As Influenza Season Approaches, Americans May be Headed for a Twindemic

Health officials are urging Americans to get their flu shot this winter, warning that the flu season could strain hospitals in the coming months and may lead to a twindemic – a wave of influenza (flu) and COVID-19 infections.  

Although Americans are becoming more optimistic as COVID-19 infections wane, now is not the time for Americans to let their guard down. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease (NIAID), recently told Fox News Sunday that the numbers could still go back up, especially with 66 million Americans still unvaccinated. The Washington Post reported that scientists who have been closely monitoring the virus believe it still appears to have plenty of room to evolve and the next “variant of concern,” if and when one does emerge, will most likely descend from the delta variant.

With fewer flu infections last year due to COVID-19, experts believe that Americans have built up less natural immunity against influenza. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital saw historically low rates of influenza and other respiratory virus transmissions last year. “Here at UC Davis Medical Center, we didn’t have anybody admitted for influenza last year. In a normal year, somewhere between 40 and 150 kids die from influenza in the U.S., but last year, one child died from influenza. That just shows you how much the masking and social distancing really helped,” he stated.  In his practice, they are already seeing a rise of respiratory viruses like influenza in the community as restrictions have lifted and businesses and schools have reopened. “People have lost a year in terms of being exposed to influenza and developing some sort of protective immunity,” said Blumberg. The Centers for Disease Control and Prevention (CDC), also reported a decrease in influenza cases following widespread adoption of community mitigation measures to reduce transmission of COVID-19.  Flu activity was unusually low throughout the 2020-2021 flu season both in the United States and globally despite high levels of testing. Data compiled by The Washington Post revealed that in 2019, during the third week of December, before the coronavirus struck the United States, the CDC’s network of clinical labs reported that a little over 16 percent of the 29,578 samples tested were positive for influenza A. During the same week in 2020, the rate was less than one percent.  

Amid early predictions of a rise in influenza and the uncertainty of the COVID-19 pandemic going into the winter when people will be spending more time indoors, Americans need to protect themselves by getting their annual flu shot and getting vaccinated. Getting inoculated is even more important this year as doctors are concerned that hospitals will be overloaded trying to care for COVID-19 and flu patients at the same time. William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine told Healthline, “We are anticipating a very vigorous winter respiratory virus season, with COVID-19 out there, perhaps increasing even more, and with influenza coming on the scene, even if we have to deal with a moderate-sized flu epidemic—which all by itself can stress hospital facilities—at the same time as the pandemic, we may be in for a quite rough winter,” Dr. Schaffner says.  He implores people to get the flu shot pointing out that it can help prevent infections, hospitalizations, and deaths. “We can use all the help we can get,” Dr. Schaffner says. He is not alone. Experts believe that getting vaccinated for the flu and COVID-19 offers the best protection against serious illness and complications. Richard Watkins, MD, an infectious disease physician in Akron, Ohio, and a professor of internal medicine at Northeast Ohio Medical University, agrees.  “People should definitely get the flu vaccine, because the last thing they need is to get COVID-19 and the flu,” Dr. Watkins says. CDC also noted the possibility of a “one-two punch.” Their website points out that people can be infected with flu viruses and the virus that causes COVID-19 at the same time.  

Along with the fear of a winter twindemic, the COVID-19 virus still has the potential to mutate.  According to a Washington Post report, scientific research reinforces the need for universal vaccination to reduce the possibility of a fitter variant gaining traction. Even with these predictions, it is hard to determine if Americans need to brace for a new winter transmissible variant like the delta variant, or if the COVID-19 virus along with seasonal influenza will wreak havoc on our already strained healthcare system. What we do know is that although many Americans are experiencing “vaccine overload,” health experts believe that getting vaccinated is the key to avoiding a possible twindemic. For those who have not gotten vaccinated for COVID-19, CDC suggests getting vaccinated for both viruses. Although both shots can be given during the same visit, CDC recommends that unvaccinated Americans should get a COVID-19 vaccine as soon as they can, and ideally get a flu vaccine by the end of October. AM analysts will continue to monitor the situation and will provide up-to-date information on COVID-19 and influenza-related trends and research.


AM LLC is currently working nationwide with multiple states and public health agencies on testing, contact tracing, and vaccination programs. Counties, states, or K-12 partners that are interested in partnering with AM for COVID-19 mitigation support should contact Dr. Christopher K Orlea at

Related Posts