Dying with the flu: Why we need to think more seriously about illness and public hygiene
One silver lining of the pandemic: we better appreciate why
A few years ago, when I was waiting in the drugstore for a prescription to be readied, I heard a discussion about the flu shots that the pharmacy would be offering.
"Flu shot?" said one fellow, who said he got once, "and I was sick all year long."
As if to drive the point a little further, he glanced my way and repeated, "All. Year. Long."
I think I nodded, but mostly for politeness. After all, everyone knows that a flu doesn't last all year long … or do they?
Ah yes, the myth of the never-ending flu. Right up there with the mistaken belief that the vaccine causes the flu.
And there's the too-common mistake of confusing a common cold for the flu. Doctors, nurses and other health professionals know all about this one, especially when people tell them they're "dying with the flu" while presenting with mild symptoms of a cold.
I often think that particular phrase — "dying with the flu" — is a conversation starter, something for friends or even strangers to chat about, much like the weather. I'm sure you've heard the convo: "How ya doing?" "Like death warmed over — I'm dying with the flu!"
But the ubiquity of the phrase also leads me to suspect that many people don't understand how serious some diseases are, and what the actual stakes are for public health. That point is particularly pointy while we continue to work our way through the COVID-19 pandemic, and circumstances that most of us have not seen in our lifetimes.
That time the flu knocked me down
I know from my own experience that if you have the actual flu, you're not likely to be involved in idle chat of any kind. (Indeed, you shouldn't be out at all, but we'll get to that in a bit.)
Four years ago this month, I was at work when my nose started running … a lot. I was presenting something at the time, so it felt a bit embarrassing. I didn't feel that bad, and I wondered if it was an allergic response, as unusual as it was.
The next day, I felt rotten and stayed home out of it. It felt like a cold, but one with a really wicked punch. Within hours, the telltale signs — the ones that say, "this is no cold" — showed up. A fever came over me, and my body started shaking. Those chills are called rigors, and they are not pleasant … and they never show up if you have a cold.
I was out of commission for the next week. The virus's attack on my muscles was intense. After the fever broke and the rigors stopped, I was so deeply fatigued that I basically slept and otherwise just … existed.
It wasn't lost on me that I was an otherwise healthy person. It really struck me what the power of that kind of attack can do to the elderly, for instance, or people with compromised immunity. Influenza is notably brutal on those groups.
I was, of course, caught off guard by the infection, in part because of the time of year. I get a flu shot every year, but usually after the time of year — mid-October — when I contracted it. (How did it happen? I think it was aboard a flight home from the U.K. or over in London itself; I had tagged along when my wife had some work over there.)
Vaccines and managing COVID
Speaking of vaccines, Newfoundland and Labrador — like other jurisdictions — is gearing up for quite the round of immunization. The government has bought 425,400 doses of this year's flu vaccine, and hopes to hit a vaccination rate of 80 per cent. In many years, the rate is between 25 per cent and 30 per cent.
The driver is COVID-19. We of course do not yet have a vaccine for SARS-CoV-2, the virus that causes the disease, but we do have the capability to mitigate illness otherwise by targeting a serious threat to public health.
Expect clinics, which open in the coming days, to be as busy as ever, but with extra complications. Physical distancing will no doubt require some patience, too.
Let's also focus on just how lethal influenza can be. In the 2018 flu season in Newfoundland and Labrador, 39 people died — almost 10 times the number of people who have died this year of COVID. That result "was the worst in decades," Dr. Claudia Sarbu, the former chief medical officer of health, told us last year.
A physician I know once told me that flu can be deadly here because many people are complacent — not just in how they shrug when the disease comes around, but in the apathy about how they think about their own conduct in terms of its transmission.
At the very least, the experiences of this year's pandemic have opened a lot of eyes to hygiene. How often in the past, for instance, did you see someone in a public place sneeze, cough, wipe their eyes or nose, and not cover their face properly, nor wash their hands immediately?
We've all had to change our behaviours this year. Hopefully a new, safe vaccine will be at hand sooner rather than later.
Hopefully one beneficial outcome of this experience is that we will more seriously recognize the threats of infectious disease, and hold ourselves accountable for stopping the spread in its tracks.
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