Steve Kraman, MD

Many are bracing for an unbelievably bad winter with the flu plus COVID-19 teaming up to devastate our population. Whether or not this happens is up to us. Many feel we can blunt this dire warning by encouraging vaccination. However, I would assert that the vaccine this year may be problematic, but we can devastate the flu virus through wearing masks and social distancing. If we do not widely embrace this public health intervention, the flu virus may team up with coronavirus disease 2019 (COVID-19) and devastate us. Here is why.

Unlike the United States, many countries in the Southern Hemisphere have embraced the wearing of masks and are taking SARS-CoV-2 very seriously. SARS-CoV-2 is very infectious with an 

. These interventions have certainly blunted this epidemic but in many areas the epidemic still rages. However, these same interventions are effective in preventing the spread of the flu. The flu is much less infective with an R0 of 1.3. In other words, these interventions may slow down, but not stop SARS-CoV-2 but they may well devastate the flu virus. And this is what appears to have happened this spring in the United States and in the Southern Hemisphere.

If one looks at the data from the CDC, the flu became almost nonexistent in the United States by the end of March, with a very steep drop-off in 

The World Health Organization (WHO) data from the Southern Hemisphere is even more 

. Summer is their peak Flu season. But unlike previous years no viral specimens were submitted to the WHO from many countries during the Summer months.

Last year Chile had 20,949 cases, this year there were only 

: “We were surprised by the decline in the other viruses like influenza. We never dreamed it would practically disappear.”

With both the reduction in international travel and the reduced specimens submitted to the WHO from the Southern Hemisphere, it may be difficult to predict which antigens to incorporate in the United States’ vaccine. Flu vaccines often are not truly effective in stopping the disease, but this year vaccine production may be problematic.

Thus, this year we have to do more than just rely on the flu vaccine. Avoiding the flu plus COVID-19 catastrophe is contingent on the US widely embracing public health guidance of wearing masks, meticulous hand hygiene and social distancing, for which we are a long way from doing. Even some of our elected officials are still downplaying the seriousness of this virus and advocating only those at high risk to wear masks, to protect the wearer. And, of course, we all need the added protection of getting a flu vaccination.

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This year we have to do more than just rely on the flu vaccine. Avoiding the flu plus COVID-19 catastrophe is contingent on the US widely embracing public health guidance of wearing masks, meticulous hand hygiene and social distancing.

Steve Kraman, MD

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The 2020 Flu: Dud or Devastation, It is Up To You