With COVID-19 well into its eighth month since having been declared a pandemic by the World Health Organization, fears that it might join forces with the viral tempest of seasonal flu to create a perfect storm of international infection and death dubbed the “twin-demic” may never materialize.
COVID-19 took hold toward the tail end of the 2019-2020 flu season, and data indicates that worldwide influenza has simultaneously plummeted nearly 98% – which is a startling and novel event. The incidence of flu in the southern hemisphere of the globe is at a nearly unprecedented low this year, causing consternation and conjecture on the part of those whose job it is to examine such information.
In Australia, for example, just 14 cases of flu were recorded in April – down from 367 at the same time last year – and by June, the tally was 0. In Chile, which logged some 7,000 influenza cases from April through October of 2019, there were just 12 cases during the same window in 2020. And in South Africa, only two cases were affirmed at the beginning of their flu season, which quickly became 0 – a stunning and improbable 99% drop from last year.
Theories abound as to the reason for this precipitous decline in worldwide flu. There is a belief among some health experts that the mitigation efforts for COVID-19 may have been of benefit to those at risk for the flu. Other notions include the idea that the flu hasn’t gone anywhere – it’s just being counted as COVID-19. Further speculation might be termed the “crowded house” thesis, which suggests that the seasonal flu virus has no room to move in with the highly virulent coronavirus so widespread. The CDC posits this as plausible, suggesting that the seasonal flu cannot “muscle in” where COVID has already set up shop.
Flu is an impressively persistent killer that is far more deadly for children than COVID-19. Internationally, the CDC estimates that between 80,000 and 120,000 Americans died during the 2017-2018 flu season, which was the worst year recently on record. 186 of those who died were children, compared with about 100 child deaths from COVID-19, which is far more virulent than the flu. Internationally, approximately 650,000 deaths from influenza were recorded that year, while over a million have died with COVID-19 so far across the globe.
Other possibilities include a theory known as “pathogenic competition” that suggests individuals who are infected with COVID and the flu at the same time are strikingly rare because the viruses effectively fight for dominion in a host – and one wins out. A Chinese study that looked at pathogenic competition between SARS and MERS suggests that infection with the flu might protect against COVID-19 to some degree.
But a Public Health England study answers the confounding question more intuitively: people who are bed-ridden with flu are less likely to leave the house, or even the bedroom, making them less likely to contract COVID-19. An answer to the question in reverse – does COVID-19 protect against the flu? – is not as easily settled as it is too early in the flu season to determine definitively.
Naturally, there is a rush to attribute the drop in influenza to draconian, ill-advised COVID strategies such as quarantines and mask mandates when there is precious little if any science to prove the truth of such assertions. Australia insists its flu vaccine was an influenza silver bullet this year, but then why wouldn’t the country have seen these dramatic drops in previous years from an infamously ineffective jab? (Flu vaccine efficacy can be as low as 19%.)
Masks have been shown to be utterly ineffective in “reducing transmission” of the flu according to a 2019 WHO study, and any good quarantines have done have been far outweighed by their devastating ancillary impacts that include an epidemic of deaths from drug and alcohol abuse, child and spousal abuse, and suicides from despair.
We haven’t had to add this rate of mortality to a grim ledger during previous flu seasons or epidemics such as the swine and avian flu outbreaks because mitigation efforts didn’t include locking the world down for long months on end, land-mining economies, and causing a tsunami of unemployment across the globe. According to the World Bank, extreme poverty internationally has increased by between 88 and 114 million people in the last eight months. That is a steep price to have paid for trying to face down a virus with a 99.74% recovery rate.
The dramatic reduction of international influenza is a bright spot in an otherwise abject and awful year of viral reckoning – and just the sort of fascinating scientific mystery with which medical professionals the world over love to grapple. As they do so in the coming months, here’s one more humble thesis: Could the general increase in handwashing in the age of COVID be the reason the flu’s seasonal onslaught is being blunted this year?
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