Coronavirus thread

[45dotACP]

Indeed. And with the lesser number of flu cases, severe cases of flu requiring hospitalizations were similarly rare. Certainly it wasn't completely absent, but factors mitigating COVID are even more effective at mitigating flu.

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[HeavyDuty]

Speaking from my own experience, we never NEEDED to test for flu, because all the cases of viral pneumonias would come back as COVID.

If you were the type of person for whom exposure to flu would make you sick, then for sure you were going to get COVID because it's just that much more infectious. It made land in the US long before the first recorded case of the pandemic and had been tearing up hospitals before that.

I remember at the beginning of the pandemic when we would get double lung pneumonia patients that were testing negative for flu, but showed severe hypoxemic respiratory failure refractory to oxygen.

I train with a lady who got COVID before the first case made land in our state. And we were one of the first states in the US to have a positive case. She even had a Facebook post saying how badly this year's (2020) "flu" sucked because she couldn't taste or smell anything and she was very short or breath. This post was before Illinois' first recorded case and she tested positive for antibodies later on that year.

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In early to mid January 2020 my partner was in a large regional hospital in the Boston area for surgery. While she was in recovery I wandered down to the ED to have a problematic drain from my own prior surgery unfucked. They were swamped with what they thought were flu cases and were requiring masks and hand sanitizer use by everyone starting in the waiting room. I was talking with the doc and nurses while they were working me over, and after I revealed my background they said they hadn’t seen anything quite like it in a long time. Even then, it was much worse for them than H1N1 in 2009.

I’m sure it was here and spreading long before the index case was identified.

[TGS]

I train with a lady who got COVID before the first case made land in our state.

I'll be honest and say that one of the things that annoys me about pre-pandemic Covid cases is that everyone claims to have had it. Not saying she didn't have it given the specifics you cited, I'm just jumping in here because it prompted the train of thought:

"Oh yeah, I got sick in December. Pretty sure I had the covids. It kind of sucked but it wasn't any big deal". No, you probably had a cold. It's like nails on a chalk board every time I hear people declare they had covid before it was cool, all because they got a common cold like every other year. Sometimes it seems like every swingin' dick with a sniffly nose declares they had covid.

One of my buddies passed out in January and started spitting up blood. Lungs looked pretty typical for what we now see common in Covid/ARDS, was hospitalized on CPAP for a week. Healthy, mid-30s, in shape, exercises 5x a week. That was probably covid.

[Dr_Thanatos]

I’ve heard this local to me as well. My question is was the flu even tested for? I have been told that in my area viral panels were hardly done if they were done at all due to the increased demand of Covid testing since it uses the same equipment and resources. I have no doubt that masks, social distancing, hand washing, etc reduced the spread of the flu but if it wasn’t tested for how do we know that it was non-existent?

We've been testing for influenza, Covid and the entire viral panel as part of a research grant. Plenty of Covid, no flu. Lots of adenovirus for some reason. The epidemiologists are having a field day with our data.

[Caballoflaco]

We've been testing for influenza, Covid and the entire viral panel as part of a research grant. Plenty of Covid, no flu. Lots of adenovirus for some reason. The epidemiologists are having a field day with our data.

Is this just dead folks y’all are testing or is it for an entire hospital or othe style of healthcare provider?

[Dr_Thanatos]

Is this just dead folks y’all are testing or is it for an entire hospital or othe style of healthcare provider?

Just our cases. But we get a pretty good cross section of the healthy population with the accident, homicide and suicide cases.

[jws]

We've been testing for influenza, Covid and the entire viral panel as part of a research grant. Plenty of Covid, no flu. Lots of adenovirus for some reason. The epidemiologists are having a field day with our data.

This is interesting. Thanks for the input and the following discussion.

[DrkBlue]

I agree that Covid was here before we knew it and and that some of the cases we thought were the flu late 2019 and early 2020 were indeed Covid. I understand the theory behind if someone has the flu they likely already have Covid. My point, while it may be pedantic, is that the presence of Covid does not equal the non-existence of the flu. I think the flu has definitely been far less prevalent this past year, but I find it hard to believe that it is non-existent.

Respectfully, I work with the epi data in a multi state region. There is some circulating influenza, but the prevalence is so low as to be statistically irrelevant, less than one case per one million population per week being detected. If you have a negative COVID test in most clinical settings but are presenting with influenza like illness, today you will get an influenza test. That likely makes influenza more likely to be caught now than pre COVID.

In my neck of the woods, influenza A & B testing was the rule out diagnostics beginning in March 2020. Influenza evaporated by early April 2020 - the mystery is why influenza disappeared. A lab microbiologist buddy and I have a year-long running argument about this - he says “hand washing” and I say “COVID transmission virulence.” He is probably right, but I would not admit that to his face. Neither of us have any idea where the reservoir of influenza disease is maintained, as population circulation by travel has been curtailed so much.

With the recent focus on COVD variants, the respective state and other reference labs are doing various genetic analysis of selected patient samples under CDC grant funds. This is the effort that finds the B.1.1.7 or P.1 or “double mutant” strains. None of the states I work with have seen any resurgence of influenza in their sample testing since initiated in this calendar year. There is some selection bias at work there, but also a bit of non-conclusive evidence that COVID crowds out influenza too.

All that means influenza is not gone, but almost undetectable. My guess is that will still be true in 2023, but that is SWAG.

[jws]

Respectfully, I work with the epi data in a multi state region. There is some circulating influenza, but the prevalence is so low as to be statistically irrelevant, less than one case per one million population per week being detected. If you have a negative COVID test in most clinical settings but are presenting with influenza like illness, today you will get an influenza test. That likely makes influenza more likely to be caught now than pre COVID.

In my neck of the woods, influenza A & B testing was the rule out diagnostics beginning in March 2020. Influenza evaporated by early April 2020 - the mystery is why influenza disappeared. A lab microbiologist buddy and I have a year-long running argument about this - he says “hand washing” and I say “COVID transmission virulence.” He is probably right, but I would not admit that to his face. Neither of us have any idea where the reservoir of influenza disease is maintained, as population circulation by travel has been curtailed so much.

With the recent focus on COVD variants, the respective state and other reference labs are doing various genetic analysis of selected patient samples under CDC grant funds. This is the effort that finds the B.1.1.7 or P.1 or “double mutant” strains. None of the states I work with have seen any resurgence of influenza in their sample testing since initiated in this calendar year. There is some selection bias at work there, but also a bit of non-conclusive evidence that COVID crowds out influenza too.

All that means influenza is not gone, but almost undetectable. My guess is that will still be true in 2023, but that is SWAG.

That is some very interesting info, thank you for your input!

[Dog Guy]

Respectfully, I work with the epi data in a multi state region. There is some circulating influenza, but the prevalence is so low as to be statistically irrelevant, less than one case per one million population per week being detected. If you have a negative COVID test in most clinical settings but are presenting with influenza like illness, today you will get an influenza test. That likely makes influenza more likely to be caught now than pre COVID.

In my neck of the woods, influenza A & B testing was the rule out diagnostics beginning in March 2020. Influenza evaporated by early April 2020 - the mystery is why influenza disappeared. A lab microbiologist buddy and I have a year-long running argument about this - he says “hand washing” and I say “COVID transmission virulence.” He is probably right, but I would not admit that to his face. Neither of us have any idea where the reservoir of influenza disease is maintained, as population circulation by travel has been curtailed so much.

With the recent focus on COVD variants, the respective state and other reference labs are doing various genetic analysis of selected patient samples under CDC grant funds. This is the effort that finds the B.1.1.7 or P.1 or “double mutant” strains. None of the states I work with have seen any resurgence of influenza in their sample testing since initiated in this calendar year. There is some selection bias at work there, but also a bit of non-conclusive evidence that COVID crowds out influenza too.

All that means influenza is not gone, but almost undetectable. My guess is that will still be true in 2023, but that is SWAG.

Could you expound on the bolded part a little bit? I would have thought that influenza and covid-19 would not be an either/or choice, and that we could catch both at the same time. What's the physiology behind one crowding out the other? Or am I misreading your meaning?