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Flu season is almost nonexistent

STEAMBOAT SPRINGS — There hasn’t been a single positive influenza test result taken at UCHealth Yampa Valley Medical Center in Steamboat Springs since the flu season arrived in late September, said the hospital’s infection preventionist, Lauren Bryan.

Each flu season is different — and unpredictable — but this year is unusually quiet, she said. There have been only 18 hospitalizations due to influenza in Colorado.

“This is an extremely puzzling phenomenon. We’re in a historic, unbelievable situation,” said pediatrician Norio Sugaya in a Jan. 21 Wall Street Journal article. Sugaya serves on a World Health Organization influenza committee.



The Centers for Disease Control and Prevention is reporting record-low numbers. During the 2019 flu season, from Sept. 29 to Dec. 28, the CDC reported more than 65,000 influenza cases in the United States. During that same period in 2020, the CDC reported just over 1,000 cases.

And the trend appears global, said Routt County Public Health Director Roberta Smith, who has spent most of her career working with infectious disease management. From 1999 to 2007, she coordinated the influenza immunization program for the Colorado Department of Public Health and Environment.



While flu seasons are inherently unpredictable, there are some hypotheses on why the 2020-21 season at this point is virtually nonexistent.

For one, Bryan said, kids aren’t in school and sharing germs as they would be during a typical year. And everything people are doing to prevent the spread of COVID-19 — mask wearing, social distancing, avoiding crowds, washing hands and cleaning surfaces — helps to prevent any respiratory diseases.

“These are the principles we’ve always touted to prevent the spread of respiratory diseases this time of year,” Smith said of washing hands and covering mouths when sneezing.

Travel is also a big part of how the different influenza strains spread each year, Bryan noted, locally and across the globe.

“It just takes a few out-of-staters to bring in a new strain, transmit that to a few locals and then to others,” Bryan said of tourism communities like Steamboat. “If you break that chain, it protects people.”

Based on how easily COVID-19 continues to spread despite all the mitigation measures in place, it would appear the coronavirus is more transmissible than influenza — though they both spread the same way.

It is possible that people were tested less for influenza and were less likely to go to the hospital, especially early on in the pandemic. However, statistics show positive flu tests in the U.S. dropped by 98% after the pandemic started, while the number of samples submitted dropped by only 61%.

More people getting the flu vaccine could also play a factor. The most recent flu vaccination data is not yet available on a state or county level, but Smith said some of the early data on people 65 and older shows a high rate of vaccination.

According to the CDC, more than 192 million doses of the flu vaccine have been distributed since the beginning of the season — the highest number of doses distributed in the U.S. in a single flu season.

There was a bigger than normal push for the flu shot this year, as health care professionals said it would help reduce the burden on the health care system and decrease the risk of co-infection of flu and COVID-19.

It also helps individuals and their doctors rule out influenza, given the similarities in the symptoms with COVID-19.

The efficacy of this year’s flu shot won’t be known for months, and the lack of data will make that harder to determine. Bryan said based on what little is known, the strains selected for this year’s shot appear to be a good match.

It isn’t too late to get a flu shot, both Bryan and Smith said. And still a very good idea to do so.

Bryan emphasizes the data shows getting a flu shot reduces all causes of mortality.

The flu season is not over, and there could be a late season spike, they warned. Other years have seen a quiet start followed by a big rise in cases in March and April, Bryan said.

“It could be that we haven’t got hit, yet,” she added.

On the whole, not burdening the health care system with an active flu season on top of COVID-19 is a very good thing. It also helps conserve supplies of personal protective equipment, Bryan noted.

“If we had a huge spike in influenza on top of COVID — our resources would absolutely be put to the max,” Bryan said.

There are also some data implications, Smith noted.

“Since there are so few strains out there, it will make the WHO’s decision to pick out the strains for next season’s vaccine more difficult,” she said.


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