Dr. Daniel Solomon was not just afraid of a flu season. With the coronavirus still circulating, he feared even a normal flu season.
“I was concerned with overloading our hospital capacity,” he says. “Our ICUs have been operating with a thin margin and I was concerned that if there was an additional flu outbreak, we simply wouldn’t have the resources to care for patients.”
Solomon is an infectious disease doctor at Brigham and Women’s Hospital, where he and his colleagues review flu numbers at weekly meetings.
“And we say, ‘Is there any flu activity?’ And we always hear, week after week, ‘No’ So it has been incredibly mild, “he says.” And there is this overwhelming feeling of astonishment 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 “twindemia”. Now, it is increasingly clear that – fortunately – this was the flu season that did not happen.
Federal flu maps use a traffic light color scheme – green when the flu is low, yellow when it is medium and red when it is high. Here in Massachusetts and across the country, the maps would normally show a lot of yellow and red in February. But this year they are pure green.
And it is not just the flu that is low. Dr. Eileen Costello, head of outpatient pediatrics at Boston Medical Center, says they are also other viruses.
“We have seen drastically reduced rates of flu this year and of the respiratory syncytial virus, which is a viral infection in babies and very young children that we see,” she says. “It’s the meat and potatoes from every pediatric clinic in America, and we are not seeing that this year.
Basically, “the flu season hasn’t started yet,” says Dr. Lynnette Brammer of the Center for Disease Control and Prevention.
She would know. She is the main influenza tracker in the country and says this is the mildest season since the current tracking system started in 2009.
“I hate dating, but this is my 30th flu season in the flu division. I think I can safely say that this is certainly the worst flu season I have ever seen,” she says.
Many factors seem to be at work. “The most obvious are the mitigation measures that are in place to try to slow the COVID pandemic: wear a mask, wash your hands, keep your distance,” says Brammer. “These things are probably having a big impact on the flu.”
In addition, a huge drop in travel, especially international travel, and more people getting flu shots.
Brammer says that much can be learned from this low flu season that could apply in more normal, non-pandemic times. Of course, nobody wants pandemic-type restrictions every winter. “But it may be worth considering that in the flu season, especially if it’s bad, you may want to consider wearing a mask, especially for people who are very vulnerable. There will be a lot to think about.”
And many calculations to be done.
“The problem, of course, is that there are tradeoffs,” says Daniel Solomon of Brigham and Women’s. “And the measures we have taken this year have just had unbelievable costs.”
They range from the toll that isolation has caused for many people, including the elderly and people living in long-term care facilities, to the loss of learning in schools.
Solomon expects great efforts to analyze which compensations make sense for a more normal year. He would like to see a different approach to the flu season – for example, wearing masks in crowded indoor environments, but not outdoors. He also expects flu vaccines to be required for school-age children, as they did last year in Massachusetts, although the measure generated some controversy.
The flu usually kills tens of thousands of Americans every year, including dozens of children. Dr. Jeb Teichman, from the non-profit Families Fighting Flu, says that in the last flu season, 188 children died, corresponding to the highest number that the CDC recorded.
This season is very different.
“It’s just incredible,” he says. “So far, until the fourth week, that is, until the end of January, a pediatric death.”
He says the record 192 million flu shots this season they were a good match for the flu strains that circulated.
“And my crystal ball, which is really confusing, is going to tell me that with the change in SARS-CoV-2 and the variants appearing, we will receive a flu shot every year and a COVID booster.”
The flu season runs until the beginning of spring, so experts say that while this may seem like a record low year, it is still too early to feel totally out of danger.