COVID reduces flu, and flu shots

COVID-19 has claimed two more victims in Australia: flu, and the availability of flu vaccinations.

The incidence of flu in Australia has been dramatically reduced in 2020, with 307 notifications of influenza reported by the Department of Health in April, compared to 18,691 in April 2019. In May, there were only 197 reported cases compared to 30,567 in May 2019.

The massive reduction in cases is linked in part to social distancing measures put in place to combat COVID-19, says Professor Robert Booy of University of Sydney.

“We’re not importing any flu and anything that stops close contact with others is going to make it harder for the influenza virus to transmit,” he told New Scientist.

The closure of our border, banning of gatherings and closure of schools has also helped reduce transmission.

If strict COVID-19 measures are maintained, flu cases should remain suppressed, says Prof. Booy. “That could mean we see fewer deaths from respiratory infections overall this year.”

Up to 3000 Australians die of influenza in most years, and 2019 was the worst influenza season on record with 313,359 notifications and more than 18,000 hospitalisations. Influenza is the most common preventable disease in Australia and the flu season typically runs from April to October, peaking in August.

Despite those good numbers, authorities are concerned that many Australians can’t source flu shots.

Earlier this year, health authorities including the deputy chief medical officer Professor Michael Kidd, the Royal Australian College of General Practitioners and health minister Greg Hunt urged Australians to get their shot as soon as possible, fearing that flu and COVID-19 would “collide”.

But an “exponential increase in demand” for vaccinations has left many waiting.

This year, from 1 March 1 to 12 May, 6,489,298 doses of seasonal influenza vaccines were administered.

“This is almost double the amount for the same period last year, which was 3,256,348 doses,” a Department of Health spokesperson told The Canberra Times.

Australian Medical Association NSW president Dr Danielle McMullen said the federal government had ordered more doses than in previous years, but that was “all pre-COVID-19”.

After experiencing supply chain issues due to the pandemic, Australia was now seeing “true shortages” of flu shots.

There are a couple of COVID-related reasons for the shortage.

“The first is that COVID-19 has focused people’s minds on infection, prevention of infection and the fact it would be a bad time to have the flu if you were also to contract COVID – it’s a bad combination,” a Pharmacy Guild of Australia spokesperson said.

“Second, it was quite a bad flu season last year.”

Local pharmacies pre-ordered flu vaccines in October 2019.

“Of course, at that time nobody had ever heard of COVID-19, so nobody quite foresaw the level of demand,” the spokesperson said.

In late April, the World Health Organisation (WHO) said it was “vital” everyone in the southern hemisphere got their seasonal flu vaccine.

Australian Medical Association Queensland branch president Dr Dilip Dhupelia was concerned a flu “crisis” could follow the COVID-19 outbreak.

And epidemiologist Professor Mary-Louise McLaws was worried that a bad flu season could create “many more spikes” in COVID-19 transmission “because a coughing season not only increases flu-like illness and colds … that has the potential for amplifying any COVID cases in the vicinity of the coughing person. It is quite worrying as a potential amplifier as we go into winter”.

Flu cases should lessen this year because of changes in people’s behaviour due to COVID-19, says Dr Kirsty Short, research fellow at the University of Queensland’s School of Chemistry and Molecular Biosciences.

“People are washing their hands more and instead of having the attitude that they can still go to work if they’re sick, they now know to stay home if they have respiratory symptoms,” she says.

However, she worries cases will rise now that students have returned to classrooms.

“Fortunately, it doesn’t seem like COVID-19 is transmitted by schoolkids, but we know that children are a hotbed of influenza infection,” says Dr Short. “It will be really interesting to see what happens.”

Prof. Mary-Louise McLaws says “Australians have complied extremely well with the physical distancing requirements” due to COVID-19, but there is a potential cost.

“We’re in a position where it’s a bit conflicting. The community are hyper-aware now of the importance of vaccination and simple things like hand hygiene and cough etiquette, and they can see the benefit of all of this. But they are so focused on COVID that I’m not sure they’re ready yet for the flu season,” she said.

Dr McMullen urges patience for those frustrated by the unavailability of flu shots.

“The advice to the public is that there may be some more availability of flu vaccines as the season progresses and that it’s never too late to be vaccinated.”

Health authorities recommend an annual influenza vaccination for everyone over six months, and strongly recommend it for at-risk groups, such as:

  • people aged 65 and older
  • people with chronic conditions including heart, lung, or neurological diseases
  • pregnant women
  • children aged six months to under five years.

At-risk groups are covered by the National Immunisation Program (NIP).

Have you been able to access a flu shot yet?

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