1. As we look to the coming winter in the Northern Hemisphere, 2 big Qs loom. What's going to happen with Covid? & Will #flu return in a significant way this winter?
@WHO's biweekly flu update suggests transmission remains at low levels globally.
All data below are from @WHO.
2. There are smatterings of #flu here and there around the globe. Some flu B in the Caribbean & Central America. Some flu A in parts of Africa and Asia.
3. How much #flu is out there? Of nearly 276K flu tests run in 88 countries from 8/30-9/12, 1,884 were positive for flu — 0.68%.
During the same 2-week period in 2019 (ie before Covid) 7.4% of tests globally were positive for influenza. In 2020, it was 0.04%, ie almost none.
4. Aside: Another Q about #flu is whether a family of flu B viruses, B/Yamagata, was driven extinct during the pandemic. Two B/Yam viruses were reported in this @WHO report but as @trvrb would say, let's see if sequences get logged into the databases. TBD. statnews.com/2021/06/02/pan…
5. I wanted to see how 0.68% test positivity compared to the rest of the pandemic. The main graph is Aug 2019 (to the left is the 2019-2020 flu season; very active) through Sept 2021. Flu vanished in April 2020. The inset is then on. We're still not back to April 2020 flu levels.
6. We're still not back to April 2020 #flu levels, but the percentage of positive tests is slowly rising.
A caveat I don't know how to adjust for: The denominator varies per 2-wk period. Mostly >100K, sometimes >200K tests, a few times <100K.
7. Another caveat: Pre-Covid, most #flu tests were likely ordered when someone had #flu-like symptoms. In the pandemic, I would imagine a lot of these are tests that look for Covid or flu or other respiratory pathogens. I don't know what that does to the comparability of data.
8. But any way you slice it, there's been a lot of testing for #flu during the pandemic & not much flu found. It appears to be inching (millimetering?) upwards, but it is still well below what it would normally be at this time of year.
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More from @HelenBranswell

26 Sep
1. Belatedly looked at this week's FluView from @CDCgov. There's something to watch here.
A child or teen in Ohio contracted a swine flu virus — an H1N2. Public health investigations can find no link between the person & pigs, ie didn't live on a farm, didn't attend a state fair.
2. Public health has concluded it is possible this person was infected by another person. According to @CDCgov, they can see no evidence of ongoing person-to-person spread. But this bears watching. The 2009 flu pandemic was caused by a swine #flu virus.
3. There are a number of cases every year of people contracting a swine #flu virus in the US. Ten reported so far this year. Typically they occur in people who live or work on a farm with pigs, live with someone who works with pigs or has had contact with pigs at a fair.
Read 4 tweets
23 Sep
1. Good day. #ACIP is meeting today to vote on recommendations about who should receive a booster shot of the Pfizer #Covid vaccine. The meeting starts at noon ET. I will be live tweeting.
@US_FDA's EUA for the Pfizer booster is veeeeeery broad. statnews.com/2021/09/22/fda…
2. The meeting is underway. Doran Fink of @US_FDA is now explaining FDA's EUA for the Pfizer booster, which was issued last night.
My observation: The group of people eligible for a booster under this EAU is very broad. 16-17 yos are excluded but many over 18 will be eligible.
3. @CDCDirector is addressing #ACIP. She acknowledges that the committee has to make decisions, sometimes with a huge amount of data, sometimes with "a paucity."
She mentions pregnant people.
My observation: Oddly, there was no mention of them in the FDA EUA.
Read 50 tweets
22 Sep
1. Good morning. #ACIP is meeting today and tomorrow. Today, at least, I will be live tweeting.
@US_FDA has not yet indicated what it is going to do with Pfizer's application for a booster license. So it's really completely up in the air at this point how this turns out.
2. You'll recall FDA's advisory committee, #VRBPAC, voted that there wasn't enough data to approve the Pfizer application to give a booster to everyone 16 & older. VRBPAC did agree there was enough data to authorize boosters for people 65 & older & people at high risk.
3. But as I mentioned, FDA hasn't indicated what it's going to do. It is not bound to follow #VRBPAC's advice, but it will cause a real stir if it does not. If it doesn't follow VRBPAC's advice, it may set up a situation where a second advisory committee #ACIP disagrees with FDA.
Read 46 tweets
13 Sep
1. Some unsettling #rabies exposure stories in a post from the invaluable @ProMED_mail tonight.
Some people in RI were feeding a raccoon that later testing showed was infected with rabies.
People: Do not feed raccoons. They do not need your help. local21news.com/newsletter-dai…
2. A grey cat that was hanging around a campground in Frederick County, Md, tested positive for #rabies. There were reports the cat was biting & scratching people between Aug 24 & Sept 3. People exposed or people whose pets were exposed to the cat should contact their MD or vet.
3. A link to the cat story here.
Important to know: #Rabies is fatal without quick post-exposure treatment. wfmd.com/2021/09/08/cat…
Read 4 tweets
10 Sep
1. Being as it's Friday, there will be a #flu update from @CDCgov later this morning. I'll add to this when it comes out.
Just looking at the weekly Covid & #influenza report from @PHE_uk. In a normal flu season, one might see a little flu activity in early Sept. Nope. Image
2. @CDCgov's FluView is up. Actual confirmed cases of #flu remain very low. There is, however, a fair amount of influenza-like illness, or ILI, activity. The report suggests it may have plateaued among 0-4 & 5-24 yr olds. Will be interesting to watch this, now that school is in. Image
3. @CDCgov reports another 2 cases of infection with swine #flu viruses have been detected, both in Iowa. Neither was sick enough to need hospital care; both recovered. Both had traceable links to pigs. Image
Read 7 tweets
3 Sep
1. Let's talk a little #flu. Or more specifically, let's talk about ILI — #influenza-like illnesses. Those are cold & flu-like ailments caused by a stew of viruses: influenza, rhinoviruses, adenoviruses, parainfluenza, human coronaviruses & respiratory syncytial virus — RSV.
2. @CDCgov releases its weekly #flu updates Friday morning. This week's (covering Aug. 22-28) showed there is more ILI activity now (red arrow) than there was at any point last winter during the traditional cold and flu season. Does that mean flu has returned? In a word, no.
3. I assume different parts of the country may be seeing different combos of bugs, but here's what's being seen in Utah, from Intermountain Healthcare's GermWatch. Lots of rhinoviruses (the most common cause of the common cold) & RSV. No flu or human CoVs. intermountainhealthcare.org/health-informa…
Read 6 tweets

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