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Physical distancing and good hand hygiene: Australian flu cases drop by more than 99%


Matt Woodley


5/06/2020 4:36:56 PM

There were only 208 laboratory-confirmed cases of influenza nationwide last month – compared to 30,567 at the same time in 2019.

Flu numbers graph
Statistics from the National Notifiable Diseases Surveillance System show Australia was experiencing above average flu numbers before social distancing.

The major disparity follows a trend that has seen a massive decrease in cases since social distancing measures were implemented across Australia in response to the coronavirus.
 
In the first two months of 2020, Australia was on track to surpass its record-breaking start to 2019, before cases essentially halved in March compared with the same time last year. This was followed by an even more dramatic 98% drop in April, when only 307 laboratory-confirmed cases were recorded compared to 18,691 in the corresponding period in 2019.
 
Dr Kerry Hancock, Chair of the RACGP Specific Interests Respiratory Medicine network, told newsGP she was ‘incredibly surprised’ by the results and described the fall in cases as ‘dramatic’.
 
‘We’re seeing now in the influenza statistics the impact that [good hygiene and social distancing] can have in reducing transmission,’ she said.
 
‘It just tells us the value of physically distancing, good hand hygiene, avoiding mass gatherings [when sick], cough etiquette and being aware of all those other strategies to avoid the transmission of infectious diseases.
 
‘Maybe it’s not the way we want to spend our lives – not being able to attend concerts and the movies and gather in crowds – but it certainly shows that we can make a difference by at least implementing some of these strategies [in the longer term].
 
‘Once again, Australia can be really proud of the fact that we’ve done what we’ve been told to do with regard to COVID-19.’
 
The drop in laboratory-confirmed flu cases is matched by data in the FluTracking surveillance system, which uses crowd-sourced information from upwards of 70,000 people each week who report whether or not they are experiencing flu-like symptoms.
 
The most recent report, from the week ending 31 May, found flu-like illness activity in Australia is ‘historically low’, with only 0.38% of respondents having a fever and cough. It also shows almost identical rates of flu-like symptoms between those who have been vaccinated and those who have not.
 
Dr Evan Ackermann, past Chair of the RACGP Expert Committee – Quality Care (REC–QC), told newsGP the trend seems to support findings from the Cochrane Reviews, which stress the importance of good hygiene in limiting the spread of influenza.
 
‘We always used to say it but now people are living it,’ he said.
 
‘People in public places are not only washing their hands, but they’re quarantining when sick, and many are using a face mask when in public. It really is something that I hope is going to lead to some long-term behavioural change.
 
‘The vaccine doesn’t last that long – it produces an immunological response but that wanes over time. What these figures suggest is that these non-drug interventions do work.’
 
Dr Ackermann also said it is an important reminder to educate patients on the value of hygiene when it comes to protecting themselves against viral infection.
 
‘For the majority of the population, improved personal hygiene options are more likely to be effective than just receiving a flu vaccine,’ he said.
 
‘This has important implications in how we advise and educate our patients. The evidence suggests promoting other measures may be more beneficial among low-risk populations.’
 
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Dr Meridee Flower   6/06/2020 7:57:35 AM

If very few people catch influenza in 2020 could waning levels of natural immunity to influenza increase the risk of future catastrophic epidemics?


Dr Sharon Muir   6/06/2020 9:18:44 AM

This is good news indeed for the effectiveness of staying home when you're sick, not "soldiering on" under the masking effect of decongestants and analgesics. However, we've seen cases of influenza-like illnesses that were never confirmed in the laboratory due to our pathology provider not testing for influenza during the peak of the pandemic. So the figures are very likely to be somewhat skewed towards less than reality. Let's hope at least some people have learned the value of staying away from others when they're sick!


Dr John Lawson   6/06/2020 10:18:49 AM

Whilst I have no doubt that social distancing has contributed to lower rates.

I am absolutely certain that pathology labs changing all resp virus PCR tests to COVID tests also has an impact on the amount of detected cases!

The statistics are flawed.


Dr Emilie Larkin   6/06/2020 11:06:48 AM

Great news with the general decreasing influenza illness trends for the year but not sure about the eye catching headline statistic...

1. GPs were specifically told not to test for influenza and indeed some labs were actually not running the test at all for a period of time. It is therefore difficult to make an accurate comparison between years given access to testing was very different. I am surprised there is no mention of this in the article.

2. Additionally, 2019 was a big influenza year compared to the other previous years on the graph. Comparing to any previous year on the graph or an aggregate of the years, there is still a reduction but not the astonishing '99%'...


Dr Ian Mark Light   6/06/2020 11:31:00 AM

Good hygiene with hand washing and physical distancing is vital and also people spaced safely in the outdoors on the sunny though cold days we still have in Winter .
That is why return to poorly ventilated school rooms will lead to outbreaks .
The windows have to be open also the doors and classes outdoors In middle and upper school with microphones and speakers on sunny days are the option .
If it is rainy and wet the best ventilated rooms with viral filtered air conditioning and 25% student classes ought protect .
Zoom or other technology connection classes can cover hundreds and with questions and breaks they could be held some in the school rooms some at home or a town hall or other meeting places with the spacing and rotating .


Dr Ian Mark Light   6/06/2020 12:17:09 PM

Good hygiene with hand washing and physical distancing is vital and also people spaced safely in the outdoors on the sunny though cold days we still have in Winter .
That is why return to poorly ventilated school rooms will lead to outbreaks .
The windows have to be open also the doors and classes outdoors In middle and upper school with microphones and speakers on sunny days are the option .
If it is rainy and wet the best ventilated rooms with viral filtered air conditioning and 25% student classes ought protect .
Zoom or other technology connection classes can cover hundreds and with questions and breaks they could be held some in the school rooms some at home or a town hall or other meeting places with the spacing and rotating .


Dr Irandani Anandi Ranasinghe-Markus   6/06/2020 3:59:26 PM

I agree with the two previous comments regarding statistics for laboratory confirmed Influenza numbers.
Usually by this time in previous years I would have sent off a number of Respiratory Virus PCRs to confirm influenza. However, this year we have been told not to bother requesting the Respiratory Virus PCR as the labs are overwhelmed by the numbers of COVID-19 tests requiring the same reagents. So, how can we say numbers are down by 99% if we are not testing?
I also have no doubt that the numbers will be down due to the efficient vaccination coverage by us GPs as well as all the isolation measures the public have taken - but to say laboratory proven cases are down when lab testing has not occurred is misleading.