Why the UK could be heading for a flu-covid ‘twindemic’ this winter

Final yr’s warnings a couple of significantly unhealthy flu season did not materialise, however an earlier and extra extreme outbreak in Australia would not bode effectively for the northern hemisphere

By Clare Wilson

Together with a number of different international locations, England is stepping up its efforts to influence at-risk teams, together with anybody aged 50 and over, to get vaccinated towards each flu and covid-19 within the coming weeks.

At present, the UK Well being Safety Company (UKHSA) launched an autumn vaccination marketing campaign in England for these illnesses, warning that this winter is more likely to be significantly unhealthy for flu.

At this level, some folks could also be experiencing déjà vu. There have been related claims 12 months in the past, however the anticipated “twindemic” of flu and covid-19 didn’t materialise wherever within the UK.

However that doesn’t imply we must always disbelieve the warnings this time round. Final winter, many individuals have been nonetheless practising social distancing, to better or lesser extents.

In England, for instance, “Plan B” guidelines have been launched when the omicron coronavirus variant started surging in December 2021. These included obligatory face masks in most indoor public areas and proof of vaccination to enter venues resembling nightclubs.

There was additionally much less social mixing in different methods, resembling extra widespread working from residence.

Ultimately, this couldn’t maintain again the omicron surge, however flu is much less transmissible than the coronavirus and it was suppressed to very low ranges.

The variety of folks hospitalised with flu in England within the winter of 2021/2022 peaked at one-sixth of the quantity seen in 2019/2020, the yr earlier than the covid-19 pandemic took maintain there.

In a mean winter, 20 to 30 per cent of persons are uncovered to the flu virus, though many haven’t any signs. Which means that for 2 years working, practically all these regular exposures didn’t occur. As this winter approaches within the UK, there might be a lot much less inhabitants immunity to flu than regular.

This winter, social mixing is more likely to be again to pre-pandemic ranges as no plans have been introduced to reintroduce restrictions in any a part of the UK. The approaching flu season subsequently appears to be like set to be the primary in three years that can permit the same old ranges of respiratory virus unfold.

Australia’s expertise over the previous few months, throughout its winter, gives an indicator of what could occur within the northern hemisphere. Circumstances peaked considerably larger there than within the three years earlier than the covid-19 pandemic started.

The principle flu variant in Australia this yr was known as H3N2, which previous analysis suggests causes extra extreme sickness than typical seasonal flu. This pressure was linked with a considerably larger flu hospitalisation charge within the UK six years in the past.

Fortuitously, the flu vaccine developed for the northern hemisphere accommodates the H3N2 virus, in an inactivated type.

The Australian flu season this yr not solely noticed the next peak of instances than common, however these additionally occurred earlier in its winter, surging in Could and June quite than July and August.

Because of this, it is crucial that anybody within the northern hemisphere who’s eligible will get vaccinated towards flu as quickly as they’ll, says the UKHSA. “You need to e book in as quickly as attainable,” Steve Russell, Nationwide Well being Service England director for vaccinations and screening, mentioned in an announcement.

Covid-19 additionally hasn’t gone away. The most recent figures from hospitals and the Workplace for Nationwide Statistics present that instances are beginning to rise once more within the UK.

“This winter could possibly be the primary time we see the results of the so-called twindemic, with each covid and flu in full circulation,” mentioned Russell.

The excellent news is that the rise in covid-19 isn’t being attributable to a radically completely different coronavirus variant, however by a number of new subvariants of omicron – and the bivalent vaccine on supply in lots of international locations accommodates an omicron part. Within the UK, everybody eligible for a booster ought to be supplied the bivalent model, barring provide disruptions.

The dual risk makes it all of the extra necessary that eligible teams take up their presents of covid-19 boosters and flu vaccines, says Simon Williams at Swansea College, UK.

“Public well being campaigns want to supply clear and powerful messages concerning the dangers of flu in addition to covid to those that are weak in addition to to the well being system – akin to the ‘Defend the NHS’ marketing campaign which labored so effectively earlier with covid,” says Williams.