The 2024 Flu Season: A Severe Outbreak with Higher Mortality Rates Than COVID-19

1. The Surge in Flu Cases: Highest in 15 Years

The 2024 flu season has brought unprecedented challenges to the United States, with the Centers for Disease Control and Prevention (CDC) reporting the highest level of flu cases since the 2009 swine flu pandemic. For the first time since the COVID-19 pandemic began in 2020, the death rate for influenza has surpassed that of COVID-19, marking a concerning milestone in public health. As of early February, over 48,000 individuals were hospitalized with influenza in a single week, exceeding the numbers seen during the H1N1 outbreak 15 years ago. This surge has left healthcare systems overwhelmed, with emergency departments, doctors’ offices, and hospitals filled with patients suffering from severe flu symptoms.

The CDC has noted that seasonal influenza activity remains elevated across the country, with "very high" or "high" flu levels reported in most states. Lab data reveals that nearly one-third of tests conducted in a single week were positive for influenza, significantly higher than the 18% recorded during the peak of the 2022-2023 flu season. These numbers underscore the severity of the current outbreak, which has already resulted in an estimated 24 million illnesses, 310,000 hospitalizations, and 13,000 deaths nationwide.

2. A Mystery in Severity: Why This Flu Season is Different

Experts are working to understand why this flu season has been so severe. Typically, flu seasons vary in intensity, often triggered by the emergence of new strains. However, this year’s outbreak does not appear to be caused by a novel strain. Instead, the circulating viruses are familiar ones: influenza A variants H1N1 and H3N2, which have been in circulation for years.

Yvonne Maldonado, MD, a professor of global health and infectious diseases at Stanford University, notes that predicting flu patterns is challenging. While the southern hemisphere’s flu season often provides insights, this year’s U.S. outbreak does not align with the patterns observed in countries like Australia and New Zealand. “It’s hard to predict what each season’s flu pattern will look like,” she explains.

Dr. Timothy Brewer of UCLA adds that while this season is severe, it is not unprecedented. He draws comparisons to the 2009-2010 swine flu pandemic, which saw an estimated 60 million cases, 274,000 hospitalizations, and nearly 12,500 deaths. “This year has been a bad flu year, but it’s not out of bounds,” Brewer says.

3. Higher Mortality Rates and Contributing Factors

One of the most concerning aspects of this flu season is the higher mortality rate attributed to influenza. According to the CDC, 2% of deaths nationwide are linked to the flu, surpassing the 1.5% attributed to COVID-19. This increase in mortality has puzzled experts, who point to several potential factors.

Dr. Inderpal Randhawa, a pediatric pulmonologist and immunologist, suggests that co-infections with other viruses may be overwhelming patients’ immune systems. “In these patients, the immune system is being overwhelmed by the back-to-back viruses,” he explains. Additionally, this season’s flu strain appears to cause rapid onset of severe symptoms, leading to delayed diagnoses and treatments. “If this hits you like a ton of bricks, don’t delay. Assume it’s the flu,” Randhawa advises.

The H3N2 variant, in particular, is known to have a higher mortality rate, which may explain the elevated number of deaths this season. Brewer notes that nearly all flu cases this year are caused by influenza A, with H1N1 and H3N2 being the dominant strains.

4. Declining Vaccination Rates: A Growing Concern

A key factor contributing to the severity of this flu season is the decline in vaccination rates. According to the CDC, only 45% of U.S. adults have been vaccinated against the flu this season, similar to last year’s rate. However, vaccination rates among children have dropped to 45%, down from 50% last year and 60% in 2020. Experts warn that this trend could have long-term consequences for public health.

“I think vaccination rates declining will lead to not only more flu outbreaks but unfortunately a greater mortality rate from influenza in future years,” says Dr. Monica Gandhi of the University of California San Francisco. Vaccines not only protect individuals from severe illness but also reduce the spread of the virus to vulnerable populations, such as the elderly and young children.

Dr. William Schaffner of Vanderbilt University emphasizes the importance of annual flu vaccination for everyone aged 6 months and older. “Unvaccinated persons run the risk of getting more severe disease, leading to more hospitalizations and deaths,” he warns.

5. Preventing the Spread: What You Can Do

While the flu season is well underway, there are steps individuals can take to reduce the spread of the virus and protect themselves and others. The CDC recommends getting vaccinated, avoiding contact with sick individuals, staying home when ill, and practicing good hygiene, such as frequent handwashing. Additional measures, such as wearing masks in crowded indoor spaces and improving ventilation, can also help curb transmission.

winger the flu is highly contagious and can be spread even before symptoms appear, these precautions are crucial for limiting its impact. If you do contract the flu, antiviral medications like oseltamivir (Tamiflu) can reduce the severity and duration of symptoms if taken promptly.

For those recovering from the flu, experts recommend staying hydrated, resting, and eating nutritious foods. Over-the-counter medications can help alleviate symptoms like fever and body aches, while humidifiers can ease respiratory discomfort.

6. Looking Ahead: The Importance of Collective Action

As the flu season continues to peak in January and February, experts urge the public to remain vigilant. Respiratory viruses like the flu tend to surge during this time due to cold, dry weather and increased indoor gatherings. By taking proactive steps to protect themselves and others, individuals can play a critical role in reducing the burden on healthcare systems and preventing further loss of life.

The declining vaccination rates among both adults and children are a particular concern for the future. As Brewer notes, “The lower vaccination rates don’t bode well for this year and they don’t bode well going further.” By prioritizing vaccination and adopting preventive measures, we can work together to mitigate the impact of this severe flu season and build stronger defenses against future outbreaks.

In the words of Dr. Randhawa, “I tell younger patients that if they don’t do it for themselves, to do it for their parents and grandparents.” This flu season serves as a powerful reminder of the importance of collective action in safeguarding public health.