The Sick Season has arrived! We know we are starting to sound like a cracked record. We have been warning about flu for weeks and weeks and weeks! The influenza update from the CDC continues to show a spreading epidemic. A few weeks ago flu was hitting the southeast and southwest. But influenza does not stay put in one region. New York City and California are also experiencing a high rate of viral infections, along with Wyoming and Colorado.
Some infectious disease pundits are calling this a “tripledemic” because rates of influenza, RSV (respiratory syncytial virus) and COVID-19 are all hitting hard. We think that may be a misnomer, though. There are other respiratory infections on the loose as well, including rhinoviruses, adenoviruses and coronaviruses (“common” cold viruses) and human metapneumovirus (we caught HMPV last winter and it was nasty!).
Remember Australia!
We have been warning that Americans could be facing a bad 2023/24 flu season since last June. That’s because the Aussies had a bad flu season six months earlier. In August we urged public health officials, businesses and individuals to “Improve Indoor Air Quality to Fight COVID and Flu.”
Very few people were interested in air filtration. It was summer and infections were down. How many businesses have installed HEPA (high efficiency particulate air) or MERV 13 air filters? Here is a photograph that I took at a high-end hotel/restaurant a few months ago. These are not high-efficiency used air filters. They are also filthy.
Used air filters from a public establishment
We suspect that most pharmacies, grocery stores, banks, movie theaters, hotels and doctors’ offices are not using high-efficiency air filters that capture viruses. Public health officials have not emphasized air quality in the fight against COVID-19 or any other virus for that matter. We wish public buildings posted information about when they last changed air filters, a bit like the inspection notices on elevators. We suspect that very few homes or apartments have HEPA or MERV 13 air filters either.
Here is a link to an interview we conducted with one of the world’s foremost authorities on air quality. Dr. Richard Corsi describes how people can improve ventilation and filtration in homes and public buildings.
We also wish all public buildings had electronic posting about CO2 (carbon dioxide) levels. In this radio show interview we discuss why CO2 is such a useful measure of air quality.
Influenza Update!
Here is your influenza update for the end of December, 2023. The flu is back and is getting worse! According to the CDC:
“Key Points:
- “Seasonal influenza activity is elevated in most parts of the country, with the southeast, south-central, and west coast areas of the country reporting the highest levels of activity.
- Outpatient respiratory illness is above baseline nationally for the sixth consecutive week and is above baseline in all 10 HHS Regions.
- The number of weekly flu hospital admissions continues to increase.
- CDC estimates that there have been at least 3.7 million illnesses, 38,000 hospitalizations, and 2,300 deaths from flu so far this season.”
The Latest Influenza Update Is Always Behind:
The CDC will issue a new “FLUVIEW” today, December 22, 2023. As I write this on the evening of December 21, 2023, the trend is UP! Last week the CDC estimated 2.6 million illnesses and 26,000 hospitalizations due to flu. It attributed 1,600 deaths to influenza. As you can see above, those estimations have gone up quickly. We will see what Friday brings.
On Thursday, December 21, 2023, the CDC Director described a “sharp increase” in flu cases. That’s before the official FLUVIEW report on Friday, December 22, 2023.
I would characterize such numbers as guestimates rather than estimates. That’s because I tend to believe the CDC’s influenza tracking system leaves a lot to be desired. I just do not believe the CDC has an adequate way of truly monitoring influenza cases in the United States.
Keep in mind that the CDC’s ability to gather data, analyze it and then report it is always a week or more behind. RSV (respiratory syncytial virus) cases are up. So are COVID cases!
COVID Cases Are Also Up:
This is not just an influenza update. Wastewater detection systems are confirming high levels of COVID-19. That’s the case in Boston and in the San Francisco Bay area. Hospitalizations are up and many institutions are restricting visitors and reinstating masking. This is all happening before the heavy holiday travel peaks.
Emergency rooms are filling up with people coughing and sneezing. Public health officials are warning that if the trends continue, hospitals could become overwhelmed. People who begin to experience symptoms of infection should stay home from festive gatherings. Hosts should install high-efficiency MERV 13 air filters before welcoming guests, assuming their HVAC can handle such a high-efficiency system.
Canadian hospitals are experiencing “significant challenges” according to the Chief Public Health Official there. There are long waits in emergency departments and there is overcrowding. We doubt that the US is very different. For example, MPR [Minnesota Public Radio] News reports that “bed space in the state’s hospitals is in short supply.”
All this was predictable, especially when it comes to influenza. The same thing was seen in Australia. The flu hit early and hard in the southern hemisphere. We detail what happened in Australia in this article from the end of November at this link.
The Bottom Line on the Influenza Update Down Under:
In a “normal flu season” in Australia, people start getting really sick in mid-July. By the end of September influenza is mostly gone.
In 2023, however, the flu started showing up in April and lasted until October. The worst of the influenza outbreaks were in early June and continued for two months until early August. That tells me we could be in for it over the next two months.
There is another reason I think the most recent influenza update is following the Australian pattern. The public health authorities there were reporting that most (80%) of their flu cases were influenza A H3N2. The CDC is reporting influenza A represents 79.9% of cases in the US. There was more H1N1 reported last week than H3N2, but we suspect that by Friday, the FLUVIEW report will show that H3N2 is climbing. As the data come in, I will do my best to provide you an influenza update.
What Should You Do?
The CDC went to its Health Alert Network (HAN) on December 14, 2023, and issued a Health Advisory to alert healthcare providers to low vaccination rates against influenza. I am not surprised. Tens of millions of Americans have become anti-vaxxers. They are shunning influenza vaccines and RSV vaccines along with COVID vaccines.
Many readers were annoyed with me when I reported a few weeks ago that life expectancy was rebounding. The fact that life expectancy went from 76.1 years in in 2021 to 77.5 years in 2022 should have been good news. It was almost as if some readers wanted life expectancy to continue going down so they could blame the bad numbers on the COVID vaccine.
Is It Too Late to Get a Flu Shot?
The CDC doesn’t think so…but I suspect that it will take a couple of weeks before the influenza vaccine really provides much protection. By then, millions of people will be exposed to the flu because of holiday parties, family get togethers and LOTS of traveling. I am not discouraging anyone from getting a flu shot, though. The CDC suggests that this year’s influenza vaccine is a good match with circulating flu strains. The CDC also reminds people that antiviral medications can be helpful in reducing the severity of illness if taken early enough.
We recently asked the question:
“Should You Have a Home Flu Test on Hand?”
Flu season is here! How would you know if you have a cold, COVID or influenza? There is now a home flu test (LUCIRA). It also reveals COVID.
A lot of people complained about the cost of Lucira. When I checked today, Amazon was offering a “deal price” of $39.00 at this link. We’re not promoting Lucira or Amazon, but for people who would like to know whether they have flu, COVID or something more mundane, this test seems like a reasonable investment.
Jody disagrees and offers this perspective:
“I don’t think flu test kits make sense. If I’m sick I’ll stay home and take care of myself. If I’m not feeling better, I’ll see my health care provider. This is how people used to respond when they got sick.”
Try getting an appointment in the middle of a tripledemic. We suspect that getting in to see a health care professional could be very challenging over the next few weeks. The only way antiviral flu meds work is if they are taken within a day or two of flu symptoms.
Marla is sick and insists that a test is unnecessary:
“I am in the midst of a bad cold with a sore throat and slight increase in temperature. I have free COVID kits from the government. I am testing negative. Everyone can order 4 kits through the USPS.
“Why would I want to purchase a $39 test? I masked up to protect others while at the store yesterday.”
What Should You Do?
As described in this influenza update, there are many different viruses circulating right now. If it’s COVID, people could ask an MD about a Paxlovid prescription. On the other hand, doctors can prescribe prescription antiviral medications like oseltamivir (Tamiflu) or baloxavir (Xofluza) for influenza.
When you are suffering from a common (or uncommon) cold, you may want to check out our eGuide to Colds, Coughs & the Flu. This online resource can be found in the Health eGuides section of this website.
Please share this article with friends and family by scrolling to the top of the page and clicking on an icon for email or social media. And if you have thoughts about influenza and flu shots, please let us know in the comment section below. Do you think a home flu test is worthwhile? If not, please let us know why. We would also like to learn what’s happening in your community. Please provide any information on flu, RSV, COVID or other respiratory viruses that may be circulating where you live.
