GPs ‘essential’ to tackling complacency over influenza

For the first two years of the COVID-19 pandemic, influenza was almost eliminated from the Australian population, with cases dropping markedly and more than a year passing without any recorded deaths.
 
But in 2022, border restrictions eased and cases returned, with laboratory-confirmed cases surpassing more than 233,000 – the third-highest year on record. And while the scale and severity of 2023’s season is still unknown, the country is already seeing higher rates of influenza in March compared to this time last year.
 
Despite this, new research suggests that many in the community remain complacent about the illness’ potential consequences.
 
In the Australian Attitudes to Influenza Index, an online survey completed by 1017 adults who are representative of the wider population, one third (33%) said the flu is only ‘somewhat serious’, and that people can get very sick and be hospitalised, but they do not think they can die from it. While a further 14% said the flu is ‘not very, or not at all, serious’.
 
Though the survey’s full results are yet to be publicly released, the preliminary findings have raised alarm among experts, given already climbing flu numbers.
 
According to the Department of Health and Aged Care’s (DoH) latest figures, Australia had recorded more than 15,500 flu cases at the time of writing – a volume of confirmed cases not seen in 2022 until early May.
 
Leading paediatrician and infectious disease expert, Professor Robert Booy is a Senior Professorial Fellow at the National Centre for Immunisation Research and Surveillance.
 
He says the emerging trend in influenza transmission coupled with people’s underestimation of the disease’s potential severity could place a ‘significant burden’ on the public health system.
 
‘People need to remember that we’ve had some bad flu seasons in Australia,’ Professor Booy said.
 
‘Modelling data from 2010–2019 estimat[es] that we averaged nearly 2800 annual deaths related to flu, with more than 6400 estimated deaths in 2017 and over 5200 in 2019.
 
‘Last year, we also saw younger populations make up a higher proportion of notifications compared to previous years, so it’s important we have high vaccination rates across all age groups.’
 
In 2022, more than 50% (126,988) of confirmed flu cases were in people aged 24 and under – compared to the 10% of cases among over 65s.
 
This may be in part due to complacency, with the survey findings showing a clear generational gap in attitudes towards disease severity. Only 20% of those aged 18–24 said they consider the flu to be ‘very serious’ and that people can die from it, compared with nearly 60% of those aged 65 and over.
 
The research, conducted between 8–13 February by YouGov on behalf of Australian vaccine company CSL Seqirus, did however point to the important role GPs have to play in influencing the approach people choose to take when it comes to prevention.
 
It found nearly 58% of Australians are unaware of the available prevention options, and that almost half (46%) want their GP or pharmacist to discuss those options so that they can make a more informed choice.
 
These numbers do not come as much surprise to Dr Zac Turner.
 
The Sydney-based GP, who is campaigning to raise awareness about the potential severity of influenza, says many patients do not understand the difference between the flu and the common cold.
 
‘Doctors working in general practice are essential for the dissemination of health knowledge that is both up-to-date and applicable to each individual patient,’ Dr Turner told newsGP.
 
‘As we are in the front line of the health system, many patients come to us first for diagnosis of conditions, treatment and of course to discuss the best health plans for each person.
 
‘What works for one patient at the time of their presentation doesn’t necessarily mean it will work for everyone and so educating patients, especially about future health planning, I believe is essential.’

Dr Zac Turner is helping to raise community awareness about influenza and its potential severity. (Image: Supplied) 
 
He says it is important for patients to understand that hospitals receive more flu admissions than they should as disease severity is ‘largely preventable’, and that even those who do not have significant complications can experience symptoms lasting up to a week.
 
Dr Turner also believes GPs should be mindful that there is a lot of information about influenza being disseminated through the news and across social media at this time of year. As a result, he often finds himself steering patients back onto the ‘right path for them’.
 
‘With regards to the flu and how to manage it, what are the signs and symptoms, along with how to help prevent the spread, as well as optimising your recovery and response are topics I talk about many times a day,’ Dr Turner said.
 
‘With nearly half of the patients I see wanting to optimise their health this is especially important at this time of year to educate and work out some action plans if family members become sick.’
 
The survey findings found people from Queensland are more likely to report being ‘unsure’ or ‘definitely not intending to be vaccinated’ against flu in 2023 (41%). That is compared to the national average of 37% and 26% in Western Australia.
 
Dr Turner says a ‘combined education’ push would be ‘very helpful’.
 
‘[This] includes giving quick knowledge points for GPs, allied health, emergency workers and pharmacists so that the information being relayed is cohesive,’ he said.
 
Despite the already high influenza numbers in Australia this year, Professor Booy says it is ‘almost impossible’ to predict when the season will peak. That’s why he says it is vital people have these conversations about prevention with their GP now.
 
‘It’s also important to maintain regular hand washing, staying at home if you’re feeling unwell, and coughing or sneezing into your elbow if you don’t have a tissue to help minimise the spread of flu,’ Professor Booy said.
 
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