COVID-19 and Influenza, Will there be a Double Epidemic?
A news article in The Lancet reviewed this double whammy.
Vijay Balakrishnan reviewed and considered the evidence for this.
As I discussed last week, the WHO reported that the worldwide circulation of influenza virus was much lower than expected for this time of year. The WHO have warned that the low circulation of influenza virus could be a matter of both reassurance and concern. The decreased circulation of the virus is attributable to the mandatory physical distancing and hygiene protocols implemented to curb SARS-CoV-2 virus transmission. However, they cautioned that the potential impact of altered infection testing priorities, healthcare personnel capacity, and health seeking behaviours during the pandemic should not be ignored. They argued that the measures put in place to control COVID-19 may have some benefits for flu as well but with resurgence of COVID-19, there may also be a double epidemic of flu and COVID-19 during the winter in the Northern Hemisphere.
They suggested that one way to prepare for this possible double epidemic was to ramp up the testing capacity for both COVID-19 and seasonal viral infections. They also strictly suggested adherence to the non-pharmaceutical interventions. Combination testing for both COVID-19 and influenza could be beneficial as a single sample can test for both infections as well as other viral infections. Using a single sample will reduce the demand for testing supplies and also reduce the exposure of healthcare workers collecting the sample.
Another strategy to reduce the likelihood of a double epidemic would be to strengthen existing influenza vaccine programs.
Here at The London General Practice we advocate that all at risk patients should be vaccinated for influenza. It is likely that healthcare workers will be mandated to have influenza vaccine and the vaccination of children should be recommended. Last season only six countries in the EU recommended the vaccination of children. This vaccination of children reduces the risk of transmission of flu to the elderly and protects them better than direct vaccination of them. However, there could be a vaccine shortage.
Overall, though, experts feel that the documented benefits of non-pharmaceutical interventions will prevent a serious double epidemic with continued social distancing, mask wearing and sanitising measures continuing well into next year will be sufficient to suppress any influenza epidemic.
There is however, a caution here that when normality returns, the very low influenza activity might result in declined herd immunity to influenza.
Professor Paul Hunter from the University of East Anglia feels that it would be a shame if we get through COVID-19 only to be hit by influenza harder in the following winter season.
Here at The London General Practice we have purchased sufficient stocks of influenza vaccine for all our patients at risk and will start to administer vaccination as soon as the vaccines have been delivered.
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