: wearing a mask, washing your hands, keeping a distance,” says Brammer. “These things probably have a big impact on flu.”
Also a big drop in travel, especially international travel, and more people getting flu vaccinations.
Brammer says much can be learned from this low flu season that may apply to a normal, non-pandemic time. Of course, no one wants pandemic restrictions every winter. “But it may be worth considering using flu masks during the flu season, especially if it’s bad, especially for people who are very vulnerable. There’s a lot to think about.”
And many calculations have to be done.
“The problem, of course, is that there are compromises,” says Daniel Solomon of Brigham and Women’s. “And the measures we took this year just had incredible costs.”
This ranges from the toll isolation that many people have adopted, including older adults and people living in long-term care facilities, and learning loss in schools.
Solomon predicts great efforts to determine what compromises make sense for a more normal year. He would like to see a nuanced approach to the flu season – for example, wearing masks indoors but not outdoors. He also hopes that flu vaccines will be needed for school children, as they did last year in Massachusetts, although the benchmark did causing controversy.
Usually, the flu kills tens of thousands of Americans each year, including dozens of children. Dr. Jeb Teichman, of the nonprofit Families Fighting Flu, says 188 children died last season, the highest number the CDC has recorded.
This season is very different.
“It’s just wonderful,” he says. “So far, by week four, it’s the end of January, one child death.”
He says the record of 192 million flu shots given this season was a good match for the flu strains.
“And my crystal ball, which is very hazy, is going to tell me that with the way the SARS-CoV-2 changes and variants appear, we get a flu shot and a COVID amplifier every year.”
Flu season lasts until early spring, so experts say although it looks like a record low year, it is still too early to feel completely out of the woods.