Every Picture Tells a Story: Influenza

Here is the data on those patients hospitalized with laboratory-confirmed influenza for the State of New York. As of this moment, we have 1,224 hospitalizations. For comparison, that is 150% more than all of 2020-2021 (last year), but only about 5% of the total for 2019-2020, the time before COVID.

That barely perceptible green line is all the documented hospitalization for influenza in New York State last year. Let’s apply some context and see if any insights shake out. Based on the latest CDC survey and extrapolations as well as their counts done last year:

• 57.2% of adults age 18 or older have received or plan to be vaccinated for influenza. This is 3.4% higher than last year.
• 13% are hesitant, and 29.6% are not going to be vaccinated against the seasonal flu.
• 43.4% of children, those under 18 but over six months, have been vaccinated. 5.9% less than last year. When broken out by race, it was 8.1% lower for Whites, 5.2% lower than Blacks.  

As you might expect, 70% of those vaccinated or planning on a COVID vaccination will get the influenza “jab,” too. For the hesitant and those not getting a COVID vaccination at all, only 8.8% are being vaccinated for flu.

This is no real data regarding how compliant any population is for wearing masks or social distancing, but might we agree that the degree of “lockdown” has been significantly reduced? And might we assume that the use of masks and social distancing has weakened a bit?

Seasonal influenza is not as infectious as COVID, especially the Omicron variant. Now we can argue about the efficacy of the influenza vaccine this year or last, but they are probably similar. And influenza is probably not more infectious this year, nor was it less contagious last year.

Is it possible that all the additional behavioral measures we took last year, wearing masks, social distancing, and taking advantage of vaccination, reduced the incidence of influenza?

The rise this year must, to some degree, be due to relaxing that behavior. What is most different are the lockdowns. So, I think it is reasonable that lockdowns are the prime mover, but those other measures contribute. Consider, some of our national influenza data. There was one pediatric death from influenza last year, compared with 37 to 199 in prior years. The CDC estimates the number of influenza deaths last year at 22,000, 64% of the deaths of the preceding year and 36% of the deaths from the year before that. So far this year, across the US, there have been 131 deaths from influenza; that number will undoubtedly rise.

Public health policy is always a tradeoff – lockdowns are too onerous in the face of seasonal flu, but what about wearing masks, not crowding together unnecessarily, and taking advantage of the vaccines that afford some protection. What is it worth to you to potentially save 100 children and 15,000 adults? When we look at the influenza statistics, wearing a mask and commonsense social distancing seems to make a difference, so what is to be lost?

Oh yes, and to those of you already doing these behaviors – thank you for your service.  

Source: New York State Department of Health weekly advisory.