Dr. Angela Branche: Flu and other seasonal respiratory illnesses

[0:00:20]

ANGELA BRANCHE: My name is Dr. Angela Branche. I’m an associate professor of medicine at the University of Rochester. I practice infectious diseases as a physician, and I also conduct clinical and translational research related to respiratory viruses like influenza, respiratory syncytial virus and recently the SARS coronavirus, too, that causes the COVID-19 pandemic.

[0:00:52]

ANGELA BRANCHE: You had the 2020-2021 flu season, which was sort of one of the peaks of one of the waves of the pandemic locally here as well as around the world. And during that particular peak, there was really no flu. It was the most interesting epidemiological phenomenon we’ve ever seen. The complete substitution of one viral illness for another is just not something we’ve ever seen in modern medicine. So to have flu kind of go away in the wintertime when you really see flu was not something that we might’ve predicted at the time. But it made sense because everybody was social distancing, and isolating, and sheltering at home, and all the things that make us not come into contact with each other and, therefore, make it harder for viruses like flu to spread. And we also were all wearing masks, and it turns out that masks are incredibly effective at preventing people from getting flu and preventing flu from spreading within communities. And so, we saw virtually no influenza in the 2020-2021 season and no influenza deaths, which was amazing and something that I don’t think our healthcare system could’ve handled.

And then, we’re now in the 2021-2022 flu season, which interestingly sort of looks a little bit like what a normal flu season looks—in that it started around the right time that flu usually starts to be seen—sort of the end of November. It seems to have peaked end of December, beginning of January, and now it’s sort of on the downward trend. It’s different, you know. We’ve probably had about a third less cases than we usually see in the flu season, and it’s not what’s causing people to be hospitalized like it usually does. But yeah, we are seeing sort of a more natural flu season compared to last year.

[0:02:57]

ANGELA BRANCHE: mean, I think there are other viruses circulating as well—RSV, other coronaviruses that cause the common cold, another similar virus called human metapneumovirus we’ve seen some cases of this year. And all of this, again, is compared to last year when really none of these things were circulating during a typical winter season.

RSV has been particularly interesting. I would say there was a very abnormal pattern where we were seeing high rates of infection in children in the summer months and in the early fall. Again, RSV is a winter virus. We don’t really see it circulating at least here in the United States and the northern hemisphere when the weather’s warm. And so, to have had sort of those bursts of infections in young kids at that abnormal period was really sort of interesting and it sort of makes us rethink everything we think we know about RSV. And now what we’re seeing with RSV is we’re seeing higher numbers of cases in older adults. So, that abnormal out of season burst of RSV was really in children this summer. Whereas this winter, the cases that we’re seeing seems to be in the group that we usually see it in which is older adults when adults get infected.

[0:04:27]

ANGELA BRANCHE: For flu season, it’s always been what we recommended for protecting people against the flu—to wash your hands, to stay home if you’re ill and not go to work or send your kids to school, to go see your doctor and get tested, so you know to separate yourself from going out in public and again, spreading the infection/spreading influenza. It’s been about covering your mouth when you cough. We don’t necessarily tell people with flu to wear masks, but we do tell them to put into place practices that prevent droplets from entering in the air, which can spread the virus—like covering your mouth when you’re coughing and you’re sneezing, washing your hands frequently, again, staying home if you’re sick and not going back out into public until your symptoms have resolved. So, those have been sort of the mainstay in flu prevention for years in addition to getting vaccinated, particularly if you’re in a group who’s vulnerable for more severe disease with influenza—children, older adults, adults with underlying medical conditions, those sorts of things.

[0:05:37]

ANGELA BRANCHE: So, influenza is the only respiratory virus for which we would recommend universal vaccination. So, everyone should get a flu vaccine if they can. I think there is just sort of the public health community reasons behind getting vaccinated, you know. We don’t want flu in our community. We don’t want the flu infecting vulnerable members of our community. So, we all get vaccinated, so that we can keep cases and rates down and prevent transmission. So, that’s always a good reason to get vaccinated. And then, certainly, if you’re in a group for whom we know flu does cause more severe illness, then we would highly recommend that you get vaccinated as well.

[0:06:28]

ANGELA BRANCHE: The mRNA vaccines—which are the ones that are most widely used here in the United States—some 2.5 billion doses have been given of Pfizer and Moderna worldwide. And so, it’s been about a year or so since we’ve had these vaccines available. We’ve given it to so many people. We really know a lot about them—about the safety, about the so-called long-term side effects that I know many people are worried about, about how they effect women who are pregnant and giving birth. And so, I think that a lot of those earlier concerns really have been allayed by time. I hope that people are feeling a little bit more comfortable with what we know about the vaccines with how effective they are, how much severe illness, hospitalizations and deaths that they have been preventing over the last year. We’re really thankful for them because as challenging as this current surge is, it would be a lot worse if people weren’t vaccinated.

[0:07:32]

ANGELA BRANCHE: I’m a respiratory virologist. So, I’ve always believed that respiratory viruses cause a significant burden of disease in human populations, so particularly people at risk. And that’s sort of my life’s work and what I work with my colleagues on studying these various different viruses. And after the pandemic passes—which God willing will be very quickly, in the next year maybe—viruses that cause colds and pneumonias will still continue to pose a threat—things like influenza and RSV. And, you know, I hope that if we take anything away from the pandemic that’s positive, it’s just sort of an awareness that it’s everyone’s job as a community to work on curbing the spread of these things by paying attention and to what’s going on in your surroundings, by practicing good habits that really curb the spread and transmission of viruses, and by getting vaccines when vaccines are available. So, that’s what we do here in Rochester with our very, very long winter season. And that’s what we’ll continue to do, you know, long after COVID-19 passes.