Global circulation of influenza viruses in 2020
who.int
who.int
Here are the charts for 2019 and 2020 in the US*: https://imgur.com/a/HvBJoj2 (Note the axes are on different time scales unfortunately).
They are very similar with two major exceptions.
1. Week 13, about March 23rd, there is a dip lower, presumably due to the lock downs.
2. There was no activity throughout this spring and summer, but that's typically the case as the 2019 chart shows. 2020 is even lower (virtually no cases). While this could be due to lack of reporting, it could also be due to social distancing and masking.
We are currently in Week 44 of 2020. During week 44 of 2019 cases began to uptick slightly and then increased parabolically into the winter. We should expect the same in 2020. And this will be how we really know if flu testing is suppressed. Anyone claiming anything otherwise is speculating.
Anecdotally, my sister caught a bug recently that tested negative for COVID, and the physician suspected the flu. However, he couldn't test for flu since there was no capacity for flu testing.
I know your text describes this but it's easy to look at the graphs and miss!
This winter the number of deaths from COVID will be an order of magnitude higher than the deaths from flu on an average tear. So even if we attributed every sobgle death from flu to covid, it wouldn’t change the overall picture on Covid really.
We're already back to average death levels (maybe even below average if the recent provisional numbers hold up):
https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm
Click "percent of expected deaths" column to see.
We thought Covid was an order of magnitude deadlier than the flu, but it's looking more and more like that's not the case. Covid may have hit a large population of vulnerable people with weak immune systems at once, and is currently becoming less deadly as it spreads among younger, healthier populations.
Covid had the element of surprise in the spring, for both immune systems and healthcare systems. Going forward, unless it mutates into some hellish form, it's not likely to continue.
But from your link : is important to note that it can take several weeks for death records to be submitted to National Center for Health Statistics (NCHS), processed, coded, and tabulated. Therefore, the data shown on this page may be incomplete, and will likely not include all deaths that occurred during a given time period, especially for the more recent time periods.
Edit: from the asterisk on the page you linked: "*Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction and cause of death."
I grant that there is, in principle, a possibility that health authorities are wrong and that these rules are not necessary because the problem has been inflated as you said.
Also, there is the possibility that, in principle, the rules themselves are ineffective.
However, if the rules are wrong, that's even more so a problem of COVID is a real problem.
If COVID has been overinflated, then the problem is not that the rules are silly but that they are not necessary (and thus their negative sideffects are worse than the benefits).
Colouring the rules themselves as "silly" only reveals a bias in your argument and probably will reduce the effectiveness in communicating your point to those in a different echo chamber.
Not to the vast majority in every age category.
I personally had COVID and it was less severe than the last time I had the flu, so why should I treat COVID different than the flu or care at all?
> Are the current rules effective?
Not in liberal democracies, that's what the data shows. If you live in an authoritarian regime where people are willing to completely give up their lives then it is effective, but at that point you might argue are they still living or just existing like zombies? In all Western nations it didn't matter if one took more stringent or more lenient actions, everyone had a first wave, everyone has a second wave. Nobody invented a testing regime, a track and trace regime which allows us to live normally, so what's the point in taking those measures when they didn't prevent a second wave for anyone?
> Colouring the rules themselves as "silly" only reveals a bias in your argument
Fair point. Young generations have been taught for many decades now that we are not in this world together. Nobody pays off your debt. Nobody else will look after your health if you don't do it yourself. Nobody will come and provide you shelter when you become homeless. Look at the most woke state in the USA - California - every woke person walks past homeless people and couldn't are less. People who claim we are in this or in anything else together are selfish afraid human beings who want to control the population out of their own fear. The notion that we are in this together is wrong and that is the education that young people have been given for many years now. This is how it was in the last economic crisis, this is how it will be in this one too. So as far as I'm concerned COVID was nothing to me and my wife and it is not a threat to our family, so why should we care any longer about this? Other people's problems is not our problem. Just like every woke Californian walks past homeless people and doesn't care, I walk past the COVID death statistics and equally don't care. Why am I the villain now?
However, some of your assertions are not true. The COVID waves were vastly different in different countries across Europe, and despite Germany having elevated cases again and a second "Lockdown" the situation is nowhere near what it was in May. No constant Sirens from Ambulances (where I live), no overcrowded ICUs (some exceptions). Similarly, the lockdown proposed now is more lenient than a couple of months ago.
There is a definite talking point to be made about which rules are more effective than others and I personally would be more lenient than what my government proposes, but all in all we fared fairly well in comparison with our neighboring countries.
One point you made about a generation only caring about itself I can falsify immediately: The only reason why I am missing a basketball game with friends tonight is because I had an encounter with a positive covid case (my cousin). While I'm >99% sure I'm COVID free, I opted to argue on the internet tonight as some of my basketball peers are in a risk group (>60).
You're not the villain. I don't know you.
You picked some extreme examples. We are in this world together. It's called a society. It's unfair, it's cruel, it's skewed, but to imply everybody is completely on their own is disillusioned. Humans cooperate. Not always willingly, but effectively. This is how we prospered for millennia and occupied every corner of the globe. You're sharing your thoughts now thanks to cooperative work by countless people who built the information age.
Thinking you can lift yourself up from your bootstraps and only think for yourself is ignoring how interconnected the society where you live is.
Pointing out extreme cases where people put a limit to their compassion doesn't change the fact that you do owe your successes in your life also to the effort of others you have never met.
https://www.who.int/influenza/gisrs_laboratory/updates/flune...
Edit: now the title has been updated, it's more accurate
> The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic have influenced to varying extents health seeking behaviours, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States. The various hygiene and physical distancing measures implemented by Member States to reduce SARS-CoV-2 virus transmission have likely played a role in reducing influenza virus transmission.
But also:
> Globally, despite continued or even increased testing for influenza in some countries influenza activity remained at lower levels than expected for this time of the year.
[1]: https://www.who.int/influenza/surveillance_monitoring/update...
So it could very well be that many people died of the flu but were counted as COVID, we'll never know.
Why would a lack of COVID tests mess up the flu-tests that they're using?
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These flu-surveys are extremely important for designing next year's flu vaccine. There are hundreds, if not thousands, of flu strains, since that virus is constantly evolving. But the flu vaccine can only protect against 5ish strains.
Some strains (in particular: Flu TypeA) are known to spread much faster than others (ie: Flu TypeC). So even if TypeC is more common, maybe Flu TypeA is prioritized because of the risk of it becoming a pandemic a year out.
https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6937a6-H.pdf
“Initially, declines in influenza virus activity were attributed to decreased testing, because persons with respiratory symptoms were often preferentially referred for SARS-CoV-2 assessment and testing. However, renewed efforts by public health officials and clinicians to test samples for influenza resulted in adequate numbers tested and detection of little to no influenza virus.”
If anything, there's less testing for flu because of covid. But nonetheless, this is sampling, not testing, the WHO performs consistent randomized sampling over time to keep the data meaningful. If they just were based on testing of reported flu cases the data would be heavily biased and basically useless in tracking the disease.
From their fortnightly report of 28 October 2019:
"data to FluNet for the time period from 30 September 2019 to 13 October 2019. The WHO GISRS laboratories tested more than 102881 specimens during that time period. 5005 were positive for influenza viruses"
And of 26 October 2020:
"...from 28 September 2020 to 11 October 2020. The WHO GISRS laboratories tested more than 81257 specimens during that time period. A total of 172 specimens were positive for influenza viruses"
Looks like minimal deaths from flu during normal flu months in 2020 followed by a large spike (COVID). The spike appears at the end of the flu season, but the previous patterns suggest you should have been seeing excess mortality earlier if flu was bad this year, so my money is on minimal flu deaths.
The title on the page: “Influenza: FluNet Summary 26 October 2020
Source: Laboratory confirmed data from the Global Influenza Surveillance and Response System (GISRS).”
It‘s also possible that those who would normally participate in the Global Influenza Surveillance and Response System just weren‘t able to do what was normally done in a non-pandemics year. The page doesn’t present any explanation.
However given the supposedly very low base rate of flu during the current season, is it more likely from a Bayesian perspective that the Covid test was a false negative?
This year, for example in the North America region, there have been 26,000 samples for weeks 35 and 36. Around 40 positives.
Last year, 27,000 in the same period. Around 1,000 positives.
As I said in multiple posts already, the WHO tries to keep consistent sampling to keep the data meaningful. It's literally their job.
All speculation. But just a plausible explanation.
WHO sites keep consistent testing for patients with respiratory symptoms. The same way that some flu cases may be "hidden" because people stay at home, likewise some flus that wouldn't be tested otherwise will because the patient thinks it's covid.
In any case if some hide because there's a pandemic or WW3, it doesn't matter because other patients will be part of the sample. If there's flu it will be seen, pandemic ongoing or not.
You may be interested in reading the Global Influenza Surveillance Manual[0]. Relevant info is in chapter 6, regarding sampling, in particular 6.2, in which it recommends against testing all and only those that seek medical assistance.
> Ad hoc or convenience sampling
> Sampling schemes that do not adhere to a pre-determined system are the easiest and least costly to implement but are also the most subject to bias. Differences in the health- seeking behavior of different groups and preconceived ideas about the risk of health- care providers can introduce unpredictable biases, consequently yielding patterns in the data that do not represent reality. While this approach may still yield data sufficient to identify transmission seasonality, and provide specimens for virological surveillance, it will not provide a reliable picture of the epidemiological characteristics of influenza or burden and should not be used if these are the objectives of the system.
In 6.4 it describes the systematic sampling strategies recommended, which remove the bias of the point you (and the other commenter) raised.
As described in 6.3, random sampling would be best, but also too expensive for tracking, and is only to be done by WHO sites performing some research where it would be needed.
https://www.who.int/influenza/resources/documents/INFSURVMAN...
Next part, since the focus of 2020 was Covid testing, I'm pretty sure flu testing resources were lessened in the process, if not borderline ignored.
At what point was it okay to judge a population on 0.0000001157142% sample size?
While I'm not a fan of the WHO anymore, to be fair to them, where the hell do they say the flu disappeared? This title is disingenuous.
If you want to evaluate quality of a sample, that's an entirely different issue. You may want to look up different sampling methods.