If you missed your flu shot this year, you may have noticed that it didn’t make a difference. The flu was bound to be overshadowed by the more virulent COVID-19 virus and variants, but in our collective efforts to combat the pandemic, it seems hardly anyone in Canada got the flu this winter.
In a normal influenza season, which typically runs from November to March, it’s estimated that around seven million Canadians come down with the flu.
But this year, Ottawa’s weekly FluWatch report began with the same observation over and over again: “All indicators of influenza activity remain exceptionally low for this time of year.”
Week after week, Canada’s flu status was unchanged — it’s almost been boring — and now here we are in late March and the flu season is essentially over before it ever began.
“Influenza is actually at a historic low,” said Dr. Susan Detmer, who studies influenza viruses in the department of veterinary pathology at the University of Saskatchewan. It’s clear to her that the measures taken to combat COVID-19 have had a significant impact on the spread of influenza.
“With the pandemic, people are actually staying home and wearing masks and they’re not coming to work sick. And a lot of people are working from home. So that has actually reduced all respiratory virus transmission across the board.”
Ellen Barbieri was out with her husband Mike Barbieri on a Toronto street when asked if they’d had the flu this winter.
“No,” said Ellen, chuckling. To her, it was obvious why. “I haven’t hugged, touched, seen anyone, touched any surfaces.”
Mike thinks he avoided sickness, in part, because he didn’t curl this winter. “At curling, there’s always a couple of times during the season where (the flu) spreads.”
No one wants to give up social activities altogether just to avoid the flu, but after a winter of keeping apart, there is a greater consciousness around the risks associated with clustering together in large groups and indoors when a virus is in the community.
The influenza season in Canada, by definition, begins the week when at least five per cent of influenza tests are positive and a minimum of 15 positive tests are observed. The last flu season began in late November 2019 and was deemed finished by the first day of spring, 2020 — coincidentally, just a few days after a global pandemic was declared for COVID-19.
That flu season had persisted for four months. This winter, that five per cent threshold needed to declare a flu season was never reached. Detmer says there was a great fear that we would face twin scourges this winter. “At least we avoided the catastrophe of having both the COVID-19 and influenza.”
Infectious disease specialist Dr. Michael Gardam says the data reflects a simple fact: “Our public health measures work” — for the flu and for COVID-19.
It’s not possible to know just how bad the pandemic would have been, but flu seasons can be compared from one year to the next, and it’s evident the measures undertaken made a big difference.
Over the previous six flu seasons, an average of 38,355 laboratory-confirmed influenza detections was identified by early March in Canada. This year, the number was 64. That’s in spite of the thousands of tests being conducted weekly, as they were in previous years. It’s an astonishing drop-off.
Dr. Gardam considers what the flu data tells us about the COVID pandemic. “It gives you a sense of what this past year could have looked like if we hadn’t taken those public health measures”
Gardam says some people have been quite vocal that the pandemic has not been so bad.
“It has not been as bad as it could have been, because we acted,” he argues. He says the mortality rate would have been much higher from COVID-19 without distancing, masks and other measures.
“Left uncontrolled, this would have been absolutely devastating to the world.”
The drastic reduction in flu will make it more difficult to identify and predict which type of influenza to plan for with vaccines next year. But the benefits of educating the public are obvious, Detmer says. “There will be people that have a new respect for washing hands, for staying at distance … and (being) more cautious about spreading viruses to others.”
In particular, Detmer hopes we have learned to stay home when we are sick. She expects many of us will revert to our old habits, such as soldiering on with our work at the office when we feel under the weather.
“When you bring your viruses with you to work or to school, you’re sharing those with the community,” Detmer says. “I certainly hope that people will be more cautious about that going forward.”
Back on Toronto streets, Lynne Bowdrey is looking forward to the pandemic ending and isn’t quite sure what her habits will be in the future. “I’ll probably be wearing a mask for quite a while, even after being vaccinated.”
But she doesn’t want mask-wearing to become a regular part of life. She wants things to be normal again: “I’m looking forward to that, to not having to be paranoid.”
Mandy Tran is another person who hopes to cast aside her mask as soon as it’s safe to do so. She didn’t get the flu this year, either. She did get a flu shot, but other changes may have been just as important: she didn’t take public transit to work, wasn’t out in public as much, and was more diligent with hand sanitizer.
Tran believes she has learned from the experience. “It definitely just shows that being cautious … helps prevent other viruses as well.”
Ellen and Mike Barbieri, however, expect some of the habits they’ve acquired recently may outlast the pandemic.
“Maybe more of the elbow,” said Ellen, instead of shaking someone’s hands. And Mike thinks that in some settings, he’ll be more careful — “a little more aware of my distance and be washing my hands a little more often.”
There hasn’t been much health news to cheer over the last 12 months, but crushing the flu, at least for this winter, is one of the positive public health stories to emerge during the COVID-19 pandemic.