engleski

COVID-19 vs. influenza: predicting the future

Acute respiratory infections (ARIs) are the most common infections in humans of all ages. The disease burden from ARIs is substantial and thus their prevention and treatment are a priority for public health agencies. Moreover, the current COVID-19 pandemic that, so far, has affected more than 195 million and killed more than 4 million people worldwide has returned the focus of human medicine to respiratory infections with great epidemic potential. Until recently, the most feared scenario was that one of the influenza viruses could be responsible for the next major pandemic. But the recent outbreak of the COVID-19 epidemic, which began in China in December 2019 and spread throughout the world during 2020, has brought coronaviruses into focus. The pandemic caused by the new coronavirus, SARS-CoV-2, is still not subsiding and has entered its second year of existence. Over the past winter season, it has completely suppressed the flu, which to our great surprise in the Northern Hemisphere was present only sporadically, with over 90% less incidence rate that was previously common. There are many possible reasons for this: a decreased circulation of influenza viruses in Europe, a decreased pool of patients with influenza in the Southern Hemisphere that were the source of epidemic in the Northern Hemisphere, a decreased intercontinental transport and migration of people and goods, decreased diagnostics of other respiratory pathogens including influenza viruses due to increased focus on SARS-CoV-2 (up to 60%), a widespread adoption of community mitigation measures to reduce the transmission of SARS- CoV-2 also decreased the transmission of other respiratory viruses, increased influenza vaccination rate in the 2020/2021 season, etc. Will this happen again in the next winter season 2021/2022? It's hard to guess. It is possible that the circulation of SARS-CoV-2 virus will suppress the circulation of influenza virus again next winter. However, it is also possible that, due to the decline in immunity among vulnerable population following lack of contact with circulating viruses, influenza epidemics might occur on an even more intense scale. It is also justified to fear a simultaneous circulation and co-infection with SASR-CoV-2 and influenza viruses because some preliminary experience has shown that simultaneous infection with these two viruses can cause a more severe clinical picture and be responsible for higher mortality in infected individuals. It is therefore justified to fear the coming winter season and what the future holds for us. Therefore, high vaccination rates for both influenza and SARS-CoV-2 could highly contribute to the decreased incidence of influenza and COVID- 19 and associated morbidity and mortality.

acute respiratory infections ; SARS-CoV-2 ; COVID-19 ; influenza

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