We are on the verge of a third winter with Covid-19. It may be difficult to remember, for me it certainly is, but this time three years ago there was no such thing as Covid-19. The Sars-CoV-2 virus was still stuck in a bat somewhere in China, and from what we currently know it had yet to jump into a human and trigger the worst pandemic in 100 years, causing at least six million deaths – although a recent estimate puts the death toll at over 22 million.
Regardless of the number, millions of loved ones have died who might otherwise still be alive.
Winter is always a concern when it comes to respiratory viruses. They’re spreading because we’re much more indoors, and viruses like Covid-19 prefer nothing better than infectious people being indoors. This is because they spread from our breath in tiny aerosols that don’t disperse as much indoors unless there is strong ventilation or an air filtration system.
And so cases of influenza and infections with a virus called respiratory syncytial virus (RSV) are piling up in Ireland every winter, putting pressure on our health service.
The flu is the main reason for the trolley crisis, which is as predictable as Christmas every winter. And now we’re adding a third respiratory virus to the mix – Sars-CoV-2 – so concerns have been raised.
HSE Chief Clinical Officer Colm Henry said last week there could well be a “twindemic” of Covid-19 and flu this winter. We have to learn another new word because of Covid-19. As always, Henry urged everyone who is entitled to a booster shot as it will not only protect people from serious illnesses but will also ease the pressure on the healthcare system.
Vaccines remain the strongest weapon we have in our arsenal against Covid-19. The evidence that they work is growing and growing. Booster vaccinations are required due to decreasing immunity from previous vaccinations, especially in the elderly and people belonging to vulnerable categories such as the elderly. B. overweight people or diabetics.
Last week, the Centers for Disease Control (CDC) in Atlanta released data from the US showing that a booster shot restores protection from death to 87 percent, while a second booster shot restores it to 96 percent. No tough nut.
As even more proof that the Irish know what’s right, we also learned that over 70 per cent of people over 65 have had their second booster shot. Efforts are being made to increase this number.
Colm Henry also reminded us that in our communities we effectively have a wall of immunity protecting us from the rise of the Omicron variant. We were lucky with Omicron as it mainly caused a mild illness but offered protection, a bit of a boost.
However, it is still recommended that a booster shot be taken when offered, as natural infection can vary, while vaccination gives a more consistent response. He also advised anyone who is eligible to get vaccinated against the flu as well.
Health Secretary Stephen Donnelly said last week he was “concerned” about a severe winter flu season. He said a major flu vaccination campaign would be launched in the coming months.
He added Ireland is “potentially seeing a perfect storm” with a combination of RSV, flu and Covid-19. He did not use the word “tridemic”.
The flu has been a bit strange during the Covid-19 pandemic. In the two years following spring 2020, there were far fewer cases worldwide. The measures taken to combat Covid-19 worked very well against the flu and saved many lives. The CDC recently said, “In terms of hospitalizations, the cumulative rate of laboratory-confirmed influenza-associated hospitalizations for the 2020-2021 season was the lowest since this type of data collection began in 2005.” This was most likely due to public health measures health, including mask wearing, social distancing, reduced travel and other Covid-19 precautions.
In the US, each major relaxation of precautionary measures has been followed by a surge in Covid-19 over the past two years. The Delta variant’s 2021 surge came after the CDC eased requirements for face masks. The Omicron variant surge in the winter of 2021-2022 came after travel restrictions were lifted.
Donnelly also referred to what was happening in Australia and New Zealand. He said the HSE is closely monitoring these countries. They’re coming out of their winter and what’s happening there has historically been a good predictor of flu season here. Like the brent geese migrating to Ireland, influenza moves with the winter season, but in the case of influenza, the migration is south to north.
The first thing to catch the eye there was an earlier than usual flu season that started in spring (her fall) of 2022 and was proving severe. Australia had 216,725 cases of the flu as of mid-August, according to the National Notifiable Diseases Surveillance System (NNDSS). These are so-called laboratory-confirmed cases, but they’re only a fraction of the total cases, as many stay at home with the flu and don’t get tested. The NNDSS also reported that 6.4 percent of flu cases were admitted to the ICU and registered 273 flu-related deaths.
That tells us why Colm Henry and Stephen Donnelly are concerned. If few precautions are taken and Australia’s flu season has already been bad, Australia is at risk of a severe flu season which, combined with a surge in RSV and a surge in Covid-19, actually risks a ‘perfect storm’. A tridemic.
Reassuringly, the HSE is aware of the dangers of the coming winter and is planning a surge in cases of Covid-19 and flu, both in terms of additional capacity and staff. But your best bet remains to avoid serious illnesses in the first place through vaccination.
If hospital admissions start to rise, public health responses may need to be stepped up again, which could include mask requirements in crowded indoor spaces or on public transport, or perhaps even reduced capacity for indoor events. We can hope these won’t be needed given immunity, but it’s important to prepare for the storm that may be coming.
Finally, last week, Dr. World Health Organisation’s Maria Van Kerkhove said Covid-19 remains in an “emergency phase” around the world, with up to 15,000 dying each week. So much for Joe Biden’s statement that the pandemic is over. However, she said the number of reported deaths from the virus had fallen and described this as “a good sign”. But she stressed that healthcare systems were very vulnerable after years of the severe phase of the pandemic, and she said countries should be prepared for a possible surge in Covid-19 and flu this winter.
All are therefore on the same page. Get ready for winter because Covid-19 isn’t done with us yet and the flu is likely to come back with a vengeance. Luckily we know what to do. Let’s make sure we do.
Luke O’Neill is Professor of Biochemistry in the Department of Biochemistry and Immunology at Trinity College Dublin
https://www.independent.ie/opinion/covid-flu-and-respiratory-viruses-is-a-perfect-storm-heading-our-way-this-winter-42014989.html Covid, flu and respiratory viruses: is a perfect storm heading our way this winter?