The 14-year-old record of lab-confirmed influenza cases in a week in Alberta fell last week.
The record was set during the H1N1 swine flu pandemic in 2009.
For the week ending Dec. 9, there were 1,800 lab-confirmed influenza cases in the province, surpassing the previous record of 1,778 set in the week of Oct. 25, 2009.
Representing nearly nine in 10 of the cases, influenza A (H1N1) is driving this epidemic as we approach the end of the calendar year.
With Christmas get-togethers just days away, there are some tried and true ways to prevent giving or receiving influenza as a gift.
At the top of Dr. Daniel Gregson’s list is getting vaccinated.
“That’s the most important thing,” the University of Calgary infectious diseases assistant professor said. “That’s going to really reduce your risk of getting infections by about half, your risk of getting in the hospital by about half.”
Gregson also recommended using the days ahead of a dinner or other get-together to prevent bringing an unwanted guest.
“You might think about other things we used, non-pharmaceutical things to prevent infection during that week before your Christmas function,” he said. “Avoiding large crowds, going out in large crowds with masks on. Those are all things you can do to reduce your risk over the holiday seasons.”
The Public Health Agency of Canada says the use of respirators, like NIOSH-certified N95 or certified KN95, can help prevent the spread of COVID-19, guidance that matches with what aerosol scientists say about preventing airborne diseases.
“The other thing really is that if you’re sick, don’t go,” Gregson said.
Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta Hospital, said there were lessons learned from the COVID-19 pandemic that can be used in a season of heightened influenza levels.
“If you’re about to go into a social situation in a smaller, enclosed space with a whole bunch of people and some of them are quite elderly or have medical compromise, you might want to rethink the space and the time for that, or spread out the visits with smaller groups over a larger time, or at least pay some attention to ventilation,” she said.
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Like Gregson, Saxinger said someone starting to feel like they’re coming down with something should take a rain check on the visit.
“If you are going to be visiting elderly people in long term care or something, because that’s when you do that, masking remains important and people often forget hand-washing actually really does help too,” she said.
While the very old and the very young tend to have weaker immune systems that are more susceptible to severe outcomes from infections, Saxinger said the H1N1 family of influenza viruses is known to produce worse for younger populations.
“I just checked the hospitalized flu case breakdown by age and indeed it has flipped. So last year, the highest group was 65-plus, and this year the highest group is 18 to 65 years old,” she said.
She said the hospital capacity situation this year is much different than 2009, with hospitals around Alberta already under high stress.
“Hospitalization numbers tend to peak a little bit later (than the peak of case counts),” she said. “People who have a complicated course may end up staying in hospital for a while, and that could really create some issues when we’re already running kind of like 110 per cent in many of our hospitals.
“Making more space is really challenging. And so it is a bit of a worry, I’ll be honest.”
Walk-ups available
One pharmacist told Global News there’s so much supply of influenza and COVID-19 vaccinations that many of his colleagues are able to help people on a walk-in basis.
Vishal Sukhadaya, pharmacist and owner of a Medicine Shoppe in Lethbridge, likened vaccinations to a first line of defence.
“The vaccines actually train our immune cells how to fight with actual viruses. If we don’t have any training, we won’t be able to fight with the viruses accordingly,” he said.
“This year, surprisingly, the flu vaccination rate is substantially low compared to last year. So we are seeing many flu cases and we have actually a few patients who are dealing with severe complications.
“I would encourage everyone to just get the vaccination done at their closest pharmacy.”
Saxinger said she expects there to be a higher than normal population of Albertans who are vulnerable to influenza, perhaps because of a loss of community-level immunity.
“I’m not sure that the influenza vaccine campaign really got a lot of traction this year. It didn’t seem super visible,” the infectious diseases specialist said.
According to the province’s dashboard, only 22.1 per cent of Albertans have received an influenza shot, making it the second-lowest coverage rate since 2009.
In the 2009-10 influenza season (which runs from autumn to autumn), 36 per cent of Albertans were immunized by the end of May 2010.
That was following the World Health Organization’s declaration of the swine flu pandemic in 2009. The province’s report reviewing that pandemic said record levels of coverage in many populations, including high-risk and Indigenous populations, were achieved due to public health officials delivering vastly more influenza shots using tactics like mass immunization clinics.
It was only in the 2020-21 flu season that Alberta broke the 2009-10 high-water mark of vaccinations.
Saxinger was quick to note that people cannot get sick with influenza from the vaccine.
“There’s no actual virus involved in the vaccine that you’re given,” she said. “It’s just sub-units.”
Saxinger noted that Albertans over 65 with a medical condition or who are immunocompromised can be eligible for prescriptions to treat an influenza or COVID infection.
“In both cases the treatment is best if started early. And so if people are beginning to become ill and they know that there’s been a horrible fever, cough illness that they’ve been exposed to, that’s probably influenza and they should consider getting tested and treated because there is useful treatment that can help keep people out of trouble.”
According the province’s dashboard, there have been 1,097 hospitalizations, 132 intensive care admissions and 34 deaths due to influenza this influenza season. The youngest death was an Albertan in their 30s, which was recorded this month.
The year of the swine flu pandemic, 64 Albertans died of that disease, 1,276 were hospitalized and 240 were admitted to ICU.
Public health officials say it takes on average about two weeks for antibodies to be produced following an immunization.
This fall, new formulas for flu and COVID-19 shots have been formulated to address strains most likely to be in circulation.
“It’s not too late for your flu shot,” Gregson said, looking ahead to the Christmas break.
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