Doubt it, really

A confidential Cabinet Office briefing seen by the Guardian also warns of a “notable risk” that in coming months the country could face a perfect storm of simultaneous disasters, including the prospect of a bad flu season on top of the medical strains caused by Covid.

‘Flu tends to kill the elderly with comorbidities. We’ve just rather depleted the national stock of those.

24 thoughts on “Doubt it, really”

  1. I don’t understand. Why we could expect to have a bad flu season? Surely all infectious diseases have gone down. If they haven’t then bloody hell WTF?

  2. Quite right @JuliaM. The sheer nonsense of the average SAGE presentation where they declare the infection rate for November was going to be higher than March, despite community immunity, social distancing etc being in place makes it clear they have something other in mind than “saving lives” 🙁

  3. So locking down the population, mandating face coverings, closing hospitality and destroying the economy isn’t enough to prevent a bad flu season. It’s a good job we haven’t tried to control any other flu-like diseases by those means then.

  4. @BiND
    The Spanish flu killed mostly young people
    Possibly a result of the times. End of WW1. A lot of armies being demobilised at the end of hostilities. It ran through US troops being shipped Stateside. And you’re looking at a period where a lot of the less well off were moving from agriculture to the cities in search of work. Living in cramped conditions. That all favours transmission of the infection. The older people more likely to remain where they in less concentrated population areas. Less likely to be infected. And, of course, life expectancy was lower. So fewer older people to start with.

  5. BiND
    The Spanish / Kansas flu got a lot of young people under the peculiar circumstances of millions of badly fed troops being demobilised, remobilised elsewhere, millions of starving refugees, catastrophic dislocation of health services, very low quality military hospitals, etc..
    Children are usually in the vulnerable population for flu. We should count our blessings that covid is an exceptionally merciful to the youth.

  6. Well, yes, sorta. One way ‘flu kills is cytokine storm. The effects of the immune system fighting it off and going into overdrive. Spanish ‘flu had a lot more of this than other flavours. Thus it killed, selectively, those with strong immune systems, those young…..

  7. “‘Flu tends to kill the elderly with comorbidities. We’ve just rather depleted the national stock of those.”

    Not substantially. Still plenty of vulnerable old people to go around. More have died than in a “normal” year but there are still plenty left – quite a large proportion of care homes didn’t have a Covid outbreak for example.

    Re Spanish flu, some posters above seem to be mixing up factors increasing transmission with the age-specific infection fatality ratio. Just because a group lives in cramped conditions so might be big transmitters doesn’t mean they’ll necessarily have a high risk per infection. Actually the peak age for mortality risk seems to have been in the 30s so the idea that the unusual death rate was a consequence of young soldiers after a hard time in the trenches already being vulnerable isn’t one taken seriously by immunologists / epidemiologists as far as I know. Re flu usually having a high mortality rate among the very young and very old, this is true – the so-called “U” curve of the age-specific IFR – and actually applied to the Spanish flu too (but with a bump in the middle so it’s often called a “W” curve), but the risk for the young is usually concentrated in very young infants, not say under-10s in general, whereas the risk among the old is larger over a wider range of ages and heads rapidly north among the very old, so it’s here that most of the damage is done usually (even if you count harm in quality-adjusted years of life lost, which is a measure that prioritises infant deaths as worth many times an elderly death).

    I don’t think a bad flu season is likely bearing in mind the mild Australian season and the additional social distancing measures. Flu has a much lower R0 than COVID and the reduced levels of individual and household contact are likely to have a bigger effect on flu than on COVID (the effects are highly non-linear and it is easier to get flu’s effective R below 1).

  8. Timmy’s comment re cytokine storms is one of the more common hypotheses re Spanish flu but isn’t universally accepted that this completely explains the fine details of the age breakdown, for some competing hypotheses see e.g. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0069586

    I don’t know within the field of immunology generally which hypotheses are currently considered the most likely but I do know it’s still an area of active debate.

  9. MBE: Fauci put his name to a paper at NIH that explained the second wave of Spanish Flu was worsethan thefirst because the populace were persuaded to wear masks for the greater good. It didn’t stop the virus spreading but it ensured that the infected got a dose of their own bacteria grown on their masksand inhaled into their lungs. They actually died of bacterial pneumonia as a secondary infection. Strange how he forgot this.

  10. Perhaps 10% of the population have had Covid and even those with comorbidities and are old the majority survive. The number likely to die of flu has not changed significantly due to them already having died of covid. As MBE says the impact of flu is likely to be lower due to a mild Australian flu season and the social distancing

  11. Much harder to get the flu if not mixing with others / not going out. If wearing masks, social distancing, washing hands etc.
    All measures added together should reduce chance of catching flu and massively reduced chance of being near someone with the flu too.
    Together – should reduce chance of getting flu, covid or whatever else is passed on by close contact normally.

    However there are millions who appear to be behaving normally. So will still get considerable infections regardless!

  12. Bloke in North Dorset

    A couple of points on the Spanish flu thing from memory as I don’t have the references:

    The soldiers were better fed and than most those of the same age left behind, but more importantly for the first wave at least soldiers had better care because a lot of cities had lost a large part of their nurse cadre to the war.

  13. The notable risk that should be causing sleepless nights in Whitehall is, that after the Government’s hysterical reaction to Covid has decimated the economy and pushed borrowing to terrifying levels, that nice Mr Xi decides to send us Wuhan Flu Two.

  14. “We’ve just rather depleted the national stock of those.”
    The majority haven’t even been infected yet, let alone died of it and become unavailable to be carried off by the usual flu. And in the usual way of things, another few hundred thousand have stepped forward to fill any gaps.

  15. Deaths in last 24 months are about 33,000 higher than deaths in the previous 24 months. That’s not a huge chunk of the older population. Nevertheless a huge proportion of those dying with Covid-19 could reasonably be described as frail and could be taken out by other conditions in short time. Sometimes with the frail it’s hard to work out what they actually died of, they stopped enjoying anything much a while ago, not even a cooked breakfast or a visit from the grandchildren. The doctor asks about and just puts what seems reasonable at the time on the death cert.
    I think Tom has it – there’s no reason to expect a bad flu season this winter.

  16. Forgot to add the reverse argument – those elderly who have had Covid-19 but not died have probably got immune systems that are still holstered. They are very likely to survive flu.

  17. If lockdown worked, we wouldn’t need a second one let alone a third for the bloody flu…….

    Cowards die a thousand deaths… Helps the Covid stats.

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