Daily Management Review

Flu Returns To Europe, Threatens A Prolonged 'Twindemic'


Flu Returns To Europe, Threatens A Prolonged 'Twindemic'
After nearly disappearing last winter, influenza has arguably made a comeback in Europe at a pace that is faster-than-expected , generating fears of a lengthy "twindemic" with Covid-19, as well as some reservations about the efficacy of flu vaccines.
During the Covid-19 epidemic, lockdowns, mask-wearing, and social separation became the standard in Europe, knocking out flu last winter, and eradicating a virus temporarily. According to health statistics from, the European Union, influenza kills over 650,000 people world wide each year. 
However, as a result of extensive immunization, countries are adopting less stringent methods to combat Covid-19.
The European Centre for Disease Prevention and Control (ECDC) stated this month that flu viruses have been spreading throughout Europe at a faster-than-expected pace since mid-December.
According to ECDC and WHO data, the number of incidents of flu in European intensive care units (ICU) progressively increased in December, peaking to 43 in the final week of last year.
That's a far cry from pre-pandemic levels when the weekly flu infections that forced people into ICUs reached more than 400 at the same point in 2018.
However, data reveals that the 2021 data was a significant rise compared to 2020, when there was only one flu incidence in an ICU for the entire month of December.
According to Pasi Penttinen, the ECDC's senior influenza expert, the virus's reappearance could signal the start of an abnormally extended flu season that could go well into the summer.
"If we start to lift all measures, the big concern I have for influenza is that, because we have had such a long time of almost no circulation in the European population, maybe we will shift away from normal seasonal patterns," he said.
Abolishing restrictive measures in the spring might extend the flu season much beyond the customary end of the European season in May, he said.
According to the ECDC, a "twindemic" might impose undue strain on the already overburdened health systems of the region.
According to data released by the French health ministry last week, three regions in France, including the Paris region, are experiencing a flu epidemic. Others are in the early stages of an epidemic.
France has had 72 significant instances of flu so far this season, with six deaths.
To make matters worse, the predominant flu strain circulating this year appears to be the H3 type of the A virus, which is known to produce the most severe cases among the elderly.
It was not yet the opportune time to make a final judgment on flu vaccines since real-world assessments need a bigger number of sick individuals, Penttinen said. However, lab studies reveal that the H3 vaccines available this year "are not going to be optimal."
This is largely due to the fact that there was little or no virus circulating when the vaccines' composition was decided last year, making it difficult for vaccine producers to forecast which strain will dominate throughout the upcoming flu season.
Vaccines Europe, which represents the region's top vaccine makers, recognized that last year's low flu circulation made strain selection more challenging, but stressed that there was insufficient data to assess the efficiency of this season's injections.
Every year, flu vaccines are improved to ensure that they are as effective as possible against ever-changing flu viruses. Their make-up is determined six months before flu season begins, based on virus circulation in the opposite hemisphere. This allows drugmakers enough time to develop and manufacture the injections.
There is currently no data on flu vaccination uptake across Europe. However, national statistics for France suggest that coverage is not as extensive as officials had intended.
To encourage vaccinations, the authorities in that country extended the vaccine schedule by one month, to the end of February. According to numbers revealed last week, 12 million people, or around 45 per cent of the target population, had been vaccinated.
Flu vaccines are adapted every year to make them as effective as possible against ever-changing flu viruses. Their composition is decided six months before the flu season kicks in, based on the circulation of viruses in the opposite hemisphere. That gives time for drugmakers to develop and make the shots.
Europe-wide data on flu vaccine uptake is not yet available. But national figures for France show coverage is not as broad as authorities hoped for.
The authorities there extended by one month the vaccination period to the end of February to boost inoculations. According to figures released last week, 12 million people have so far been vaccinated, about 45% of the targeted population.
"There is still a large room for improvement to limit the impact of the flu epidemic," the health ministry said in a statement on Jan. 11. This year's target is to vaccinate 75% of people at risk.
Vaccines Europe stated the sector had supplied a considerable number of flu vaccines despite the pandemic's impact on production infrastructure.