Why are 'flu levels so low worldwide now?

[yorkie]

I came across this poorly written article today:

Flu Has Disappeared for More Than a Year

Mask wearing, social distancing and other steps to stop COVID-19 have also curtailed influenza

www.scientificamerican.com

Since the novel coronavirus began its global spread, influenza cases reported to the World Health Organization have dropped to minuscule levels. The reason, epidemiologists think, is that the public health measures taken to keep the coronavirus from spreading also stop the flu

The article goes on to state that the reduction in the US was from 34,000 flu deaths two years ago down to 600.

That's a decrease of a factor of nearly 60!

(Of course the true number would surely be far higher if deaths were measured with flu rather than due to flu but that's a whole new topic )

There is no doubt that Sars-CoV-2 has pushed influenza out, but the key question is why?

I do not believe that the unnamed epidemiologists who purportedly claim it was due to "public health measures"; if this is true then the countries with the least stringent measures are also being successful, and you'd also expect a correlation between stringency of measures and levels of flu. But there is no evidence of this.

I believe viral interference is much more likely, for example the 2009 H1N1 pandemic may have been disrupted by Rhinovirus strains:

Interference between rhinovirus and influenza A virus: a clinical data analysis and experimental infection study

These findings show that one respiratory virus can block infection with another through stimulation of antiviral defences in the airway mucosa, supporting the idea that interference from rhinovirus disrupted the 2009 IAV pandemic in Europe. These results indicate that viral interference can...

www.thelancet.com

During the 2009 pandemic of an emerging influenza A virus (IAV; H1N1pdm09), data from several European countries indicated that the spread of the virus might have been interrupted by the annual autumn rhinovirus epidemic. We aimed to investigate viral interference between rhinovirus and IAV with use of clinical data and an experimental model...

These findings show that one respiratory virus can block infection with another through stimulation of antiviral defences in the airway mucosa, supporting the idea that interference from rhinovirus disrupted the 2009 IAV pandemic in Europe. These results indicate that viral interference can potentially affect the course of an epidemic...

I've also wondered if Rhinovirus infections among school children have kept Sars-CoV-2 cases relatively low, particularly around September/October, which is when the Rhinovirus season commences.

Also, some people claim flu has gone. It hasn't; it's just at very low levels.

Pneumonia and flu now kill more people than Covid

Covid-19 death rate at lowest level in seven months as flu and pneumonia overtake

www.thetimes.co.uk

More people are dying from flu and pneumonia than from the coronavirus for the first time since the second wave. Deaths from the virus have fallen by a third in a week, according to official figures.

Covid-19 was listed as the underlying cause of death of 176 of the victims. In comparison, flu and pneumonia were the underlying cause for 278 deaths in the same seven-day period and were mentioned on 1,203 certificates.

I suspect the disparity may be greater, as there is less likelihood of testing of flu.

So it's great news that levels of flu are really low, but I think it's important not to draw the wrong conclusions and to keep an open mind.

 

[Mcr Warrior]

The old adage was always "coughs and sneezes spread diseases".

Wonder whether the reduction in the spread of 'flu is down to a significant worldwide reduction in social interactions, local journeys and international travel, and maybe the general requirement to wear face coverings in many indoor public settings (less likely that folk are coughing and spluttering in confined areas just now), which must surely have been possible factors in the spread of 'flu during more "normal" times?

Interesting thread, be good to read others' takes on this.

 

[initiation]

In various parts of the world flu cases plummeted last March as shown in these graphs. I have seen some assertions that this was down to mask usage however remember masks were not recommended, let alone mandated in much of the world until well after then.

Flu cases in Sweden also dropped of a cliff at the same time - they had no severe restrictions or mandatory social distancing.

 

[yorkie]

Indeed, mask usage can absolutely be ruled out as having any effect, as can actual "lockdowns".

I'd be prepared to accept a reduction in social interactions has probably had some effect, but there must be other factors at play; some countries were criticised for allowing mass gatherings yet influenza levels remained low there.

 

[pdeaves]

Just thinking out loud, but could it be that either reporting has dropped off because of other pressures, or diagnoses have changed (i.e. it's flu but it's recorded as covid-19 because that's all anyone thinks about now)?

Maybe, maybe not, I don't know.

 

[Bantamzen]

Just thinking out loud, but could it be that either reporting has dropped off because of other pressures, or diagnoses have changed (i.e. it's flu but it's recorded as covid-19 because that's all anyone thinks about now)?

Maybe, maybe not, I don't know.

This is certainly my first reaction.

 

[Devonian]

Even countries which have not gone for strict social distancing and mask wearing have recommended simple changes that will have made a huge difference to flu. Number one is regular, effective hand-washing, which is often overlooked as a good way to avoid transmission of things like flu and colds: people touch their faces all the time without realising it, and an awful lot of colds and flu infections start that way rather than just from people coughing and sneezing. And second there has also been an emphasis on keeping sick people at home: in a normal year we have all encountered people who are clearly ill and infectious but who come into work, merrily infecting colleagues, commuters and club-goers with colds and flu; this year there has been a heavy emphasis on not doing this all round the world, which will have had a signifcant impact on transmission of all sorts of diseases, including flu and diarrhoea/vomiting bugs which have also seen a decline.

Brazil is one country where there has been a significantly different approach, with not even basic infection precautions promoted by the goverment. Their flu levels dropped: but nowhere near as much as other countries; for example, in July 2020 hospitalised flu cases were running at about 60% the previous year's levels.

I believe viral interference is much more likely, for example the 2009 H1N1 pandemic may have been disrupted by Rhinovirus strains:

It may well have been a factor: but it cannot be the only factor, or areas with low incidence of Covid-19 might have been expected to have seen a greater incidence of flu more like a normal year. That hasn't happened.

mask usage can absolutely be ruled out as having any effect, as can actual "lockdowns"

That claim is rather bold, and medical studies over many decades report that non-medical hygiene interventions can have a significant effect on transmission of disease, with studies over the last year suggesting that Covid-19 is no exception. If wearing a mask did not reduce transmission of airborne infections, then medical staff would not have been wearing them (without ill effects) for a century or so. And separating ill people from healthy people has always been an effective way of preventing transmission. The effects may be less than commonly assumed, and the measures we have endured more strict and frustrating than necessary, but it is a strong exaggeration to say that they have had no effect at all.

Neither of these measures absolutely stops transmission, but they will reduce transmision of respiratory disease. It's important to note that even a limited effect on transmission can have a more significant impact on flu levels than Covid: the R-rate that has become so familiar in the Covid stats is naturally much lower for flu (typically about 1.3, compared with 2-3 for Covid-19), so requires less strict interventions to keep transmission levels below those needed for rapid growth of infections. In other words, weak or partially-observed precautions that don't work for highly infectious Covid can still work against flu.

it's flu but it's recorded as covid-19 because that's all anyone thinks about now

Possible: but there is extensive testing for Covid-19 in many countries, so unless people are suffering both conditions simultaneously and Covid-19 asymptomatically, we have a pretty good idea of how many are ill with bone-fide Covid-19 and not just a bit of a sniffle.

 

[WelshBluebird]

The measures put in place to combat COVID-19 will absolutely be having an impact. Even if you take the view that the specific legal restrictions and things like masks don't have much of impact - just the very fact that people have been staying at home more, aren't mixing as much as usual etc will have had a massive impact. Even in places that haven't had as strict guidelines and legal restrictions as we have, people have still being mixing less than normal, there haven't been as many large scale events as normal etc, and so that is why you still see they have had a massive drop off too.

And at least in the UK, we had a larger than usual takeup of the flu jab in the winter which would have helped too. And I wouldn't be surprised if other countries had the same.

And then of course you will have some other things at play too, like already mentioned by someone else, people's attention has been on COVID so people who have flu like symptoms may well have got tested for COVID but not flu. And yes, a small number of false diagnosis's where either because of the accuracy of tests or other reasons, a small number of flu cases may have been counted as COVID (but the idea that was posted on this forum a while ago that flu was being purposefully misdiagnosed as COVID is just bananas).

some countries were criticised for allowing mass gatherings yet influenza levels remained low there.

Unless those countries did nothing about COVID, then I don't see how you can do any real comparison. I'm not taking masks and lockdowns, I'm just talking about in general people mixing less than a regular year and people washing their hands more etc. It was my understanding that flu is less transmissible than COVID (as it was initially reported last year, and has been reported several time since then, but I'll admit I've not read much detail) so any action taken to try to prevent COVID would likely have a larger effect on flu.

 

[yorkie]

The measures put in place to combat COVID-19 will absolutely be having an impact. Even if you take the view that the specific legal restrictions and things like masks don't have much of impact - just the very fact that people have been staying at home more, aren't mixing as much as usual etc will have had a massive impact...

Are levels of influenza high in places like India, where there was until recently a lot of mixing, right now?

... I'm just talking about in general people mixing less than a regular year and people washing their hands more etc. ...

Has that been occurring in places like India in recent months?

Are you saying you don't believe viral interference exists, or that you believe it has only a minimal impact?

...That claim is rather bold, and medical studies over many decades report that non-medical hygiene interventions can have a significant effect on transmission of disease, with studies over the last year suggesting that Covid-19 is no exception. If wearing a mask did not reduce transmission of airborne infections, then medical staff would not have been wearing them (without ill effects) for a century or so....

How do you explain places like Sweden then? Hardly any mask wearing there.

 

[WelshBluebird]

Are levels of influenza high in places like India, where there was until recently a lot of mixing, right now?

My understanding is that India put in place measures like lockdowns, closing non essential businesses, larger scale than usual working from home etc etc.
Similar in nature to some of the measures put in place in countries like ours actually.

Now, by all means you can have an argument about how effective those were at combating COVID (especially in India's case where their reaction causes a lot of issues with migrants and people wanting to travel back to their families etc). But that isn't what I want to get into.

The fact is that they did act in some way so it is pretty disingenuous to suggest that they didn't. And it certainly can't be used as an example where efforts to combat COVID couldn't have impacted flu, because they did do things to combat COVID (or at least try).
The only way your comparison would be a fair one as far as I can see is if you had a country where the government and the people who live there didn't do anything to combat COVID and you saw the massive dropoff in flu cases there too. And as far as I am aware, that country doesn't exist because pretty much everywhere has done something (even if some places have been less strict than others - at the very least most places have had some kind of social distancing and better hygiene, either enforced or voluntary).

And as I said, there are also other things at play. Things like a higher takeup of the flu vaccine (at least in the UK, but likely elsewhere too).

Has that been occurring in places like India in recent months?

As above. They had lockdowns and many other measures in during the course of 2020 to now.
How effective that has been is a different matter - but claiming some of the things to try to combat COVID haven't happened in India is just false.

Are you saying you don't believe viral interference exists, or that you believe it has only a minimal impact?

I did say "and then of course you will have some other things at play too". You pick up on a few of them in the original post too (e.g. just generally there is less testing for flu, both in comparison to COVID but also probably less flu testing this year than in previous years).
There will be a fairly large number of things affecting this, too many to list in a forum post whilst I am waiting for my code to build and deploy!

But to answer you directly, I think it probably has an impact (the BBC reported something along those lines not too long ago about the common cold impacting COVID, so I wouldn't be surprised if something similar is happening with COVID and the flu too). But I don't think it has had as much impact as people mostly staying away from each other for over a year (or at least people staying more away from each other than a normal year).

 

[greyman42]

Possible: but there is extensive testing for Covid-19 in many countries, so unless people are suffering both conditions simultaneously and Covid-19 asymptomatically, we have a pretty good idea of how many are ill with bone-fide Covid-19 and not just a bit of a sniffle.

Flu is much more than a bit of a sniffle. I had Covid over the Xmas period and i had genuine flu about two and a half years ago. I would say that the flu was slightly worse but both share the same sort of symptoms.

 

[yorkie]

My understanding is that India put in place measures like lockdowns, closing non essential businesses, larger scale than usual working from home etc etc.

They did but they unlocked quite rapidly. Are you saying imposing a lockdown for a brief period gets rid of influenza a year later?

Similar in nature to some of the measures put in place in countries like ours actually.

Are you sure India had similar measures to the UK earlier this year?

Now, by all means you can have an argument about how effective those were at combating COVID (especially in India's case where their reaction causes a lot of issues with migrants and people wanting to travel back to their families etc). But that isn't what I want to get into.

The fact is that they did act in some way so it is pretty disingenuous to suggest that they didn't.

But what about recent months? I'm not just talking about a year ago! It is you who is being disingenuous, not me.

And it certainly can't be used as an example where efforts to combat COVID couldn't have impacted flu, because they did do things to combat COVID (or at least try).

See above.

The only way your comparison would be a fair one as far as I can see is if you had a country where the government and the people who live there didn't do anything to combat COVID and you saw the massive dropoff in flu cases there too. And as far as I am aware, that country doesn't exist because pretty much everywhere has done something (even if some places have been less strict than others - at the very least most places have had some kind of social distancing and better hygiene, either enforced or voluntary).

You can say it's not fair all you like, but you have not offered any explanation as to why it is that influenza rates are consistently so low across the globe, and especially so in places that have had high rates of Sars-CoV-2.

And as I said, there are also other things at play. Things like a higher takeup of the flu vaccine (at least in the UK, but likely elsewhere too).

Are you saying everywhere in the world has a high takeup of the flu vaccine?

Flu is much more than a bit of a sniffle. I had Covid over the Xmas period and i had genuine flu about two and a half years ago. I would say that the flu was slightly worse but both share the same sort of symptoms.

It really depends on the person; many people can be asymptomatic with influenza, or with Sars-CoV-2. I also know someone who was hospitalised with a Rhinovirus.

 

[YorkshireBear]

Is it possible that COVID-19, as it is more transmittable (that is an assumption on my part) is just infecting and killing those that would often succumb to flu. Not as an exclusive rule but could that take out a high number, especially over 70s.

 

[Horizon22]

I'd have thought even the very basic measures - the first of which is regular hand-washing - would on its own have a measurable impact on reduce spread and infection. Also it may be that initial transmitters and spreaders had already been infected and sadly lost their lives to Covid-19. I'm no epidemiologist but there's got to be some crossover between a novel disease "muscling out" the seasonal flu.

I guess we'll only truly know when we get to Autumn / Winter this year and see what the relative rates are.

 

[yorkie]

Is it possible that COVID-19, as it is more transmittable (that is an assumption on my part) is just infecting and killing those that would often succumb to flu. Not as an exclusive rule but could that take out a high number, especially over 70s.

Absolutely, and it's pushing 'flu out due to viral interference, in my opinion.

I'm surprised to see some people (who I believe are very pro-restriction) appear to be denying this.

Here is another article regarding the phenomenon:

Human Rhinovirus Infection Blocks Severe Acute Respiratory Syndrome Coronavirus 2 Replication Within the Respiratory Epithelium: Implications for COVID-19 Epidemiology

Human rhinovirus triggers an innate immune response that blocks severe acute respiratory syndrome coronavirus 2 replication within human respiratory epithe

academic.oup.com

Virus-virus interactions influence the epidemiology of respiratory infections. However, the impact of viruses causing upper respiratory infections on SARS-CoV-2 replication and transmission is currently unknown. Human rhinoviruses cause the common cold and are the most prevalent respiratory viruses of humans. Interactions between rhinoviruses and co-circulating respiratory viruses have been shown to shape virus epidemiology at the individual host and population level. Here, we examined the replication kinetics of SARS-CoV-2 in the human respiratory epithelium in the presence or absence of rhinovirus. We show that human rhinovirus triggers an interferon response that blocks SARS-CoV-2 replication. Mathematical simulations show that this virus-virus interaction is likely to have a population-wide effect as an increasing prevalence of rhinovirus will reduce the number of new COVID-19 cases.

I remember in the autumn seeing many kids who were clearly unwell being sent home. I suspect they had rhinoviruses. The idea that they didn't get viruses at all due to apparent distancing measures (which had them sitting in close proximity to each other) seems preposterous to me.

I'd have thought even the very basic measures - the first of which is regular hand-washing - would on its own have a measurable impact on reduce spread and infection. ...

To some extent, but not to anywhere near the extent we have seen. So if this was the answer, we would see a similar reduction in Rhinovirus transmission.

But I know from personal experience Rhinoviruses were rampant in the usual Rhinovirus season!

 

[WelshBluebird]

They did but they unlocked quite rapidly.

Nope. They went into lockdown at the end of March and the unlocking started at the start of June, but with different restrictions still in place throughout basically all of the year.
Not that different to us (lockdown at the end of March, opening up starting in the middle of June with different restrictions in place through the rest of the year). The difference started really in October / November where we locked down again, India didn't - but they did keep some measures still in place.

Are you saying imposing a lockdown for a brief period gets rid of influenza a year later?

They still had various restrictions in place for most of the year and into this year (which then got stricter again once they started having another wave).
So I am saying that ongoing actions to limit the mixing of people (which is what we have seen in nearly every single country for the last 12 - 14 months) does essentially get rid of flu (and before you try to suggest that I am am supporting this - I am absolutely not suggesting we should try that going forward to eliminate flu).

Are you sure India had similar measures to the UK earlier this year?

My comparison to the UK was based on the initial reaction both countries had last year. But in terms of earlier this year, my understanding is that they still had various restrictions in place. Not as strict as we had it, but still with things like indoor capacity limits, mask wearing in public etc.

But what about recent months? I'm not just talking about a year ago! It is you who is being disingenuous, not me.

See above.

As above - they certainly had some level of restrictions over the last few months.

You can say it's not fair all you like, but you have not offered any explanation as to why it is that influenza rates are consistently so low across the globe

Pretty much every country across the globe has done something to try to combat COVID. Given flu is less transmissible, those measures have been enough to essentially strangle the flu for this year.

Are you saying everywhere in the world has a high takeup of the flu vaccine?

I am saying that the UK had a higher takeup than regular years and so it is likely at least some other countries have seen the same that has helped.
It will be one of the numerous other things going on at the same time - and I suspect that aside from measures relating to COVID, each country will likely have its own mix of reasons.

 

[Darandio]

Possible: but there is extensive testing for Covid-19 in many countries, so unless people are suffering both conditions simultaneously and Covid-19 asymptomatically, we have a pretty good idea of how many are ill with bone-fide Covid-19 and not just a bit of a sniffle.

Have you ever had flu? From this i'm guessing not.

 

[Mcr Warrior]

Pretty much every country across the globe has done something to try to combat COVID. Given flu is less transmissible, those measures have been enough to essentially strangle the flu for this year.

That would certainly seem to be a common sense interpretation, maybe something positive from over a year of COVID-19!

 

[yorkie]

@WelshBluebird as you've ducked the questions and not posted anything compelling to support your position, which makes no real sense to me, there is nothing much for me to say in response.

That would certainly seem to be a common sense interpretation, maybe something positive from over a year of COVID-19!

To be clear are you suggesting you do not think viral interference plays an important part?

How do you explain rhinovirus infections not reducing to a similar level?

 

[EssexGonzo]

Is it possible that COVID-19, as it is more transmittable (that is an assumption on my part) is just infecting and killing those that would often succumb to flu. Not as an exclusive rule but could that take out a high number, especially over 70s.

This was also described as the “dry tinder” effect by one scientist. Covid has cleared out a large group of people who were already vulnerable to respiratory viruses and were “waiting to be picked off by something or other” (a paraphrase of said scientists comments). This may also lead to lower flu cases in the upcoming flu season.

 

[30907]

In various parts of the world flu cases plummeted last March as shown in these graphs. I have seen some assertions that this was down to mask usage however remember masks were not recommended, let alone mandated in much of the world until well after then.

Flu cases in Sweden also dropped of a cliff at the same time - they had no severe restrictions or mandatory social distancing.

Flu is a seasonal illness that peaks in January, so the sharp drop in March 2020 is not that unusual. The almost-absence of a flu season in both hemispheres subsequently is much more interesting.

 

[Mcr Warrior]

To be clear are you suggesting you do not think viral interference plays an important part?

Whilst it's very possible that viruses outcompeting each other may be a factor of some significance in 'flu levels currently being low, I am nevertheless still of the opinion that the more simpler explanation (reduced global opportunities for transmission) is the more likely to have been the reason for this phenomenon.

Happy to change my opinion, though, if anyone is able to put forward a more persuasive argument.

After all, that's what "the science" is all about!

 

[yorkie]

This was also described as the “dry tinder” effect by one scientist. Covid has cleared out a large group of people who were already vulnerable to respiratory viruses and were “waiting to be picked off by something or other” (a paraphrase of said scientists comments). This may also lead to lower flu cases in the upcoming flu season.

This absolutely true in terms of influenza deaths but I don't think this explains low levels of the virus in circulation.

Flu is a seasonal illness that peaks in January, so the sharp drop in March 2020 is not that unusual. The almost-absence of a flu season in both hemispheres subsequently is much more interesting.

Yes that's right. The influenza season follows the Rhinovirus season.

If Sars-CoV-2 becomes endemic (which seems highly likely in my opinion), I suspect it will fit in between the two. It will be interesting to see if that happens...

 

[Devonian]

How do you explain places like Sweden then? Hardly any mask wearing there.

I refer you back to another part of my earlier comment: Sweden does have in place other measures such as hand-washing and discouraging sick people from circulating, which will have a significant impact on infectious disease in general (though not enough to stop an eventual rise in Covid-19). Mask wearing is only one of the tools that has been put into place, and a highly unusual step due to the increased airborne transmissibility of Covid-19 in comparison with other resiratory diseases.

So if this was the answer, we would see a similar reduction in Rhinovirus transmission.

But I know from personal experience Rhinoviruses were rampant in the usual Rhinovirus season!

Rhinoviruses are more infectious than flu - they can have a similar level of infectiousness to Covid-19. However, they are much more frequently asymptomatic than flu or Covid-19, so may be spread more widely by asymptomatic carriers. There was significant reduction in detected Rhinovirus transmission in the first half of 2020 after the first stay-at-home order. It is true that Rhinoviruses began to circulate again once initial lockdown measures were eased, but not to the extent that they would normally do: about 80% less than the previous year with no summer peak (https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30502-6/fulltext#fig1). However, you are right there was a huge resurgence of Rhinoviruses once the schools went back in September, with school-age people and their families particularly affected. It is up to you whether you consider this to be likely due to the notorious difficulties of making children follow hygiene and distancing guidance in crowded schools and on school buses, or to the lower incidence of Covid-19 in that age group! EDIT: Note that both Rhinovirus and Covid levels were high in December, suggesting that the former was not blocking the latter.

[Covid-19 is] pushing 'flu out due to viral interference, in my opinion.

I'm surprised to see some people (who I believe are very pro-restriction) appear to be denying this.

Again, in my original reply I agreed that this may well be one factor, and there is certainly evidence of the general principal that one virus can block another, but there are two examples readily at hand that suggest that this is not necessarily the only factor, or even the most important factor, in reduced flu: (1) Brazil, with a high incidence of Covid-19 and low implementation of infection prevention measures, has seen a higher level of flu than countries which have put strict measures in place; and (2) areas with low incidence of Covid have not seen a higher prevalence of flu instead. I absolutely agree that there is likely that there will be some viral interference - and it would surprise me as much as it would surprise you if Covid-19 didn't 'trump' flu if a person were exposed to both - but not enough to remove the need for a multi-pronged approach, unfortunately. Ultimately it is better if neither flu nor Covid-19 is circulating widely, because, as others have noted, flu is a serious illness too.

Of the measures that have been put in place in the last year, I hope that better hygiene and better arrangements for allowing infectious people to be off work without stigma or financial penalty will be positive long-term things to come out of this dreadful period. They are the least intrusive measures that are likely to have the greatest benefits for reducing transmission of a wide range of illnesses.

 

[Yew]

R for flu is lower, therefore it wouldn't surprise me if the lower restrictions we had over the summer were still more than enough to put a massive dent in circulation

Furthermore, the NHS has been super on it with the flu jabs, we probably have our highest ever flu jab uptake.

And of course, if someone dies from flu-driven pneumonia, but has some traces of dead virus in their lungs, we count it as covid.

 

[RuralRambler]

Indeed, mask usage can absolutely be ruled out as having any effect, as can actual "lockdowns".

I'd be prepared to accept a reduction in social interactions has probably had some effect, but there must be other factors at play; some countries were criticised for allowing mass gatherings yet influenza levels remained low there.

I fully agree it wasn't masks as they were hard to find to buy back in March and, like you I think, I think masks are mostly a waste of time. But there were a lot of precautions being suggested from the end of February that could help account for it, in the UK at least, such as people being told to wash hands more often, avoid hand shakes, social distance where possible indoors in pubs & restaurants, etc. My last face to face client meeting was 10th March and I remember us both almost shaking hands, automatically, and then realising at the the same moment, to bump elbows instead, so as early as 10 March, people were starting to take precautions - I've checked my office diary to get the date of that memorable meeting. We also went for a short break in the February half term (to take son to Uni open day) and I remember my wife wiping down the surfaces etc in the hotel room with anti-bac, so again, the risks of covid must have been "a thing" back as far as late February.

 

[24Grange]

Flu rebranded as Covid ( or mixed in with statistics) so that flu isn't reported? Don't know basically

 

[yorkie]

I fully agree it wasn't masks ...

Indeed; authoritarians are really scraping the barrel with that one!

...I remember us both almost shaking hands, automatically, and then realising at the the same moment, to bump elbows instead, so as early as 10 March, people were starting to take precautions - I've checked my office diary to get the date of that memorable meeting. We also went for a short break in the February half term (to take son to Uni open day) and I remember my wife wiping down the surfaces etc in the hotel room with anti-bac, so again, the risks of covid must have been "a thing" back as far as late February.

But would this apply throughout the Southern Hemisphere? That would seem a bit far-fetched to me.

 

[Purple Orange]

Who are the authoritarians? Not some mumbo jumbo about non-existent lockdown junkies, but who with power and influence? And is it the power that makes them act in an authoritarian manner in your view?

 

[LancasterRed]

What has caused the reduction in flu? Honestly, I'd guesstimate a bit of everything. Improved hygiene standards I would attribute mainly, but to take a holistic view would be the most logical.

Flu rebranded as Covid ( or mixed in with statistics) so that flu isn't reported? Don't know basically

Likely a bit of this too.