Flu took a break in 2020, but it's officially back. Experts say it's not too late for Americans to get vaccinated. – USA TODAY

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The U.S. may have dodged a ‘twindemic’ last year, but health experts say the country may not be so lucky this season.
While the U.S. continues to report more than 800,000 coronavirus cases per week, flu cases and hospitalizations are also steadily increasing.
Flu is back, said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.
“We talked about a ‘twindemic’ last year, but I think we’re going to see it now this year because there’s been a relaxation of masks and social distancing,” he said. 
Flu cases haven’t reached pre-pandemic levels yet. But as of Dec. 4, the Walgreens Flu Index reports flu activity is 335% higher nationwide this season compared with last season during the same period.
“Several Southern states and markets are showing the most widespread flu activity this season, consistent with trends seen over the last two flu seasons,” said Dr. Kevin Ban, chief medical officer at Walgreens. “This may be due to the increased face-to-face interaction and reduced COVID-19 mitigation measures in certain regions.”
Weekly hospitalizations for the flu increased from 288 in the week ending Oct. 30 to nearly 500 in the week ending Nov. 27, according to the Centers for Disease Control and Prevention’s weekly flu surveillance report. 
Flu hospitalizations pale in comparison to the 90,000 COVID-19 hospitalizations reported in the last week, but health experts say hospital systems can’t handle any extra stress.
Hospitals in 39 states reported more COVID-19 patients than a week earlier, while hospitals in 36 states had more COVID-19 patients in intensive-care beds, according to a USA TODAY analysis of U.S. Health and Human Services data.
“Hospital capacity is an issue (and) the addition of influenza this season could portend a real danger in terms of patients being able to receive care in hospitals,” Glatter said. “With flu expected to hit hard, we’re in for a tough winter season.”
Health experts are also concerned about the availability of testing supplies, as double the number of people are getting tested for flu this season compared to the 2019-2020 season. In the week ending Nov. 27, the CDC reported more than 43,000 specimens tested for flu. Only about 21,000 specimens were tested during the same week in 2019.
The surge in testing is due to dual COVID-19 and flu testing, experts say. With a single swab, people can get tested for the coronavirus as well as influenza A and B. With COVID-19, flu and cold cases rising, more Americans are waking up with the sniffles and getting tested to find out if they need to quarantine.
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“There is a concern that rising flu rates may result in resource constraints,” said Arvind Kothandaraman, managing director of specialty diagnostics at PerkinElmer, a diagnostics and life sciences company. “Last year, health care systems were overburdened by the pandemic, especially strained by shortage of components needed for infectious disease testing.”
While a record number of Americans showed up to get their flu shot in 2020, a recent survey suggests not as many people are getting vaccinated this year.
The survey published by SingleCare, a free prescription savings service, found fills for flu vaccine from August to November were 53% lower than fills during the same time frame in 2020.
“Whether it’s because people are feeling protected with their COVID vaccine, experiencing vaccine fatigue, or don’t realize they can and should also get their flu shot, the low vaccination rates are concerning,” said Ramzi Yacoub, chief pharmacy officer at SingleCare. “People need to be aware that it remains important to receive annual immunizations from the flu.”
As of Nov. 20, about 39% of the U.S. populationhad gotten this season’s flu vaccine, according the CDC.
The CDC recommends everyone over the age of 6 months receive an annual flu shot by the end of October,. But health experts say it’s never too late to get vaccinated. 
“With the holiday season well underway and more people gathering and traveling, flu activity may remain on an upward trajectory in the coming months,” Ban said. “This latest data underscores the critical importance of getting vaccinated against the flu as another line of defense to help keep yourself and those around you healthy.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT. 
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.


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