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Is a Twindemic on the Horizon?

Friends, welcome back to the season of traveling armed against all viral bacteria threats, both seen, and especially, unseen. Masks? Hand Sanitizer? Kleenex? Many Iowans are checking all the boxes this season as a third straight vacation from a serious influenza season seems highly unlikely.

As we bravely venture into an Iowa winter and a cold and flu season bringing limitless unknown health dangers, it’s important as ever to keep up our infection guard as strong as Fort Knox safeguards its locks and entry passcodes. We have to protect our and our family’s health like the CIA protects its secrets.

The challenge: COVID’s dominant arrival and infiltration of all areas of the United States has both weakened our overall acquired immunity, but also brought in an untold number of new coronavirus variants, difficult-to-detect new viruses, and viruses that normally aren’t frequently present in the Midwest U.S.

“Because of all the COVID restrictions, we have far less acquired immunity, as a group, more of us are vulnerable now,”’s Helen Branswell writes. “And that increase is susceptibility, experts suggest, means we may experience some wonkiness as we work toward a new post-pandemic equilibrium with the bugs that infect us.

“Larger waves of illness could hit, which in some cases may bring to light problems these bugs had triggered. Diseases could circulate at times or in places where they normally would not.”

And with an alarming number of Americans reporting they do not plan to get flu shots or COVID-19 vaccine boosters this season, health officials are very worried about the long-feared twindemic: the simultaneous outbreaks of flu and COVID.

Officials’ No. 1 recommendation to everyone able this season: Get the needle. For starters, “We’re not back to normal yet,” Dr. Kristen Said, Assistant Director of Duke’s Employee Occupational Health & Wellness (EOHW), told Duke Today.

A vaccine double play of both the flu and COVID booster shots greatly increase a person’s ability to avoid contracting and successfully fighting off aggressive symptoms of both influenza and multiple strains of the coronavirus. The new bivalent COVID-19 booster offers protection against two prevalent dominant strains: Omicron BA.4 and BA.5. This year’s flu vaccine formulas are focused the expected dominant influenza strains this season: H1N1 and H3N2 (Type A viruses) and Victoria and Yamagata lineages (Type B viruses).

A Twindemic on the Horizon?

Getting immunized this winter is especially important given that relaxed COVID-19 safety precautions and behaviors could lead to a sizable spike in flu cases. The University of Pittsburgh Graduate School of Public Health foresees a flu season likely to be more severe than average and hitting young children especially hard.

“In the United States, immunity against flu is lower than in prior years, so this is one of the reasons why it’s expected to be a more severe season,” Dr. Jennifer Lighter, pediatric infectious disease specialist at NYU Langone, told NBC’s Today show.

Throw in the USA’s waning population-level immunity and the 2021-22 Iowa winter could be the perfect storm for a twindemic.

Said stresses getting vaccinated against influenza and receiving the new COVID-19 booster is a good way to avert a “Twindemic.” Don’t expect a cakewalk of a flu season like we’ve enjoyed the past two seasons.

“All signs point to it being a pretty significant respiratory illness season,” notes Dr. Said. “We can look at countries that have winter before us, like Australia, and see that they had a really bad flu season. That’s usually a good predictor for us. I see nothing that suggests it will be a mild flu season.”
That makes it essential that Americans don’t try to weather the invisible and potentially lethal double threat of influenza and COVID-19 unarmed. Vaccinate yourself for your health, your family’s and your friends and neighbors. On average, you will increase your chances of avoiding winter’s sickliest feeling by 40 to 60 percent, GoodRX Health stresses.

“As COVID-19 containment measures – such as masking, distancing and school closures – are relaxed around the world, we’re seeing a fierce resurgence of other respiratory viruses, which does not bode well for the coming flu season,” Marc Roberts, M.D., director of the Public Health Dynamics Laboratory at Pitt Public Health. “In a worst-case situation with a highly transmissible flu strain dominating and low influenza vaccination uptake, our predictive models indicate for the potential for up to nearly half a million more flu hospitalizations this winter, compared to a normal flu season.

“Vaccinating as many people against flu as possible will be key to avoiding this scenario.”

And the time to protect yourself and your family is here and now.

“Now is the time to get your flu shot if you live in the United States,”’s Caroline Kee writes.