Due to the corona measures, there have been very few flu infections for two years, but the season could be all the more violent next winter. A clear sign of this is an early and very sharp increase in flu in Australia, which threatens to be as bad as 2017.
Whether and how effectively which restrictive measures were able to keep Covid-19 in check is still being hotly debated in view of a possible new corona wave next autumn. What is certain, however, is that the AHA L rules have led to the fact that the flu season has almost completely failed over the past two years. But now there are signs of a comeback for the influenza virus, as a look at Australia shows, where the number of cases is increasing very rapidly very early on.
Due to the corona measures, the flu wave in Germany ebbed around two weeks earlier in 2019/20 and there was not a significant number of influenza infections in either the following season or the previous season. For example, Brandenburg reported just 672 confirmed cases for autumn/winter 2021/22, and only 31 in the previous season. Before the pandemic, there were over 6,000.
The development did not come as a surprise for Europe, since the flu outbreaks had previously failed in the southern hemisphere, including in Australia and New Zealand. A look down under is all the more alarming, because the flu wave started there early in April and the number of laboratory-confirmed cases skyrocketed in May.
The flu season this time is "particularly bad" and comparable to that of 2017, according to the Prime Minister of the Australian state of Queensland. According to the Ministry of Health, the country had just under 600 confirmed influenza infections as of November 2021, compared to a total of 38,743 cases this year as of May 22. This corresponds to 150.5 infections per 100,000 inhabitants.
26,193 cases of flu were reported in the last 14 days alone - three times more than in the two weeks before. Since mid-April, the number of confirmed flu infections in Australia has exceeded the five-year average. The current infections have already almost reached the peak that the very severe wave of 2019 reached in early July.
The steep increase, with the number of infections currently doubling every week, is more comparable to the particularly violent 2017 season, as Health Minister Annastacia Palaszczuk said. This wave started two months later and peaked in August.
The high number of reported infections can probably be partly attributed to the increased testing capacities during the corona pandemic, which are now being used for influenza. The test positive rate is 3 percent. However, 368 Australian flu patients have already been hospitalized, with almost 8 percent requiring intensive care. At least three of the 38,743 registered cases have died since April 22.
Younger people are particularly affected. Almost half of those infected are under the age of 16, around 30 percent are between 16 and 64 years old, and only around 5 percent are older. However, the highest risk is by far the elderly, the three people who officially died of flu in Australia were 87 to 92 years old.
The probability that Europe will go through a similar development in the autumn is quite high. In 2019/20, the flu epidemic was less severe here than in Australia, probably only because of the corona measures taken. In autumn and winter 2017/18, Germany, like the southern hemisphere before it, was hit particularly hard, with the RKI registering almost 1,700 official deaths at the time. The Institute estimates the actual number of victims at 25,100, since influenza is often not entered as the cause of death on the death certificate.
The Federal Republic should therefore be forewarned and prepare a vaccination campaign for the autumn in terms of organization and information, especially for older people. However, it remains to be seen whether enough vaccines will be available. According to the Paul Ehrlich Institute (PEI), medical practices and pharmacies should have ordered the flu vaccines by April 1st. After that, the production and the approval of the adaptation of the strain of the vaccine take place over a period of about four to five months.
Shortly before the end of the period, the PEI wrote that the number of pre-ordered vaccine doses still deviated significantly from the needs determined for the coming flu season. In the worst case, this could lead to restrictions in availability. ntv.de asked the PEI whether enough cans had been ordered, but received no concrete answer. Assessing this is like looking into the crystal ball, since it ultimately depends on the specific demand whether the vaccines ordered are sufficient.
An indication of the low interest in vaccinations in the past two seasons suggests that vaccines could become scarce if there is a strong flu epidemic in autumn. The PEI therefore also points out the need for a "flu vaccine reimbursement regulation". This means that pharmacies or doctors should be compensated for vaccines that have been ordered but not used.
According to the National Association of Statutory Health Insurance Physicians (KBV), doctors can by law take recourse if the ordered amount of influenza vaccine is more than the amount consumed. For the 2021/2022 vaccination season, exceedances of up to 30 percent would still have been considered economical. However, it is still unclear whether this regulation will be extended and thus also apply to the 2022/2023 vaccination season.
(This article was first published on Monday, May 30, 2022.)