Both Covid and flu could increase this winter causing a dreaded ‘twindemia’, experts fear, with some southern states already feeling the early stages of a flu resurgence.
The flu was largely eliminated during the last two years of the pandemic when lockdowns, working from home and the much more transmissible coronavirus limited its ability to spread.
But there are concerns that the seasonal virus will be deadly again this winter after sweeping the southern hemisphere in recent months.
Lack of exposure to the pathogen over the past two years has left many Americans’ immune systems unprepared for the flu, increasing the risk of a more serious infection.
There are already early signs that the flu is returning with large increases in the southern United States in recent weeks, with Texas reporting a tripling of cases over the past three weeks.
Dr. Luis Ostrosky, chief of infectious diseases at UTHealth Houston and Memorial Hermann, told DailyMail.com that the current numbers in Texas are not typically experienced until the peak of flu season in December.
The Centers for Disease Control and Prevention (CDC) also reports moderate flu activity in Georgia and New Mexico. Florida also reported an unusual spike in the virus over the summer that has since tapered off. Washington DC is also experiencing what the agency describes as the worst outbreak in the nation right now.
Health officials across the country have only confirmed a few hundred cases of the flu this month, though the numbers are significantly underreported. As colder weather pushes more Americans indoors, experts fear the virus will begin to spread rampantly among an unprepared population.
If previous winters are anything to go by, Covid cases are also bound to explode this winter, with the latter half of 2020 and 2021 seeing spikes.
Officials say poor uptake of the vaccine — only one percent of eligible Americans have had the new Omicron booster — means there’s still room for a deadly Covid outbreak, even with the BA subvariants .4 and lighter BA.5.
The virus is being felt most in the southern United States, with Texas, Georgia and New Mexico experiencing “moderate” flu circulation, according to the CDC.
Flu cases have increased slightly in recent weeks, with the CDC reporting 378 and 425 confirmed infections in the previous two weeks, up from 257 infections reported in the last week of August.
“We’re in for a tough flu season this year,” Dr. Ostrosky told DailyMail.com
‘We haven’t reached the top yet. We are starting to see the numbers rise very soon.’
Experts have urged Americans to get vaccinated against the flu and the new bivalent vaccine before fall in an effort to limit the twindemic.
The American Academy of Pediatrics (AAP) even recommended that parents give their children two flu shots this year if they have never received the annual shot.
While House Covid response co-ordinator Dr Ashish Jha said earlier this month: “I really think that’s why God gave us two arms, one for the flu shot and the other for to the Covid vaccine”.
Where did the flu go the last two years…and when will it return?
The spread of flu was massively slowed in the first two years of the COVID-19 pandemic
Viral interference from Covid combined with mitigation measures such as masking and restrictions on indoor events led to little spread of the virus
As a result, many did not build up natural immunity to the virus in the past two years and have neglected their annual jab.
Experts fear this year’s flu season will be the worst in years after New Zealand and Australia were hit by the annual southern hemisphere nuisance.
Dr. Anthony Fauci, the nation’s top infectious disease expert, issued a warning about the flu’s rampant spread in the southern hemisphere last month.
Some southern states like Texas, Georgia and New Mexico are already seeing spikes in the virus in September, before flu season officially begins in October.
Experts are on high alert about the virus after it re-emerged in the southern hemisphere, which typically has a flu season that runs from April to October.
Australia suffered its worst flu season in half a decade this year, with peak case rates reaching levels three times higher than usual. He also struck unusually early.
In New Zealand, flu cases this year returned to pre-pandemic levels after two years of sharp declines.
“The southern hemisphere has had a pretty bad flu season and it came early,” Dr. Anthony Fauci, the nation’s top infectious disease expert, said in late August.
“The flu, as we’ve all experienced over the years, can be a serious illness, especially when it’s a bad season.”
This is not the first storm warning issued by US officials. Many feared that the flu would make a big comeback in 2021 after being almost non-existent in 2020. But that wasn’t the case.
However, at the end of September, a rise in the common flu is already starting to be noticed. The CDC reported 378 cases in the week ending Sept. 23 and 425 the week before. Only 257 cases were reported in the last full week of August, which ended on August 26.
These numbers are likely to be significant infrastructure, as many will overcome mild cases at home without seeking medical attention and never get a confirmed positive test as a result.
Hospitalizations caused by the flu, while rare, are largely among the elderly and children under the age of four, the groups that typically face the highest risk from the virus.
The start of a flu surge could already be erupting in the southern US.
Weekly reported cases have increased in Texas in recent weeks, with the state reporting 186 infections in the week ending Sept. 17.
That’s more than double the 73 cases reported in the week ending Sept. 3 and a nearly five-fold increase from the 40 cases reported on Aug. 20.
Dr Ostrosky told DailyMail.com that these numbers are not usually reached until December, the peak of the flu season.
He fears the numbers will only continue to rise in the coming months.
Dr. Ostrosky says that while the twindemic may not have occurred in previous years, early data shows that this will be the year it takes shape.
Less viral interference from Covid, the absence of pandemic mitigation measures and a lack of population immunity after the virus’ low spread last year and low vaccine coverage have left Americans vulnerable to the flu this year.
As of noon Thursday, the CDC also considers neighboring New Mexico and Georgia to be experiencing “moderate” flu activity.
Reported cases of the flu are rising rapidly in Texas, more than doubling in the past two weeks and quadrupling since the end of August.
Covid cases have remained stable in the United States over the past month, although experts fear they will increase in the fall and winter, just as they did in 2020 and 2021.
Florida also saw an unusual spike in the annual virus over the summer, though it quickly receded.
Dr. Ostrosky says the southern United States is usually in sync with the rest of America when it comes to the flu, and he’s not sure why it’s rising in the region faster than others.
Washington DC is experiencing “very high” flu circulation, according to the CDC, the worst of any part of the country.
Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University in Nashville, told NPR, “This could be the year we see a twindemic.
“That is, we have an increase in COVID and at the same time an increase in the flu. We could have both affecting our population at the same time.’
Dr. Schaffner fears that this flu spike, combined with the usual jump in Covid cases associated with colder weather months, could spell trouble for the United States.
“If we have a severe flu season, and if the omicron variants continue to cause mostly mild disease, this coming winter could be a much worse flu season than Covid,” he said.
Officials are also reacting to these fears. The AAP issued a warning earlier this month that children between the ages of six months and eight years who have received less than two flu shots in their lifetime should get double the shots this time.
The two shots should be received about a month apart.
The AAP’s recommendations are not entirely without precedent. In 2009, the Centers for Disease Control and Prevention told parents to give their children a double shot against the flu if they had not previously received one.
The guide has remained in place ever since, but has been largely ignored and not announced every year.
US officials have pushed Omicron-sized Covid boosters, designed to prevent infection by the highly transmissible strain, in an effort to slow the pandemic ahead of the cold weather months.
Ostrosky told DailyMail.com that a person who has received both an Omicron booster and a flu shot should feel safe heading into twindemic season.