What Happened to the Influenza Virus?

By Yvette C Terrie, BS Pharm, RPh, Consultant Pharmacist

The influenza virus and common cold viruses are typically widespread during this time of year, but this year activity is historically low. According to the CDC, influenza activity for the 2020-2021 influenza season thus far is “remarkably low.” The most recent data from the CDC reveals that of the 554,588 specimens tested by clinical laboratories since September 2020, only 1316 (0.2%) have been positive for influenza.¹ According to the CDC’s US Influenza Weekly Surveillance Report Week 5 ending February 6, 2021, the CDC notes that, “Nationwide during week 5, 1.1% of patient visits to health care providers were for influenza like illness and remains stable compared to the previous week. ² This percentage is below the national baseline of 2.6%.² Around the same time last year, the CDC reported an estimated 129,997 positive influenza cases.”²

Statistics From Past Influenza Seasons

In the 2019-2020 influenza season, the CDC estimated that more than 38 million became ill with influenza, leading to 400,000 hospitalizations and 22,000 deaths.³ The CDC estimates that the burden of illness due to influenza during the 2018–2019 season included an estimated 35.5 million cases of influenza, 16.5 million individuals seeking medical care from a health care provider, 490,600 hospitalizations, and 34,200 deaths from influenza.⁴ For the 2017-2018 influenza season, the CDC reported that there were an estimated 45 million influenza illnesses, 21 million influenza-associated medical visits, 810,000 influenza-related hospitalizations, and 61,000 influenza-associated deaths.⁵

What Some Health Care Providers Have Observed This Season

In recent conversations with several health care providers in various health care settings, the HCPs have reported little to no cases of influenza and have performed a minimal amount of influenza testing. One physician indicated that there have only been 1 or 2 cases in the practice and had not had any patients who tested positive for influenza. Another physician indicated that their practice has only encountered less than 10 cases in a three month time frame. Three nurses practicing in the hospital setting have not treated any patients with influenza and 2 pharmacists indicated that they have not dispensed any antivirals commonly prescribed for the influenza virus since the influenza season has begun. Many of these HCPs believe that the low influenza activity can be attributed to multiple factors such as social distancing, the ongoing universal infection control measures implemented to curb the transmission of the COVID-19 virus and possibly some patients are still apprehensive about seeking medical care due to fear of contracting the COVID-19 virus.  The majority of HCPs believe that the infection control measures for the COVID-19 virus are the primary reason for low influenza activity. Also while the statistics are not available, many HCPs reported an uptake in influenza vaccines this season.  

Results from a new national survey involving more than 2,000 individuals conducted by The Ohio State University indicated that the majority of adults surveyed intend to continue implementing preventative measures including routine hand washing, use of alcohol based sanitizers, wearing masks and social distancing after the end of the COVID-19 pandemic. Results from the survey revealed: ⁶

• 72% of those surveyed indicated that they plan to continue wearing masks.
• 82% intend to avoid crowds after the pandemic is over.
• 90% intend to continue routine hand-washing and using hand sanitizer.
• 73% of respondents plan to stay home when they are ill.⁶

In a recent press release about the survey, Dr Gosenhauser, chief quality and patient safety officer at The Ohio State Wexner Medical Center stated. “Masks and physical distancing are still our best weapons for limiting spread and, now that we have a vaccine, will make those precautions even more effective and will drive new cases way down if we stay the course.” Dr Gosenhauser also stated that, “Flu cases and hospitalizations are way down compared to recent years. A lot of that is likely because precautions like masking, physical distancing and hand hygiene are working to prevent the flu. I think a lot of people realize what we’ve learned from COVID-19 can be applied more generally to keep our population healthy.”⁶

Reports of low influenza activity thus far have eased the anxieties and fears of many individuals during this ongoing COVID-19 pandemic. Many individuals including HCPs are wondering if the lessons learned during the pandemic can aid in lowering the incidence of influenza and other respiratory viruses from now on. The low numbers for influenza activity this season thus far and the results from the aforementioned survey indicate that many individuals are employing recommended preventative measures and many seem to indicate that they plan to continue them after the pandemic is over. In the meantime, we should all remain vigilant and do our part in curbing the spread of the COVID-19 virus and other respiratory illnesses via universal infection control measures to continue to protect our loved ones, our fellow human beings and ourselves. Once the pandemic is over and life returns to some degree of normalcy, it will be interesting to see which measures will be routinely recommended by health experts to decrease the transmission of many respiratory viruses especially during future cold and influenza seasons.  

Yvette C. Terrie, Consultant Pharmacist, Medical Writer and creator of A Pharmacist’s Perspective (https://apharmacistsperspective.blogspot.com/).