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The Flu Season Is About to Get Really, Really Bad, Experts Say

There’s no way to know how the upcoming flu season will turn out. But if we had to take a guess? It’s not going to be easy.

COVID cases are falling throughout much of the country. Kids ages 5 to 11 are now eligible to get the COVID vaccine. And worried adults can get booster shots, even if they’re not technically eligible. So you can finally take a sigh of relief… right? Although all those facts are invariably great, there are some not-so-great prospects on the horizon when it comes to another respiratory viral disease: the flu. It’s impossible to predict exactly how bad this flu season will be, but experts say to expect a high number of flu cases.

That’s nothing to balk at, because each year the flu kills tens of thousands of people and hospitalizes hundreds of thousands more. If levels of the flu and vaccination against it are in the normal range this year, 102,000 more people in the U.S. than average could land in the hospital because of the flu, according to a pre-print study that has not yet been peer-reviewed. That’s a 20 percent increase over the average number of hospitalizations per year.

So why is this flu season winding up to be so terrible? A lot of it has to do with the fact that the 2020 flu season was so easy. With masks, social distancing, and other COVID precautions, the U.S. saw incredibly low levels of flu. Flu-related hospitalizations hit an all-time low since health systems began recording that data in 2005. And there were 100 times less infections, hospitalizations, and deaths from the flu than average, according to the New York Times. People didn’t have much exposure to influenza, which leaves their immune systems vulnerable to the virus this year. 

“In many ways, being exposed to a virus maintains your immunity over time even if you don’t become infected by the virus,” Carlos Oliveira, MD, PhD, a pediatric infectious disease specialist at Yale Medicine, said in an article by the hospital. “So, it’s very possible there will be a huge number of people who will have very little to no antibodies to the incoming flu strain, and we might have a bad flu season.”

And this year, as the Delta variant wanes in much of the U.S. and many people head back into the world without masks and social distancing, the flu will have a much easier time hopping from person to person. 

Of course, just because the flu season has the potential to be devastating doesn’t mean it necessarily will be. Experts often look to the Southern Hemisphere, where flu season lasts from April to September, for a prediction of how severe our flu season will be. This year, the flu was mild in the Southern Hemisphere, similar to the region’s flu levels last year. However, a major reason for this is that countries in the Southern Hemisphere are largely keeping up their COVID precautions, according to NBC. Those that aren’t are getting hit by the flu worse.

What’s more, a mild flu season in the Southern Hemisphere can be detrimental to the U.S. because scientists base our flu vaccine on which strains were circulating in the Southern Hemisphere during its flu season. With less spread, there’s less data, so it’s possible the vaccine may be less effective than usual. “If a different strain suddenly appears than the ones that we included in the vaccine, we could have a vaccine mismatch, and that leads to a more severe flu season,” Lisa Maragakis, MD, MPH, senior director of infection prevention at The Johns Hopkins Health System, told the Times.

Usually, flu season tends to peak between December and February. But it could peak earlier this year because many people don’t have immunity, according to the Times. So far, we’re seeing more flu cases than last year around this time. As of October 20, flu activity was up 23 percent compared to that date in 2020, according to Prevention. However, overall flu activity is still low throughout the country, except for New Mexico, which is seeing moderate flu activity, according to the Centers for Disease Control and Prevention (CDC). This is typical for this time of year. The flu could still very easily rip through the population in a few months.

Assessing Your Family’s Risk for the 2021-2022 Flu Season

How worried you should be depends on how high of a risk your family has for severe illness from the flu. Children under 5 years are at higher risk of serious flu complications, according to the CDC. Those under 2 are at even higher risk, and those under six months are at even higher risk, especially because they’re too young to get vaccinated. Pregnant people, adults 65 and older, and people with certain underlying conditions are also at high risk.

Between 7,000 and 26,000 kids aged 5 and under are hospitalized with the flu each year. Between 37 and 199 children are reported to die from the flu each year. However, the true numbers are likely larger. Although 199 pediatric deaths were reported in the 2019-2020 flu season, statistical modeling suggests that 434 children died.

Before you freak out, those numbers need to be taken into context. For comparison, an average of 3,960 children die from drowning every year, according to the CDC. In 2019, 608 kids 12 and under died from car accidents. This probably doesn’t keep you from letting your kid go swimming or from driving them in a car. But you do take precautions, such as teaching them how to float and to use a seat belt. The same approach applies to the flu. You can use precautions such as vaccination, masks, and frequent hand-washing to mitigate flu risks.

Get Your Flu Shot Already!

Only 55 percent of people in the U.S. have gotten or plan to get the flu shot this year, according to a survey of 1,000 people by SingleCare. It’s unclear how many parents will get their children vaccinated. Yet about 80 percent of the children who die from the flu are unvaccinated, according to the CDC. And to prevent the 102,000 more flu deaths than usual that are expected this year, vaccination needs to increase by 50 percent more than the normal rate, assuming vaccine efficacy stays the same, according to the preprint study.

The ideal time to get your flu shot is October. But unless you have an active influenza infection, it’s never too late to get your shot. So don’t wait any longer. Go get your flu vaccine to up your odds of staying safe this flu season.