We Don't Have to Accept a Bad Flu Season Every Winter

Flu-related cases, hospitalizations, and deaths were low again this winter, largely thanks to many public health measures meant to contain covid-19.

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Photo: Oli Scarff (Getty Images)

Another horrific winter of the covid-19 pandemic in the U.S. has once again come with a silver lining: barely-there influenza. CDC data this week continues to show little flu activity in what’s already been an incredibly mild season. Though it’s not realistic to expect that the seasonal flu will always remain this neutered, it does suggest that there’s plenty we can do to reduce its harms from now on.

According to the CDC’s latest Influenza Surveillance Report, released on Friday, flu activity is minimal to low across the entire United States, though there has been some recent uptick in a few areas. The weekly percentage of doctors’ visits related to respiratory illness (which may include flu and diseases like covid-19) has continued to decline as well and is now below the baseline seen during a typical flu season. And while the cumulative hospitalization rate linked to the flu this winter is higher than it was last winter, it’s remained smaller than any of the four previous flu seasons.

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During the 2020-2021 winter, which saw the deadliest peak of the covid-19 pandemic in the U.S. to date, the flu was essentially non-existent. This disappearing act was attributed to pandemic-related measures such as mask-wearing, a reduction in large public gatherings, and increased social distancing—measures that were often enforced by federal and state government policy (a slightly higher-than-usual flu vaccination rate may have helped as well). While these measures may have only slowed the spread of the highly transmissible coronavirus, they seemed to completely curtail the less contagious seasonal flu.

By this winter, though, many of these interventions had gone by the wayside, or at least weren’t being as strictly enforced or practiced. And early on, it did appear as though the flu would return to its old form. But despite some large outbreaks and the occasional case of an unlucky co-infection with both the flu and the coronavirus, the flu remained much tamer than usual. According to the CDC’s estimates, there have only been 2.3 million flu cases, 22,000 hospitalizations, and 1,300 deaths this winter—far below the numbers you would see from even the mildest flu seasons prior to the pandemic (the low-end average number of deaths pre-covid was around 12,000). There is a chance that flu cases could still see a jump in some areas, but this is about when the season begins to end.

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Some states have explicitly avoided enforcing the sorts of measures seen in the first year of covid-19 this winter, such as mask mandates. But survey data does suggest that most people still wear masks, at least occasionally. It also seems likely that the pandemic shaped people’s behavior without the need for explicit government rules. During the most recent Omicron-led surge, for instance, many workplaces extended or reinstituted remote work policies, sometimes due to sheer necessity as employees all got sick at once. Data also suggests that people stopped going to restaurants and other public places as often as they did before Omicron was on the scene. One unlikely reason for the mild flu season is vaccination, since only about 40% of Americans got their flu shot, a rate more in line with past years.

While a majority of Americans do still support these pandemic-related measures, many politicians, pundits, and even some professed public health experts have made it clear that they want people to go back to their normal routines sooner rather than later (even if it might endanger people who remain at higher risk from covid-19). So we will eventually have a winter ripe for the flu to spread like usual. But that’s not a status quo that we necessarily have to accept.

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States might completely abandon mask mandates, for instance, but that doesn’t mean that you personally can’t wear masks in certain high-risk situations (notably, in some Asian countries pre-covid, mask-wearing during the flu season was routinely practiced). More people might choose to skip social gatherings or to stay home from work when they feel the sniffles coming on, provided that their workplaces actually have paid sick leave policies. Handwashing, which doesn’t seem to do much for covid-19 but can prevent the spread of the flu and common colds, might continue to enjoy a renaissance. More effort can also be made to contain outbreaks in high-risk environments, like nursing homes. And in the not-so-distant future, we may even have improved flu vaccines.

Of course, as covid-19 has shown us, there can be a limit to how much our actions will prevent the spread of contagious illnesses. Even during a typical flu season, cases, hospitalizations, and deaths can vary widely, depending on many outside factors, like an inherently more contagious strain or a poorly matched vaccine. And there are still strains of flu spreading regularly between animals and humans that could threaten to become the next pandemic. But these past two winters should show us that we don’t have to accept the flu-related misery and death we usually see every year as normal. There can be a better, less snot-filled future for us all.