For two years, we have had infection control measures that have kept the coronavirus in check. The measures have been effective, and at the same time have ensured that two rounds of seasonal flu have never come.
Normally, the flu kills around 1000 people over a short period of time, even if we have a vaccine. The burden on the hospitals is significant.
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FHI fears that the next regular flu season may become extra serious because it is now a long time since most of us were last infected.
One question many are now asking themselves is the following: Now that we know that the flu can be stopped with measures, should we still let it go?
The rationale for the measures has changed dramatically
Prior to March 2020, government orders for infection control measures for the population were a non-issue. The messages from China and Italy changed this. One feared a large number of dead and completely overloaded hospitals.
Since then, the rationale for the measures has shifted dramatically. Now it is no longer a question of capacity in the health care system, deaths or limiting the number of infected people.
Instead, it is about the authorities not wanting too many people to be away from work at the same time, and a more general uncertainty about how the development will be.
«The Norwegian Directorate of Health considers that the risk of total congestion in the specialist health service is now low. […] In order to be able to take a position on the recommendation for a further level of measures, sickness absence and other absences are a key factor, which must be linked to the capacity in the various services and sectors.», Writes the Norwegian Directorate of Health in its recommendation to the Government.
This is the reason for retaining infection control measures that two years ago would have been considered completely unthinkable:
The state requires the use of face masks in a number of situations, there are clear recommendations and requirements to keep a distance that have major consequences for shops, workplaces and nightclubs, and people without symptoms can be punished for violating the obligation to isolate.
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Today’s justification can also be used against the flu
This justification will be equally valid to limit the spread of influenza in a normal season.
- Influenza can lead to very many simultaneously infected and sick
- Influenza leads to great pressure on hospitals
- There is great uncertainty about how well the season’s vaccine will work, and which variants will become widespread.
- The number of deaths is typically around 1000 people, and children can also die
In September, FHI told that they were more concerned about a powerful flu season, than new varieties of the coronavirus.
And a survey from last year concluded that Norwegians largely want to continue to protect themselves against disease. The online pharmacy Farmasiet told that half the population wants to continue wearing face masks by high spread of colds, flu and other infectious diseases – so as not to infect others.
– I think everything we have learned about infection through the pandemic has made us more aware of the spread of diseases other than corona, which can also be serious. Previously, there has not been much talk about the deaths associated with influenza, but we are more aware of that today, said operations director Stig Henning Pedersen.
NIPH warns against measures against other diseases
FHI chief physician Preben Aavitsland is aware that the flu is a burden on society, but is strongly critical of continuing to use infection control measures to limit disease:
– The contact-reducing measures against corona and the advice to stay home in case of symptoms effectively help to prevent the flu as well. Therefore, we had no flu epidemic last winter and maybe not this winter either, says Aavitsland.
– The annual flu epidemics create challenges for the health service and society every January-February: The hospitals get a few thousand extra patients, including a few hundred in the intensive care unit. The country’s GPs and emergency services receive tens of thousands of extra consultations. The nursing homes get more deaths. Society as a whole is getting more sick leave. The excess mortality in the country in these weeks can be a few hundred. Vaccination of the elderly and risk groups only prevents some of this.
– We understand that next winter it may be tempting for municipalities and the state to implement contact-reducing measures to prevent all this.
According to Aavitsland, this should not be done:
– We think it is unwise. We now have a balance between the flu virus and the population. That balance depends on a large part of the population encountering the virus or vaccine every year and thus having their basic immunity to influenza upgraded. Most of them thus get only fairly mild illness.
– If we now have two winters without the flu, the population will incur an “immunity debt”. The balance is upset, and many more will be more prone to more serious illness this coming winter. If we prevent a flu winter, we just push the problem in front of us, and it gets bigger.
– We should therefore still have the flu every winter, but become even better at protecting those who are particularly vulnerable to serious illness. In addition, of course, comes the fact that contact-reducing measures are very expensive for society and create freedom for individuals, he points out.
The government does not want measures against the flu
As of today, infection control measures can not be implemented against influenza, due to the fact that it is not defined as a generally dangerous infectious disease.
The government has no desire to change this.
– The government’s goal is still to have control of the pandemic, therefore we now retain some measures. As Nettavisen points out, there has been great uncertainty associated with omikron and whether the virus will create an unmanageable situation in the health service, says State Secretary Ole Henrik Krat Bjørkholt in the Ministry of Health and Care Services.
– For influenza, however, the situation is different: Influenza outbreaks are expected and occur at the same time every year, they are treated equally from year to year, and both hospitals, municipalities and GPs are used to dealing with these and have plans for this. Most people have had the flu one or more times and the immunity is therefore good in the population. We also have a flu vaccination program that is well established, in addition to advice and recommendations on infection control in the health services, he says.
The big difference, according to the Secretary of State, is the prevalence of the disease:
– Influenza affects a maximum of 20 percent of the population during a season. Omikron we reckon will infect at least 80 percent. Covid-19, unlike the flu, is defined as a generally dangerous infectious disease, he says.
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