Winter is Coming and so are Waves of Respiratory Illnesses

When the COVID-19 pandemic hit its first fall, many worried about the potential for a “twindemic” wherein influenza and COVID-19 would experience concurrent seasonal waves that brought untold death upon the country and the world at large. However, because all of the activities of non-pharmaceutical intervention used to mitigate COVID-19 are the same as what’s needed to prevent influenza, the 2020-2021 Flu season was remarkably quiet.

Likely the least active Flu season on record, the United States experienced only one pediatric death during the 2020-2019 fall and winter months. Comparatively, the 2009-2010 Flu season was one that was considered “pandemic” with the H1N1 strain (sometimes called “swine flu”) with 288 pediatric deaths and the 2019-2020 season saw 199 pediatric deaths, according to the U.S. Centers for Disease Control and Prevention’s (CDC’s) “FluView” data, which tracks influenza, influenza-like-illnesses (“ILI”), and, since testing became widely available, COVID-19. The data includes diagnoses, hospitalization, and deaths, among other factors and the important thing to remember when viewing the 2019-2020 Flu season is it accounts for the initial period of time when COVID-19 as wholly novel and such a threat whole governments and countries shut down, and the year still outpaces the immediate previous two seasons. The 2021-2022 Flu season saw a slight, though only remarkable in how low the number was, return to regular flu season – still only 48 children died from Flu in the 2021-2022 season.

Typically, “Flu” seasons, which we should really start calling “respiratory illness season” begins in “week 40” of the year (which also typically falls as the first full week of October). As of this year’s respiratory illness seasons, we’re already above the national baseline for outpatient ILI diagnoses and far outpacing all previous seasons at week 40 through 2017-2018. Dr. Mark Kline, of Children’s Hospital New Orleans and the leading pediatrician in the state, is regularly posting the hospital’s respiratory census and urging parents, families, and individuals to get their updated booster shots and return to precautions we’ve now deemed “COVID precautions” but generally work to halt the transmission of most respiratory illnesses. While COVID-19 isn’t the largest share of pediatric hospitalizations for respiratory illnesses, it does rank. Influenza A and Rhino and Enterovirus (generally illnesses that cause the common cold and most “stomach bugs”). Co-infections are common. Another virus they’re watching closely is respiratory syncytial virus (RSV) because it’s typically the leading cause of pediatric hospitalization. There is no vaccine for RSV, currently, but several manufacturers are pursuing candidates at the moment.

In short, this respiratory illness season is likely to be… “bad” is an understatement. But there’s things you can do to help ease these risks and protect the people around you. You can ensure you’ve had your annual flu shot and updated COVID-19 booster, you can opt to return to masking or even selective masking, and the washing of hands and limiting our interactions when ill is just plain courteous.