Flu reporting season starts today in Kansas. Will lax COVID-19 policies result in more sickness this year?
Influenza reporting season starts Wednesday in Kansas, and the removal of mask mandates in most of the state could prompt a worse flu season than last year.
Kansas Department of Health and Environment influenza surveillance data show the 2020-21 season had four deaths where flu was the direct cause of death. Two additional deaths had the flu as a contributing cause of death.
Those six total flu deaths are about a 96% drop from the 141 flu deaths reported statewide in the 2019-20 flu season. Influenza reporting season in Kansas runs from Sept. 1 to May 30.
The last flu season in Kansas and across the United States had unusually low activity as COVID-19 prevention measures also slowed the spread of the flu.
"The mitigation to stop the spread of COVID-19, like social distancing, wearing masks, washing your hands, also helped stop the spread of influenza in Kansas," said Ashley Goss, the KDHE deputy secretary for public health, in an email. "We also saw a higher than usual rate of the population (particularly adults) vaccinated against the flu last year."
While there is a lack of predictive data, Goss said it is likely that flu activity will return to pre-pandemic levels this flu season, "particularly in groups and areas of the state where active mitigation is less common."
"The more people return to mask-wearing, frequent hand washing and social distancing, the more likely spread of flu will be less than in previous years," she said. "As previously stated, the mitigation efforts that were very active last flu season proved to be a very big factor in less spread of the flu."
Dana Hawkinson, an infectious disease specialist at The University of Kansas Health System, said during a Monday media briefing that the hospital saw "hardly any flu" last season.
He pointed to continued low flu activity in the southern hemisphere, especially in Australia, as encouraging signs for the flu season in the U.S. and Kansas. Flu season in the southern hemisphere happens during the spring and summer months and is often cited as an indicator for fall and winter seasons in the northern hemisphere.
"It's really going to be hard to predict what's happening (with the flu)," Hawkinson said. "There are such different restrictions, mandates, issues going out with every different country. We know that here in the United States, really there isn't a lot of masking that is going on. Some areas and geographic regions do have mandates; others do not.
"I think it will be interesting to see what does happen this year once we all go back inside. When it gets colder, we aren't able to do things outdoors anymore. And if there really is no masking or some of those restrictions are lifted, it would be interesting to see what is happening. I would expect we would have more influenza activity this influenza season than we did last year, mainly because of any lifting on restrictions or mask mandates."
COVID-19 is worse than the flu
Angela Myers, a pediatric infectious disease specialist at Children's Mercy, warned the public to take the spread of COVID-19 seriously.
"It isn't the same (as the flu), it is more serious and it can be deadly," Myers said at Monday's media briefing from The University of Kansas Health System.
The CDC provisional data as of last week showed 454 COVID-19 deaths nationwide among ages infant to 18 years old.
"That's more than what we would typically see from influenza," Myers said." A lot of people have come back to me and said 'this isn't a very bad disease in kids, and kids don't get very sick and this is like influenza.' That's not true.
"In a typical influenza season, we have between 100 and 150 kids pass away in our country from influenza. We've had 450 kids in the last 18 months die from COVID-19."
In the 2020-21 flu season, there was only one influenza-associated pediatric death reported to the Centers for Disease Control and Prevention.
More severe flu season could stress hospitals
The CDC reported an "unusually low" level of flu activity during the 2020-21 flu season and "dramatically fewer" illnesses, hospitalizations and deaths. The agency attributed the low flu activity to a record number of influenza vaccine doses distributed combined with COVID-19 mitigation measures, such as wearing face masks, school closures, staying home and physical distancing.
"While it’s not possible to say with certainty what will happen in the fall and winter, CDC believes it’s likely that flu viruses and the virus that causes COVID-19 will both be spreading at that time," the CDC says in an online question and answer webpage. "Relaxed COVID-19 mitigation measures (such as stay-at-home orders, or mask mandates) may result in an increase in flu activity during the upcoming 2021–2022 flu season."
The low flu activity since the onset of the coronavirus pandemic could make for a worse flu season now.
"Reduced population immunity due to lack of flu virus activity since March 2020 could result in an early and possibly severe flu season," the CDC reports.
As the COVID-19 surge fueled by the delta coronavirus variant has filled hospitals again, the flu could further strain limited resources, USA Today reported.
“We do face this threat of multiple serious respiratory viruses circulating in our community simultaneously," Daniel Solomon, a physician in the division of infectious diseases at Brigham and Women’s Hospital, told the newspaper. "If that comes to pass, it could strain our hospital system in ways we’re seeing now with COVID alone."
Goss said the state health department wants to stress that COVID-19 vaccines don't protect against the flu, so it is important for everyone who is eligible to be fully vaccinated against both viruses.
"We are encouraging all Kansans to get the flu vaccine later this year," she said. "In addition to getting the flu vaccine, we learned last year that wearing a mask, washing your hands and social distancing work to prevent the spread of flu and COVID-19."
Flu vaccines are 'more important than ever'
Officials at the CDC and KDHE, as well as KU doctors, all say that patients can get COVID-19 vaccines at the same time as the flu shot and other vaccines. Public health experts generally recommend getting vaccinated early in the fall, ideally no later than Halloween, before the typical peak in the flu season.
Hy-Vee Pharmacy and CVS Pharmacy are offering flu shots, company officials said in news releases last week.
Flu vaccines are available at Hy-Vee Kansas locations without a prescription during regular pharmacy hours to patients aged 3 years and older. No appointment is necessary. Patients who get a flu vaccine can earn a 20-cent fuel saver reward.
At CVS, appointments can be scheduled online or by walking into a pharmacy. For a limited time, customers will receive a $5 or $20 shopping pass with any vaccine visit.
"As the country continues to deal with the impact of the COVID-19 pandemic it is more important than ever to stay current with vaccinations and other routine health care needs," CVS Health officials said in a statement. "By getting a flu shot this fall and taking other proactive measures to improve general health and immunity, individuals and families can protect themselves against seasonal flu and help safeguard the overall health of the community."