Why experts are worried about the looming flu season

During the height of the COVID-19 pandemic, cases of the flu almost disappeared. However, evidence now suggests that the tricky disease is making a comeback with more cases than would be expected this time of year. Here's everything you need to know about the 2022-2023 flu season:

How is flu season looking this year?

The White House has already predicted a rise in COVID cases during the upcoming holiday season and since September, experts have also warned that we may experience a "twindemic," or an increase of influenza alongside a simultaneous COVID-19 spike.

For the past two years, cases of the flu have been down, likely due to the precautions people took to prevent the spread of COVID-19, The Associated Press explained back in February. However, there is evidence to suggest that the flu is on the rise once again. Australia — where the flu season runs from April to October — experienced its worst flu season in five years in 2022, a likely indicator of what's to come for North America, where the flu season runs from October to May, peaking between December and February, CNN reports.

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According to the Centers for Disease Control and Prevention (CDC), the southeast and south-central parts of the United States have already begun to see an uptick in flu cases, indicating that the start of the season is picking up sooner than anticipated. Since doctors are not required to report every positive case of influenza, the CDC instead monitors possible flu activity by looking at influenza-like illnesses (ILIs) characterized by a fever of at least 100 degrees Farhenheit and a cough or sore throat, NBC News reports. Following this metric, high levels of ILIs have been reported in Georgia, Texas, South Carolina, and Tennessee. New York City and the District of Columbia have also reportedly had a large number of ILIs.

The CDC has expressed concern over the low flu vaccination rate due to the pandemic.

Why is the flu picking up again?

Two main reasons the disease is posited to be more rampant than usual are the ease-up of COVID restrictions and a lower-than-average vaccination rate.

The ways to prevent the spread of the flu along with a number of other ILIs are almost the same as the ways to prevent the spread of COVID. For that reason, the U.S. saw just 646 flu deaths during the 2020-2021 flu season when averages would usually be in the tens of thousands. As restrictions on distancing, masking, and travel were lifted, viral diseases started to resurface, and at non-peak times, Nature reports. For example, the common cold saw a resurgence in spring 2021, which is an unusual time for that disease to spread.

The CDC has also attributed the rise in viral infections like the flu to schools reopening without restrictions and the susceptibility of infants and young children. San Diego, California, has experienced a pretty steep increase in cases of the flu. The county has already recorded 1,082 flu cases, which is far more than this time last year, reports The San Diego Union-Tribune. At Patrick Henry High School in the neighborhood of San Carlos, 1,000 of the school's 2,600 students were absent due to illness, the largest outbreak in the area.

Flu vaccination rates have also lagged recently, especially in states with a low COVID-19 vaccination rate, a UCLA study shows. The main reason seems to be the distrust in public health, with the COVID vaccine controversy making its way to the flu vaccine as well. "It is alarming that controversy surrounding COVID-19 vaccination may be undermining separate public health efforts that save thousands of lives each year," said Dr. Richard Leuchter, the study's lead author.

The CDC's Flu Vaccination Dashboard shows that the trend of not getting the flu vaccination applies to almost every group including children, the elderly, and adults. This pattern, mixed with less restriction on distancing and masking, is leading to a particularly aggressive resurgence of the flu. Despite only being the start of the flu season, lab specimen testing for the flu is already at a 3.3 percent positive rate, and visits to healthcare providers for respiratory illness are at 2.6 percent, slightly above the national baseline of 2.5 percent. This is likely to increase as flu season continues.

What can you do to protect yourself?

The biggest thing you can do is get the flu vaccine. While the vaccine is not foolproof in preventing the flu, it can still reduce the chances of contracting the disease by 40 to 60 percent, the CDC explains. The effectiveness of the vaccine is impacted by the genetics of the person receiving the vaccine and how well the vaccine is matched with the prevalent variants of the season.

The vaccine can also reduce the severity of symptoms if you were to catch the flu, which could prevent the need to be admitted to the ICU. It is particularly effective for young children, pregnant people, and those who are immunocompromised or suffer from chronic illness, the CDC continues.

It is also good practice to continue to follow some of the COVID preventative measures. Regularly washing your hands and isolating yourself when you are sick are steps you can take to prevent the spread of the flu.

A rise in both COVID and the flu can spell trouble for hospitals around the country, further emphasizing the importance of protecting yourself, reports CNN. "Flu has not become an afterthought," said Jeffrey Shaman, a modeling expert at Columbia University's Mailman School of Public Health. "Seasonal flu has and continues to impose a very heavy burden on society, one we would like to get a handle on."