Friday, October 08, 2021

UK: Preparing For A "Reasonable Worst-Case" Winter Scenario

 

Credit CDC

“Our modelling of a reasonable worst-case scenario also shows we could be dealing with around twice the levels of influenza and RSV this autumn and winter, causing widespread ill health and even greater pressures on the NHS.” - Professor Azra Ghani FMedSci, Expert Advisory Group member

#16,237

Last July, in UK Academy Of Medical Sciences: Looking Ahead To COVID-19 Over Winter 2021/22 & Beyondwe took a deep dive into a lengthy (133 page PDF) report on what this fall and winter - and beyond - may look like in the UK with both COVID-19 and other respiratory illnesses (Influenza, RSV, etc.) concurrently spreading in the community.

While we've discussed the potential for seeing a `twindemic' of COVID and influenza numerous times over the past year (see June 2020's COVID-19, The Next Flu Season, And The Temporary Immunity Hypothesis) - so far, between `viral interference' and the public's use of NPIs - it hasn't come to pass. 

This summer, however, we've seen an international surge in RSV cases, and this fall we've begun to see scattered reports of influenza and other respiratory viruses (see UK: `Worst Cold Ever' Trending On Social Media) in the Northern Hemisphere. 

Add in early indications that coinfection with COVID and Flu can produce even more serious illness and a greater risk of death - along with an already overburdened NHS - and UK officials are understandably concerned. 

In the press release to their July report, the UK Academy of Medicine wrote:

Winter viruses and COVID-19 could push NHS to breaking point, warns new report
 
Thursday 15th July 2021

A lethal triple mix of COVID-19, influenza, and the respiratory virus Respiratory Syncytial Virus (RSV), could push an already depleted NHS to breaking point this winter unless we act now, says a new report released today [Thursday 15 July].

The report* from the Academy of Medical Sciences brought together 29 leading experts alongside 57 members of the public** at the request of the Government Chief Scientific Adviser to forecast the greatest risks to health this winter. They include:
    • A potential surge in respiratory viruses could cause widespread ill health and put pressure on the NHS. New modelling carried out for the report suggests this winter influenza and RSV hospital admissions and deaths could be two times that of a ‘normal’ year and could coincide with an increase of COVID-19 infections, and their associated long-term consequences.
    • Dealing with the current third wave of COVID-19, as well as multiple subsequent outbreaks, between summer 2021 and spring 2022, meaning the NHS cannot catch up with the backlog of routine care.
    • The NHS is already under pressure, and so is likely to be less able to cope with extra winter health challenges. Before the pandemic, winter bed occupancy in the NHS regularly exceeded 95%. This year the NHS will also be operating with a reduced number of beds because of infection control measures. The report also highlights that the NHS is reporting a shortage of nearly 84,000 staff, and a shortage of 2,500 GPs. Staff fatigue and burnout will also be a challenge.
    • Worse physical and mental health in the UK population – including that due to delayed diagnosis and treatment and other impacts of the pandemic – could lead to even higher rates of conditions such as asthma, COPD, heart attack and stroke this winter.
(SNIP)

Between 15,000 and 60,000 people could die from influenza this winter according to new modelling for the report, though the planned widespread flu vaccination should help to reduce this risk. The report is calling for measures to make sure that everyone who is eligible for a flu vaccination gets vaccinated, and for wider use of testing and antivirals to treat influenza for the most vulnerable, and those who become particularly ill.


While trying to predict what influenza (or COVID) will do 3 or 6 months from now may be an exercise in futility, there are ample reasons to be concerned that when influenza does return (whether it's this year or next), it could be severe.  Particularly if paired with COVID. 

Individual and community immunity have likely waned significantly, and after nearly two years of COVID, too many people now regard flu as a `trivial disease'. 

Today, in anticipation of a very tough winter COVID/Flu season ahead, the UK has unveiled a national campaign to encourage both seasonal flu shots and COVID Boosters for everyone who is eligible. 


New film launched urging public to get flu and COVID-19 vaccines

New campaign encourages those eligible to get free flu vaccine and COVID-19 booster vaccine ahead of winter.


  • New campaign supported by charities and healthcare organisations encourages those eligible to get vital protection with a free flu vaccine and COVID-19 booster vaccine ahead of winter
  • Comes after the government has launched the biggest flu programme in history for 2021 to 2022 and the COVID-19 booster campaign is well under way to protect as many lives as possible
  • New research suggests adults are underestimating the combined threat of COVID-19 and flu this winter
Those eligible for the free flu vaccine and COVID-19 booster jab are being urged to book their appointments as soon as possible in a new film campaign launched today (Friday 8 October) aiming to help people give themselves and their loved ones the best possible protection this winter.

The new film sees media medics Dr Amir Khan, Dr Dawn Harper and Dr Karan Ranj explain why it is more important than ever for people to get their winter vaccines as soon as possible this autumn, as both viruses have the potential to cause serious illness and hospitalisation.

The campaign is launched as new research released today suggests that adults in England are severely underestimating the combined threat of COVID-19 and flu this winter.

There could be a significant flu surge this winter coinciding with continuing or rising COVID-19 cases. This is due to colder weather which favours transmission, darker nights which mean increased social contact indoors where it is less well ventilated, and expected lower immunity to flu due to lower levels in circulation last winter.

A recent survey seeking views from 3,000 participants found that nearly one third (32%) were unaware that flu and COVID-19 can circulate at the same time, over a quarter (26%) did not know that flu can be fatal and over half (55%) underestimated the number of people who die from flu in an average year in England (which is approximately 11,000).

Even those deemed high risk for COVID-19 had low awareness of the possible dangers. Nearly a quarter of those over 50 (24%) and 29% of those with long-term health conditions (who are a priority group for the COVID-19 booster and an eligible group for the flu vaccine), were unaware that flu and COVID-19 could circulate at the same time. Over a third (37%) of pregnant women, who are an eligible group for a free flu vaccine, were also unaware that you can still catch flu if you’ve had the COVID-19 vaccine.

(Continue . . . )

 
Putting aside my fervent hopes that these poll results don't truly represent of the level of influenza misinformation held by the general public, I suspect - after 18 months of non-stop COVID warnings - that many people are just too burned out to care. 

While you can't paint any flu season with a broad brush, and assume it will be the same across the affected hemisphere, there are reasons to believe that many other countries - including the United States - could face similar challenges this winter. 

With the UK running at about 40K COVID Cases each day, and the United States around 100K, the introduction of influenza, RSV, or other winter respiratory viruses to the mix could quickly overwhelm already stressed healthcare delivery systems. 

While no one can say just how close of a match, or how effective, this year's flu vaccine will be until the end of the flu season, I've already gotten mine (see #NatlPrep: Giving Your Preparedness Plan A Shot In The Arm), and I'll be grateful for whatever protection it does provide. 

I figure, given the added risks of our concurrent COVID pandemic, anything that can help keep you out of the hospital this fall and winter is well worth doing.