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December 21, 2021

'Twindemic' possible this winter

Variants, unvaccinated could push health systems to the breaking point

Madison, Wis. – UW Health experts expect high case numbers of both COVID-19 and influenza this winter and they urge the public to get vaccinated for both and a return to adherence to public health measures.

In 2020, health officials worried about a possible "twindemic" if large numbers of flu and COVID-19 cases occurred at the same time, but flu rates stayed low because there were dramatic community-wide infection control measures across the country such as masking, social distancing, remote learning, and decreased social activities and travel, according to Dr. Jim Conway, medical director of immunization program, and pediatric infectious disease physician, UW Health.

In 2021, flu cases are already on the rise and hospital systems across the state simply can’t take in any more patients, he said.

“Last year, near-zero influenza rates were remarkable, but that won’t be the case this year because restrictions are loosening and we already saw an increase of COVID-19 and flu cases after the Thanksgiving holiday,” he said. “Holiday gatherings, less masking, more travel, low influenza vaccine rates and the Omicron variant are a recipe for a potential 'twindemic' surge, as soon as mid-January, that will put a lot of stress on our already stretched health systems."

There were only 100 recorded cases of influenza in Wisconsin in the 2020-21 season due to the measures outlined by Conway, but experts fear flu numbers closer to pre-pandemic levels if preventive measures are not taken. In the 2019-2020 flu season, before the pandemic began, Wisconsin reported 36,175 influenza cases, including more than 4,400 hospitalizations.

"If we see flu hospitalizations rise anywhere near pre-pandemic levels alongside this rapidly surging Omicron variant, hospitals will not be able to handle it. We are already struggling," he said.

Wisconsin’s peak flu season is usually in January and February and normally about 45 percent of Wisconsinites get the flu shot, with a higher percentage in older adults, according to Conway. But this year only about 30 percent of people in Wisconsin are vaccinated against influenza.

"I think there is significant vaccine fatigue, but it is so important to get your flu shot and your COVID-19 vaccine including boosters," he said. "These vaccines do what they are supposed to do, prevent against severe illness, hospitalization and death."

COVID-19 vaccines and the flu vaccine should go hand-in-hand and both are well studied and have been thoroughly tested, Conway said.

"This really has become the pandemic of the unvaccinated, because those hospitalized with the flu or COVID-19 are mostly unvaccinated," he said. "The best gift you can give this holiday season is to get vaccinated."

In addition to the influenza and primary COVID-19 vaccines, Conway has a few more tips to stay safe:

  • Stay home if you are sick.

  • If family members get sick, try to isolate at home.

  • Wash your hands.

  • Masking helps prevent not only COVID-19, but influenza and other respiratory illnesses.

  • Encourage friends and family to get COVID-19 boosters. Everyone 16 years of age and older is now eligible.