Health officials warn of nasty flu season, 'twindemic' this year

More than two years after the COVID-19 pandemic began, and following two largely tame influenza seasons, Tennessee public health experts say influenza is poised for a big comeback this year. And, if novel coronavirus cases begin to surge again, they worry about the prospects of a long-feared "twindemic" this fall and winter.

Flu reports in Australia ― often a good predictor of the coming season in the Northern Hemisphere ― were the worst reported since the start of the pandemic, according to the Australian government.

"What happened in Australia is certainly a bit sobering because they had a moderately severe season," said Dr. William Schaffner, an infectious diseases expert at Vanderbilt University and past president of the National Foundation for Infectious Diseases. "It started a bit early and was exclusively an H3N2 season. That's one of those influenza viruses that can be a bit more severe, and, particularly, it kind of seeks out older persons."

Schaffner added that the South American country of Chile also reported a moderately severe flu season, though with different flu variants. Given that, the flu vaccines available this season in the United States will include protections against multiple types, he said.

He added that the summer's declining COVID numbers, coupled with years of mild flu seasons could lead people to head into the holiday season with their guard down.

"We're concerned that we're all, or most of us, are going to be out and about, traveling, going to religious services, going to concerts. These are all opportunities for the influenza virus to spread, as well as COVID," he said. "So we may, indeed, finally have that 'twindemic' that we've worried about − a substantial influenza season along with a surge in COVID this winter."

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Public health officials also worry that people are now letting their guard down because they believe the COVID-19 pandemic is over. Those same safety protocols protect people against the flu, said Dr. Joanna Shaw-KaiKai with the Metro Nashville Department of Health.

"One of our concerns is that, over the past couple of years, people have been doing more social distancing, masking, paying more attention to hand and respiratory hygiene, but are now getting a little bit lax," Shaw-KaiKai said.

Flu season in Tennessee typically begins in the early fall and peaks in the winter months. Mild to severe symptoms generally include fever/chills, coughing, sore throat, runny/stuffy nose, muscle/body aches, fatigue and (more commonly in children) vomiting and diarrhea.

In some, particularly the severely immuno-compromised, the very young and the very old, the flu can be fatal. The age-adjusted death rate in Tennessee for influenza/pneumonia was 18.5 per 100,000 in 2020, the most recent data available, according to the Centers for Disease Control and Prevention. That's the second-highest rate in the nation.

Tennessee has a "moderate" level of flu activity as of this week, according to the CDC, though neighboring Georgia is now seeing high transmission rates. Tennessee's flu season generally starts in earnest in November.

"We're encouraging people to go ahead and get their flu shots now because it takes about two weeks for that immune response to occur," Shaw-KaiKai said. "We want to make sure that when November hits, that every person is fully immune."

Frank Gluck is the health care reporter for The Tennessean. He can be reached at fgluck@tennessean.com. Follow him on Twitter at @FrankGluck.

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This article originally appeared on Nashville Tennessean: Health officials warn of nasty flu season and COVID 'twindemic'