Seriously, the flu might be bad this year

Sometime in the spring of 2020, after centuries, perhaps millennia of turbulent coexistence with humanity, influenza it suddenly got darkaround the world, documented virus infection case completely crater As the world tried to combat SARS-CoV-2.About this time last year, American experts I’m starting to worry that the unprecedented flu sabbatical will be too weird and short-lived: Perhaps the group of viruses that cause this disease are poised for an epic comeback and will condemn us with ‘a little more punch’ than usual… time.

However, those concerns were not realized.His 2021 winter season of flu in the southern hemisphere again eerily Tranquility; in the north, The Incident Sneaked in December— just Peter out before Spring’s lackluster reprise.

Now, with the weather cooling again in this hemisphere and the winter holidays looming, experts are nervously looking ahead.rear 2 season skip In the Southern Hemisphere, influenza swept across the lower half of the globe in 2022, wreaking havoc since the COVID crisis began. And in his three-year pandemic to date, this one foreshadows the strongest signs yet of a raging flu season.

It remains likely that the flu will remain mild for a third year in a row, and the experts’ pessimistic suspicions are a welcome mistake. Australia recently ended an unusually early “very critical” season with influenza viruses, said Kanta Subbarao, director of the WHO Collaborating Center for Reference and Research on Influenza at the Doherty Institute.According to the number of confirmed cases, this season worst country in years. of South AfricaBy pre-pandemic standards, “it was a very typical flu season,” said Cheryl Cohen, co-director of the Center for Respiratory Diseases and Meningitis at the National Institute of Infectious Diseases. After a long, long hiatus, Subbarao told me, the Southern Hemisphere flu is “definitely back.”

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That doesn’t bode well for us in the North. The same viruses that seed outbreaks in the South tend to cause epidemics here as the seasons change each year. “I take the South as my indicator,” says Seema Rakudawala, an influenza infection expert at Emory University. And if the flu hits again here, we’ll run into people who haven’t seen similar symptoms in years and are already trying to put together a flu response. Several dangerous pathogens at once.

Worst-case scenarios don’t always work. What’s happening below the equator is not a perfect predictor of what’s happening above it. COVID-19 and the world’s reaction to it are further confusing experts’ few predictive tools. But the Southern experience still lives on. In South Africa and Australia, for example, many of his COVID mitigation measures, such as general mask recommendations and post-travel quarantines, were lifted with the arrival of winter, allowing excess respiratory virus to penetrate the entire population. became. The flu flood came two years after he had basically no flu.

Some of the same factors are working against us north of the equator, perhaps to an even greater extent. Many children, especially young children, have never dealt with a virus. Webby said the chances of children being beaten disproportionately were “very, very high.” looks like you’re in australia—However, Subbarao points out that this trend may have been driven by more cautious behavior in older populations, which may skew the disease in younger people.

Growing interest in vaccination fell during the pandemic: “People are feeling pretty tired,” says Helen Chu, a doctor and flu expert at the University of Washington, after booster after booster for more than a year. Further down. (Flu vaccination coverage in the U.S. peaks in good years) about 50 percentAnd some protections against the virus that were still in place last winter have now almost completely disappeared. increase. According to Webby, there are “far more flus” all over the world map. With international travel in full swing, the virus is even more likely to leap across borders and cause outbreaks. And with the health infrastructure already strained by the simultaneous outbreak of COVID, monkeypox and polio, America may not be able to handle another addition well if such an epidemic occurs. “Overall, we are not ready,” Chu said.

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At the same time, however, countries around the world are taking very different approaches to mitigating COVID, so the pandemic may have further decoupled the fate of the flu season. For example, Australia’s flu experience began, peaked and ended earlier this year. The new arrival of more relaxed travel policies likely played a role in the beginning of the outbreak. Mid-year BA.5 surge It can hasten the plunge. Also, it is very unclear whether the situation in the US is good or bad. last flu season It was feeble, oddly shaped, and unusually slow. In South Africa, influenza epidemics also increased unusually during the summer. These infections, Cohen told me, may have left a fresh dust of immunity and dulled the severity of the next season. “I said pretty strongly that I really believe South Africa is going to have a tough season,” she said. “And apparently I was wrong.” The long summer tail of the northern hemisphere’s recent flu season also make worse John McCauley, director of the Worldwide Influenza Center at the Francis Crick Institute in London, says the severity of the upcoming winter season. May have an easier perspective to emerge.

The COVID crash has also changed flu dynamics across the board. The pandemic has “squeezed out” a lot of diversity from the flu virus population, Webby told me. Some bloodlines may even have been completely blown. But others may still be simmering and mutating as they may be in the unmonitored pockets of animals and the world. The possible emergence of these strains in the general population is “my bigger concern,” he said. Certain strains of influenza circulating in the United States appear to align fairly well with this year’s vaccine, but the dominant strain attacking the north may still change, he said. They also tend to wobble and jump when returning from long vacations. It may take a season or two for the flu to find its normal rhythm.

Another epic SARS-CoV-2 variant could also counteract the flu peak.Influenza cases rise at the end of 2021, and the terrifying “twindemic” loomed. But then Omicron hit, and the flu “basically he was gone in a month and a half,” Krammer told me. Co-infection or serial transmission of SARS-CoV-2 and influenza viruses is possible, but the active spread of the novel coronavirus variant may have destabilized people’s lives. Being on high alert makes it much harder for another pathogen to gain a foothold.

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Regardless of the likelihood of entering flu season, human behavior can change the course of winter. “People understand contagion better than ever,” Camelwalla told me. Subbarao believes the wisdom of the new coronavirus has helped keep Australia’s flu death toll down. Perhaps populations across the northern hemisphere will act in a similar way.

But Webby isn’t sure he’s optimistic. “People have heard enough about viruses in general,” he told me. Unfortunately, the flu doesn’t feel the same about us.