The 2022-2023 flu season is off to an unwelcome early start, and public-health officials have been warning for weeks that this one could be a bad one. According to the latest CDC FluView report, flu activity is now “low but increasing in most of the country,” with the highest levels of activity thus far in the southeast and south-central U.S. Meanwhile, New York’s flu season is also underway and early and looking like it will definitely suck.
The prospect of an early and potentially severe flu season means that Americans who haven’t yet gotten an annual flu vaccine shot should try to get one as soon as possible, and particularly seniors, young children, pregnant women, and people with chronic health conditions that put them at higher risk for serious complications from flu. The Biden administration has also been urging people to go ahead and get their flu shots and bivalent updated COVID booster shots at the same time this fall.
There are signs that influenza is poised to stage its first real COVID-era comeback in the U.S., where pandemic precautions — many of which also helped suppress influenza cases — have mostly been abandoned. Should a COVID surge coincide with a severe flu season, it would mark the first “twindemic” of the pandemic, which could put a lot of people in hospital and become a significant strain on the U.S. health-care system. Typically, flu season runs from October to May and peaks sometime between December and February, but the exact timing of the peak is notoriously difficult to estimate ahead of time. Last year’s peak was very late; this season’s may come early.
Another flashing warning light is that some countries in the Southern Hemisphere, like Australia, experienced early flu seasons during their winter months this year. Australia’s flu season was the worst it has faced in five years, and it hit young Australians particularly hard. Indeed, many experts are concerned that young kids in the U.S. are going to be particularly exposed this season, since most children under the age of three have had little to no exposure to the flu in recent years. “You have the 1-year-olds, the 2-year-olds, and the 3-year-olds who will all be seeing it for the first time, and none of them have any preexisting immunity to influenza,” University of Washington infectious disease researcher Dr. Helen Y. Chu warned NPR late last month. Less preexisting immunity increases the risk of both more severe illness and faster spread — a bad combo for sure.
“Not everybody got flu vaccinated last year, and many people did not get the flu,” CDC’s director, Dr. Rochelle Walensky told NBC News last week. “So that makes us ripe to have potentially a severe flu season.” While it’s not possible to predict, at this point, what kind of COVID surges the U.S. may experience in the next several months, some scientists have warned that flu season this winter may be worse than COVID — which still kills hundreds of Americans every day. And again, it’s not at all clear how having two major respiratory viruses hitting the country at the same time would play out.
New York health officials have also noted that the state’s flu metrics have already been outpacing recent years and advised New Yorkers to seek out flu shots amid the season’s “early and aggressive” start. New York City is already reporting a high rate of flu activity. And last week in San Diego, a suspected flu outbreak prompted almost 40 percent of the students at one high school to call out sick, stunning San Diego County health officials. Several other San Diego high schools have reported abnormally high numbers of absences due to cold and flu-like symptoms over the past week, and it appears the kids are not testing positive for COVID.
There has also been evidence of a spike in respiratory syncytial virus (RSV) cases among children in San Diego county, according to the Los Angeles Times. RSV is one of the viruses that causes the common cold, but it is rarely detected in high numbers this early. It can cause serious illness in children with lung diseases or compromised immune systems, and doctors in five states (California, Illinois, Massachusetts, North Carolina, and Rhode Island) told NBC News this weekend that they are seeing surges in young RSV patients that have strained their pediatric hospital bed capacities.
Most of the flu cases currently being detected in the U.S. are from influenza A (H3N2) viruses, which is one of the ones targeted by the annually updated multivalent flu vaccine. Though it’s not fully clear how well this year’s versions will do against H3N2, there is at least some data to suggest the vaccine is well matched against the current strains. Regardless, the flu vaccine is the best weapon we have — and flu vaccination rates are already lagging previous years, both during the pandemic and before it. So if you still haven’t gotten your flu shot (or your COVID booster!) — now is the time.
This post has been updated.
