July 23, 2020

July 23, 2020

Influenza Surveillance Update – Alicia Budd (CDC)

Alicia provided an update for influenza activity through Week 28, ending July 11, 2020.  She also called attention to CDC’s weekly COVIDView surveillance summary, which will continue to be issued each week throughout the summer. This includes many of the same systems highlighted in FluView, as well as a few additional reports specific to COVID-19. She emphasized that COVIDView is not meant to be an all-inclusive source of COVID information. The remainder of Alicia’s presentation included information gleaned from both FluView and COVIDView.

SARS-CoV-2 has been increasing dramatically over the last few weeks. In contrast, influenza activity continues to remain very low, as has been true for several weeks. Of the low number of flu specimens that have been submitted, the majority of positives appear to be H1N1, with a small amount of influenza B. COVID testing results have varied by part of the country, with the largest increases in positives occurring in the southeast, south central, southwest, and southern west coast areas. Interpretation of lab reports has been challenging. Tests are classified by the date of collection, and there has been some lag in receipt of these reports, particularly after the July 4 holiday. This has increased the difficulty in making comparisons across weeks.

Reported influenza-like illness (ILI) has been well below baseline levels for several weeks at both the national and regional levels. Although two areas (Louisiana and Puerto Rico) are reporting moderate ILI activity, all other states and areas are at “minimal” levels. COVID ILI collected from the National Syndromic Surveillance Program (NSSP) Essence system indicates similar levels.

Lab-confirmed hospitalization data for both pneumonia and influenza (P&I) and COVID is captured in specific sites across the country. The FluSurvNet system has been stopped for this season. Not surprisingly, COVID-Net data indicate a 2-week increase in hospitalization rates, with 114/100,000 hospitalizations for all ages. Rates were highest in those 65 years of age and older, followed by persons 50–64 years of age. Hospitalization rates for children with COVID are much lower than those typically seen with influenza.

A total of 185 pediatric deaths from influenza have occurred during the current season. The most recently reported death actually occurred in May.

NCHS data for pneumonia and influenza (P&I) mortality indicates 5.3% of deaths were attributable to P&I. Although this is below the epidemic threshold, Alicia noted this may increase as additional death certificates are processed. When P&I and COVID (PIC) mortality reports are combined, the rate is 6.4%, which is above the epidemic threshold.

Current influenza reports from the Southern Hemisphere are lower than typically seen at this time of year. Approximately equal amounts of influenza A (both H1 and H3) and influenza B have been seen. Alicia reminded partners that global influenza data should be interpreted with caution, as the pandemic has influenced healthcare seeking behavior throughout the world. In addition, it is difficult to know if the lower levels seen in the Southern Hemisphere will translate to similar levels when flu appears in the U.S.

Because of possible co-circulation of influenza, COVID, and other respiratory diseases this season, it will be more important than ever to promote influenza vaccine, to reduce the impact on healthcare systems.

High dose influenza vaccine for persons age 65 and older will not be available to states through CDC’s supplemental vaccine purchase for the upcoming season. One partner suggested this is because Medicare covers flu vaccine for this age group.

Announcements – L.J Tan (IAC)
  • Summit Webinar: Impact of COVID-19 on Adult Immunization Coverage Rates and Update from CDC on Influenza Communications for 2020-2021 (July 30, 2020, 10am – 12pm ET) – During this virtual meeting, 6 vaccine manufacturers will present data on the impact of COVID-19 on adult immunization coverage rates , as well planned efforts to address this steep decline. In addition, BD will present on their efforts to ensure a stable supply chain of syringes and needles. Finally, CDC will provide information on communications plans for the upcoming influenza season.Registration information for the meeting is available online.
  • Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic – This valuable IAC/Coalition Network resource repository for healthcare professionals and partners includes links to a wealth of guidance and advocacy materials for maintaining immunizations during the pandemic. The listed items can be sorted and searched by date, title, geographic area, source, type, category and setting.
  • Summit Schedule – The Summit plans to reinstitute weekly meetings during the fall, though this can be impacted by COVID. L.J reminded partners to be sure to watch for email announcements.


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