Several issues concerning COVID-19 vaccines need to be addressed – The Robesonian

September 05, 2020

Its time to talk about flu season. COVID-19 may provide a complication to influenza spread this year as the evidence is mixed.

Weve been following the flu season in the Southern Hemisphere to get an idea of what to expect. The flu season began there in March amid the COVID-19 pandemic. Epidemiologists recently reported in Science magazine that data emerging from places like South Africa, Australia, New Zealand and parts of South America are interesting.

The South African National Institute for Communicable Diseases, or NICD, was prepared for the onslaught of both COVID-19 and influenza. But it never happened.

Typically, NICD surveillance would track 700 cases there. They only logged one case since the end of March. Australias flu season runs from March to August. It listed less than 200 cases, compared to 2,000 this past year.

Most of the cases were probably overshadowed by COVID-19, as many clinics were closed, patients with mild symptoms never went to the doctor or social distancing decreased the numbers. It is unlikely influenza numbers dropped that much. But it happened. Other Southern Hemisphere nations reported similar experiences.

Though the Northern Hemisphere is hopeful for a similar experience, this is unclear. Though flu numbers are currently low, there is the fear that as COVID-19 restrictions are slowly lifted, influenza season will then be upon us. Restrictions may be what depressed influenza numbers in the Southern Hemisphere. Habits such as distancing and hand washing developed during COVID-19 also decrease influenza. It is just unclear if our experience will be the same. There are many concerns to consider either way.

One concern is co-infection. Getting infected with both is worse than getting infected by one. To make things more complicated, getting infected with one may change someones chance of getting infected with the other. Epidemiologists are actually a little concerned about a third virus called Respiratory Syncytial Virus, or RSV, that is also a seasonal pathogen that affects the young and elderly. Having one of these infections may increase the persons susceptibility to other respiratory viruses.

A twindemic of both COVID-19 and influenza is the fear this year. It is for this reason that the Centers for Disease Control and Prevention is recommending that everyone receive the flu vaccine. They also recommend to start getting the shot in September or October before the start of the flu season. The growing concern of two viruses circulating has increased the urgency for vaccinations before Nov. 1.

Influenza simply adds complexity. We still have no idea regarding the trajectory of COVID-19 this winter. Tracking and containing one virus is enough. Two viruses circulating brings uncertainty that vaccines will help mitigate. As communities spend more time indoors during the approaching cooler weather, the risk of transmission heightens for both the flu and COVID-19.

The decreased number of influenza cases in the Southern Hemisphere also decreases the evidence we need regarding the genetic variants that we can expect in the Northern Hemisphere. Viral experts say this creates a genetic bottleneck. The flu variants that survive a record low season will be the most vigorous flu strains.

Vaccines and rapid flu tests have been the workhorses at controlling influenza. Though a rapid COVID-19 test is now available, it may be mid-winter before a COVID-19 vaccine is also available. Vaccinations, testing, containment and prevention strategies will be vital this winter.

No one knows what happens when COVID-19 and influenza collide in the United States. Our flu season generally peaks between December and February. COVID-19 on the other hand doesnt seem to be seasonal as evidenced by increasing cases during the summer.

Influenza is a leading cause of death in nonpandemic years. Differentiating influenza from COVID-19, which has similar symptoms, will be critical to management strategies this winter. People with influenza have never been told to isolate as strictly as those with COVID-19. But this will be one of many challenges faced this season.

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Several issues concerning COVID-19 vaccines need to be addressed - The Robesonian