Weekly US influenza cases highest on record

The Centers for Disease Control and Prevention (CDC) reported through its weekly US influenza surveillance dashboard that during week 47 of 2022, ending November 26, the agency received 130,584 specimens, of which 25.1 percent were positive. This translates into more than 32,600 cases of the flu in one week. 

To place this number in context, the highest figure reached for the same week during flu seasons dating back to 2016 was under 5,000 (in 2019), six times lower. In fact, more positive flu tests were reported in the week ending November 26 than in any single week for any flu season as far back as 1997. 

Overall, for the 2022-2023 flu season, the CDC has estimated there have so far been 8.7 million illnesses, 78,000 hospitalizations, and 4,500 deaths. The cumulative hospitalization rate has reached 16.6 per 100,000, which “is higher than the rate observed in week 47 during every previous season since 2010-2011” according to the CDC. 

Close to 20,000 people were admitted to hospitals across the country in week 47, twice the number admitted to hospitals the previous week. These numbers are expected to continue their upward trajectory, given that nearly 55 million Americans traveled for the Thanksgiving holiday to visit friends and families. 

[Photo: CDC]

Unsurprisingly, those being admitted are both the oldest and youngest in the population, who are most vulnerable to such infections. The hospitalization rate among those 65 and older is 39.9 per 100,000 or 2.5 times the national average. For those 85 and older, that rate is at 71.3 per 100,000, more than four times the average. For those under five years of age, the rate is 28.4 per 100,000, nearly double the average.

Currently, 44 states are registering very high influenza-like illness (ILI) activity. Only Alaska, Michigan, Vermont and New Hampshire have low to minimal rates. The percentage of outpatient visits for respiratory illness reported by the US Outpatient ILI Surveillance Network (ILINET), has reached 7.5 percent of all patient visits. This figure is three times higher than the national baseline of 2.5 percent and has already reached the peak of the 2017-2018 season, set in the middle of February 2018.

[Photo: CDC]

Rates of outpatient visits for respiratory illnesses, as the figures from the CDC demonstrates, are highest among infants and toddlers, followed by young children, adolescents, and young adults. However, as the graph shows, since Thanksgiving, the rates of respiratory illnesses have turned sharply upwards for all age groups.

That rates are highest among children comes as no surprise as influenza and RSV, like COVID, are respiratory illnesses transmitted via airborne aerosols with schools, universities and day care centers functioning as vectors for the transmission of these illnesses into the communities. As with COVID, these facilities have fully opened without an iota of mitigation measures in place, propelling the current explosive and early start to these illnesses. 

[Photo: CDC]

One can peruse the recent news sites and social media to glimpse at the scale of infections afflicting schools just a month ago. On Friday, November 4, Williamstown Independent Schools in Kentucky held a “non-traditional instruction” day, due to the high number of student and staff illness. On the same day, the McNairy County school district in Tennessee closed its doors in the face of increasing illness among student, faculty and staff.  

At North Carolina’s Shining Rock Academy, doors were closed on October 28. As the social media post said, “By 1 pm today, nearly 24 percent of the school was absent, primarily due to diagnosed cases of the flu, or flu-like symptoms.” They added, “The day will be utilized to conduct a deep cleaning” of the campus.

A recent summit held at the White House on indoor air quality, led by coronavirus adviser Dr. Ashish Jha and a panel of experts, focused on the need for improving indoor air quality in schools, with the opening panel chaired by EPA’s Tracy Enger, Dr. Jesus Jara, superintendent of Clark County School district in Nevada (Las Vegas) and Dr. Alex Marrero, superintendent of Denver Public Schools. 

However, much of the discussion that followed the opening remarks centered on the massive gaps in funding that continue to block any real infrastructure initiatives to make public school indoor air quality a priority. 

Having acknowledged these obvious shortcomings, the panel on schools ended where it began with a major question mark lingering on how the Biden administration will lead on these issues. Denver Public Schools Superintendent Marrero concluded:

I’m thrilled that we’re being shined on in terms of a spotlight, but by no means does Denver Public Schools have it all figured out. I’m sure there are others that are struggling just like we are … When it comes to the matter of evaluation, the truth of the matter is there is nothing holding us accountable to doing this, and that is the scary part. I want to just let that simmer for a second, because anyone can avoid this, right? But there are competing priorities when it comes to test scores, when it comes to anything you can imagine. [These] are things we are held responsible for. It doesn’t happen at the federal level or locally. It’s a value statement for a board of education or board of trustees to say okay this is important for us.

He then highlighted the difficulties schools faced during COVID and the teacher shortages that are impacting school operations and student learning. Indeed, the pandemic has laid bare deeper issues confronting public education in the United States, including the long-term decline of air quality in aging school facilities.

Dr. Joseph Allen, director of the Healthy Buildings program at Harvard University, who gave the opening remarks at the summit after Dr. Jha, highlighted the dilapidated conditions of poorly ventilated schools that are on average more than 45 years old, with HVAC systems outdated and in need of urgent repairs. In March 2022, he told NPR, “I don’t think a lot of people recognize that the design standards [that govern ventilation rates in schools and other buildings] are bare minimums. They were never actually set for health.” 

On Monday, the CDC Director Dr. Rochelle Walensky spoke with reporters. Walensky has done everything in her power to end all the COVID mitigation measures since being sworn into her current position by Biden. But with a straight face she said her message to Americans was, “We also encourage you to wear a high-quality, well-fitting mask to prevent the spread of respiratory illnesses … One need not wait on CDC action in order to put a mask on.”

Around 25 percent of all adults and 40 percent of children have received a flu shot this season. Additionally, only 15 percent of all adults eligible for the bivalent COVID booster jabs have taken them. In fact, most Americans have essentially abandoned the preventive measures that proved effective in slowing COVID. This is the result of the deliberate systematic anti-public-health policy promoted by both the Trump administration and now the Biden administration.

Meanwhile, the rise in hospitalizations is accompanied by shortages of medications to treat complications associated with viral respiratory illnesses. Specifically, antibiotics like amoxicillin are in short supply. Cold medicines and antivirals are difficult to find. Staffing shortages at health systems are exacerbating the ability to treat the sick. 

Flu seasons usually peak during the deep winter months. The extremely high figures reported by the CDC in late November portend a crushing wave of respiratory illnesses on the horizon.