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Canada heading for flu season in the middle of fourth wave of COVID-19

OTTAWA — The country could be heading for its first typical flu season since the pandemic began, even as health systems are still battling the fourth wave of COVID-19, Canada's top doctor warns.
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OTTAWA — The country could be heading for its first typical flu season since the pandemic began, even as health systems are still battling the fourth wave of COVID-19, Canada's top doctor warns.

Last year the flu was "virtually non-existent," in Canada, thanks to strict public health measures to protect against COVID-19, chief public health officer Dr. Theresa Tam said Friday.

What served as a blessing last fall, sparing already overwhelmed health systems, could now mean Canadians have less immunity against common strains of the flu. 

Surveillance data from the Public Health Agency of Canada shows higher rates of infection than expected for some of Canada's most common seasonal viruses: respiratory syncytial virus, or RSV. and human parainfluenza.

"This year we are anticipating a possible flu resurgence, due to lower levels of immunity in the population as a result of less circulation last flu season, and the easing of some restrictive, community-based public health measures," Tam said. 

Even during non-pandemic times, flu season has been known to bring hospitals to their knees, overcrowding emergency rooms and intensive care units.

Now, with some hospitals already at capacity and staff across the country burnt out by a year and a half of providing pandemic care, an intense flu season could be especially dire.

"This is definitely not the year to have influenza wreak havoc," Tam said. 

That's why public health officials say it will be more important than ever that people get flu shots to avoid complications like pneumonia and protect hospitals from becoming overloaded.

On Oct. 7, The National Advisory Committee on Immunization suggested the flu vaccine can be given any time before or after — or even at the same time as — the COVID-19 vaccine, so there's no reason to postpone either shot.

It's too early to say how severe the flu season is likely to be, but pediatric hospitals are already feeling the ill effects. 

The emergency room at the Children's Hospital of Eastern Ontario is packed to the level the hospital would normally see at the peak of flu season. 

The surge has been driven partly by routine injuries, but also from a "potpourri" of viruses, including RSV, said Tammy DeGiovanni, the hospital's senior vice-president of clinical services and chief nurse executive.

Because of COVID-19, she said, CHEO has had to cancel surgeries and add to already length backlogs. Flu cases would only compound that problem further and create lengthy waits for non-urgent care. 

"What we worry about is our capacity and our ability to staff," DeGiovanni said in an interview Friday. "What we try not to do, but we've been forced to, are some cancellations."

A similar situation is playing out at other children's hospitals as well, she said. 

Tam said the federal government has been bolstering health-care systems throughout the pandemic by ensuring emergency aid from the Canadian Armed Forces and the Canadian Red Cross, but the solution is not sustainable.

"Health-care capacity cannot be generated overnight, and particularly things like ICU capacity," Tam said.  

"People need to do everything they can to reduce both COVID and other respiratory viruses in order to keep our system going."

Tam's deputy, Dr. Howard Njoo, said one of the silver linings of the pandemic may be the prevalence of flu prevention measures, like hand-sanitation stations and mask wearing.

"Hopefully these types of behaviors will carry on long past ... COVID-19 and become part of normal healthy behaviors to protect yourselves in the future against other respiratory infections, including annual flu." 

This report by The Canadian Press was first published Oct. 15, 2021

Laura Osman, The Canadian Press