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Between flu and Covid-19, winter ‘could be complicated’


By Jen Christensen, CNN

If there ever was a year to get a flu shot, this one may be it.

Typically, the US Centers for Disease Control and Prevention suggests people get a flu shot by the end of October.

But the coming flu season may be a bad one. With Covid-19 still complicating things, the experts say you may want to do it even earlier.

“Years ago, we would say you should wait as long as you can to get a shot, but if you get it in the fall, that really should cover you through the season,” said Dr. Claudia Hoyen, director of pediatric infection control at UH Rainbow Babies and Children’s Hospital in Cleveland. “If people get the chance to go ahead and get their flu shot, whenever they can do it is probably good.”

Based on the number of viruses she’s seen hitting people early this year, she thinks it doesn’t bode well for the flu season. Hoyen’s children’s hospital has been much busier this summer compared to last, treating children for a bigger mix of viruses.

“Once we all took our masks off, the viruses did what they do best and found lots of people to give runny noses to,” Hoyen said.

What the flu season will look like this year

The US isn’t seeing a lot of influenza yet, according to the US Centers for Disease Control and Prevention, but that could soon change.

To predict what kind of flu numbers the US should expect, experts often look to the Southern hemisphere, where flu season usually starts in June and peaks in August.

“The story is mixed so far,” said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center.

Australia, with its tight pandemic restrictions on travelers coming into the country, has had very low flu activity, Schaffner said.

“But China, which has more interactions with the outer world, has had a moderate flu season,” Schaffner said.

“So we think we’ll have at least a moderate season this year.”

Children the ‘distribution franchise’ for flu

Typically what kicks off the flu season is the start of the school year. With more kids going back to the classroom than last year, unless kids are wearing masks, and everyone else for that matter, there will likely be more cases, he said.

“Children are the ‘distribution franchise’ for the influenza virus. They’re on top of each other and they are not the most hygienic little lovelies, so they spread the flu virus amongst themselves,” said Schaffner.

“When kids get infected, they shed the virus for a longer period of time than adults do, so they’re really the people who bring the virus into the family and spread it about to the neighbors and, well, everybody,” Schaffner said.

Flu by the numbers

In an average season, the US sees between 9 and 45 million cases of the flu each year, according to the CDC.

Last year was no average season. Flu was practically non-existent in the US with only a few thousand cases for the entire year. One child died. For comparison, in 2019-2020, there were 199 flu-related deaths in children and 144 the season before that.

The “twindemic” with a high number of flu and Covid-19 cases that some experts predicted for 2020 thankfully never happened.

What’s different this year

What may have helped are the extra precautions people took to stop the spread of Covid-19.

Masks, good hand hygiene, limited in-person school, restricted travel and less interaction with others can help prevent Covid-19 and the spread of the flu.

As the country has opened back up, protection from a flu shot therefore becomes even more essential for just about everyone.

A person can get a flu shot and a Covid-19 vaccine at the same time, so if they haven’t been vaccinated against Covid-19 yet, or they need a booster, there are no real medical reasons to space them apart from a flu shot, Schaffner said

“If it’s your opportunity to get both, I would say get both,” Schaffner said. Of course, children 11 and younger cannot be vaccinated against Covid-19 yet.

Flu shots are already available at pharmacies like CVS and Walgreen’s.

An added motivation to get a flu shot

While Dr. Anthony Fauci told CNN’s Anderson Cooper Monday that the United States could get back to a “degree of normality” by spring of 2022 if the majority unvaccinated in this country get the Covid-19 vaccine, the Director of the National Institute of Allergy and Infectious Diseases noted that getting through the winter “could be complicated” by the flu.

Getting vaccinated could certainly keep those numbers to a minimum and with Covid-19 in circulation, Hoyen said people have an added incentive to get a flu shot this year.

Kids under 12 still can’t get a Covid-19 vaccine, and while the disease can be milder in the little ones, Hoyen said hospitals are seeing more children with Covid-19 and another virus.

“Even if we don’t think these things are important for ourselves, we should really do them for a child in our lives so that they can get back to a little more normal,” Hoyen said.

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