Image: Lusa

Flu epidemic ‘peak’ still to come, with majority of 60-69 year olds still unvaccinated

Authorities concerned by spike in all-cause mortality in people over age of 45

With warnings that the flu epidemic has not yet reached its peak, authorities are concerned by what they describe as a “higher than expected all-cause mortality in people over 45”, and the discovery (among cases being treated in hospital) that more than half the 60-69 year olds have not taken up the offer of their annual flu vaccines.

Lusa news agency reports today on the thousands of respiratory infections treated in hospitals during the week between Christmas and New Year (38,771), as well as the 6,262 cases of flu, saying that of the 36 patients who ended up in intensive care (32 of which suffered chronic illnesses), 33 had been recommended for a seasonal flu jab, but only nine had actually taken up the offer of the vaccine.

Says Lusa, “since the start of the surveillance season (2nd October), 85 cases of flu have been reported by the ICUs (intensive care units) that collaborate in surveillance. Of the total number of cases, 85.9% (73) had an underlying chronic illness and 91.8% (78) were recommended to be vaccinated against seasonal flu, but only 36.1% (22) were vaccinated.

“In the last week of the year, 1,472 positive cases for the flu virus were identified, of which 1,372 were type A and 49 type B. 

It is the A(H1) strain that has been detected in 88.7% of flu cases since October 2 – and this can pose added problems when there is co-infection with SARS-CoV-2, which “has been detected”, says the latest Bulletin of Epidemiological Surveillance of Influenza and other Respiratory Viruses, from the national health institute Doutor Ricardo Jorge (INSA).

Other infections adding to the complicated picture are acute respiratory infection/flu syndrome (ARI/FRS), rhinovirus, respiratory syncytial virus, parainfluenza, adenovirus and enterovirus.

With regard to Respiratory Syncytial Virus (RSV), INSA reports “a probable downward trend” in  the number of new hospitalisations in children under the age of two, stressing this trend “must be interpreted with caution” given the possible delays in notification and the effect of the festive period.

But with the constraints habitually suffered in hospitals at this time of year, and the effects of various work-to-rules, many hospitals have been stretched beyond workable limits. Television stations have been interviewing people emerging from A&E departments and describing “absolute chaos”; waiting times are off the board in most places, and the customary entreaties by authorities for ‘no-one to go to hospital unless they are seriously ill” are being sounded.

With a new ‘polar wave’ of cold weather expected, the ‘unusually high mortality rates’ that frequently characterise January are expected to continue. 

DGS director general Rita Sá Machado has told Expresso, high all cause mortality is expected to remain in place until the end of the month, insisting that vaccination is “fundamental” for the most ‘at risk groups’ (which particularly refer to those with chronic illnesses).

The problem with this terminology is that data shows the majority of healthy 60-69 year olds clearly do not believe they are part of an at risk group. Less than 50% have come forwards for their seasonal flu jabs, while the over-70s/ over-80s are much more compliant (both having around 75% vaccinated).

In Rita Sá Machado’s perspective, the DGS would prefer to see the 60’s generation follow their elders. In the perspective of pneumologist Filipe Frões “vaccine hesitancy only favours circulation of the virus” (whichever virus: flu/ Covid, etc).

Dr Frões, pilloried during the pandemic for his support of pharmaceutical companies, cuts to the chase in today’s article in Expresso: “In the over-80s, 75% have been vaccinated, meaning one in four is not vaccinated. Where are they? In A&E, intensive care or the cemetery”.

Bottom line, even in the peak of the flu season there is reason to come forwards to be vaccinated, says Frões, as the flu will continue for quite a few more months to come.

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