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A needle and syringe used to administer the flu shot in Virgil, Ont., Oct. 5, 2020.Tara Walton/The Canadian Press

Fears of a “twindemic” have not materialized this year, with hardly any cases of the flu in Canada this season, while COVID-19 cases continue to rise across the country.

Testing for the flu has been significantly higher than in past years. From Dec. 6 to 12, the Public Health Agency of Canada (PHAC) tallied 14,113 tests, twice the average for this week over the past six seasons. Just 0.02 per cent of tests were positive, compared with an average 16.8 per cent over the previous six years.

Dr. Danuta Skowronski, the Epidemiology Lead of Influenza at the BC Centre for Disease Control, says she has never seen such low circulation of the flu.

“I’ve been working on influenza surveillance and research for more than 20 years, and I’ve never seen this exceptionally low activity,” she said.

Dr. Shelita Dattani, director of professional affairs at the Canadian Pharmacists Association, says physical distancing and mask rules aimed at slowing the spread of COVID-19 have limited cases of the flu dramatically. With flu season now past its peak, she doesn’t expect numbers to jump in January and February.

“The efforts that we’re taking to reduce the spread of COVID are working … people are masking and distancing and staying away from each other and using hand hygiene, so I think all of these efforts combined are contributing to lower rates.”

A sharp reduction in international travel may also be limiting circulation of the flu, according to Dr. Samir Sinha, director of geriatrics at Sinai Health in Toronto.

Severe reactions to the flu are also virtually nonexistent. PHAC has not reported a single flu-related hospitalization or death since tracking started in late August. Last flu season, there were 274 flu-related hospitalizations, 31 intensive care unit admissions and three deaths.

Dr. Sinha says the lack of flu has eased pressures on hospital staff that are already stretched thin by the pandemic.

“Our hospitals are absolutely [at] capacity in Ontario, and we’re not coping well already with the current second wave,” he said. “Just imagine if you then put our usual hospitalization volumes related to pneumonia and the flu on top of that. Our system would’ve collapsed weeks ago.”

At Vancouver Coastal Health, a regional authority that operates 13 hospitals, there are fewer hospitalizations owing to the flu.

“Each year, we see a rise in hospitalization rates during influenza season, particularly among older populations most vulnerable to severe illness,” said Rachel Galligan, a spokesperson for VCH. “Physical-distancing guidelines and the provincial health orders have reduced the transmission of influenza in our community, and this has in turn lowered hospitalization rates.”

In British Columbia, Dr. Skowronski says they haven’t detected any seasonal influenza, even though they have more than doubled their testing efforts compared with years past. Usually, she says, the province would have detected hundreds of cases by now.

COVID-19 restrictions have changed where people receive the shot. The workplace flu clinic has been replaced by drive-thru clinics that allow for physical distancing. Dr. Dattani says there has been a sharp increase in flu-shot demand, with more people getting vaccinated this year than usual.

“The demand in some provinces has been up [by] hundreds of percentages,” she said. In Alberta, more than 1.4 million people have already received the flu shot this season; that is how many people received it from August, 2019, to May this year.

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