Our colleagues in the US last week pointed out, that seasonal influenza numbers are extraordinarily low this season (reduced by a factor of 50 compared to previous years). This was communicated in the weekly US Centers for Disease Control and Prevention (CDC) update. The European Flu News Network is also reporting unusually low infection numbers, that in most countries do not exceed interseason numbers. For week 50, the Robert-Koch-Institute did not report a single case of Influenza.
Since risk mitigating efforts are being implemented – more or less disciplined – it was expected that infection numbers not just of SARS-CoV-2 might decline but also those of Influenza as a side effect.
Indeed, it is being observed that Influenza numbers are at a record low in all countries. However, and this is in stark contrast to political expectations, SARS-CoV-2 numbers are increasing at a scary rate.
Four explanations for the influenza numbers jump into our mind:
- Maybe this season’s influenza is less infectious than previous ones. This we think is rather improbable, since there is more than one influenza strain each season. Not all four or five of them will lose infectivity at the same time.
- The influenza season in the Southern Hemisphere was weaker than before. At the same time, air traffic was reduced for reasons of the SARS-CoV-2 pandemic. Thus, there were less cases of influenza import into the Northern Hemisphere. This might have reduced initial numbers, but not the spread.
- Influenza vaccination rates in the US and Europe are higher than in previous years, but this does not explain the magnitude of the observed effect.
- In our post of September 10, 2020, we had indicated a possible positive side-effect of the measures imposed against COVID-19: They will show an effect on the spread of other seasonal respiratory pathogens as well.
What does this mean for SARS-CoV-2? Unfortunately, this is yet another cause for concern. If the protective measures do help against influenza virus infections, they do so because they prevent droplet infections, the main route of infection with influenza.
On the other hand, this is indicating that SARS-CoV-2 might be much better transmitted via aerosols than previously thought. Otherwise, the measures should have had an effect on SARS-CoV-2 infection numbers as well.
That would explain the steady increase of weekly SARS-CoV-2 infection numbers in Germany irrespective of any risk mitigating efforts in place right now. Public transportation is running as usual, and factories and offices remain open. Until last week, even schools, childcare centers, and shops were open.
Globally today we are counting 76.9 million cases. Germany alone had already 1.5 million infections, with a weekly rate of 164,152. Weekly infections still are increasing: last week by 4 % compaired to the previous one. This pandemic we are experiencing is extraordinary. It has a historic magnitude.
Thus, it would be advisable to abstain from any indoor gathering. Aerosols may linger in a closed space for hours.
Here is our recommendation: Have your celebrations in the smallest possible group, from ONE household EXCLUSIVELY! Should this be impossible for you and your family, gather in your garden or on the patio, otherwise open the windows regularly and protect yourself with N95 (!) masks. Further reduce your personal contacts. Avoid visits over the holidays.
All of this will have a major impact on your festivity, therefore why not cancel the event altogether? And instead try to look forward to the 2021 holiday season.
Christmas celebrations in closed spaces may lead to superspreading events even under the application of protective measures, if just one infected person is present. The currently advised measures do not provide a 100 % protection.
We are writing this post because we do not want you to celebrate Christmas with the necessary risk mitigation, to just find out a week later that there have been infections. We wouldn’t know how to cope with such a feeling of guilt.
Over the weekend, there have been news from the UK as well. It seems that a new SARS-CoV-2 mutant is spreading there, that might be more infectious than the run-of-the-mill variant. Data are scarce, however, just its fast pace was recorded yet. Since this variant has been found in the Netherlands and Denmark, we think it already will be circulating in Germany as well. Note: It is a matter of time for mutants to arise, that are outpacing others. The more cases of infection, the more often mutants have a chance to arise, and the more opportunities for a more dangerous variant to come up.
Both news are sending a strong signal: From now on it is even more important to keep a distance, to wear N95 masks, and to avoid gatherings.
Thus: You CANNOT plan any travel these days. This will continue to be the case in 2021, until a large part of the population has received their shots AND new drugs are available.
Nevertheless, have a Merry Holiday Season! Do not take risks to stay healthy!
Yours, Sabine and Jörg
SAJO is consulting all around infectious diseases. We are applying our know-how, that we have acquired in more than 20 years. We do what we can to fight this pandemic.
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