Mark S. Roberts, MD, MPP, Director of Public Health Dynamics Laboratory, University of Pittsburgh Graduate School of Public Health, talks about how COVID will impact the upcoming Flu season.
Talk a little bit about the season that nobody wants to talk about yet, but here it comes, flu season. Because we’ve just been going non-stop with COVID.
ROBERTS: Yeah, the way we have been saying it internally is winter is coming, which is a problem because the flu season comes in the wintertime. And what we are facing this winter is what many people are calling a twindemic of both the incredible increase in COVID we’re seeing because of the Delta variant as well as a resurgence of influenza in the wintertime. And we have an unfortunate situation that we have a high likelihood of having a very serious flu season because the flu season last year was so mild because people wore masks, schools were closed, social distancing occurred. So, all of the things that reduce COVID and that were used as mitigation against COVID also prevent influenza. And one of the problems with that is that much of our immunity to influenza comes from people who had it last year, and a lot of that’s gone. So, our modelling studies have shown that there could be a substantial increase in influenza this winter. And when you look at some of the intensive care units in the South and Midwest that are already full and breaking, they’re getting near breaking capacity with just COVID, there’s always most influenza seasons, there’s many, many thousands of people who require ICUs as well. So, we’re very worried about the upcoming flu season.
When you say substantial, doctor, can you put a number on it yet?
ROBERTS: We can. The models were slightly different in how they estimated it, but the agent based simulation model said that the likelihood is that there could be 20% or 30% more cases. The mathematical model that we use said as many as 400,000 extra hospitalizations.
So, with that in mind, what do you say to the American public at this point?
ROBERTS: Well, what we can do is the other things that we do to protect ourselves, and that’s to get vaccinated. We also demonstrated in these models that, if we were to vaccinate more effectively, we would have a substantial likelihood of decreasing the impact of this next year’s flu season. You know, many people don’t get the flu vaccine every year. And even though the flu vaccine is not as effective as the COVID vaccine is, it is still effective at preventing serious disease and it’s more effective than not. And so, I would strongly suggest that we do the best we can to vaccinate against influenza this year, especially in children because children are a fairly large spreader of influenza to grandparents and parents and things like that. And especially since schools and those things are opening up again, we have to worry that children can be a fairly big reason that influenza springs back again this winter.
When is the prime time to vaccinate?
ROBERTS: The prime time to vaccinate is in the late fall, early winter. For example, our clinic does not yet have the flu vaccine for this year, but it will, it usually gets it sometime around the end of September, first of October. There’s actually quite a bit of debate about whether or not getting vaccinated early is exactly the right time for everybody. Our models have shown that it’s possible that there are some people who should wait a little bit of time because, after you get a vaccine, the vaccine immunity wanes and so, if you get it too early, before the end of the flu season, you may have waned a little bit. That’s nowhere near a strong recommendation yet because we just can’t, we don’t have the data yet for it.
What kind of impact could other mitigation efforts have? For example, you know, we’ve sort of become accustomed to these things on our faces and, you know, we got into the habit of better hand hygiene. Again, are these things that could impact the numbers that you and your colleagues are running?
ROBERTS: Absolutely they can. And we can, if you change the transmission characteristics by wearing masks, by social distancing, by those sorts of things, you will decrease the incidence of influenza in the coming flu season. One of the things that we did demonstrate, however, is that when you choose to then drop those tools, you know, whether you do it two years, three years, four years, there’s the potential for having a fairly large resurgence. And with flu, it’s a little bit harder to predict because how much the resurgence matters depends upon how alike the flu strain is to the flu strain that existed in the previous years.
And that’s one question I asked you before we get started. I know our viewers, and I, certainly want to know do you have any indication of what strain and what might be effective against the strain yet?
ROBERTS: Not so much yet. I do not know a lot of the data yet of what’s been happening in the southern hemisphere. Part of that is because the southern hemisphere is where we normally get our data about annual flu vaccines and we see what’s going on in their winter, which, you know, is our summer and will become our winter later, that there’s been a fairly substantial decrease in influenza in those countries as well. So, we don’t know exactly. But the CDC is looking at that and is trying its best to make the match. The other thing that’s important to remember about the flu vaccine which is different than the COVID vaccine is the flu vaccine always includes components that are essentially directed towards the four major strains of influenza. Sometimes they match nearly perfectly what comes, sometimes they don’t, but they are a broader-based vaccination than COVID, which is only against the COVID-19 virus.
While we’re talking about that, I know the question will come up, will this flu vaccine have any impact on my COVID vaccine? If I’m supposed to get a booster, can I get a flu vaccine at the same time? Are they going to interact and cause…
ROBERTS: They will not interact. You can get them at the same time. I suppose there’s a possibility, you know, people don’t feel very well after a vaccine for a day or so. You might not feel as well if you get two vaccines at once. But there’s no contraindications to getting the flu vaccine when you get a COVID vaccine or there’s not enough data about the booster, but I can’t imagine that there would be any problem with that either.
If we had a fall where we have a lot of people standing up and getting vaccinated for the flu, have you run the numbers, do you know what kind of a decrease in those cases?
ROBERTS: Well, we did do some numbers and we showed what would happen if 25% and 50% more people got vaccinated than typically get vaccinated in a year, and that substantially decreases the huge burden of potential influenza but doesn’t eliminate it. It’s almost impossible to eliminate it given the flu vaccine is substantially less effective than the COVID vaccine. So, we can make it better but we can’t make the potential difficulties for a strong flu season go away.
Is there anything I didn’t ask you, sir, that you would want to make sure people know?
ROBERTS: I don’t think so. Get vaccinated. Get vaccinated against COVID, get vaccinated against flu and protect yourself, protect your children, protect your grandparents. And that’s the best we can do.
Interview conducted by Ivanhoe Broadcast News.
END OF INTERVIEW
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