Cases of flu are down

CELINA - As COVID-19 continues to pull focus both globally and locally, seasonal influenza activity has been almost nonexistent in Mercer County and the U.S.

Flu activity in the U.S. has been "unusually low," according to the Centers for Disease Control and Prevention. In fact, flu activity is the lowest it's been since the CDC started routinely collecting data in 2005.

In the U.S., flu season occurs in the fall and winter, according to Mercer County Health District epidemiologist Deb Scheer, typically starting around October. While influenza viruses circulate year-round, most flu activity peaks between December and February, but activity can last as late as May.

In a normal year, flu cases would be on the rise in February, but that's not the case in 2021. Across the U.S., all states experienced minimal outpatient illnesses the week ending Feb. 13.

Outpatient illnesses are patients who are not hospitalized but may have visited a doctor or urgent care clinic, Scheer explained.

Influenza is not a reportable disease, so there isn't a sure way to track how many cases are going around in the U.S. However, national and local experts can gauge how a flu season is going based on hospitalizations, outpatient illnesses and pediatric deaths, which are reportable.

Mercer County has been following the national trend of low flu activity. So far this flu season, the health district has yet to see any reports of flu-associated hospitalizations or outpatient illnesses, according to Scheer.

It's a large improvement over previous years. In Jan. 2020, the health district reported 19 hospitalized influenza patients, and 16 in Feb. 2020. Hospitalizations dwindled in March 2020 to eight hospitalizations, and only one was reported in April 2020.

The health district reported 50 flu-associated hospitalizations in 2019, 59 hospitalizations in 2018 and 51 hospitalizations in 2017.

Although Scheer's report of annual hospitalizations in 2020 was not finalized by press time, she estimated there were roughly 44 hospitalizations last flu season.

The health district also has yet to receive any reports of pediatric deaths due to the flu. Only one pediatric death in the U.S. has been reported to the CDC this flu season, which is down considerably from the 195 pediatric flu deaths reported in the 2019-2020 flu season.

According to the Ohio Department of Health, there have been approximately 81 hospitalizations in the state due to influenza so far this season. It's a tremendous reduction from the 11,098 hospitalizations reported statewide during the 2019-2020 flu season.

An estimated 200,000 people are hospitalized with the flu each year in the U.S., and on average there are more than 20,000 flu-related deaths, according to ODH.

So what has led to the historically low flu activity? COVID-19 prevention methods might have a lot to do with it, according to national and local health experts.

As many people take steps such as wearing masks, social distancing, practicing good hygiene and avoiding travel to prevent COVID-19, it also helps prevent the flu.

Similar to COVID-19, the flu virus spreads through respiratory droplets, so the change is not a complete surprise to many health experts.

"I think the steps that we're taking to alleviate COVID-19 is helping us avoid seasonal influenza," Scheer said.

Children also likely play a large role in preventing the spread. Children are usually heavy distributors of the flu, picking it up at school and bringing it home to their families or vice versa.

But with the COVID-19 pandemic, many children are wearing masks, social distancing at school or even learning from home.

Many people also received the flu vaccine this year. More than 193 million doses of the flu vaccine have been administered as of early February according to the CDC, which is a record number of doses.

The low prevalence of the flu has eased worries that a severe flu season combined with the COVID-19 pandemic could lead to a "twindemic" with the potential to overwhelm health care facilities.

However, there could also be some additional explanations. For example, the CDC urges some caution over the outpatient illness data they present for a couple reasons.

First, the CDC uses the U.S. Outpatient Influenza-like Illness Surveillance Network, or ILINet, to monitor for its namesake - outpatient visits for flu-like illnesses.

According to the CDC, ILINet monitors for illnesses similar to the flu, not laboratory-confirmed flu cases, so it will capture visits due to other respiratory pathogens with similar symptoms, such as the virus that causes COVID-19.

Perhaps most notably though, health care seeking behaviors have changed dramatically during the pandemic. Many people are accessing health care systems in alternative settings, which may or may not be captured by the surveillance network.

Health experts nonetheless are recommending people continue to take steps to prevent the flu. The annual flu vaccine is the best way to protect against the flu and its potentially serious complications, so the CDC and the Mercer County Health District suggest getting vaccinated. The CDC recommends everyone six months of age or older get the flu vaccine.