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Many cases of flu this year: the fault of the pandemic

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Many cases of flu this year: the fault of the pandemic

The flu is back, and it’s hard not to notice. Since the beginning of winter there are already two and a half million Italians bedridden by flu or flu-like syndromes, 760 thousand in the last week alone. Practically double compared to the same period last year. And looking at the rest of the world, the situation is the same everywhere. What happens? Nothing strange, actually, because it’s a situation that has been foreseen for some time. Which depends on several factors, as a consequence of the efforts made in recent years to stem Covid 19.

The phenomenon we are witnessing is in fact largely caused by what specialists call immunity gap, or more recently immunity debt. A term that in the past was mainly used when talking about vaccines, to refer to the risk of new epidemics when vaccination coverage falls below the safety threshold. In recent months, however, he has been used more and more often to talk about the circulation of respiratory viruses following the abolition of the distancing measures with which we have faced Covid 19.

Put simply, speaking of an immunity “gap” or “debt” simply means noting that anti-Covid measures have brought down cases of flu and other respiratory diseases in the past two years, and that this flu season without distancing and masks offers viruses the perfect opportunity to get back on track. That the 2020 and 2021 infection debt, in short, will have to be paid, and with interest.

In a normal winter, a good percentage of the population encounters seasonal pathogens: influenza viruses, the many parainfluenza viruses, colds, or the respiratory syncytial virus (dangerous mainly for the little ones). Someone gets sick, someone has mild symptoms, someone is completely asymptomatic. The important thing is that millions of people following the infection develop antibodies that will defend them during the following season.

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Or at least, they will to some extent. In fact, viruses such as the flu are particularly good at mutating so as not to be recognized by our immune system. And at the same time, the defenses that our body develops against these pathogens are short-lived. That’s why the flu and colds come back every year, inexorably. Despite everything, periodic exposure to pathogens still guarantees a certain percentage of resistance to a significant portion of the population.

However, if the viruses don’t show up for a couple of years, as happened while we were fighting against Covid, things change. The percentage of people who are immune drops dramatically. That of susceptible people grows. And viruses find the perfect conditions to circulate freely, causing faster and more intense epidemics than normal.

That’s not the only reason why this year’s flu season got underway so quickly. As we said, there are many possible causes, and they probably all contribute to pushing the virus race. For example, someone cites a phenomenon known as viral interference, i.e. the fact that multiple viruses competing to infect the same population can get in the way. A phenomenon that we have all experienced in our lives: getting infected with one virus immediately after recovering from another is something extremely rare. The reason is not certain, but it is suspected that it is due to the activation of the immune system, which once defeated the disease remains at the highest levels of alert, and is therefore more difficult for any pathogen to evade.

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In the past two years, Covid has dominated the scene, being extremely virulent and also unknown to our immune system, and in this way has limited the circulation of other respiratory viruses precisely due to the phenomenon of viral interference. Now that most of us are vaccinated or have had Covid 19 (or both), the benefit of Sars-Cov-2 is very small, and the other viruses can run wild again.

Last but not least, it is possible that the flu circulating this year is caused by a particularly infectious or virulent virus. In Australia, where the flu season precedes that of the northern hemisphere by several months, this year’s outbreak was indeed particularly severe. And the virus that has been circulating the most in Italy in recent weeks, a subtype called H3N3 – Darwin, was identified for the first time in Australia at the end of 2021

Fortunately, the Australian virus is among those thrown into the mix making up this year’s flu vaccine. Elderly, children, frail people and all the other categories for which vaccination is recommended, if they follow the recommendations of our Ministry of Health, they will therefore be protected, at least from the risk of the most serious symptoms of the flu. For others, it is somehow about getting back to normal. Respiratory viruses existed before Covid, and will continue to exist in the future. Influenza epidemics and pandemics will continue to strike with regularity, and prevention rules can only help up to a point. When you get sick, therefore, all you have to do is go to bed and wait for it to pass, without exaggerating with anxiety.

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