Upcoming flu season could be severe, posing risk for ‘twindemic’ with COVID-19

Abnormal influenza activity last year means that it may be harder for experts to predict the 2021-22 flu season. But national experts already are warning Americans they could be in for a severe season.

Reduced population immunity due to a lack of influenza activity since the pandemic began in March 2020 could mean the United States will face an “early and possibly severe flu season” this year, U.S. Centers for Disease Control and Prevention officials have warned.

That potential for a “twindemic” of both widespread flu and COVID-19 cases is at the forefront of local public health officials’ minds as the winter months draw closer, highlighting the importance of getting vaccinated against both viruses and taking other steps to avoid infection.

“Our health care partners have been working so hard for so long, let’s not burden them with things we can prevent so easily,” said Sam Jarvis, community health division manager at Johnson County Public Health.

Residents need to do their part by keeping themselves healthy, said Heather Meador, clinical services supervisor at Linn County Public Health.

”We need to get our flu shot, we need to wash our hands, cover our coughs and sneezes, and stay home when we’re sick,“ she said.

Federal health officials note it is difficult to predict the spread and severity of the virus season to season. That’s particularly true for this upcoming season, as last year’s atypical influenza activity has made it difficult for CDC officials to generate a prediction for this year, Meador said.

“It’s all a guess,” Meador said. “We won’t know until we’re there. That’s why we need to do all we can to be preventive.”

Last year’s flu season highlights the fact that spread of respiratory viruses is dependent on behavior, Jarvis said.

Despite high levels of testing, the United States saw unusually low influenza activity during the 2020-21 flu season that contributed to “dramatically fewer” illnesses, hospitalization and deaths, according to the CDC.

From Sept. 28, 2020, to May 22, 2021, 1,675 influenza cases were detected by clinical labs across the nation. Other estimates put the total number of flu cases closer to 2,000.

Either way, last year’s illnesses was dramatically less a typical year, when somewhere between 20 million to 40 million Americans get sick with the flu, the CDC states.

Total hospitalizations also were the lowest recorded since the federal health agency started collecting that data in 2005.

About 750 influenza-related deaths were reported and the CDC only received one report of a pediatric flu death during the past season. Since federal officials began tracking flu deaths in children, the lowest number of reported was 37 and that was during the 2011-12 season.

Experts point to widespread use of face masks, social distancing and other COVID-19 mitigation practices as the reason influenza spread was dramatically reduced nationwide during the 2020-21 season.

The community also saw unusual low activity of other respiratory viruses, such as RSV, last winter as a result of these practices.

But heading into the 2021-22 season, vigilance around masking and physically distancing among Iowans “is much lower than before,” Johnson County’s Jarvis said.

Local public health officials say everyone should be vaccinated against both flu and COVID-19 heading into this winter. Individuals now can get both shots at the same time at local pharmacies, at health care providers’ offices or at other locations that provide the vaccines.

Individuals aged six months and older should receive a flu vaccine. This year’s flu vaccines are quadrivalent, meaning they contain components to protect individuals from four different flu viruses, according to the CDC.

Meador recommends residents get the influenza vaccine now, before there’s widespread community spread of the virus. She also emphasizes it’s important to be fully vaccinated before the holidays, when individuals will be gathering with friends and loved ones.

Local public health officials also encourage residents to take other steps to keep themselves healthy as part of a layered mitigation approach to prevent widespread infections. In addition to getting vaccinated, individuals should cover their cough, wash their hands and stay home when they’re feeling ill.

“We hope that the community will keep some of those basic infection prevention measures that are part of the layered approach in mind,” Jarvis said.

Both public health officials also encourage anyone to seek out a COVID-19 test whenever they are experiencing symptoms.

Symptoms of the flu include fever, cough, sore throat, stuffy nose, headaches, body aches, chills and fatigue.

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