Why are flu cases SO low?

Worldwide, flu numbers are a tiny fraction of what they normally are. The reason given is that the Covid precautions (masks, distancing, lockdowns, etc) have been responsible. This doesn’t make sense to me, given how many idiots are still out there, ignoring all the precautions. I could see flu numbers being reduced, even reduced substantially, but it’s amazing that they have nearly vanished. I recently read that flu hospitalization in the US dropped by 98% this winter. Fight my ignorance!

The number of people following rules, mandatory shutdowns* and restrictions on international travel is good enough explanation for me.

*especially schools

We’ve heard so much that the rise in cases is exponential in epidemic conditions, but the reverse is also true. Behaviour that reduces transmission - like hand-washing, mask-wearing, social distincing - also serves to drive numbers down exponentially.

Covid differs from the flu in that it has a much stronger contribution from asymptomatic infection. If you only reluctantly behave yourself when you are visibly sick and snotty with the flu (or are shunned by your co-workers), that covers much of your contagious period.

The explanation that Covid precautions are preventing the spread of “conventional” influenza TOTALLY makes sense. Yes, we hear about the kooks that are not following pandemic protocols but we forget about the huge numbers that are.

I would expect that people are taking symptoms much more seriously now. Whereas in the past people would push through and keep going to work when they felt under the weather, now people are staying home and getting tested. And also employers are being much more lenient with sick days and even have forced time off if someone feels sick. In the past workers were expected to push through minor symptoms. Employers gave lip service about sick employees taking time off, but often the employer would pressure the employee to work or say they had to get a note from a doctor if they didn’t want to get fired. So now when people get initial flu-like symptoms, they take it seriously and so do their employers. That would greatly reduce the number of subsequent people to get infected.

There’s speculation new viruses (such as covid) can somehow out-compete older viruses

So perhaps a biological process, whereby viruses engage in some form of competition, or interactions, can better explain disappearances such as those currently being observed.

Article contains links to research papers.

This physician is very good at explaining complicated technical terms in simple English.

TL : DW - the respiratory system can’t seem to be colonized by COVID, and another virus, at the same time.

And, speaking of symptoms, lots of places are checking temperatures before letting people in, including my work place (for those few people who are going into my workplace – I’ve been posting, uh, working from home for more than a year).

Since the flu is (usually?) symptomatic, and one of those symptoms is the flu, even anti-maskers are going to be sent away if they have a fever.

The answer is twofold. It is the COVID protocols and the fact that the large majority of schools were closed for an extended period of time. As someone who has worked in education as both a teacher and a district IT person, I cannot overstate how conducive schools are for the spread of germs. If a pathogen lives a righteous life, dies, and goes to “heaven”, “heaven” is an elementary or high school.

You have hundreds of students packed together all day long breathing the same air, touching the same things, etc. Viruses have a field spreading and then catching rides home to the families to spread some more.

I never used hand sanitizer before, never. Now it is everywhere and free, so I use it now just because it is there and it is free. I think this alone cuts down transmission of regular ol bugs in half and is something that society should continue to provide after all the mask wearing becomes last years news.

His long did people keep wearing mask after the 1919 Spanish flu subsided? I don’t recall seeing anyone wearing one in old 1920’s pictures.

Or … maybe there aren’t? Maybe this is, in fact, good evidence that most people are following precautions – and doing so at an unprecedented level, enough to suppress flu almost completely – but expecting those same behavioral changes to suppress a newer, more contagious virus is not possible in practice.

One factor may be that people are more reluctant to be around someone who has flu-like symptoms now. In the past people may have ignored or not been too concerned if someone coughed or sneezed near them, but now people may totally avoid the area where a symptomatic person is or has recently been. Since CV-19 often can be asymptomatic at first, that might help explain why that continues to expand. We don’t avoid a person shedding coronavirus since they may look like a healthy person. Since traditional flu has early symptoms, we are tending to keep our distance from flu suffers and avoid catching it from them.

Whether people continued to wear masks or not after the Spanish flu, the chances are they would have pulled them down for pictures. Candid pictures were not really a thing yet at that point. You still needed a very powerful flash to take a picture, and that still required dangerous flash powder, so pictures were mostly posed.

Unless the point of a picture was to show the flu conditions, and all the people in masks, it’s doubtful people kept them on for pictures.

I can tell you what is happening at preschools. It used to be that if a kid woke up with a temperature, his (or her) parents gave him a dose of Tylenol, and took him to school. The fever wouldn’t return until after lunch, and the parent wouldn’t get the call to pick up until about 1pm, at which point, the parent had gotten in most of a day’s work, and some parents would ignore the call or email, and figure a couple more hours weren’t going to hurt.

Well, now a lot of parents are working from home, so while keeping a sick kid home interferes with work, it’s not the huge problem it was when the parent used to have to go in some place. Not to mention, a kid who developed a fever at school is going to be isolated from the other kids, and possibly masked (depending on age), and the parents, as well as any “alternate pick-up people” on the kid’s form are going to receive calls every 15 minutes until someone agreed to pick the kid up.

Plus, if you proactively keep a kid home for a day, and don’t mention a fever, you can send the kid back as soon as there is no fever. If the kid runs a fever at school, you are are least going to be told to keep the kid out for 24 hours AFTER there is absent fever, and maybe longer-- up to two weeks, or possibly told the kid must have a negative COVID test.

So, parents used to do just about everything to shoehorn a sick kid into the schoolday. Now, they are being kept home for anything. If one sibling is sick, all the kids are kept home.

That’s just one example of how things have changed. I’m sure it’s not just happening with school kids; I’m sure it is happening everywhere.

I woke up with a scratchy throat the morning I had an appointment with another doctor, for something unrelated to throats, and upper respiratory stuff. I called off the appointment, and was not charged for calling off with less than 24 hours notice, which would have been the case before 2020. The scratchy throat turned out to be nothing. I was fine by the evening. I am still glad I did that. I got a rapid COVID test (negative) as well, because DH works with a vulnerable population.

In addition to all the regular stuff, there are more things happening that a lot of people don’t think about-- nailbiters are trying to break the habit in droves, according to someone who works in a pharmacy-- for the first several months on the lockdown last year, several people a day came in asking about aids for stopping the habit. People do not pet each other’s dogs anymore. More people are carrying canes, apparently, to avoid having to touch railings and banisters. It’s something my doctor mentioned off-handedly to me-- I have a little arthritis in one knee, and he asked if I touched “public” railings a lot. (I don’t.)

I think that anyone who says the changes people have made for COVID can’t be preventing flu don’t realize how pervasive and radical the changes have been.

All good info.

As to the kids in preschool; it’s a real clear example of “You get the behavior you incentivize, whether that’s what you want or not.” Pre-COVID, the collective result of incentives on families, businesses, and pre-schools incentivized parents dropping sick kids off at school. Probably the opposite of what each group really wanted. Post-COVID, the sum of the incentives changed. And therefore so did there behavior.

Man, is that ever true. My son was feeling a little under the weather last summer, so I called off a socially distance get-together outside with three or four friends. In the past, if my kid was feeling off, I would happily let people hang out with me inside my house.

ETA: The get-together was for my friends and me. My son wouldn’t have been near us.

Additional to all the good arguments about the many Covid-19 precautions already mentioned, is it possible that the pandemic raised the general awareness for vaccination, and that more people than usual got a flu shot this season? I’ve got no numbers, it’s just a hunch from personal experience. I got my first flu shot ever last fall, not because I was an anti-vaxxer before, but because I had always been too lazy and careless, but Covid reminded me that the flu is no picnic either, and I have medical preconditions (I got a cardiac stent 5 years ago) that elevate the risk of a flu.

People go into work and restaurants even when a) they are hacking up a lung, and b) when they know other people in the office are hacking up a lung. They take chances with flu - and they sometimes underestimate that risk with fatal consequences.

But with COVID, nobody’s taking chances. Coughing is probably enough to scare the shit out of us just enough to avoid taking unnecessary risks.

It’s pretty straightforward that what would work for COVID would be even more effective for influenza, as it doesn’t have an asymptomatic component, or if it does, it’s not nearly so pivotal, and it’s not as communicable either.

So all the stuff that seems to barely keep COVID kinda-sorta constrained, works like gangbusters against influenza. Masks, social distancing, frequent handwashing/sanitizing, school closures, being more vigilant about symptoms, working from home, etc… It’s all considerably more effective against influenza, so the spread this year is historically small.

I think you have a point here. Yeah, there’s a lot of maskholes out there, and bad stories are more memorable, so we think that there’s a lot more than there actually are. It seems like half the people are getting together at parties or bars and restaurants or whatever, but maybe it’s only the most vocal 5%. Well, if 95% of the people are staying home, wearing masks, etc., then the normal seasonal flu has 95% fewer chances to spread.

Another thing folks should keep in mind is that most influenza strains emerge in tropical Asia then migrate to the Americas, probably due to a combination of climate and demography (much denser populations). Countries like China and Vietnam have been altogether more compulsive/compliant/draconian about hygiene regulations. It is likely they are largely nipping flu in the bud before it ever has a chance to propagate worldwide.