SIOUX FALLS, S.D. (KELO) — Seven hospitalizations. Two deaths. Doesn’t sound like a typical South Dakota influenza season, does it?
Cases of influenza throughout the state were reported at record lows this year, with only 66 lab confirmed cases, seven hospitalization and two deaths as of March 27.
In the 2018-2019 flu season report, there were 9,555 lab confirmed cases, 653 hospitalizations and 43 deaths associated with influenza.
Active levels of influenza throughout the country are reported to be at a minimal activity level.
Why did cases rapidly decrease this year?
Dr. Jennifer McKay, M.D. at Avera Medical Group, said that a higher vaccination rate and a decrease in traveling have been factors in why the influenza case numbers are at record lows this year. And on a national scale, not necessarily in South Dakota, she said, was having schools not being in session face-to-face.
“Traditionally, what would happen is we would get the holidays and everyone would sort of mix-up the germs and then we would start seeing the flu season after that,” McKay said.
McKay said masking is also playing a role. She said that all the precautions that have been recommended for COVID-19 have also been helping fight against other viruses.
“Even if not everyone is masking, many people are masking much more than they ever have,” McKay said.
Dr. Josh Clayton, State Epidemiologist at the South Dakota Department of Health, said he thinks the decrease comes from people taking precautions to protect themselves against COVID-19 and those same precautions are also effective against influenza. We have not seen these levels of precautions taken in previous years, he said.
Dr. Jeremy Cauwels, M.D., Stanford Health’s Chief Physician, also mentioned precautions such as frequent hand washing and social distancing, both in schools and other public places, as well as face masking as influences in keeping cases of influenza low, especially in school-aged children.
Influenza typically affects those in the 65 year or older age range, Clayton said. The difficulty with comparing this current flu season to past years is that there are so few cases this year. Individuals that are more likely to get tested are those that are hospitalized, he said.
The older population tends to have more severe cases and be hospitalized for influenza, Clayton said.
Clayton said the state has seen flu vaccination rates very similar to past seasons; the percentage has been roughly the same.
“That is not totally a bad thing,” Clayton said. “We know that South Dakotans do get vaccinated at a higher rate than many other residents of other states, so we want to make sure that we use this opportunity to make sure that individuals know that the vaccine is safe and effective and that they should get vaccinated, even though there’s only a few more weeks for the traditional flu season here in South Dakota.”
Although the numbers may not be significantly different, Cauwels said they saw more people coming in at the beginning of the year to get vaccinated than normal, probably more before November 1 than they have seen in previous years.
“It was really about people being active on the front and being aggressive,” Cauwels said.
When a person comes in showing symptoms, they can test for both influenza and COVID-19, McKay said, it just really depends on the clinical suspicion.
McKay said the nice thing about the COVID-19 test is if you want to rule out COVID-19, it is pretty quick and easy to get a test. However, with an influenza test, that needs to be done through a visit with your doctor. In the hospital, she said they culture test for other viruses, not just influenza or COVID-19, because they all can kind of do the same thing.
“I think really it just adds context to the course that the person going to have depending on what they have been diagnosed with,” McKay said.
Influenza cases have been going down as the flu season is winding down, McKay said. However, as more people are getting COVID-19 vaccines, she said travel will pick up and people will start mixing together, which may increase cases of influenza.
“It is important that, you know, if you haven’t been vaccinated, you can really get vaccinated at any time, so I wouldn’t think you are out of the window, it doesn’t have to be September for you to get a flu vaccine,” McKay said.
McKay advises that people continue to pay attention, as the flu can happen at any time of the year.
“We are hopeful that this will allow individuals to focus on influenza a little bit, get vaccinated,” Clayton said. “It’s still not too late, we are not at the end of the season and we could see some additional influenza cases, hospitalization and deaths before our flu season ends.”
Cauwels said he sees the flu numbers coming back sometime next winter, being something similar to a normal flu season.
Some people will see the effect that COVID-19 precautions have had on helping to stop the spread of influenza, Cauwels said, and some people may change their patterns completely and implement the precautions in context of influenza, while some may only change slightly, but he says that little bit might be enough to change the influenza patterns.
Clayton said his hope for future flu seasons is that we will have a strong focus on vaccinations and staying home when people are sick.
“I do hope that the lessons that we’ve learned for COVID-19 will translate to fewer influenza cases,” Clayton said. “I do think that we will see a rebound in future flu seasons to be more closely aligned with what we have seen in past seasons, but again, I am hopeful that individuals will take the precautions that they have learned during COVID-19, and use them against influenza.”
When is “flu season”?
In past times, we have thought of flu season as beginning in October and ending in either late in April or as late as May, Clayton said.
“We tend to see influenzas viruses circulating year-round, it is just at a much lower level,” Clayton said.
As far as their surveillance and weekly updates, the DOH tends to begin in October and end the last week of April, Clayton said. However, they do track influenza year-round.
In the summer, those cases may be variants, so they do take a little bit of a different approach identifying whether they are detectable using the current tests or it may be something between a human and an animal.
Why was there such an increase in the 2018-2019 flu season?
The biology of influenza is incredibly interesting, McKay said.
Is it influenza or it is COVID-19? What’s the difference?
The symptoms of influenza and COVID-19 are very similar. Dr. Clayton and Dr. McKay explain the difference between the two viruses. McKay said you aren’t going to know unless you get a test.
Clayton said COVID-19 can be about ten times worse than influenza.
Cauwels said one of the major differences is that COVID-19 takes a little while to build into an illness, while influenza tends to hit right away.
“I think that is probably the hardest part about COVID is, you can feel kind of okay for five or six days before you really get sick, where influenza when people get it, people generally know that right away,” Cauwels said.
It is important that if you are experiencing symptoms of these viruses that you stay home. Do the COVID-19 screening test questions, get the test and get COVID-19 ruled out, McKay said.
“Once the COVID is ruled out, then it’s kind of helpful in terms of what to do next,” McKay said. “But otherwise, you’re not necessarily going to know, which is why these viruses are kind of pesky anyways is they kind of all do the same thing.”
As flu season is winding down, Cauwels said he thinks the most important thing they can say is that there are still waves of influenza and COVID-19 unfortunately coming, so if you haven’t had a chance to get vaccinated yet, make an appointment and get your shot.