Are We Setting Ourselves Up for the ‘Twindemic’ We Dodged Last Year?

When the gravity of the COVID-19 pandemic first became evident, the term “twindemic” (simultaneous high rates of both SARS-CoV-2 and seasonal influenza) was everywhere. Not only did it never emerge, but new data published in Morbidity and Mortality Weekly Report show that incidence of flu, respiratory syncytial virus, common human coronaviruses, parainfluenza viruses, human metapneumovirus, respiratory adenovirus, and rhinovirus and enterovirus were all actually lower than previous years. The authors speculate that the lower-than-average activity was the result of mask-wearing and social distancing practices, leading them to stress that “fall influenza vaccination campaigns are important as schools and workplaces resume in-person activities with relaxed COVID-19 mitigation practices.” Implied is the prospect that failing to maintain vigilance could leave the door open for higher rates of COVID-19—which we’re already seeing—and a more typical flu season. The message for urgent care providers is clear: It’s time to promote flu shots while continuing to recommend vaccination against COVID-19 for all patients who are eligible.