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Flu season expected to be severe, experts warn

Influenza hit Australia and the Southern Hemisphere hard — and early — sparking concerns that flu season will be tough in 2022-23

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A flu vaccine is readied at the L.A. Care and Blue Shield of California Promise Health Plans’ Community Resource Center in Lynwood, Calif.

A flu vaccine is readied at the L.A. Care and Blue Shield of California Promise Health Plans’ Community Resource Center where they were offering members and the public free flu and COVID-19 vaccines on Friday, Oct. 28, 2022, in Lynwood, Calif. The U.S. flu season is off to an unusually fast start, adding to a 2022 autumn mix of viruses that have been filling hospitals and doctor waiting rooms.

Mark J. Terrill, Associated Press

COVID-19 played a role in reducing influenza cases the last two years, as people wore masks and social distanced to avoid spreading the coronavirus. This flu season, COVID-19 is more likely to be the gasoline poured on dry branches, as restrictions like masking and social distancing have largely gone away, but folks have not developed any immunity to flu in recent years.

Pharmacy Times is among those reporting that the 2022-23 flu season could be severe. The trade publication reported that “low antibody levels related to low exposure, poor exposure and relaxed COVID-19 restrictions all played parts in the latest flu surge.”

“You can never predict with 100 percent certainty, but all signs predict influenza will be back this year, and data from Australia suggests it will be a strong flu season,” Andrew Pekosz, a virologist and professor of microbiology at the Johns Hopkins University School of Public Health, told AARP.

Infectious disease experts at Cedars-Sinai Medical Center are also predicting “a tough flu season.” They base the prediction on loosening of pandemic restrictions and a “sharp increase in flu cases in the Southern Hemisphere.” Get ready, they say, for a “bad flu season this year.”

Flu circulation in Australia in April from October, according to these experts, is the proverbial canary in the coal mine, hinting at what’s to come. And the article said that “the flu wasn’t only severe in Australia this year — it came on fast,” showing up two months earlier than usual and hitting children ages 5-9 especially hard.

Infectious disease specialist Dr. Soniya Gandhi, associate chief medical officer at Cedars-Sinai, said that immunity to influenza declined as people were more isolated. That and fewer safety measures now will make the population more vulnerable. “When you throw all that into the mix, it’s not surprising that we may have the worst flu season we’ve seen in a while,” she said.

Flu symptoms

The World Health Organization warns that seasonal influenza comes on suddenly, unlike a cold. One minute you may feel fine and the next you've got a fever, headache, cough, muscle and joint pain, sore throat and runny nose. You are quite apt to feel terrible, or as WHO puts it, experience “severe malaise.” The cough can last a couple of weeks or longer, though the rest of the symptoms typically leave within a week or so.

But people also die from the flu. Just prior to the pandemic, 34,157 deaths were reported in the United States as a result of seasonal flu during the 2018-2019 flu season.

The CDC has an estimated range of the annual burden of flu between 2010 and 2020. According to it, the flu each year resulted in between 9 and 41 million illnesses, 140,000-710,000 hospitalizations and 12,000-52,000 deaths each year.

At least two child deaths resulting from flu complications have been reported already this season, according to different local health departments.

The North Carolina Department of Health and Human Services reported that a child in the eastern part of the state died of flu complications. No information was released other than the fact that the death was a pediatric patient.

The notice said that five adult flu-associated deaths were also already reported this flu season in North Carolina. And it noted another child death reported as of Nov. 2, from another, unnamed state.

Respiratory illness and flu vaccine

Meanwhile, Respiratory Syncytial Virus is complicating an already complicated medical landscape. RSV, as it’s commonly called, has many of the same symptoms as both COVID-19 and flu. And all three will likely be circulating simultaneously, as will seasonal colds.

Now’s the time if you haven’t gotten your flu shot, according to recommendations from the Centers for Disease Control and Prevention. “While ideally it’s recommended to get vaccinated by the end of October, it’s important to know that vaccination after October can still provide protection during the peak of flu season,” the CDC reports.

The CDC recommends that anyone age 6 months and older should get an annual flu vaccine. Besides offering some protection against influenza illness, hospitalization and even death, being vaccinated helps protect others, including babies and young children, older adults and those with certain medical conditions that are chronic.

This year, the CDC has recommended that older adults, age 65 and up, receive one of three specific high-dose vaccines, though there’s no particular recommendation for those who are younger. The three vaccines for older adults are Fluzone High-Dose Quadrivalent vaccineFlublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. The three are all believed to be “potentially more effective than standard dose” vaccines among older adults.