As cases of omicron and influenza surge across the United States this winter, Vox's Dylan Scott argues that "flurona" will become the new "post-pandemic normal" flu season.

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Flu activity remains elevated despite a slight decline

Overall, flu activity in the United States during the week ending in Jan. 8 remained significantly higher than the 2020-2021 season —a trend that is expected to continue for several weeks.

According to CDC data, a total of 617 new flu cases were reported for the week ending in Jan. 8, down from 785 for the week ending in Jan. 1. During the same time period in 2021, the United States recorded just 4 and 16 new flu cases in those weeks, respectively.

Reports of influenza-like illnesses remained stable for individuals 65 and older and declined for all other age groups, CDC data shows. For the week ending in Jan. 8, 4.3% of patient visits reported nationwide were from respiratory illness that included a fever, cough, or sore throat, down from 4.8% the week prior. 

In addition, hospitalizations for influenza also declined. According to CDC data, 1,804 new hospital admissions for influenza occurred the week ending in Jan. 8, down from 2,615 the week prior.

Will we have a 'flurona' wave every year?

Influenza has always been a seasonal virus, with the dominant strain peaking sometime between December and February, Scott writes. However, Covid-19 spikes are not bound to a specific season, and in 2020 and 2021, the United States typically experienced small Covid-19 surges in the summer and larger surges in the winter.

Now is the time to move the needle on flu vaccinations

During the 2020-21 flu season, flu case numbers were abnormally low. Experts said measures meant to stem the spread of Covid-19, including school closures, social distancing, mask-wearing, and canceled travel, likely contributed to lower flu numbers. But now, flu cases are rising again, and Covid-19 case numbers and hospitalizations are at record levels.

Before the Covid-19 pandemic began, flu activity alone would place a significant strain on U.S. hospitals. Now, with the potential for both viruses' timelines to overlap, Scott says the United States will need to develop a new public health strategy that addresses Covid-19 and influenza surges as a single, unified threat.

"We are on the lip. We are in a transitional phase, moving from pandemic to endemic," said William Schaffner, medical director of the National Foundation for Infectious Diseases and a professor at Vanderbilt University. "With two of these respiratory viruses going on at pretty much the same time, I think that will create a greater stress on the health care system."

Separately, Richard Webby, an influenza expert at St. Jude Children's Research Hospital, said, "We know during a pretty bad flu season, that can put a strain on things," however, "[n]ow we're talking about two flu seasons."

However, according to Webby, this scenario is still hypothetical. It is possible that the flu and Covid-19 won't surge at the same time, and will instead spike and fade in cycles, Scott writes. And if the viruses spike in alternating waves, it could decrease the risk of an overwhelming number of patients flooding into U.S. hospitals.

2 reasons why flu season could be awful (and 2 reasons it might not be)

But, in a recent medical journal article, a group of advisers to President Joe Biden's transition team wrote that "Covid-19 must now be considered among the risks posed by all respiratory viral illnesses combined," and that this combination of respiratory viruses could overwhelm the U.S. health care system every winter.

According to Scott, the imperative to "flatten the curve" to limit "flurona" cases from overwhelming hospitals will be "with us for a long time." To combat these future waves, Anand Parekh, chief medical adviser at the Bipartisan Policy Center, said the United States should focus on vaccination, testing, treatment, and masking. (Scott, Vox, 1/18)