COVID-19 Q&A: Looking to the 2021 flu season and beyond
As COVID-19 vaccinations become more widespread throughout the U.S., many people are hoping to pack up their masks, put the pandemic behind them, and move on. But viruses rarely disappear completely, and the likelihood of COVID-19 simply going away is slim. With that in mind, Matthew Binnicker, Ph.D., director of the Clinical Virology Laboratory in Mayo Clinic’s Division of Clinical Microbiology, considers the prospects for COVID-19 this fall as the traditional influenza season ramps up. He also discusses advances in testing that have been developed over the last 16 months as a result of the pandemic, and re-emphasizes the crucial role of vaccines.
Last year, we didn’t see much of an influenza season at all. We were bracing for both influenza and COVID-19 at the same time. But there turned out to be very few influenza cases across the country. At Mayo Clinic’s Rochester campus, we conducted about 20,000 tests for the flu from November through January, and we didn’t detect any positive cases of influenza, which is pretty remarkable.
I think the reason for that was the strong adherence to COVID-19 mitigation measures like masking. A lot of people were continuing to work remotely at that time. Students were not in school, and there wasn’t much travel. All of those factors combined to keep flu case counts low.
Coronaviruses typically have a seasonal predominance where we see more cases in the winter. Couple that with the fact that the country has started to reopen — there’s less adherence with masking and people are getting together again — and we’re contending with variants, and we’ll likely see a resurgence in COVID-19 this fall. It’s also probable that we’ll experience a more typical influenza season.
We’ve already started to see an increase in respiratory viruses now, including RSV, which is unusual during the summer months. That emphasizes the fact that these viruses don’t just go away. They’re out there, and when there’s an opening, they are going to take advantage and cause disease.
Although I don’t think we’re going to see the level of hospitalizations and deaths that we saw last December and January from COVID-19, it’s still a concern. Even if we see 20% of what we saw last year, along with a more typical influenza season, it could make for tough times in hospitals and clinics across the country.
We do have several options now for combined COVID-19/influenza testing, as well as for RSV. So, yes, we have the capacity to do that type of testing. The concern is always that if we see a dramatic increase in influenza cases, along with an increase in COVID-19, will the test manufacturers be able to produce enough test reagents so all the labs can get what they need for testing? That was a problem last year, and we could be facing it again this year.
There are also at-home COVID-19 testing options now that we didn’t have before. So rather than going to a doctor, and having a doctor order the lab test, people have the option to go to a drugstore, purchase the test and take it at home. It’s a reasonable approach. My concern is that a lot of those methods haven’t been vigorously studied yet to determine how they compare with lab-based tests. For example, could a negative test be a result of a test taken too soon? How do we ensure a patient gets the care they need if they do get a positive test? These are challenges we still need to tackle.
One of the benefits, though, is that the technology for at-home testing and at-home sample collection has accelerated rapidly due to the COVID-19 pandemic. That could have widespread application for other infectious diseases going forward — increasing convenience for patients and potentially decreasing risk of spreading disease.
How well the country heeds the recommendations for both COVID-19 and flu vaccination will determine the severity of what we experience this fall and winter. A lot of people did a good job of getting the flu vaccine last year because they heard the messages about flu vaccinations being crucial amid the COVID-19 pandemic. We need the same thing to happen this year. When the flu vaccine becomes available, I’m urging everyone to get it.
We also need to build up our defenses as high as possible against COVID-19 now. In many parts of the country, the rates of COVID-19 are lower today than they were four or five months ago. Some states are having significant surges, but overall, the rates are lower than they were last winter. And they likely are lower now than they will be this fall and winter. So if you haven’t received your COVID-19 vaccine yet, now is definitely the time.