In 2021, precautions that people took against COVID-19 – like masking and social distancing – helped create an unusually light flu season, says Jennifer Shuford, MD, chief state epidemiologist at the Texas Department of State Health Services (DSHS). In 2022, Texas probably will not be as lucky.
While predicting any flu season is difficult, this perennial respiratory disease appears to be bouncing back, she said. Flu cases already are rising sharply in neighboring states like New Mexico and Oklahoma. Also, more Texans are back at work and school in person, while fewer are wearing masks.
“What we’re seeing right now in Texas is that the influenza-like activity is still low,” said Dr. Shuford, who is also a consultant to the Texas Medical Association Committee on Infectious Diseases and a member of TMA’s COVID-19 Task Force. “But that is not what other states across the United States are experiencing. So we expect that flu activity in Texas is going to increase here very soon.”
That will complicate a public health environment already awash in the COVID-19 omicron variant and numerous other respiratory illnesses, says John Carlo, MD, a member of TMA’s COVID-19 Task Force and CEO of Prism Health North Texas. Many of those illnesses present symptoms like COVID-19 or influenza but remain unidentified.
“We have a lot of our own staff who have respiratory illness that’s COVID-negative, influenza-negative, and all the other respiratory viruses we checked were negative, and still we had a lot of people that were symptomatic,” he said. “So I think what this shows us is that this year is different from last year. We are in a challenging period where we have a lot of different things circulating that could be causing COVID-like symptoms.”
At this point, physicians confronted with a patient showing symptoms of respiratory illness should always test for influenza and COVID-19, Dr. Shuford says.
“For right now, it’s best for those with symptoms consistent with flu or COVID to test for both because they use different therapeutics and different isolation protocols,” she said. “It’s really important to know if it’s flu or COVID.”
Prompt testing for flu is a priority in part because medications that minimize its symptoms work best right after those symptoms appear, Dr. Shuford said: “It’s really important to get the flu treatment on board within 48 hours from the onset [of the illness].”
Data on the effectiveness of this year’s flu vaccine won’t be available from the Centers for Disease Control and Prevention (CDC) until February, Dr. Shuford said. Nevertheless, physicians should encourage anyone who remains unvaccinated to get a flu shot.
Early data suggest the number of people who have been vaccinated so far this flu season is down, according to CDC. That is especially true among certain high-risk groups such as pregnant people and children.
Influenza vaccines are produced annually and are typically no more than about 60% effective in stopping the illness. That would be considered low among other vaccines, but research shows that even that rate of effectiveness can greatly reduce the number of flu cases and hospitalizations each year. Vaccination also can minimize the severity of flu symptoms.
The current flu season is just getting started, and while the timing of flu seasons can vary, flu activity most commonly peaks in February and can last into May, according to CDC.
The spread of the omicron variant alone would be straining Texas’ health system, Dr. Carlo says. Since the World Health Organization classified omicron as a variant of concern on Nov. 27, 2021, the seven-day average number of new confirmed COVID-19 cases in Texas has skyrocketed from around 2,000 to more than 30,000, according to DSHS.
That combined with flu and other respiratory ailments will make the coming weeks a challenge for Texas physicians.
“That’s a lot of people out sick at the same time,” Dr. Carlo said. “And that’s going to result in entire households being ill at once, entire businesses and medical offices having staffing issues, because so many people are sick at the same point in time.”