I provided one link to the SE Asia origination of flu in my post above. There's plenty more information out there.

Obviously it can technically originate/mutate from anywhere, but most come from South, East, and SE Asia due to climate and population density.

If the flu in every place was simply due to local mutation, then developing a vaccine each year would be impossible.

Instead - there are mutations from source locations, that then spread seasonally. That's how they can pick which strains to put in the vaccine before it arrives in Northern temperate climates.

Not sure the data is available anywhere, but it would be interesting to see number of tests performed and % positives per week on the flu. I'm curious if the number of tests has dropped because of the resources and concern put into COVID.

Are patients with a mild flu going to get COVID tested and then by the time those results are negative are too late for the flu test to matter, possibly getting over the flu already? My daughter was tested at our local CVS recently and got the results back on Sat from a Wed test. She didn't have symptoms but was a potential contact and was negative. But that is a 4 day delay in results and if she actually had the flu, would have been 4-5 days into a 7 day illness, likely starting to feel better. Unless the symptoms are bad enough to seek a doctor, and I'm guessing the threshold of that may be higher for a lot of people this year, just ride it out at home and know it isn't COVID but never get a positive test.

Are docs testing every case of flu like symptoms for COVID and skipping the rapid flu test? In years past, and hint of flu like symptoms during flu season has resulted in a rapid flu test. Now everyone is thinking COVID first rather than flu. Docs should be able to run the rapid flu and take the COVID sample to send to the lab at the same time, but I have also heard of doc offices doing telemedicine for a flu/COVID like illness and sending to drive through testing rather than come into the office. No chance to do a flu test if you don't let them in the building.

Apples and oranges but took our daughter to our pediatrician because of strep symptoms. First thing they did was the quick strep test which came back negative and then did a covid test.

Both ended up being negative.

Whats up with Iowa?

BiochemAg97 said:

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Not sure the data is available anywhere, but it would be interesting to see number of tests performed and % positives per week on the flu. I'm curious if the number of tests has dropped because of the resources and concern put into COVID.

Are patients with a mild flu going to get COVID tested and then by the time those results are negative are too late for the flu test to matter, possibly getting over the flu already? My daughter was tested at our local CVS recently and got the results back on Sat from a Wed test. She didn't have symptoms but was a potential contact and was negative. But that is a 4 day delay in results and if she actually had the flu, would have been 4-5 days into a 7 day illness, likely starting to feel better. Unless the symptoms are bad enough to seek a doctor, and I'm guessing the threshold of that may be higher for a lot of people this year, just ride it out at home and know it isn't COVID but never get a positive test.

Are docs testing every case of flu like symptoms for COVID and skipping the rapid flu test? In years past, and hint of flu like symptoms during flu season has resulted in a rapid flu test. Now everyone is thinking COVID first rather than flu. Docs should be able to run the rapid flu and take the COVID sample to send to the lab at the same time, but I have also heard of doc offices doing telemedicine for a flu/COVID like illness and sending to drive through testing rather than come into the office. No chance to do a flu test if you don't let them in the building.

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We do park and test outside of our clinic and anyone with fever gets a rapid flu test in addition to a COVID test. We finally saw our first positive flu test (Type B) this week on one of my patients.

Early on this year we had to set people up at remote drive through testing locations, but we were able to ALSO order flu and other testing to be done at the remote covid testing site at the same time.

ADDENDUM 11/20/2020 (Not sure I've seen a state go from such a high level to minimal so quickly. Not sure as to why this is the case. There are several potential explanations but It would presumptuous to speculate as to why. Has anyone else heard any explanation?)

There needs to be research done on why flu is so minimal this season.

I know there are a lot of theories but I'd be curious to know what we find out post flu season.

my concern is that we're now set up to the re-evaluate risk from a moral perspective across the western world

in strict terms, this disease is closer to the 1968 pandemic than it is to the Spanish Flu. but our cultural response has been to treat it as the latter. so the value we place on life has increased significantly in a very visible way (not a bad thing necessarily). and I think the trauma associated with this episode will make us re-evaluate all risk. especially those closest to the current risk (i.e. respiratory spread ailments).

cone said:

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maybe masking is great for the flu and mediocre at best for COVID

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This board was flooded with years and years of peer reviewed papers showing masks don't work against the flu. It was pointed out by the posters that these conclusions were probably valid for SARS-CoV-2. They were shouted down and deleted.

Masks don't work for the flu.

welp I dunno it's magic I guess

cone said:

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welp I dunno it's magic I guess

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Probably just washing hands and social distancing.

And if that's the case damn.

Makes you wonder how dirty people have been.

It has been a couple of weeks since we had a couple of flu tests be positive in my clinic. That has been a blessing that I have certainly been thankful for this Thanksgiving.

Like this map shows, they said on the local news this morning that the flu is almost non-existent in Texas right now. I expect this trend to continue. Not sure why people thought this could be a "strong flu season" with all the lockdown measures, working/school from home, masks, etc.?

Aust Ag said:

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Like this map shows, they said on the local news this morning that the flu is almost non-existent in Texas right now. I expect this trend to continue. Not sure why people thought this could be a "strong flu season" with all the lockdown measures, working/school from home, masks, etc.?

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That doesn't really explain Florida or the other states that have less restrictions.

I'm sure there is a large amount of people working from home in FL.

To some extent some people and employers will change behavior even if the behaviors aren't mandated. In addition there reportedly is a record number of flu immunizations this year also. I think 195 Million was the number I saw regarding flu vaccines this year. Previous record I believe was last year at around 170 million vaccinated. I'm sure the change in flu prevalence is multifactorial, but glad we aren't having to deal with both flu and covid at the same time... at least not yet.

Saw a few cases of influenza this past week, but overall not too bad... I hope that trend holds. One of my partners and I were speculating on whether or not we will see a late flu season in March-April as more people are vaccinated for Covid and as some of mitigation efforts for Covid are relaxed. With us being 6 months removed from many people getting flu vaccines and with little natural seasonal immunity due to low numbers of flu cases to date it will be interesting to see what happens...

wouldn't such a late season require some sort of global momentum at least

AgE Doc said:

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Saw a few cases of influenza this past week, but overall not too bad... I hope that trend holds. One of my partners and I were speculating on whether or not we will see a late flu season in March-April as more people are vaccinated for Covid and as some of mitigation efforts for Covid are relaxed. With us being 6 months removed from many people getting flu vaccines and with little natural seasonal immunity due to low numbers of flu cases to date it will be interesting to see what happens...

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This is why I elected to get my flu vaccine in December rather than October. Pushed my effective timeline back two months.

cone said:

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wouldn't such a late season require some sort of global momentum at least

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As long as there is at least some influenza in the country, I think it can spread locally without global momentum. Not sure if it will. School and Work attendance culture once symptomatic with fever may have changed enough this year where we won't see major outbreaks of flu.

It may depend how quickly we get a critical number of people vaccinated to covid and subsequently how quickly we relax mitigation efforts. If those things aren't accomplished until late spring/summer then we probably won't see much of flu season. If they are accomplished by the end of March then maybe we will see a late flu season before the heat of the summer squashes it.

We are very likely getting flu cases that also have the COVIDs but I bet don't get flu tested unless. What one for the COVIDs.

Agsrback12 said:

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We are very likely getting flu cases that also have the COVIDs but I bet don't get flu tested unless. What one for the COVIDs.

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All fevers get tested for BOTH flu & Covid at our clinic. That seems to be the situation from All of the ER Follow up visit reports I've Seen.

Greatly reduced international travel impacting flu as well?

Flu numbers are down because the masks and lockdowns work for the flu. Not so much for COVID. So why are we still persisting with the masks and lockdowns?

Isn't arguing the efficacy of mask wearing rather asinine when you can be masked while walking by a tables full of patrons without masks? or how about this scenario 5300 skiable acres at 25% capacity or less and you have to wear a mask yet again walk into the restaurant just to take it off?