“The Problem Child of Seasonal Flu”: Beware This Winter’s Virus | Hacker News Reader

“The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

scientificamerican.com

120 pointskatiey103 comments

Personal anecdata about this flu season.

I got the flu shot. My spouse did not. They ended up getting the full-blown flu with 103 degree fever and a positive flu test at the doctor. I, on the other hand, felt kind of crappy but I wasn't knocked on my feet and my temperature was normal the whole time. I asked our doctor if I essentially had a milder version of the flu because I got the shot and he said that was basically the case.

So get your shot! Get your shot for herd immunity, get your shot to (apparently) stave off the worst of the virus, get your shot, get your shot.

You're correct. Basically what happens is your body still gets primed for some type of flu and produces antibodies. The predominant circulating strain H3N2 is genetically a bit different than the vaccine strain of H3N2. So even though you don't have exactly the right antibodies, you still have some that can recognize the circulating strain and can start the response a bit earlier than someone with no antibodies.

As a counter anecdote, I got the flu shot and still ended up out of commission for 4 working days + a weekend of recovery.

Still get your flu shot as it helps prevent spread and probably saved me a trip to the hospital. But don't expect to be immune.

Same thing. Got the shot. Got the flu. It was annoying but didn't need a trip to the doctor or hospital.

A friend without shot who got the flu at the same NYE party as I did ended up needing to go to the doctor to get tests and tamiflu.

Interestingly, the doc was able to test for the specific strain (#2) and they were also entered into a national database.

Similar anecdote here. Everyone living in our house got the shot, with the exception of the newborn infant who was too young to get it. The infant was the only one who got the full-blown flu (very scary, but they are fine now). Everyone else who had any symptoms just got a case of what seemed to be a bad two day cold.

I've heard differing opinions as to whether the shot really helps cases be less severe if you do get it, but I've heard a lot of similar stories recently.

I just wish that people who get infected would wear a freaking mask when going out in public. I've heard that masks don't do much for people who aren't infected, but I imagine a mask would catch a lot of the droplets that come out of someone's mouth when they cough.

I've never been more glad to live alone.

The catch to this is there is substantial reason to believe that non-exposure can actually make you more subsceptible later on, so it’s better to just get the flu to stay on pace with antigens for future strains.

Does the flu vaccine count as exposure?

that is exactly what the vaccine is. exposure to a inactivated flu virus.

then, lots of research and crossed fingers that hope any flu's you are exposed to are the ones that you vaccinated against.

That may be true for many people, but what about young children and the elderly?

> The catch to this is there is substantial reason to believe that non-exposure can actually make you more subsceptible later on

Don't flu shots work by giving you a mini-flu?

Only the nasal spray flu vaccines contain live virus.

The CDC is recommending against the nasal spray this season, so chances are you'll get a shot, which contains only dead virus, which can't cause anything you'd describe as "mini flu" as a result.

https://www.cdc.gov/flu/about/season/flu-season-2017-2018.ht...

The nasal vaccine has been deprecated for a long time now, I'm not sure you can get it anywhere ATM.

The flu shot seems to put me a bit under the weather for a couple of days after I get it. I don't have the flu, but I'm not 100% either.

Have there been studies that show the masks are effective? I'm just curious is all not trying to knock you down.

https://www.hsph.harvard.edu/news/features/face-masks-flu/

> McDevitt and his colleagues screened 89 volunteers, 37 of whom tested positive for the flu and were asked to provide exhaled breath samples with and without a surgical mask. Among the volunteers, 43% exhaled large influenza-containing particles while not wearing a mask, compared to 11% while wearing a mask; 92% exhaled small influenza-containing particles while not wearing a mask, compared to 78% while wearing a mask. In addition, they found that the flu virus was 8.8 times more numerous in exhaled small particles than in large particles.

From what I understand that suggests that surgical masks are only slightly effective. But that study only tests surgical masks that don't filter particles less than 0.5 microns, and not N95 masks which can filter out particles as small as 0.3 microns.

http://www.cidrap.umn.edu/news-perspective/2012/04/lab-study...

> A US-Chinese team of researchers created a simulated examination room with mechanized mannequins spaced 6 feet apart to represent coughing and breathing humans. They found that flu viruses floated between the two and were "inhaled" by the breathing mannequin, but that an N95 respirator sealed to the mannequin's face stopped 99.8% of them.

If that's accurate, it's pretty incredible. Out of paranoia I've sometimes worn surgical masks for viral transmission to the office during flu season, but it looks like I should be visiting Home Depot instead of Walgreens.

I've heard (and seen) that in JP, people wear masks to protect other people from sickness. That said, I don't think I've seen an example of a debilitatingly sick person wearing a mask; only their caregivers wear masks. A seriously sick person has no ability to receive the training and certification to wear an N95 mask.

Besides infected people are contagious before they're symptomatic so no one would know to suggest they wear a mask. Early warning nasal swab? Pillow mounted HEPA filter? I'm not sure we know about enough about transmission to really understand how to prevent it...

"A seriously sick person has no ability to receive the training and certification to wear an N95 mask." What does that mean?

In the state of Georgia it's actually illegal to wear a mask in public/on private property without permission. I think they consider it a security concern, which makes sense in some situations. But really sucks for trying to not spread sickness. On the plus side, I've noticed a lot of doctor's waiting rooms have a sign saying you can ask for a mask if you have XYZ symptoms. But I wish it was common at work, too. For the same reason I wish handshakes weren't so common in business. I'm pretty sure I know the exact moment the flu was passed to me this year.

"(a) A person is guilty of a misdemeanor when he wears a mask, hood, or device by which any portion of the face is so hidden, concealed, or covered as to conceal the identity of the wearer and is upon any public way or public property or upon the private property of another without the written permission of the owner or occupier of the property to do so."[1]

[1] https://law.justia.com/codes/georgia/2010/title-16/chapter-1...

This article is good and reminded me of a key issue: herd immunity. I wish I could explain to more of my friends how irresponsible it is to not get the flu shot - they view it as simply an individual decision like "I'm choosing to not get the shot knowing full well I might get sick" - but they don't think of the possibility that if they do get sick, they may play a part in infecting other, more vulnerable people, such as a grandparent. Even though the vaccine isn't that effective this year, as long as it's at least somewhat effective in mitigating transmission, it's worth it.

>"Even though the vaccine isn't that effective this year, as long as its at least somewhat effective in mitigating transmission, it's worth it"

How can you tell if something is "worth it" without considering any costs (side effects, price, time, etc)?

I suppose if it's only 0.001% effective it would not be worth it, but that's really a pedantic nitpick because we know it's not that ineffective.

The vaccine this year is about 32% effective against H3N2 in the US and 39% effective overall [0]. That's not amazing but it's definitely "worth it" for a few dollars and 5 minutes at a CVS.

[0]https://www.cdc.gov/flu/about/season/flu-season-2017-2018.ht...

Basically your argument is that the costs of getting the vaccine are so negligible they can be ignored?

What about side effects? https://www.cdc.gov/flu/protect/vaccine/general.htm

Yes, they exist and aren't that common/severe. I mean at the end of the day it's a personal decision and if you're already unhealthy I understand why you wouldn't want to get the side effects. The problem is one of ignorance: people don't even know what herd immunity is and why it's important. In my opinion the side effects pale in comparison to the effects of getting the flu and are not a big "sacrifice" to make whatsoever - but you need to understand the importance of herd immunity to make a truly informed decision

I'm not going to continue replying to this conversation because I can sense that it's going to become unproductive

Ok, but besides my main point (regarding doing a cost benefit analysis), from your comments I doubt you understand herd immunity, and probably should not be attempting to teach others about it...

If the virus is too infectious you need very high rates of immunization for it to work.

https://en.wikipedia.org/wiki/Basic_reproduction_number

Most of the time those R0 values assume "well mixed populations" (any one person is just as likely to contact any other person) amongst other things, so don't take them too seriously. However, the basic idea that you don't automatically get herd immunity is simple enough. Eg, just what I found quickly on the topic:

>"Whether vaccination of healthcare personnel can lead to a herd effect reducing laboratory-confirmed influenza among patients is still inconclusive. Pooled data from a Cochrane review of 3 cluster randomized controlled trials showed no reduction of laboratory-confirmed influenza (OR 0.86, 95% CI 0.44–1.68; p = 0.66), lower respiratory tract infections, admission to hospital (OR 0.89, 95% CI 0.75–1.06), and deaths from pneumonia (OR 0.82, 95% CI 0.45–1.49) in patients when healthcare personnel were vaccinated [35]. However, given that mathematical models suggest a herd effect [36], more rigorous studies need to be conducted." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171704/

Yep, all you have to do is review the government statistics on vaccine injuries to see the list of all the people who got GBS from the flu shot

https://www.hrsa.gov/advisorycommittees/childhoodvaccines/Me...

I wasn't really thinking about GBS, but that is one of the more severe possible (but rare) side effects. Most people (everyone?) feels under the weather for a few days after a flu shot.

All I had to do was take time out of my day to go to the pharmacy, copay with my insurance was $0. Which just makes sense from a financial point of view for the insurance companies, too.

This gives an inaccurate assessment of the cost. Obviously you are paying for the shot by paying more for insurance (either directly or via taxes or via taxes spent on that rather than some other government service you could take advantage of).

My point is that you can't say something "is worth it" without considering both costs AND benefits (I have recently seen friends get so ill they almost got fired because doctors ignored the side effects of prescriptions). Also, costs aren't zero just because they were prepaid or deferred.

> Obviously you are paying for the shot by paying more for insurance

Wrong calculation. The insurance company is trying to SAVE expenditures of doctors and hospitalizations; therefore, customers getting the flu shot cost the insurer less. Even further for herd immunity (the pt), 1 insured getting the flu shot might reduce 4-8 others from getting the flu.

And in the case of workplace or family, are likely covered by the same insurer. There's probably some patient n with diminishing returns for the modern tech workplace, where, if they live alone, commute alone, visit no family, and have no onsites.

>"The insurance company is trying to SAVE expenditures of doctors and hospitalization"

Interesting point (not sure how far down a rabbit hole this can go...), so you are claiming that the introduction of flu shots has reduced insurance costs? Is it even possible to assess this or are there just too many confounds?

Just did a quick google https://www.news-medical.net/news/20110614/Universal-influen...

That model is from 2011 and it looks like they made some predictions. How accurate did it turn out?

As you indicate, it's a model and based on the predicate of 100% immunization. It can't "turn out" until everybody is immunized. Also, like I said, quick Google, perhaps you can find something more relevant for your questions and share it.

But it does objectively suggest that immunization is economically cheaper for insurers, with and without 100% immunization rates.

Well, the reason I am somewhat incredulous is that health insurance rates have only risen as more and more people get vaccinated. Perhaps it is cheaper for the insurance companies but they are not passing this along?

Obviously, there are many other factors in play as well but I don't think anything has been "objectively suggested" just because someone created a model that hasn't been (and probably will never be) tested.

Health insurance rates have a number of factors to consider, the least of which is a flu vaccine given by your corner pharmacy by a Physician's Assistant.

Getting the flu, or having a more severe case of the flu increases your chances of 1) going to see a real doctor instead of a P.A 2) being mis-prescribed antibiotics 3) emergency room care 4) Torts originating from severe disease while in a Doctor's care

It's the opposite -- the insurance company saves money by having people get the flu shot:

1 flu shot reduces probability of flu to ~70% of what it was before.

0.7 * Cost to treat average flu case + Cost Flu shot < 1.0 * Cost to treat average flu case

Insurance companies have pretty good stats underlying that sort of decision. At CMU this year, they were paying you to get a flu shot (in the form of a $5 gift card, with the flu shot being free).

One strange thing about this thread is all the people equating the net cost to the insurance company with the cost to themselves. I don't normally come across that attitude, usually the insurance company is perceived as an adversary you need to fight to get the deserved coverage.

The world is more complex than that. Many (probably every) large organization/industry does both good and bad things.

Insurance, ultimately, is a way of sharing risk. Even more abstractly, it is about aligning interests. I think this is one part of why people get so upset with insurance when there is dispute - it feels a little like a betrayal.

I'm not really talking about health insurance in the abstract, but rather the current implementation (which seems very shady to many people).

I doubt current insurance companies care whether you get the flu or not. They just care whether you go to the doctor for it, eg if enough people think "It must be a cold" and self-medicate that works for them.

You should consider costs. This tradeoff is a large part of what the field of epidemiology studies. Turns out vaccines don't need to be that effective to be worthwhile, because of the way disease spreads. There's this concept of a "reproduction number" (r-naught) that predicts how many people a given infected person will pass the disease to, based on a combination of the virulence of a disease, how long infected people remain contagious, how much contact people have with each other, etc. The flu often has a value of around 2, meaning the average infected person will infect two others before they're over it.

You can use this number to estimate how fast a disease will spread, how likely it is to be successfully contained, or in the case of seasonal diseases, how many people will get it before seasonal societal changes (school getting out, people spending more time outside, etc.) will effectively curtail transmission for the year.

Looking at a vaccine on an individual basis, if it's only, say, 50% effective, that sounds pretty awful -- maybe almost not worth the bother. But on a society-wide basis, if every person were vaccinated, that would effectively knock the R0 value from 2 to 1, which is huge. Transmission is exponential: if you infect two people and they infect two people and they infect two people, etc., the total number of infected looks dramatically different than if everybody only infects one person. So in isolation it's only 50%, but societally, with high vaccination rates, there's a huge multiplicative effect that has the potential to dramatically reduce each person's risk of infection if vaccination rates are high enough. And that's still true even if it's even less effective than 50%, and has all sorts of economic and social consequences.

>"The flu often has a value of around 2, meaning the average infected person will infect two others before they're over it."

The R0 value refers to the potential for infection (ie in a 100% susceptible population it would be what you wrote).

>"But on a society-wide basis, if every person were vaccinated, that would effectively knock the R0 value from 2 to 1, which is huge. Transmission is exponential: if you infect two people and they infect two people and they infect two people, etc., the total number of infected looks dramatically different than if everybody only infects one person."

I just wrote a little SIR model and did not see this behavior. Depending on the parameters either 100% of the susceptible population was eventually infected, the infection died out quickly, or, if turnover was high enough (eg birth/death/viral mutation leading to a constant stream of susceptibles), there was a cycle and about the same number of people got infected either way.

Do you have a source for this behavior so I can see the details of the model?

Doesn't that just raise the question of why an at-risk elderly person wouldn't get the flu shot to protect themselves from all the people who don't? I've heard this irresponsibility argument a lot, I understand it, but I think it's overblown. Herd immunity works best when the vaccine is actually effective. For flu vaccines, every year they're not very effective.

Even if they do, since the vaccine is not 100% effective it still helps if other people are vaccinated since it decreases the chance of them getting it in the first place.

The vaccine is still >30% effective. And you may be confused regarding how vaccines for things like the flu work: they have varying efficacy against different strains but getting vaccinated for a certain strain does not at all mean you won't get sick with that strain - it reduces the likelihood.

Imagine all the people in the world as a graph with weighted edges representing the probability of one person transmitting the flu to another. The more people become vaccinated, the less the weights of the edges, and the less people get sick overall.

Sure, I'm not disputing that flu vaccines suck compared to vaccines for other things. I'm just disputing that "irresponsibility" is a poor argument against those who decide not to get one, given that the flu vaccines suck, and given the greatest magnitude intervention for an at-risk person ought to be getting the vaccine themselves no? (If you wanted to make a stronger argument for irresponsibility, I think you'd need to provide some actual numbers. Raising or lowering the likelihood doesn't mean much without knowing the magnitude and what the base rates are. After that one could attempt to translate it into a measure of irresponsibility, but that's probably where most of the less productive arguments would happen, including what-about comparisons to other choices that may or may not have much greater impact magnitude like not coming to work while feeling sick, so there's still not much point to the exercise.)

Think of it this way: If the vaccine is, say, 30% effective, then a single person vaccinating themselves will bring their risk down by 30%. But if there are N people between that person and patient zero, and all those people are vaccinated, the risk is brought down by 1-0.7^N.

For the virus to propagate through a chain of 3 vaccinated people that comes out to 66%, an effect more than twice as effective as that of just the person getting the vaccine themselves.

(It's more complicated than that, especially since getting the flu isn't binary, but it should give an indication of how the effects scale.)

> For the virus to propagate through a chain of 3 vaccinated people that comes out to 66%, an effect more than twice as effective as that of just the person getting the vaccine themselves.

Is this true if the vaccine is ineffective against the strain which is circulating or is the effectiveness of the vaccine partly chance? Genuinely curious.

Not nitpicking or trying to be an idiot but shouldn't it be the vulnerable individuals that get the shot?

It seems that the only people I know who get vaccinated for something as benign as the flu are: nurses, teachers, children, elderly.

Everyone else simply take one or two day off during flu season in the event that they do catch it (most don't).

Am I missing something? I have never been vaccinated for it and asking around me, nobody at my current place of employment did either.

https://www.cdc.gov/flu/protect/whoshouldvax.htm

> Children younger than 6 months are too young to get a flu shot.

> People with severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine. This might include gelatin, antibiotics, or other ingredients. See Special Considerations Regarding Egg Allergy for more information about egg allergies and flu vaccine.

Vaccines aren't perfect - you can get vaccinated for certain diseases/strains (such as the flu) and still get them. It's the aggregate of vaccines that stops transmission and prevents disease outbreaks. That's what a lot of people (including other people that replied to my comment) don't understand about vaccinations - they reduce the chance of acquiring a disease. It's still entirely possible to get vaccinated, spend a lot of time around infected people, and get sick.

The entire point of herd immunity is to make disease less likely to spread between individuals so that outbreaks don't occur in the first place. Even though the vaccine this year is less effective than normal at preventing the spread of flu, it's still pretty effective, and in a way that means that collectively it's more important to get vaccinated this year.

Some nontrivial percentage of the time, though, the vaccine doesn't take, and this becomes more likely in immunocompromised people (e.g., the elderly). Those people might end up protected from ending up getting infected even though the vaccine won't end up helping them if the people they interact with are also vaccinated and had better luck.

As for nobody at your place of employment getting vaccinated: these days that seems pretty surprising to me, but maybe it's a regional thing or something? My office brings in a nurse to do everybody at once.

Evolution has provided viruses with an incubation period - the time required for the virus to develop in the host - during which you don't feel sick but you can be spreading it to the others.

It seems like healthy people that tend to power through the flu are the ones most prone to spread it far and wide, especially to those most vulnerable.

The flu is a little bit more than a slight inconvenience. I've had it before and felt horrible for 3-4 days. I'd gladly pay $30 per year for a 30% lower chance of experiencing that again.

As someone who didn't have any kind of health insurance growing up, and had both parents working for hourly wages, I would like to add that it is a little more complex than "irresponsibility".

My working-class parents would have certainly felt the impact on their budget spending ~$50/person for a shot that might not even work that year, not to mention the money lost by not working to go get the shot.

I think people should get their flu shots, but am a bit more hesitant to judge those who don't.

Under the ACA, the flu shot is free (no copay/deductible), and everyone's supposed to have insurance. Cost should be a substantially lower issue than in the past.

There are over 27 million uninsured people in the U.S.

Yes, which is down by half (plus the folks whose insurance didn't cover it pre-ACA), hence "substantially lower issue". That leaves 300 million people for whom cost is not a good reason to avoid it.

tell me about it. This year my entire house got flu at the same time and, ten days after my fever is gone, I still feel a little down. I have no idea how my kids really feel but my kid has a nasty cough and the other one seems a little "off/tired".

On the bright side, hopefully it was an H3 variant and this is your kids' first flu so they will be imprinted/more resistant to it in the future as mentioned in the article. As a 50 plus year old, this was the sickest I've felt in at least 30 years.

Out of curiosity, have you taken Vitamin D supplements before for a longer period of time? If yes - what was the daily dosage ? Have you taken flu shots at the beginning of the season?

What would the relationship be between Vit D and this (or any) flu?

As I understand it - many people in the northern hemisphere are Vitamin D deficient and that can lead to suppressed immune function.

There was a study linked on HN related to an error in Vitamin D dosage recommendations. Original article:

https://www.ncbi.nlm.nih.gov/m/pubmed/28768407/

Vitamin D is relevant to proper functioning of immune system, however it seems that it is hard to find "the right amount" for everyone as it depends on several factors.

I'm wondering if Vitamin D intake can improve response against recurring infections like flu, sometimes they can bring you down several times in a season, so it takes quite a heavy toll on productivity and mood.

I'd love to know the answer to this, if there is one.

Anecdotally: I have seen a couple studies pop up recently talking about how daily value of vitamin D has been wrong for a long time. This makes me think taking vitamin D might be the new fad medical thing to do, kinda like how going gluten free was the big thing a couple years ago.

For transparency I have not read all of these but they all have popped up recently: https://news.ycombinator.com/item?id=15867918 https://news.ycombinator.com/item?id=16062697 https://news.ycombinator.com/item?id=15877289 https://news.ycombinator.com/item?id=15687217

Except that in this case you can just go to your doctor and get your vitamin D level tested. Then you adjust your dosage as needed to reach the recommended blood concentration. Adequate vitamin D levels are the subject of a little controversy [0], but I don't think it is a fad to consider that people need a certain level of vitamin D.

[0]https://www.health.harvard.edu/blog/vitamin-d-whats-right-le...

Alternative thoughts on adequate vitamin D: https://www.vitamindcouncil.org/i-tested-my-vitamin-d-level-...

There have also been randomized controlled trials of Vitamin D vs placebo measuring flu rates. This is one meta-analysis I found: http://www.bmj.com/content/356/bmj.i6583

There's an hypothesis, which conceptually makes sense though not sure how proven it is, about why flu season is Jan/Feb - March/April.

Basically during Fall as the amount of sunlight drops our bodies vitamin D, for which there is clinical evidence that it helps with immunity, drops leaving us more susceptible to infections leading to the overall flu season starting in Jan/Feb time frame. As the sunlight picks up, vitamin D increases and flu season tapers off.

Do you have more info about that hypothesis? I always thought that the usual explanation was simply that people are inside buildings and cars (and thus around other people) more often when it is colder outside.

https://www.medicalnewstoday.com/releases/51913.php

Not the OP, but my whole family also caught this flu (type A) during Christmas week, followed by bronchitis. We've had coughs for going on 3-4 weeks.

I take 2,000 IUs of extra Vitamin D a day and we all got the flu shot in September. From what I've read, this year's flu shot is largely ineffective.

This is a brutal flu. If you catch it, stay home and get rest.

I got both, the flu (type A) and the strep throat a few weeks ago. I started taking Vitamin D after that. During the weekend I started feeling bad and I thought I was going to catch something. I am doing fine.

Edit: I am taking 5,000 units daily. Didn't have the flu vaccine this year.

Worst medical study ever.

Should I abandon any hopes of winning the Nobel in physiology any time soon ?

In my defense the parent comment was asking for anecdotal evidence.

I've taken a regular multivitamin (same with the whole family) but now that I am in recovery I have added a D and C

My wife and all of my children are dealing with the flu right now, too. It's the first time my kids have caught it, and according to this article, maybe there's a silver lining...

I had a B strain last February, which was the sickest I've ever been. I got the flu shot this year (quadrivalent vaccine, though apparently not very effective) and I take at least 5,000 IUs of vitamin D every day (though I've upped that to 10,000+ IUs since my family got sick last week). I'm not sick yet this time around. Hoping against hope...

Ya this, for years I didn't know what getting the flu really felt like, it was always couples days and I'm fine but in 2016 I got the flu and it wrecked me for 2 weeks. Doctors confirmed it was the flu. Now I'm the first one in line for a flu shot every year.

I had the asian flu when I was very young (1957 I think). I was so sick as was my mother. I remember it. So far only my youngest daughter (she is 19) got the flu this year. She is better. We all had the shots. I'm carrying a paper towel to open doors with and washing my hands a lot.

take care everyone

> H3N2 is especially hard on seniors

Luckily, we here at Trend Co. (YC Winter 2016) openly discriminate against seniors to such an extent that we employ none at all, so our trendy open office plan won't be nearly as big of a health hazard as it would normally be.

Last year's flu was horrible. My family in MN was still having lingering effects about 4 weeks after the initial sickness. My Dad and brother's stomachs kept acting up. Many a day, they ate only toast.

This looks promising: https://www.cnn.com/2018/01/18/health/flu-vaccine-design-stu...

Any actual numbers for how much worse H3 is vs H1 in general? I know the question isn’t quite so simple as mortality rates change over time after a new strain emerges and starts circulating. But TFA seems to be devoid of any actual quantitative data to backup its thesis.

I'm in the southern hemisphere (NZ) and I got it after new years, It's the first time I've ever had the flu during summer.

I got the flu shot late last year, but it didn't help much against this strain. I'm just getting over it now. It's a quite a nasty cold.

Australia seemed to be first to point out a vaccine mismatch in the 2017 season, which seems to have translated north to our 2017-2018 season.

http://www.virology.ws/2009/06/02/pathogenesis-of-influenza-...

To keep your coworkers from getting the flu, go home as soon as you think you might be coming down with something. The amount of virus you are shedding into your environment is nicely exponential in how bad you are feeling, with one exception: The day before you start feeling really bad, you are shedding nearly as much virus as when you are feeling worst.

If you have to choose, it's better to go home early and come back before you are feeling 100%, than it is to stay at work until you are certain you are sick and stay home longer. It's always better to shift your sick days earlier in the illness.

This is all true, but sadly not going to work is only an option for the more privileged in the USA.

A waiter paid minimum wage + tips struggling to pay for cost of living/child care/debt/medical expenses/etc is likely to go to work anyway, putting the health of potentially hundreds of people at risk.

EDIT: 1 hour later, currently sitting at -1 - if you disagree so much that you feel the need to downvote, please explain why - I am genuinely curious!

Very true - this argument helped pass mandatory sick leave entitlements in Seattle recently (I think it just came into effect).

Unfortunately no mandatory sick leave will affect the majority of workers who are contingent, temporary, or otherwise even more at risk of losing pay and firing if they(we) go home sick. I had H3N2 last week and I came to work because I was told I risked being fired if I didn’t. Everyone in the office hated it but I didn’t want to lose my job.

Sometimes even the privileged won't have this option. I get 6 sick days a year, accumulating 4 hours a month. I have a young child in school, so I'm not sure I've ever managed to hit 3 days...

Pretty sure I had the flu last week. Still showed up because I don't want to blow any of my precious 2 weeks vacation time. Got it from my coworkers anyway, who are probably thinking the same thing.

Would take a pretty big shift in US work culture to change any of this.

Also worth noting:

Please do NOT come back to work just because taking medication made you feel better. Too many people load up on daytime meds and show up to work exposing their co-workers needlessly to their illness. Don't be that guy, seriously.

The regime I recommend to everyone since it has worked for me for years (whenever I do get sick enough to 'take stuff')...

Standard personal care applies. Hot showers are nice for getting clean and steaming out the lungs. Plenty of water, simple food to that's easy to digest.

Rest in bed or bundled up and watching TV or something if not sleepy.

To promote better breathing and deal with drippy ickies...

Go to your pharmacy, ask them how you get the REAL cold medicine that you've heard you need to show ID for.

https://www.explainxkcd.com/wiki/index.php/1618:_Cold_Medici...

There are two drugs worth considering:

Night time (an hour or so before you want to pass out from exhaustion):

What used to be maximum strength over the counter Sudafed http://en.wikipedia.org/wiki/pseudoephedrine

Sudafed has stimulant properties, they're an unwanted side effect but if you're REALLY sick you should be able to lay in bed for a bit breathing well and slip off to sleep; I suggest it before bed ONLY, since it tells the body to stop making mucus which allows for a good night's sleep without filling the lungs back up.

Day Time (take with your first meal (literal break-fast(ing))):

Under many brand names (often Mucinex) https://en.wikipedia.org/wiki/Guaifenesin promotes coughing up the stuff that is clinging to the lungs. Be ready to deposit the results somewhere sanitary.

Can't begin to tell you how many people I've met that think they're longer contagious because they have symptoms now.

"go home as soon as you think you might be coming down with something"

I wish. I just can't do that. To quote The Faculty "I'm saving my sick days for when I feel better" When your only vacation for the year hinges on working while sick, you'll choose to struggle through it.

I wish it was culturally acceptable to wear a hospital mask in public in the USA. I do it anyway and look like a weaboo or something, but still.

I wish it were culturally acceptable to let send people home or for people to stay home when they are sick in the US. I hate seeing people come to work sick because they don't want to be perceived as "weak" or a "slacker". It also seems especially prevalent in people who think that they are high achievers.

Since SARS in Toronto, it's become more and more prevalent, especially among Asians. I was in high school at the time, and we used to make fun of people wearing these masks, and how crazy they looked.

Now in my older and wiser years, I realize that they were probably the smart ones!

In my experience people from Asia bring the culture with them, which might explain why it seems ethnically Asian people are wearing the masks more - they might just literally be Chinese or Japanese people, among whom it's totally normal.

We've been through that, vaccine manufacturers marketing, I don't remember having flu - because I've never been vaccinated on anything.

RIP the sick, elderly and very young that you interact with.

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