STUMP » Articles » Memory Monday: Current Flu and First Week of February 1918 » 5 February 2018, 03:48

Where Stu & MP spout off about everything.

Memory Monday: Current Flu and First Week of February 1918  

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5 February 2018, 03:48

Before we jump back 100 years, it is a bad seasonal flu year here in the U.S.

Think Flu Season Is Bad? It Could Get Worse Before It’s Over

“Flu is everywhere in the U.S. right now,” said Dan Jernigan, director of the influenza division at the national Center for Immunization and Respiratory Diseases. “This is the first year we have had the entire continental U.S. be the same color on the graph, meaning there is widespread activity in all of the continental U.S. at this point.”

The most optimistic assumption among government experts is that the season peaked a few weeks ago [end of December], marking the apex of what was already an early and severe outbreak. However, such an outlook requires observers to ignore that outpatient doctor visits have continued to climb (albeit more slowly) in the first week of 2018, yielding the most flu cases ever for this time of the year.
…..
That may already be happening. The CDC is starting to see infections caused by the H1N1 strain of the virus in states grappling with high levels of the H3N2 strain, the predominant version this season. In addition, Jernigan said yet another type of flu, caused by the influenza B viruses, is still expected to show up later in the season.

H3N2 has compounded the damage usually wrought by the annual flu outbreak. It’s known for both its severity and ability to evade the protection provided by vaccinations that are typically more effective against the other types of flu.

…..
The CDC’s latest method to categorize the severity of a flu outbreak, which takes into account indicators including hospitalizations, outpatient visits and deaths across an entire outbreak, already places the current season in the top three. During the 2014-2015 flu season, there were more than 700,000 hospitalizations. The current outbreak is matching the beginning of that period, though it’s unclear what the remainder of the season will look like, Jernigan said. Last year’s entire season saw more than 600,000 hospitalizations.

This Year’s Flu Season Keeps Getting Worse, Now Thanks to Kids

There are several unique, worrisome aspects to this season’s outbreak: It’s hitting everywhere at once; it’s continuing, rather than peaking quickly; and it’s affecting a broader range of older Americans than in the past. The entire continental U.S. reported widespread flu every week for the past three weeks, Jernigan said in a conference call with reporters.

…..
The season is shaping up to be similar to the epidemic of late 2014 and early 2015, which entailed 710,000 hospitalizations and 56,000 deaths, according to the CDC. The agency is expecting similar numbers this year, Jernigan said.Activity levels vary in different states, however.

Hospitalizations in California are running at four times the level seen in 2014 and 2015, while Minnesota’s rate is double. In New York, the numbers are starting to surpass the national average.

An additional unexpected finding is the impact on middle-aged Americans, who typically withstand the flu pretty well. While hospitalization rates are predictably highest among the elderly, younger baby boomers aged 50 to 65 are in second place, Jernigan said. This is especially bad news for them, given a new study linking the flu to increased risk of heart attacks.“Baby boomers have higher rates than their grandchildren right now,” he said.

Children are little disease vectors, I know. After hearing that New York loosened some of the requirements for distributing pediatric flu vaccines, I took my kids to get flu shots (I get mine in October every year, at work).

While we were there, I got the vaccine for tetanus/pertussis. I was way behind on that, and figured I may as well.

My church has the following notice right now:

Cold/ Flu Season
At the sign of peace , consider a kind word, a bow, nod or wave instead of shaking hands. Hand shaking is not required. Avoiding close contact with others will go a long way in helping prevent the spread of the common cold/flu. Thank you for your cooperation.

And one need not partake in the Eucharist every Mass, either.

Schumer called for a flu surveillance team for NY, but I’m a bit wary of this particular article:

Over the past four years, 25 patients have died from the flu in New York State alone.

That sounds really, really low. I’m sorry, far more than 25 people die from the flu in NY every year.

LET’S CHECK THE NUMBERS

The CDC flu report is here, and let me grab some graphs.

First off, the CDC has the nastiest powerpoint template. Check out this slide:

Ugh, I’m going to make my own graphs. Notice that the biggest bar is for Flu A H3N2, as mentioned in the articles.

Here is a nicer place to play around with data, but it’s only through the second week of 2018 as I write this. And looking at the underlying data, some of the most recent numbers are likely to be adjusted. They’re not “fully developed”, meaning some of the reporting lags.

I was sent this item on flu deaths, and yes, flu/pneumonia deaths are higher this year (again, a lot of the pneumonia deaths aren’t from flu). Peak flu season is not necessarily yet to come — the peak usually is in end of December/begin of January. Yes, tens of thousands of Americans are dying — mainly older folks, and yes, they usually die in the tens of thousands from the flu/pneumonia every year. You generally don’t hear about it because heart disease and cancer are killing hundreds of thousands of old folks. It generally doesn’t even make the top ten causes of death for old folks.

So let’s get some perspective, shall we?

Here is a weekly death count, where death by flu, pneumonia, and everything else is broken out:

Things to note:

  • The most recent death data are “undeveloped”, meaning the death numbers may rise
  • There is a general rising trend to deaths — which I partially explained here: namely, the pig-in-a-python Baby Boomers are bumping up the death numbers.
  • Yes, most deaths are in the winter. There are reasons, and it’s not all flu/pneumonia.

Let’s look at the flu & pneumonia death numbers without the huge numbers of other causes.

So… it doesn’t look so bad according to these stats. Maybe as bad as 2014-2015, but do you remember media going on about how bad the flu season was then? I dunno, maybe I’ll look that up next week.

To be annoyingly actuarial though, these numbers aren’t fully developed. I actually originally pulled these numbers a week back, and then pulled them again — some of the death numbers went up, which doesn’t surprise. There’s a lag in reporting.

But for right now, *mortality*-wise, the flu seems to be about where the 2014-2015 season was. Pneumonia deaths tend to be orders of magnitude higher — and, again, I think the numbers I have for that will adjust upward.

Unfortunately, using data on hand, it’s too soon to tell about flu severity in terms of deaths.

Here is a breakout by age groupings — I will do this in two graphs, so you can really see the breakout. (I am going to use the data through first week of 2018 here — I just want you to see the general pattern).

Flu deaths alone:

Pneumonia deaths alone:

Again, the 2017-2018 season numbers are not yet fully developed and may increase. But with regards to mortality specifically, it’s not clear to me that it’s worse than the 2014-2015 season. I can believe the current season may have higher frequency of sufferers (that is what we call morbidity), but this seems within the normal range of flu deaths.

And again, there are tens of thousands of these deaths each year. You don’t hear about them, because they’re mostly older people, who people expect to die. You hear about the very few pediatric deaths because they’re extremely unusual. If you look at my graphs, you will not be able to see the under age 18 range… they’re not zero, they’re just orders of magnitude smaller than the older folks groups.

As a final flu note, I hear that Pink sang the National Anthem while suffering flu, and also Super Bowl attendance or parties are prime flu-spreading places. I hope y’all washed your hands.

I, on the other hand, was safe at home…. composing this post. Whee.

BACK TO 1918

Okay, still not much to report flu-wise from the year 1918. Again, I don’t expect to hear anything about this til fall 1918, but I figure let’s keep tabs on what is reported.

Many items are war-related, and I’m not excerpting them all. There is a piece about American sugar being exported to Europe…. trying to read between the lines, but it seems people are a bit annoyed with this. What is sugar needed for in war?

The Red Cross notes they need more nurses:

There are various tech-in-war pieces, but I want to point out this one:

It’s not because they mention the telephone… but that they call it the World War. I think that the issue is before the U.S. entered, it was indeed called the Great War. But Americans saw this more as the World War than the Great War.

Americans were always better at branding and marketing than people from anywhere else. It’s not just the PT Barnum thing…thought that’s not unrelated.

Finally a few notes from my neck of the woods:

Those are just from the Croton Falls column, and the snarky/gossipy tone is always funny to read. Nobody much complained about flour being needed overseas for the war effort. It was just the sugar, it seems.

Elsewhere in the paper, they printed some letters from local boys sent home… I wonder about the effectiveness of military censorship… but then, I doubt the Germans & Austrians were reading the Brewster Standard in time for that knowledge to give any benefit. The letter would have been written weeks before, and the people writing would have little idea of the exact geography of where they were.

I think because of our relatively limited involvement in WWI, Americans tend to be less interested in it (also, it didn’t end in atomic bombs). But I think it’s a fascinating war, and this Kickstarter for a book called 1918 caught my eye… I’m thinking of backing it to get a poster.

Too often we don’t pay attention to history. It’s not so much that we’ll repeat it again, but that so many things make more sense if you actually know the cause-effect chain.

This is partly why I’m looking at the Spanish flu pandemic via local media of the time. I’m wanting to see what it looked like then.

Thing is, the media were a bit different business then — now, there may be interest in exaggerating the effects of the flu. I’m just a bit skeptical that this flu is worse in terms of mortality… next week I’ll try to grab the morbidity numbers, and that may give us a better feel as to whether the media hype is warranted.