What to Expect During an Unpredictable Flu Season

COVID-19, public health misinformation, limited natural immunity pose new challenges

October 15, 2021

Before the pandemic, the preparation for the flu season could be fairly consistent.

We’ve always known the basics: The prevalence of respiratory illnesses during the winter means more patients with symptoms at hospitals and health systems. We look to the world’s public health experts to produce a vaccine that has the best chance of matching the dominant variants for the coming year. Hospitals and public health organizations adapt to seasonal challenges through regular education, prevention, and vaccination programs.

While we’ve always been able to count on our flu strategies, here comes the curveball. COVID-19 has changed the landscape for infectious disease planning, mitigation, and response. Interest in public health is at an all-time high as people seek out information to make health decisions from reliable and not-so-reliable sources. This winter, hospitals could face a potential flu epidemic on top of their COVID-19 caseloads.

As we enter flu season, we know we’ll have to prepare for some new public health challenges while using some of the proven strategies that have helped us respond during the past.

Here’s what you need to know as flu season approaches.

Consider Your Message

Setting ourselves up for a successful flu season means thinking about our internal and external audiences.

For the general public, that includes early education about the benefits of the flu shot and simple public health precautions like staying home when sick. We know the vaccine adds an extra layer of protection from the circulating viruses and that a higher vaccination rate means fewer patients at hospitals.

But our words are heard in a different context this year. Standard fact- and science-based public health messages—which may have previously been received and understood with little resistance—now are struggling to be heard against a cacophony of misinformed and off-the-wall ideas. We’re entering a new era where people have stronger opinions about what public health should look like.

We must deliver clear information that cuts through the noise. Public education regarding the importance of receiving both the COVID-19 and flu shots should continue since vaccines are safe, effective, and a tried-and-true public health intervention that can give hospitals the edge they need.

Preparing for the Unknown

The pandemic hasn’t just changed the way we talk about public health; it’s also had a direct influence on the patients we see in the hospital.

As it turns out, our efforts to mitigate COVID-19 may have had a corresponding effect on the prevalence of the flu. It seems that masks, social distancing, and quarantining designed to limit the spread of COVID-19 may have resulted in the 2020–2021 season having the lowest incidence of the flu in recent times. 

While this was certainly a good thing at the time, it could set us up for some significant challenges this winter in two important ways:

1. As COVID-19 mitigation efforts wane, individuals will have more opportunities to pass influenza to others in their communities
2. A slow 2020–2021 flu season may mean that fewer people have protection via natural immunity this year

Public health researchers are watching this closely, saying there’s potential that the lowest case-incidence season could be followed by a really, really challenging one. 

The COVID-19 pandemic is not over, and other viruses such as respiratory syncytial virus (RSV) are spreading. This sets us up for a convergence resulting in a significant hospital and health care system impact this “flu” season.

Next Steps

So how do we prepare for the uncertainty?

Well, we need to remain vigilant and support the mitigation efforts currently underway. Getting a handle on the COVID-19 pandemic remains a priority, because that will allow us to dedicate precious resources toward other issues and outbreaks. 

While we hope that mitigation efforts put us in a better position, preparedness activities should continue and be high on the emergency manager’s task list. 

You can:

• Review your plans:  Be sure that influenza response plans are up to date and reflect the current state of public health (Were they written with COVID-19 in mind?)
• Check capacity:  Ensure that surge response capabilities and assets are available and ready for deployment (Do you and your regional partners have room to accommodate more patients beyond those with COVID-19?)
• Stay updated:  Follow updates from the Centers for Disease Control and Prevention and your state health department for the latest trend and prediction data
• Think regionally:  Regular contact with your regional health care coalition is valuable. Ensure your chief medical officer or other executive-level decision-makers are participating in regional medical planning discussions about surge capability

And, as always, member hospitals and health systems can stay connected to the latest emergency management information by joining the HAP Emergency Management (EM) team online each Wednesday at 1 p.m. for our weekly EM Weekly Briefing.

If you or your organization would like to learn more about preparing for the flu season, contact HAP’s Emergency Management Team or HAPevolve for more information.