Insights

When Is Peak Flu Season? COVID-19 & Flu season

Khang T. Vuong, MHA22 Dec 2020

Flu season in The United States 

Influenza (flu) season in the United States occurs in the fall and winter. It specifically starts in October and can continue until as late as April. The impact of people infected with the flu varies every year and is also dependent on the number of people who receive the vaccine. 

Texas, Oklahoma, and Connecticut have the highest number of influenza cases, based on the activity over the past six years during February (when thereā€šs the most amount of recorded cases), and the score is then weighted to determine high activity over moderate and low. Another factor is the average cost of doctor visits in the state as well as access to flu care.
 

COVID-19 & flu season- Will it be worse?

Unfortunately, there is no simple answer regarding how COVID-19 will impact the spread and severity of this upcoming flu season. However, there is some recent research suggesting how the flu season may be different this year. There are two ways that the 2020-2021 season can play out: 

1. According to several studies done by the CDC, the spread of influenza decreased since the implementation of mask-wearing, social distancing, and sanitation measures to prevent COVID-19 outbreaks. Since the flu and COVID-19 are both spread through respiratory droplets in the air, these safety protocols not only prevent contracting COVID-19 but the flu as well. Health professionals suggest that if community mitigation measures, such as mask-wearing and social distancing, are maintained, there may be lower levels of flu activity this season. 

2. There is also a chance that COVID-19 exacerbates the effects of the flu. Since COVID-19 and the flu and caused by different pathogens, it is likely that people can get sick with both at the same time. In addition, every flu season is different so people do not know how hard the flu will hit this year. 

If individuals stop wearing masks and practicing social distancing, we risk overwhelming the health system with both COVID-19 and influenza cases. It is highly important to remain vigilant about COVID-19 mitigation protocols, as we risk experiencing another peak without such measures in place.

Peak flu season occurs within the first few weeks of February

A peak is when the highest amount during a specific amount of time, in terms of the flu season, the peak is reached when the highest amount of cases occurs during the season. Based on the past flu seasons, the peak for many states occurs during the first few weeks of February.

Below is a graph made by the CDC depicting the monthly distribution of flu seasonal peaks. As seen in the graph, the seasonal peak is usually in February, sometimes in December, January, or March, and rarely in October, November, April, or May.

Last February, the flu was considered widespread in every state other than Oregon.

Flu seasonal peak. Source: https://www.cdc.gov/flu/about/season/flu-season.htm

StateFlu Activity Level
AlabamaVery High
AlaskaLow
ArizonaHigh
ArkansasVery High
CaliforniaHigh
ColoradoVery High
ConnecticutVery High
DelawareMinimal
District of ColumbiaModerate
FloridaHigh
GeorgiaVery High
HawaiiHigh
IdahoLow
IllinoisVery High
IndianaVery High
IowaHigh
KansasVery High
KentuckyVery High
LouisianaVery High
MaineHigh
MarylandVery High
MassachusettsVery High
MichiganHigh
MinnesotaHigh
MississippiVery High
MissouriVery High
MontanaHigh
NebraskaHigh
NevadaLow
New HampshireHigh
New JerseyVery High
New MexicoVery High
New YorkVery High
North CarolinaVery High
North DakotaHigh
OhioHigh
OklahomaVery High
OregonModerate
PennsylvaniaHigh
Rhode IslandVery High
South CarolinaVery High
South DakotaHigh
TennesseeVery High
TexasVery High
UtahVery High
VermontVery High
VirginiaVery High
WashingtonHigh
West VirginiaVery High
WisconsinHigh
WyomingVery High
New York CityVery High
Puerto RicoVery High
Virgin IslandsLow


Flu cases in 50 states

The CDC compiled data on the number of deaths cases by the flu in 2018. Below are the deaths and the death rates in all 50 states. The death rate is the number of deaths per 100,000 people. According to the Kaiser Family Foundation, the U.S. had average flu and pneumonia death rate of 13.5 deaths per 100,000 population for the 2019- 2020 season.

Flu and Pneumonia age-adjusted deaths in 2018 by state. Source: https://www.cdc.gov/nchs/pressroom/sosmap/flu_pneumonia_mortality/flu_pneumonia.htm

Can I get the flu year-round?

While it is possible to catch the flu at any time during the year, it is much more probable to contract it between October and March.

There are several possible reasons why flu season spikes in the winter:

1. People are indoors more often and in close contact with others, which makes it easier for the virus to spread

2. Colder and less humid air is likely more conducive to the spread of the flu, as the virus is able to live for longer in these conditions.

3. Due to fewer daylight hours, our vitamin D and melatonin intake decrease, which weakens our immune systems.

Find out if you are at high-risk for the flu

Like COVID-19, the flu is a respiratory virus, meaning it is predominantly spread through respiratory droplets. People expel respiratory droplets into the air when they talk, cough, or sneeze. It is estimated that these droplets can reach people who are about 6 feet away. 

It is also possible to contract the flu from touching a contaminated surface; however, this is less likely. People are typically contagious beginning the day before they develop symptoms and 5-7 days after symptom onset. This differs from a case of COVID-19, where an individual may be contagious for 14 days. 

The current measures that we have been implementing to mitigate the spread of COVID-19 will likely decrease your chance of contracting the flu as well. These measures include keeping a physical distance of 6 feet from others, wearing a mask or cloth face covering, and frequently washing hands and surfaces. 

In addition, following a routine that will boost your immune system can help prevent it. These practices include exercising, maintaining a healthy diet, taking vitamin supplements, and getting enough sleep.

Flu vs. COVID vs. Cold 

Since many symptoms of the flu, COVID-19, and the common cold are very similar, it may be difficult to differentiate between the three illnesses. When you have a sore throat, fever, and cough, you may not know if you have the flu, coronavirus, or a cold. It is important to be able to differentiate between the three in order to get the appropriate treatment. 

For more information on differentiating the symptoms of the flu, cold, and coronavirus, see our article here.

Overview of Symptoms - COVID-19, Flu, and Common Cold

When should I get a flu shot in 2020?

The Centers for Disease Control made a statement noting that getting the flu shot during the 2020-2021 season is more important than ever. Public health officials are reminding everyone that getting a flu shot, or influenza vaccination, this season is imperative to protect yourself from getting the flu and prevent overwhelming the hospital during the COVID-19 pandemic.  

It is recommended that everyone 6 months or older get a flu vaccine by the end of October 2020. Flu shots are typically effective for about 6 months, so getting the shot by the end of October is the best option to increase the chance of protection during the entirety of the season.

Research supports that the flu shot is safe for pregnant women and important to avoid health problems during pregnancy.

Sources:

https://www.cdc.gov/mmwr/volumes/69/wr/mm6937a6.htm?s_cid=mm6937a6_w

https://www.cidrap.umn.edu/news-perspective/2020/09/fears-perfect-storm-flu-season-nears

https://www.cdc.gov/flu/about/disease/spread.htm

http://sitn.hms.harvard.edu/flash/2014/the-reason-for-the-season-why-flu-strikes-in-winter/#:~:text=The%20flu%20season%20in%20the,falls%20between%20June%20and%20September.

https://www.cdc.gov/flu/prevent/vaccinations.htm

https://www.cdc.gov/flu/weekly/index.htm

https://www.aafp.org/news/health-of-the-public/20200909acipflu.html

https://www.beckershospitalreview.com/quality/50-states-ranked-by-amount-of-flu-pneumonia-deaths.html



 

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