Photography by Simarik / E+ / via Getty Images
The numbers were grim. In December, after years of COVID-19 surges, St. Louis emergency departments were once again overloaded. But this time, it was a threefold convergence of COVID-19, influenza, and respiratory syncytial virus (RSV)—the so-called “tripledemic”—and area hospitals were strained. Dr. Robert Poirier, clinical director of Barnes-Jewish Hospital’s emergency department and a Washington University emergency medicine physician, says that in December, he saw flu cases doubling every week.
The really bad news? Poirier says it will take a few years before we see a milder flu season again: “That’s because, for the last two or three years during COVID, we didn’t see a lot of flu, and that’s because people were socially isolating and wearing masks, and the schools were out.”
It’s a concept called “immunity debt,” a term coined by French researchers in 2021. Immunity debt is caused by a “growing proportion of ‘susceptible’ people and a declined herd immunity in the population.” The longer the period of low exposure to viruses and bacteria, like the flu, researchers wrote, the bigger the debt, and the greater likelihood of a future epidemic, just as we’re seeing now.
Lower flu vaccine rates also account for an uptick in cases. “This year, we’re seeing people vaccinating at much lower rates [for the flu],” Poirier says. After living through the pandemic and undergoing regular vaccinations, people have “vaccine fatigue.” Plus, this year’s flu season came on atypically early. Usually, the flu season in St. Louis comes at the end of December and into January and February. This year, flu cases began appearing during the fall. “It hit us with a bang in October,” Poirier says. The result is a strain on St. Louis hospitals and emergency departments that were struggling to cope with cases of the flu, COVID-19, and RSV all at once. There have been four influenza-related deaths in Missouri this flu season.
Misinformation about the flu vaccine can also lead to people not getting vaccinated, but Poirier says that this year’s flu vaccine “covers the flu very well.” Getting the vaccine lessens your chance of getting the flu, and it decreases the likelihood of needing to go to the hospital if you do get the flu. But there are other things you can do to minimize your risk, and they’re familiar from the trenches of the COVID pandemic.
“Wear the mask. The masks are actually very helpful to prevent you from getting influenza,” Poirier says. “You want to get good rest, get exercise; treat your body well so your immune system stays healthy.”
Temperature Check
Feeling crummy? Here’s where to go to get care for the flu.
If you find yourself with the flu, it’s important to know where to go for care, depending upon the severity of your symptoms, so the St. Louis healthcare system isn’t strained further. If you’re having a mild case, you likely don’t need to go to the hospital. Here’s what the Pandemic Task Force advises.
Mild flu symptoms
Cough, sore throat, runny nose, body aches, headaches, or low fever or no fever.
Stay home, rest, drink fluids, and take over-the-counter medication.
Mild to moderate flu symptoms
All of the above plus a fever of 101 degrees or higher.
Visit your primary care physician or pediatrician, or go to a convenient care location.
Severe flu symptoms
Difficulty breathing, dizziness, lots vomiting and dehydration, or high fever or a 100.4-degree or higher fever in infants.
Visit the emergency department, where Poirier says, “we’ll check things out and get you on any treatments that are necessary.”
