Treat the Flu Like Covid, Says The Economist

The Government should treat the flu similar to how it has treated Covid, the Economist has argued. Here’s an excerpt:

The Government’s plan is to deal with [COVID-19] in a “similar way to other existing respiratory illnesses” such as the flu. In practice, that means less surveillance, fewer vaccinations and a greater willingness to accept infections and deaths. This trade-off seems reasonable to many (though less so to clinically vulnerable people). But dialling down the response to be more like the approach to flu is not the only option. Another would be to treat flu more like Covid. “There is a fatalism about flu,” says Professor Ajit Lalvani of Imperial College London. “Every year the winter flu season overwhelms the NHS. Applying the lessons learnt through Covid could help.”

If ever there was a time to think differently about the disease, this is it. Epidemiologists worry that two years of low exposure to flu may have caused immunity to wane to low levels. That may result in an extraordinary number of cases this winter, at a point when huge waiting-lists will still clog up the National Health Service (NHS).

Before asking how things might be done differently, start with how things usually are. Pre-Covid estimates based on serological surveys suggest that as many as one in five Britons contract the flu each year. The vast majority of people get a relatively mild illness but for some a trip to the doctor will be needed. A study in 2007 estimated that flu results in some 800,000 visits to family doctors each year. Unlike Covid, it particularly affects the very young as well as the elderly: children under 14 accounted for two-thirds of visits.

If a respiratory infection worsens sufficiently, treatment at hospital is needed. As many as 40,000 people are hospitalised each year with breathing difficulties caused by the flu; the average total in-patient cost is £7,500 ($9,360). Because respiratory infections are slow to shift, patients stay for 11 days on average. Occupancy of the NHS’s 100,000 hospital beds rises from about 88% to over 95% during the winter; flu plays a big part in that.

Official data suggest that, on average, around 500 people died from flu each year in the decade to 2020. But since flu infections are not systematically diagnosed, that number is a massive undercount. To estimate the true number of deaths from influenza, epidemiologists model excess winter mortality, disaggregating flu infections from cold snaps that also lead to death. On this basis an average of 10,000 died each year from flu in the ten years to 2020; in the winter of 2014-15 as many as 29,000 died.

The leading business and current affairs magazine suggests that this could mean widening the vaccination programme, including to children, increasing surveillance and testing, and encouraging those infected to isolate and wear a mask while symptomatic. It also says failure to go further than this, while likely, “may have consequences” come the winter.