No one has died from influenza yet in Washington this year and during the current flu season.
This time last year, 70 Washington residents had died from the flu.
There is very little flu circulating in Washington and nationwide as of the seventh week of the flu season, and there are several potential reasons why.
Public health officials point to the precautions like masking, social distancing and better hand hygiene during the coronavirus pandemic as key reasons that flu rates are so low. Spokane County Interim Health Officer Dr. Francisco Velázquez said that while flu immunization rates were not as high as previous years, local case rates remain virtually nonexistent so far.
"We've not seen any serious illness, hospitalization or death from flu in the county," he told reporters last week. "And the theory behind that is the precautions we're taking for COVID are also functional against the flu, which has, in many ways, a similar transmission method. So the fact that we've been this diligent with public health measures is the main reason we have not seen any significant impact of the flu season."
Last fall, public health officials, including Dr. Anthony Fauci and local health officers, begged the public to get their flu shots to prevent hospitals from dealing with a surge in both COVID-19 and flu cases this year. The flu surge has yet to materialize, however, and while health experts expected public health measures to help cut down on transmission, they didn't expect the numbers to be as low as they are.
Dr. Janet Englund, who researches infectious diseases in children at Seattle Children's Hospital, said looking to the Southern Hemisphere, she and her colleagues knew that the flu season would not be as bad this year.
"It's not a surprise, but we didn't think it would be down this low," she said.
Washington's data is reflected in nationwide data as well. While there have been some flu cases confirmed, those amount to well below the baseline percentages expected by this point in the flu season.
Hospital surveillance from the Centers for Disease Control and Prevention from 14 states found 183 flu hospitalizations since October, which amounts to a rate of 0.6 cases per 100,000 people. This rate is much lower than average for this time of year and is also lower than any rates recorded for flu seasons since 2005, according to the CDC.
While experts think public health measures have helped cut down transmission, Englund said there are several other factors at play too. First, she points to who usually spreads the flu: children.
"Flu is spread predominantly and very well by school-aged children," Englund said. "It's very contagious in younger children and more contagious than COVID, so if the children aren't going to school, and if they're staying home when they feel sick and wearing masks, we think that's contributing to the lack of spread."
COVID-19 is more contagious among certain populations and age groups than flu, according to the CDC, and the novel coronavirus is far more deadly.
Last flu season, 114 Washington residents died from the flu. In 2017-18, the worst season in the past decade, 296 Washington residents died from the flu.
Since the first COVID-19 deaths were recorded in Washington a year ago, 4,956 residents have died from the virus.
While the data look promising for a low or nonexistent flu season this year, a surge later is still possible.
"It's highly unlikely we'll be having a big surge of influenza at this time," Englund said. "Having said that, back in 2009 when we had the H1N1 pandemic, we actually did have a summer surge of flu — it can happen."
Public health and infectious disease experts are hopeful that continued masking, social distancing and the fact that kids will not be back in school this summer will help prevent a flu surge, Englund said.
Looking to countries like Australia and New Zealand, Englund said reopening will mean the return of several respiratory viruses, especially in the fall. She said getting the flu shot this coming year will be incredibly important, especially if kids are back in schools full time.
"As we open up and as school starts, it's very likely there will be more flu, and it will spread," she said. "It will be very difficult to distinguish flu from COVID disease."
Englund, who studies pediatric infectious diseases, said that younger children going back to school who have not been exposed to the flu or other respiratory viruses, including respiratory syncytial virus, this year will be particularly vulnerable to those viruses in the coming year.
"Many of us think there's a chance they will come back," she said. "And the question is when?"