A flu season in full force

For the past two years, we’ve kept our distance from others, sanitised regularly and isolated ourselves inside the home, which basically has meant we’ve been as far away from the common cold during flu season as possible.

This year, with regulations loosened and people going about their business almost as before, we’re more exposed and less immune than ever. Healthcare professionals are preparing for flu season in full force.

As we know, usually between April and October, people generally become more susceptible to experiencing the flu or the common cold. These months are colder but this isn’t the sole reason for cases of flu rising at this time.

Flu season’s causes include:

  • Lack of sunlight. Days are shorter in winter, with the reduced sunlight meaning decreased levels of vitamin D and melatonin, both of which require sunshine for generation. Lack of vitamin D compromises immune systems, which inevitably decreases the body’s ability to fight a virus.¹
  • More time spent indoors. With people inside more and windows often sealed, they are more likely to breathe the same air as a flu-infected person and can thus contract the virus.¹
  • Flu survives better in colder, drier climates. Therefore, a larger number of people than usual can be infected with the flu virus.¹

For years, Australians have been used to the flu season and ready for it when it arrives, so it’s understandable that when Covid-19 arrived and the flu season came to a screaming halt, it was a shock to the system.

Pharmacists play an integral role when it comes to advice on flu season issues, and community pharmacies can ensure the appropriate products, services and treatment advice are provided to help protect customers as best they can.

Accredited consultant pharmacist Karalyn Huxhagen works in a Queensland community pharmacy and often provides advice on the management of colds and flu for customers.

“The last winter season we saw a significant decline in cold and flu presentation,” she said.

“In the past two years patients have been isolating at home, following distance rules and wearing masks, so all the contagion diseases spread by droplet transmission have been less.”

In 2021, flu was recorded at historically low levels in Australia, according to the online  Flutracking surveillance system.²

The system recorded no cases of flu among more than 52,000 participants in its weekly report issued on 21 April 2021, while for the first 16 weeks of that year, there were only 214 laboratory-confirmed cases nationwide.²

For comparison, by the same time in 2020, there were 20,366 recorded cases and in 2019 the figure topped more than 43,000.²

Flu makes a 2022 comeback 

Since the thick of Covid-19, social distancing, mask-wearing and other hygiene practices have begun to lag, which puts the community in a dangerous position. For so long across the world, countries have practised strict hygiene rules and confined themselves indoors, which has reduced their chances of catching the virus.

Ms Huxhagen says pharmacies have raised concerns about the flu season of 2022 and will be encouraging practices aimed at ensuring community safety this season.

“There’s been a significant awareness program to have patients vaccinated against pneumonia, but due to Covid and patients being seen more by using telehealth rather than in face-to-face consults with their GP, there’s been less surveillance and administration of vaccine programs, other than [for] Covid-19,” she said.

Deputy Director of the World Health Organisation Collaborating Centre for Reference and Research on Influenza at the Doherty Institute, Professor Ian Barr was emphatic in his prediction to newsGP (RACGP-owned media) that “flu will be back this year”.⁴

“With increased travel and more porous borders, and lack of quarantine and no testing for influenza at border sites, it’s inevitable it’ll get back in this year,” he said.⁴

It’s generally agreed across the healthcare industry that the flu vaccine will be the best solution for ensuring our communities are kept safe.

Solutions of the season 

According to Ms Huxhagen, the most important service that pharmacists can provide is valuable and helpful advice that leads the customer in the right direction.

“We will support customers with quality advice and recommend products that are effective to manage their symptoms,” she said.

“We will provide counselling on non-pharmacological treatments [for flu patients] such as staying well hydrated, staying at home until well, and eating nourishing food.”

Ms Huxhagen says community pharmacy customers should be advised of ways in which they can increase their protection against flu this year: “Stay away from people who have coughs and colds, increase hand washing and be aware of your environment and the chance of catching a cold or flu. Stay well and healthy with a good diet, sleep and exercise.”

The US Centres for Disease Control and Prevention (CDC) echoes this advice in its tips to help people avoid succumbing to cold or flu:⁵

  • Avoid close contacts. Stay away from those that are sick, and if you become sick, ensure you keep your distance from others to protect them from getting sick as well.
  • Stay home. If possible, stay home from work, school and errands when you have the flu. This will prevent spreading your illness to others.
  • Cover the mouth and nose with a tissue when coughing and/or sneezing – a simple, yet effective move.
  • Avoid touching the eyes, nose or mouth. Germs are spread when a person touches a surface contaminated with germs and then touches their eyes, nose or mouth, which can spread those germs further.

Advice for pharmacists 

Ms Huxhagen advises her fellow pharmacists to take particular care when it comes to the types of products they choose to recommend to customers in their community during flu season.

“Always know the role of each ingredient in a product and its potential to do harm or be of benefit,” she said.

“Treat the symptoms and always ask the questions to determine which product is the best for the customer.”

References:

  1. Harvard University. 2014. ‘The reason for the season: Why flu strikes in winter’. hms.harvard.edu/flash/2014/the-reason-for-the-season-why-flu-strikes-in-winter/
  2. RACGP. 2021. ‘Influenza remains at record low levels to start 2021’. racgp.org.au/newsgp/clinical/influenza-remains-at-record-low-levels-to-start-20
  3. Young G, et al. 2020. ‘Rapid decline of seasonal influenza during the outbreak of Covid-19’. DOI: 1183/23120541.00296-2020.
  4. RACGP. 2022. ‘Flu return ‘inevitable’ in 2022’. racgp.org.au/newsgp/clinical/flu-return-inevitable-in-2022
  5. CDC. 2021. ‘Healthy habits to help protect against flu’. cdc.gov/flu/prevent/actions-prevent-flu.html

This feature was originally published in the May issue of Retail Pharmacy magazine. 

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