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Considering the missing flu season, colds and COVID

7c6bb68ee7_Woster Ty White.jpg
Ty White, director of infection prevention and control at Monument Health

This interview is from SDPB's daily public-affairs show, In the Moment, hosted by Lori Walsh.

Remember last year’s flu season?

Yeah, me neither. We didn’t have one.

OK, OK, so we had one, sort of. But it was tiny. I mean, really tiny. As in 71 confirmed cases statewide, seven people hospitalized and two deaths.

“Last year, we really didn’t have a flu season,” says Ty White, director of infection prevention and control for Monument Health here in Rapid City. “It was almost nonexistent.”

Of course, two people still died. And to those people and their families, flu is a painful life-altering reality, even during a season that was almost not a season at all.

Why was that? Well, some of it is the mercurial nature of infectious diseases, White says. But there are some logical conclusions to be reached. And they’re all about COVID, and COVID prevention methods.

“I think a big part of it was those things people were doing for COVID actually worked really well in preventing influenza — wearing their masks, you know, and social distancing, and proper hand washing. And also just thinking about what your hands have touched, and not touching your face.”

Trust me when I tell you, I was rigorous in following those COVID protocols, along with getting my COVID vaccines and boosters as soon as I was eligible. I also got a flu shot. I’ve been getting flu shots for at least 30 years. And I’ve only had the flu once.

Oh yeah, I could tell, right away. It was more than a cold. And the test at the clinic showed it.

But that was a year that the flu shot wasn’t formulated just right for the particular strain of flu that came through South Dakota. Or maybe it was another strain that came late in the flu season. I can’t remember which.

Vaccines aren’t perfect. But they are essential. They prevent illness and save lives.

Not missing the common cold at all

But back to COVID prevention techniques and their effects. I haven’t had a common cold in more than two years. I can’t remember how much more it has been. But it was months prior to when I started taking COVID precautions two years ago this month.

So, even as I ease up slowly and carefully on my COVID prevention methods, I’m probably going to keep some of those methods in my daily life, at least to a degree, to reduce the chance of colds and other infectious diseases.

It just makes sense.

As for that flu season we really didn’t have last year, things changed this year. And initially they changed in an alarming way.

By this year, many if not most people had had about enough of COVID prevention. Vaccinated or not, most people seemed to stop wearing masks, and stop any serious social distancing. What they did about hand washing and sanitizing I’m not sure. But I’m guessing that dropped off, too.

And guess what, flu came back with a vengeance, at least early on in the season. Fortunately, it settled down after that.

“It has been a weird year for flu,” White says. “We peaked way early in cases in South Dakota, back in early December, and were headed for a record flu year when cases just dropped off.”

South Dakota Department of Health data shows that the typical peak for the flu season in the state over the previous five years was the third week in February. From 2016-2021, the state averaged 6,478 confirmed influenza cases with 631 people hospitalized and 39 deaths.

This year the state has had 8,826 confirmed influenza cases, 183 hospitalizations and 13 deaths. The peak for confirmed cases was the fourth week in December, almost two months earlier than recent averages.

Considering COVID and the seasonal nature of flu

And, hey, speaking of the seasonal nature of influenza, why do we have flu seasons and not COVID seasons? Wouldn’t it be nice, or at least helpful, if COVID started to show up like flu in late autumn or early winter and was pretty much gone as a substantial health threat by spring?

Instead, COVID seems to be around all year, even though it wanes somewhat during the summer months. Sort of. Although it didn’t wane much in the month and a half of summer following the 2020 Sturgis rally, as I recall. It spread, heading for a brutal surge in late Autumn and early winter that year.

On the subject of the seasonal flu and COVID, White says there is a seasonal nature to COVID, but it hasn’t been like the flu.

“When you’re in a pandemic, the amount of active cases in a community is so high and it’s so much more transmissible that it carries on through the summer,” he says.

Even so, summer is not quite like the other times of the year, when COVID transmission gets worse. That first big surge of the Delta variant, for example, was in October and November of 2020. Then the surge of the Omicron variant this season built through early winter and surged after the first of this year. But it has been falling steadily since then.

“Three things probably play into it,” White says. “One, the way we live in the winter and fall, the colder temperatures, so we’re inside more. We’re closer together and around other people more inside, so there’s more people and closer contact and more likelihood of transmission.

“Then, two, and maybe even a bigger role is the humidity level — and cold, dry air versus moist, hot air. That plays a huge role,” White says. “These respiratory viruses do a lot better with cold, dry air. Have warm air and 80 percent humidity and that virus won’t last very long outside a person’s cells.”

And three?

“This is less of a thing on seasonality, but the days are shorter in the fall and winter, and so we’re not getting as much Vitamin D. Our resistance might not be as good at fighting off viruses or other pathogens,” White says. “And, of course, you’re more likely to be inside when it’s dark out, again putting you in contact with others.”

White stresses again that COVID is extraordinarily transmissible, much more so than influenza. That was true in the early strains, and especially true with Omicron 1. Indications are that Omicron 2, which is just now starting to work its way through the state, is even more transmissible.

“It’s not quite to the measles level of how infectious it is. But it’s certainly more than the flu, and more than other coronaviruses, the common cold, for example,” White says.

The good news so far on both Omicrons is that the vaccines seem to be effective against them., which doesn’t guarantee that the vaccinated won’t get infected. Breakthrough infections happen with some regularity, but are typically mild.

Despite breakthrough infections, vaccines doing their main job well

People should not avoid vaccines or lose faith in them because vaccinated people sometimes contract the virus anyway, White says. While the vaccines do offer protection against contracting a COVID infection, the key is how well they do at preventing serious illness and death. And in that they do very well. Very, very well.

“You still might get infected, but if you do and you’re not vaccinated the chances are 30 times higher that you’ll be hospitalized and even die,” White says. “During Delta it was even higher, with the unvaccinated 63 more times to get really sick or die.

“My biggest thing to get out is that the vaccine still works. It can still save lives every day.”

He’s preaching to the choir when he preaches that message to me. I believe in the vaccines, both to prevent the infection in the first place and to prevent serious or fatal illness if a breakthrough infection does occur.

Speaking of breakthrough cases, it happens with the flu, of course. No flu vaccine is 100 percent effective, any more than any COVID vaccine is. But both save lives.

And White says the vaccines and work to alter them to meet the demands of COVID strains will be key to a healthier future. COVID isn’t going anywhere anytime soon. And it’s always working on changing to present new challenges.

“I think we’re crazy if we think that more variants aren’t coming, with this much transmission throughout the world,” White says.

Some day, infectious disease research and vaccine development might offer one vaccine for all coronaviruses, including the common cold,” White says. “Until we have something like that, I feel like they’ll have to keep adjusting vaccines.”

And I don’t know about you, but I’ll keep using those vaccines as directed by medical professionals. And I’ll stick with common-sense measures to reduce the chances of catching COVID and other infectious diseases, including wearing a mask and keeping my distance when it seems appropriate.

I sure don’t want to catch COVID if I can help it. Or the flu.

And know what? It’s been nice not having those common colds, too.