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Flu season in Dallas County turned out to be mild, despite recent omicron surge

This story, originally published in The Dallas Morning News, is reprinted as part of a collaborative partnership between The Dallas Morning News and Texas Metro News. The partnership seeks to boost coverage of Dallas’ communities of color, particularly in southern Dallas.

February is one of the worst months for the flu. Health experts say people should still get the flu vaccine and take other steps like wearing a mask and working from home.

CVS Pharmacy
A CVS Pharmacy in the 8000 block of Walnut Hill Lane in Dallas advertises Flu and COVID-19 vaccinations, Monday, September 20, 2021.(Brandon Wade / Special Contributor)

By Catherine Marfin

Throughout the pandemic, health experts have warned of the disastrous impacts from a severe flu season coupled with a COVID-19 surge on an already overwhelmed health care system.

And although people for some time feared “flurona,” or getting the flu virus and COVID-19 at the same time, health experts say it’s been a relatively rare occurrence.

So far this year, Dallas County has had a mild flu season despite the rapid spread of the omicron variant of COVID-19 over the past several weeks. County and state trends mirror what’s been seen across the country — nationally, only 2.6% of all influenza tests since Oct. 3, 2021, have come back positive, according to the Centers for Disease Control and Prevention.

But how can the flu virus be so low when omicron was surging? Here’re some questions, and answers from the experts.

How does this flu season compare to others?

Flu season typically begins in October and peaks between December and February, according to the CDC.

Dallas County ran just under 47,000 tests for the influenza virus between Sept. 26 and Jan. 29, and a little over 800 — or just under 2% — came back positive, according to county data. Only one adult death has been reported to date.

Those numbers are higher than what was recorded during the same time period in the 2020-2021 flu season, but it’s hard to say by how much, said Dr. Philip Huang, director of Dallas County’s health department.

During the 2020 season, the number of flu samples being tested or coming back positive were so sparse that the county did not compile regular influenza reports.

“At that time we had so many infection-control measures in place with people teleworking, distancing, masking,” Huang said. “The things that slow down the spread of COVID then slow down the spread of a flu. … There’s an element of that this year.”

But the numbers are still significantly low when compared to pre-pandemic seasons. With the exception of last season, the county had recorded more positive flu cases each season since 2016, according to available county data.

Statewide, flu reports show a similar trend. Across Texas, 148,022 total influenza tests were run between Oct. 3, 2021, and Jan. 29, and about 3.6%, or 5,339, came back positive, according to state data.

That’s fewer positive tests than were reported statewide during the same time since the 2017-2018 season. The only exception is the 2020 flu season, when only about 680 people tested positive for influenza.

When omicron was surging, why was flu activity low?

It’s possible that omicron is even more contagious than the influenza virus, said Dr. Grant Fowler, family medicine department chair at TCU School of Medicine in Fort Worth and chairman of the family medicine department at JPS Health Network.

“I think omicron is probably more contagious than the flu,” he said, “and I think people are just really hopefully trying to prevent the omicron.”

Health experts say disease mitigation measures that were common during the 2020 flu season, like mask-wearing and opting for outdoor gatherings, are still common enough to tamp down the spread of flu.

“Many people still are not acting the same way they did pre-COVID in terms of getting out in crowds and wearing masks,” Huang said.

Face masks, Fowler said, can provide more benefits aside from their effectiveness in stopping the spread.

“One of the things that masks prevent you from doing — if you do have symptoms or a virus — is you don’t touch your nose with your hands [after touching] metal where the virus could stay alive for a while,” he said. “That may be part of the benefit of the mask — not just preventing the virus coming out through the mask.”

Fowler said it’s also possible that the population as a whole has more immunity from flu viruses that have circulated in past seasons. Past COVID-19 infections provide people with some natural immunity if they get re-infected, and the same can happen with the flu.

“The flu strain from two years ago, it was way worse than both of these years,” he said. “Maybe it’s going to protect us a little bit.”

This year’s flu vaccines may be more effective

Flu vaccines are only about 40% to 60% effective each year.

That’s because each year’s vaccine is made to combat the flu strains that researchers predict will be most common in the U.S. based on which ones are circulating in other parts of the world, health experts say.

Booster shots against COVID-19 were recommended for all adults in mid-November — roughly around the same time that people were getting a flu shot — so it’s also possible more people got flu shots when they got their boosters.

“We might’ve been on target better than before,” Fowler said.

Fowler said he still encourages people to get a flu shot if they haven’t. February is typically one of the worst months for flu activity, and it can circulate well into the spring, he said.

“I still would encourage everybody to get the vaccine,” he said. “I still would encourage everybody to get the COVID-19 vaccine or boosted if they haven’t.”

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