Covid may help us sidestep a flu outbreak, but long-term fears remain

Winter is coming, and with it a growing apprehension that a second wave of Covid-19 will clash with the annual flu season, crippling the health service and sending death rates soaring.

This week, the Government announced it will expand the flu vaccination programme, both to better protect vulnerable groups and to prevent people needlessly being tested or self-isolating from influenza, which has similar symptoms to the coronavirus.

But there is emerging evidence that Britain could have a historically low number of infections this year because the usual spread is being stopped by social distancing, face coverings and increased hand washing.

All the measures imposed to defeat coronavirus seem to be having an extremely positive impact on other contagious illnesses. In fact, by some measures, the country has never been healthier. Latest data from the Royal College of GPS, running up to July 19, show that communicable and respiratory diseases have plummeted since March.

Cases of the common cold have dropped from about 50 in 100,000 people to five in 100,000. Likewise, cases of viral hepatitis, asthma, tonsillitis, and respiratory and chest conditions have been halved. Chickenpox is down nearly fivefold and laryngitis threefold.

Infectious intestinal diseases, often caused by poor hand hygiene, have also fallen from about 12 in 100,000 to fewer than five in 100,000. Upper respiratory tract infections have plummeted by two thirds, while cases of bronchitis and conjunctivitis have been more than halved.

Oxford University also discovered there have been far fewer “influenzalike illnesses” (ILIS) in children since lockdown.

Dr Jason Oke, of the Centre for Evidence-based Medicine at Oxford

University, said: “I think it is reasonable to assume that if people adhere to social distancing protocols that we would see fewer ILIS in adults during flu season.”

Looking elsewhere in the world is also proving illuminating. In Australia, just 0.37 per cent of people are currently showing symptoms of flu compared with 2.1 per cent in the same week last year. The Australian flu

season usually runs from June to August, with cases starting to grow slowly from January. But, although the country started with high flu rates at the beginning of the year, cases dropped significantly by the spring as social distancing measures were imposed. In April, there were just 229 cases, compared with 18,709 the previous year.

A senior government scientist said that experts were watching Australia closely to find out what might be expected in Britain’s winter flu season.

“If you look at the southern hemisphere it is perhaps a little less bad and it’s conceivable that’s because of measures to protect against Covid, but we’ll have to wait and see how that translates into the flu season here,” the government adviser said.

Prof Baron Peter Piot, of the London School of Hygiene and Tropical Medicine, told MPS that the public could play a big role in lessening winter pressures on the NHS.

“Whether we will have a major problem or a more controllable problem in the winter will depend on what we do now in terms of policies but also individual behaviour,” he told the Commons science and technology select committee.

“It’s not just the Government; this requires the co-operation of everybody. Look at Australia and there has been a major decrease of incidence of influenza and all kinds of respiratory infections most likely because of all the measures of social distancing.”

He argued that cultural norms such as bowing instead of shaking hands in East Asia may have their origins in the desire to avoid disease.

“Many of the cultural behaviours may have been determined by the need to avoid epidemics, that might have been the origin of not shaking hands.

“We’re talking about the long term view. Even when we have a vaccine we will have to live with it [the virus] because it’s unlikely we will have a vaccine that’s 100 per cent effective.”

However, other experts argued that the fall in disease has coincided with children being off school and spikes may occur once “super-spreader” pupils return in the autumn.

Dr Anu Goenka, of the University of Bristol, said it was important to prepare for the worst.

“The Australian data are definitely interesting but flu season varies considerably and it’s pretty hard to predict what will happen,” he said.

“What we do know is that flu on top of other viral infections, whatever they are, is usually not a good thing. With Covid, this could create a massive pressure on our NHS right at the point where we don’t want it.”