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Health care systems brace for potential 'twindemic' of flu and COVID-19

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WASHINGTON, D.C. – It’s a convergence of two health crises: the ongoing coronavirus pandemic and a new flu season now underway.

“There’s not much flu in the northern hemisphere in the summer - but there is a lot in the southern hemisphere,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and an infectious disease critical care and emergency medicine physician.

Dr. Adalja said health care professionals have observed the flu in places like Australia and New Zealand during the past several months, which could offer clues into what might be expected here as our weather gets colder.

“The southern hemisphere has had a remarkable flu season mostly because it's 99% lower than what they've seen in prior years,” Dr. Adalja said. “This has to do with the fact that the social distancing that people are doing for COVID-19 also has an impact on influenza because they're both spread in the same manner.”

However, the U.S. has failed to control the spread of the coronavirus, leading to fears that the country might be facing a “twindemic,” where COVID-19 and the flu collide.

The one silver lining: less international travel around the world may make it harder for the flu to spread globally like it has in years past.

“The point we have to continue to emphasize is we don't know for sure if we'll have a light flu season and we have to prepare for one that's severe,” Dr. Adalja said.

So far, the coronavirus has killed more than 210,000 people in the U.S. this year. According to the Centers for Disease Control, that’s more than the previous five flu seasons combined.

Estimated flu season deaths:

2015-16: 23,000
2016-17: 38,000
2017-18: 61,000
2018-19: 34,000
2019-20: 22,000

Total 2015-2020: 178,000

Still, any uptick in hospitalizations because of the flu could further strain hospitals already dealing with COVID-19. One region of concern is the upper Midwest, in places like Wisconsin, which is a current coronavirus hotspot.

"It is stretching our hospital capacity, and it is overwhelming our public health infrastructure,” said Andrea Palm of the Wisconsin Department of Health Services.

One step that could help is to ensure everyone gets a flu shot, even if it doesn’t end up being a perfect match to this year’s strain.

“Even if it isn't a complete match and it doesn't prevent you from getting the flu, it still will prevent you from dying from influenza and getting hospitalized with influenza or getting complications from influenza,” Dr. Adalja said.

It is also now one of the few tools available in a time of great uncertainty.