Easing The Burden—What We Missed

Written by Leigh Henderson

COVID-19 has dominated the headlines, quarantined much of the U.S. population, and devastated the U.S. economy. As of June 12, the United States reported 2 million confirmed and probable cases with 111,000 deaths.1 There were, an estimated 271,000 hospitalizations.2

When COVID-19 was first reported, most of the population was self-quarantined and non-essential businesses were closed. We were told that this would ‘flatten’ the epidemic curve. It would extend the duration of the epidemic but would ease the burden on overtaxed hospitals. The number of patients would be distributed over a longer period, but there would be fewer at any one time.

Why did we not take the most obvious step to ‘ease the burden’? 

Seasonal influenza occurs every year from about October through April, peaking in January or February. Every year, it infects some 30 million or more Americans, hospitalizes several hundred thousand, and is linked to more than 40,000 deaths.3 The burden this season was predicted to be especially heavy, with 47.5 million cases (±8.5 million), 43,000 deaths (±19,000), and 575,000 hospitalizations (±165,000).4

Both influenza and COVID-19 place heavy burdens on laboratory testing capacity and on hospital resources for treating severe respiratory illness. Although caused by different viruses, they have similar effects. Both attack primarily the lower respiratory system. Comorbid conditions, especially common in the older population, and complications such as pneumonia contribute significantly to severe illness, hospitalization, and death.

Influenza can be prevented by a vaccine. However, the burden of illness and death seems acceptable—only about half the population get vaccinated against influenza,5 although vaccination is readily available at little or no cost. (Even fewer are vaccinated against the most common type of pneumonia.)

We knew that COVID-19 was coming to the US. We knew that it would arrive during the influenza season. We knew that it would place heavy demands on the same resources. Would it not have been sensible to ‘ease the burden’ on hospitals by urging influenza vaccination? Reducing influenza by even 25% could have reduced hospitalizations by 143,000 and deaths by 19,000. Why was this simple and obvious step not taken?

Leigh A Henderson, Ph.D., is an epidemiologist and curator of the online Target Zero: Smallpox Eradication Archives and an executive producer of A Good War podcast