To the infectious diseases community, the southern hemisphere is like an influenza crystal ball. Winter down there comes before ours, and their flu season foreshadows how things will go north of the equator. Peer into the viral illness Magic 8 Ball this year, and the answer is clear: Outlook not so good.
"The Australians have had a worse flu season than they normally do," says Dr. Robert Geise, an infectious diseases physician at Virginia Mason Franciscan Health. And by "worse" he means more hospitalizations, more deaths, and more cases overall.
While a bad flu season any year isn't good news, this year's round of influenza brings a certain level of complication. "If you look at the data, all of a sudden in March of 2020, flu disappears because we were isolated and wearing masks," Geise explains. There was virtually no flu season in the ensuing pandemic years. What that means now, though, is that there's little to no pre-existing immunity in the community, making us all more susceptible to getting sick with the flu.
On top of that, many (hello, President Biden) think the Covid-19 pandemic is over and are no longer masking indoors. That just opens up the doorway for—say it all together now—aerosols to travel from one person to the next, leading to more virus circulation.
In this area, Geise says, flu season tends to run from December through March, sometimes into April if the strain is particularly persistent. "January and February are generally our peak months," he adds, but cases can sometimes start appearing earlier in fall and linger as late as May depending on the influenza variant.
Despite the different conditions this year as the world tiptoes back into normalcy, the preventive and protective measures heading into this winter's flu season haven't changed: Get your flu shot, Geise all but pleads. Wash your hands. Don't touch your face. Stay home when you're sick. This all sound familiar?
Timing is important, too. The ideal time to get your flu shot is before the end of October so your body has time to build up immunity and fend off any early fall cases. But Geise adds, anytime is a good time to get a flu shot, even if it's well into winter.
As for that balance of bivalent Covid boosters and flu shots, we don't need a crystal ball to see the answer: "It's absolutely fine to get both shots at the same time," Geise says. "I would, in fact, encourage it."