Northeast Ohio enjoys second mild flu season in row; COVID-19 measures also slow spread of flu

CLEVELAND, Ohio — COVID-19 precautions delivered a welcome dividend — the second mild flu season in a row in Northeast Ohio, health experts say.

Cuyahoga County has recorded only one death for the 2021-22 season, an 83-year-old male.

Compare that to 39 flu-related deaths and more than 2,000 flu-related hospitalizations during the last normal, pre-pandemic flu season in Cuyahoga County.

Summit and Medina counties also recorded low numbers of flu-related deaths and hospitalizations this season.

“It really has been more mild than what I was expecting,” said Dr Christine Alexander, chair of family medicine at MetroHealth System. However, there still could be an uptick in flu cases before the season officially ends in spring.

COVID-19 procedures—wearing masks, not congregating, and washing hands—contributed to the previous flu season being unusually mild, health experts said.

During the current flu season, COVID-19 restrictions on gatherings have eased, bars and restaurants are in full swing and most schools are offering in-person instruction.

So why didn’t the flu come roaring back?

The omicron-fueled surge prompted many people to keep washing their hands, using hand sanitizer, covering coughs and sneezes, and wearing masks.

“I know there were definitely a lot (of people) still using masks and still taking some precautions, especially during omicron, so it all plays a role,” said Richard Stacklin, public health data analyst for the Cuyahoga County Board of Health.

People either continued working from home or returned to their home office, Stacklin said.

Less international travel also helped stop the spread of flu.

Nationally, the rest of the country also is seeing a mild flu season, according to federal data, with sporadic influenza activity increasing in some areas.

Alexander hopes that people keep wearing masks during the winter, regardless of COVID-19.

“I think it really helped to decrease the spread of lots of different infections, not just coronavirus,” Alexander said. “I would love to see some degree of masking in an ongoing fashion just to decrease many (airborne) infections.”

Fewer Americans got flu shots this season

The flu shot may have had something to do with the mild flu season, but not because a record number of Americans were immunized against flu.

Fewer people got the jab this season.

Nationally, about 20 million fewer flu vaccines have been distributed so far this flu season, as compared to this point in the previous flu season, according to the US Centers for Disease Control and Prevention.

A year earlier, a record number of Americans got the flu vaccine during the 2020-2021 flu season. They heeded warnings of a “twindemic” — a predicted simultaneous spike in flu and COVID-19 cases that didn’t materialize.

The effectiveness of the flu shot also could be a contributing factor behind the back-to-back mild seasons.

The CDC did not estimate flu vaccine effectiveness for the 2020-2021 season due to the low flu virus circulation.

Data on vaccine effectiveness for the current season has not been released, but it seems as if this season’s flu shot may be a good match against the predominant strains in circulation, Alexander said.

“When you have that kind of good match, then you will have a mild flu season,” Alexander said.

Has COVID-19 replaced influenza as a worrisome virus?

COVID-19 won’t replace influenza as the most worrisome endemic disease in this country, but it will become another endemic virus alongside influenza, Alexander said. We’ll have to be concerned about both viruses on an ongoing basis, she said.

An endemic illness is one that is always in circulation, but doesn’t overwhelm hospitals with seriously ill people.

There is no comparison between the two illnesses, because COVID-19 kills more people, Stacklin said. Just this year, there have been more than 500 COVID-19 deaths in Cuyahoga County, but about 200 influenza-related deaths over the previous nine flu seasons combined, he said.

COVID-19 also has long-term health impacts, such as heart inflammation, that isn’t seen as much with flu.

Influenza by the numbers

As of late February, flu activity in Cuyahoga County was “minimal” for the seventh consecutive week.

Cuyahoga County saw 45 influenza-related hospitalizations through mid-February, as compared to about 1,000 influenza-related hospitalizations in past seasons, Stacklin said.

Summit County had recorded two flu-related deaths this season, and 40 influenza-associated hospitalizations, through the end of February.

Medina County had recorded zero deaths and three hospitalizations related to flu through the end of February. Medina County’s hospitalization rate is lower than the five-year average, according to health records.

Third mild flu season in a row in the future?

After two mild seasons in a row, getting a third isn’t likely, Alexander said. “We tend to have some years that are good and some years that are not good,” she said.

Which way the next flu season goes depends, in part, on whether COVID-19 precautions – which also slow influenza — will still be recommended, Alexander said.

If pandemic precautions continue to be lifted, the result could be a stronger influenza circulation during the 2022-23 season, Stacklin said.

“The less that public health measures are followed, the more likely people are to become sick,” he said.