After following Covid-19 safety precautions for several months, everyone braced for a deadly "twindemic" 2020-2021 flu season—but it never came, thanks in large part to behavioral changes aimed at reducing the coronavirus's spread, Jacob Stern writes for The Atlantic.
Each year, according to Stern, the flu infects roughly 30 million people and kills over 30,000 people in the United States alone. As a result, experts feared that after Covid-19 hit, America would eventually face a twindemic during the 2020-2021 flu season, with both Covid-19 and influenza infecting people.
However, during the 2020-2021 flu season, the United States recorded around 2,000 cases—17,000 times less than the 35 million reported cases in 2019-2020—and had one known child casualty, compared with 199 pediatric fatalities the previous season.
"We've looked for flu in communities and doctors' offices and hospitals, and we've gotten almost zero," Emily Martin, a University of Michigan epidemiologist, who is part of CDC's flu-monitoring network, said.
According to CDC, the hospitalization rate for the 2020-21 flu season in America was just 0.7 per 100,000 people—the lowest since the agency started tracking flu data in 2005.
Part of the reason for the sudden drop-off could simply be a lack of testing for influenza, as health officials had to focus their resources on addressing Covid-19, John McCauley, director of the Worldwide Influenza Centre at the Francis Crick Institute, said.
However, most of the epidemiologists Stern spoke with emphasized the importance of behavioral changes resulting from Covid-19 precautions, including masking, distancing, remote learning, working from home, and limiting indoor social gatherings. And even though those Covid-19 safety measures weren't consistently enforced in the United States, they helped slow the spread of the coronavirus—and unexpectedly stagnated influenza.
"This is one of the clear signals that these interventions work," Rachel Baker, who studies public health and infectious disease at Princeton University's High Meadows Environmental Institute, said. "They are really efficient at stopping the spread of these viruses."
"But our triumph over the flu also poses a dilemma," Stern writes, in that the country has demonstrated it can save "nearly everyone who dies of the flu"—so long as certain measures are taken. So what does that mean post-pandemic, when Covid-19 safety measures are no longer in place? According to Stern, now that we know how to reduce infection and death from the flu, doing nothing and returning to roughly 30,000 deaths each year without even attempting to save some lives would be irresponsible.
On the one hand, Stern writes, public health experts agreed it would not be "feasible nor desirable" to implement lockdowns each year. He adds that the experts also told him "[b]road restrictions on travel and large indoor gatherings … also seem like nonstarters."
Similarly, even moderate capacity limitations—though beneficial from a health perspective—are "tricky for business," according to Saskia Popescu, an epidemiologist at George Mason University.
However, Seema Lakdawala, a flu-transmission expert at the University of Pittsburgh, suggested organizations could take some partial measures, such as considering rescheduling annual holiday parties for the summer months and hosting those celebrations outdoors.
Linsey Marr, an environmental engineer at Virginia Tech, added that entities could implement a "circuit breaker" system, "in which schools and workplaces could go remote for a week or two to slow flu transmission during severe local outbreaks," Stern writes.
And perhaps most simple of all would be normalizing masking measures. Emory University immunologist, Anice Lowen, said masks are "the low-hanging fruit," since they don't disrupt daily life the way shutdowns or restrictions on indoor gatherings can.
According to Marr, "we would see huge reductions in colds and flus. No question," if wearing masks in crowded indoor spaces during flu season—or at least when case counts rise—became the norm.
However, Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization, warned that even so limited a measure could draw backlash. "[Y]ou're going to have a lot of people who are like, 'Well, we saw this coming. First you mandated masks for Covid,'" she said, "'now you're mandating masks all the time. It's all about control! What about my freedom?'"
Currently, Stern writes, CDC has no plans to endorse any new anti-flu interventions, relying still on the "interim guidance" it published in 2004. That guidance mentions social distancing and school closures as potential "community measures," but emphasizes that no single intervention can provide total protection. In addition, it suggests that only people diagnosed with the flu by a doctor or who have a fever and respiratory symptoms during a known local outbreak should consider wearing a mask.
Speaking on behalf of CDC, David Wentworth, the virology, surveillance, and diagnosis chief within the agency's influenza division, said, "It sounds like we're doing nothing, but really we want to understand what factors have the big impact before you start making those kinds of recommendations." He added, "It's not that we don't care about the tens of thousands of people who are impacted by flu."
For his part, Stern cites policy changes that could make a difference, "[g]iving workers and students the ability to stay home when sick"—although he acknowledges that policy changes alone won't change the problem.
"There's a real culture … that if you're not on your deathbed or you're not going to the hospital, that you're fine to go to work," Rasmussen said. "If you're sick, you should stay home. It seems like a no-brainer, but people are actually really resistant to that."
Ultimately, experts agree that it is unlikely we will be able to consistently repeat the nonexistent 2020-2021 flu season—and, as of right now, flu shots and nonpharmaceutical interventions are the best prevention tool we have. (Stern, The Atlantic, 10/13)
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Baada ya kufuata tahadhari za usalama za COVID-19 kwa miezi kadhaa, kila mtu alijitayarisha kwa msimu wa mafua wa 2020-2021 wa "mlipuko" wa mauti, lakini haikufika kamwe, shukrani kwa sehemu kubwa kwa mabadiliko ya tabia yaliyolenga kupunguza kuenea kwa coronavirus, anaandika Jacob Stern kwa Atlantic. Kulingana na utafiti wa Stern, kila mwaka, mafua huambukiza watu milioni 30 na kuua zaidi ya watu 30,000 nchini Marekani pekee. Wataalamu wanaogopa kwamba baada ya COVID-19 kugonga, Amerika hatimaye itakabiliwa na twindemic wakati wa msimu wa mafua ya 2020-2021 na COVID-19 na mafua kuambukiza watu. Hata hivyo, wakati wa msimu wa homa ya 2020-2021, Marekani ilirekodi karibu kesi 2,000 - mara 17,000 chini ya kesi milioni 35 zilizoripotiwa katika 2019-2020 - na ilikuwa na ajali moja ya mtoto inayojulikana, ikilinganishwa na vifo vya watoto 199 msimu uliopita. "Tumekuwa tukitafuta virusi vya mafua katika jamii na ofisi za madaktari na hospitali, na tumepata karibu sifuri, ""Alisema Emily Martin, mtaalamu wa magonjwa ya kuambukiza wa Chuo Kikuu cha Michigan, ambaye ni sehemu ya mtandao wa ufuatiliaji wa mafua wa CDC." Kulingana na CDC, kiwango cha kulazwa hospitalini kwa msimu wa mafua ya 2020-2021 nchini Marekani kilikuwa 0.7 tu kwa watu 100,000 - kiwango cha chini zaidi tangu shirika hilo kuanza kufuatilia data za mafua mnamo 2005. "Sehemu ya sababu ya kupungua kwa ghafla inaweza kuwa tu ukosefu wa upimaji wa homa, kwani maafisa wa afya walilazimika kuzingatia rasilimali zao juu ya kushughulikia COVID-19, ""John McCauley, mkurugenzi wa Kituo cha Homa cha Ulimwenguni katika Taasisi ya Francis Crick, alisema." "Wanafunzi wa utafiti wa ugonjwa wa Covid-19 ambao Stern alizungumza nao walikazia umuhimu wa mabadiliko ya tabia yanayotokana na tahadhari za COVID-19, pamoja na ""kufunika uso, kujitenga, kujifunza kwa mbali, kufanya kazi kutoka nyumbani, na kupunguza mikusanyiko ya kijamii ya ndani.""" Na ingawa hatua hizo za usalama za COVID-19 hazikutekelezwa kwa uthabiti nchini Marekani, zilisaidia kupunguza kuenea kwa virusi vya corona na kwa njia isiyotazamiwa kupunguza ugonjwa wa mafua. "Hii ni moja ya ishara za wazi kwamba hatua hizi zinafanya kazi, ""Rachel Baker, ambaye anajifunza afya ya umma na magonjwa ya kuambukiza katika Taasisi ya Mazingira ya Chuo Kikuu cha Princeton, alisema." "Zina uwezo mkubwa sana wa kuzuia kuenea kwa virusi hivyo". "Lakini ushindi wetu juu ya mafua pia unazua tatizo", Stern anaandika, katika kwamba nchi imeonyesha inaweza kuokoa "karibu kila mtu anayekufa kutokana na mafua" - mradi tu hatua fulani zinachukuliwa. Kwa hivyo, ni nini kinachohusika baada ya janga, wakati hatua za usalama za COVID-19 hazipo tena? "Sterner alisema: ""Sasa kwa kuwa tunajua jinsi ya kupunguza maambukizi na vifo kutokana na homa, kufanya chochote na kurudi kwa vifo vya karibu 30,000 kila mwaka bila hata kujaribu kuokoa maisha ya watu wengine itakuwa ni jambo lisilo la wajibu.""" "Sterner aliandika kuwa "" wataalamu wa afya ya umma walikubali kwamba haingekuwa ""inawezekana wala kutamaniwa "" kutekeleza kufungwa kila mwaka." "Amesema: ""Wanafunzi wa shule za sekondari wanaona kuwa vikwazo vya barabarani vya kusafiri na mikutano mikubwa ya ndani ya nyumba pia ni vitu visivyofaa." Vivyo hivyo, hata mapungufu ya uwezo wa wastani - ingawa ni ya manufaa kutoka kwa mtazamo wa afya - ni "mzuri kwa biashara", kulingana na Saskia Popescu, mtaalamu wa magonjwa ya kuambukiza katika Chuo Kikuu cha George Mason. Hata hivyo, Seema Lakdawala, mtaalamu wa maambukizi ya homa katika Chuo Kikuu cha Pittsburgh, alitoa pendekezo kwamba mashirika yanaweza kuchukua hatua fulani, kama vile kufikiria kuandaa tena sherehe za likizo za kila mwaka kwa miezi ya majira ya joto na kuandaa sherehe hizo nje. Linsey Marr, mhandisi wa mazingira katika Virginia Tech, aliongeza kuwa mashirika yanaweza kutekeleza mfumo wa "kuvunja mzunguko", ambapo shule na maeneo ya kazi yanaweza kwenda mbali kwa wiki moja au mbili kupunguza maambukizi ya homa wakati wa milipuko mikubwa ya ndani. Na labda rahisi zaidi ya yote ingekuwa kuharakisha hatua za kujificha. "Mtaalamu wa kinga wa Chuo Kikuu cha Emory, Anice Lowen, alisema ""masks ni matunda ya chini, kwa kuwa hayavunji maisha ya kila siku kama vile kufungwa au vizuizi vya mikutano ya ndani vinavyoweza.""" Kulingana na Marr, "tungeona kupungua kwa kiasi kikubwa kwa homa na homa. Hakuna swali", kama kuvaa vinyago katika nafasi za ndani zilizojaa watu wakati wa msimu wa mafua - au angalau wakati hesabu ya kesi inapoongezeka - ikawa kawaida. Angela Rasmussen, mtaalamu wa virusi katika Shirika la Chanjo na Magonjwa ya Kuambukiza, amesema kuwa hatua hiyo ya kuepuka virusi inaweza kusababisha athari mbaya. """Tunajua kuwa kuna watu wengi ambao wanahisi kama, 'Hii ni kitu ambacho tuliona kinakuja.' """ """Kwanza mlikuwa mkiamuru watu kuvaa vinyago vya uso kwa ajili ya COVID,"" alisema, ""sasa mnataka watu kuvaa vinyago vya uso kila wakati." Yote ni juu ya udhibiti! Namna gani kuhusu uhuru wangu?'" "Sterling aliandika: ""Kwa sasa, CDC haina mipango ya kuidhinisha hatua yoyote mpya ya kupambana na homa, ikitegemea bado ""mwongozo wa muda"" uliochapishwa mnamo 2004." Mwongozo huo unataja umbali wa kijamii na kufungwa kwa shule kama "hatua za jamii" zinazowezekana, lakini unasisitiza kwamba hakuna hatua moja inayoweza kutoa ulinzi kamili. Kwa kuongezea, inashauri kwamba watu tu waliogunduliwa na mafua na daktari au ambao wana homa na dalili za kupumua wakati wa mlipuko unaojulikana wa ndani wanapaswa kuzingatia kuvaa kinyago. "Kulingana na David Wentworth, mkuu wa Idara ya Virolojia, Ufuatiliaji na Utambuzi katika Idara ya Virolojia ya CDC, ""Inaonekana kama hatufanyi chochote, lakini kwa kweli tunataka kuelewa ni nini kinachohusika kabla ya kuanza kutoa mapendekezo kama hayo.""" "Alichangia: ""Hatujali kuhusu maelfu ya watu wanaosumbuliwa na homa." Kwa upande wake, Stern anataja mabadiliko ya sera ambayo yanaweza kufanya tofauti, "kutoa wafanyakazi na wanafunzi uwezo wa kukaa nyumbani wakati ni mgonjwa" ingawa anakiri kwamba mabadiliko ya sera peke yake hayatabadilisha tatizo. """Kuna utamaduni halisi... kwamba ikiwa hauko kitandani mwa kifo au haupo hospitalini, ni sawa kwenda kazini,"" alisema Rasmussen." "Ikiwa wewe ni mgonjwa, unapaswa kukaa nyumbani. Inaonekana ni jambo la kawaida, lakini kwa kweli watu hupinga jambo hilo sana". Wataalamu wanakubali kwamba ni uwezekano mdogo kwamba tutaweza kurudia msimu wa mafua wa 2020-2021 ambao haupo, na kwa sasa, chanjo za mafua na uingiliaji usio wa dawa ndio chombo bora cha kuzuia tunacho. (Stern, The Atlantic, 10-13) Kuunda akaunti yako ya bure ya kupata rasilimali 2 kila mwezi, ikiwa ni pamoja na utafiti wa hivi karibuni na webinars. Kuna rasilimali mbili za bure za wanachama tu zilizobaki mwezi huu. Kamwe usikose habari mpya za afya zilizobuniwa kwa ajili yako.