Alberta doctors brace for tough flu season paired with possible fall COVID surge

Alberta could be in for a particularly rough flu season this fall, and coupled with another potential surge in COVID-19 cases, it's causing doctors some concern.

Infectious disease experts often look at trends in the southern hemisphere to predict what the Canadian influenza season will be like. So far, Australia is being hit hard.

Its flu season started early, and lab confirmed case counts are higher than the five-year average.

"The concern is we're going to have what we call a 'bad influenza season,' which results in a lot of hospitalizations. And in addition to that, we've got an unknown situation that's going to occur with COVID at the same time," said Dr. Dan Gregson, an infectious disease physician, medical microbiologist and associate professor at the University of Calgary's Cumming School of Medicine.

"If our COVID admissions are up at the same time as we have a larger than usual influenza outbreak, our hospital capacity would be stretched a little bit thin again."

Alberta didn't report any influenza cases during the 2020-21 season.

But with the elimination of pandemic-related public health measures, Alberta has seen a resurgence of respiratory viruses and an unusually late flu season this year.

This is due to a phenomenon known as immunity debt, explained Dr. Stephanie Smith, University of Alberta Hospital infectious disease physician.

"Essentially we haven't been exposed to so many of these viruses for really almost two years now. So our antibodies have waned and all of the sudden you're exposed and you really don't have that kind of extra layer of protection. So people are going to be more susceptible to a variety of infections."

Pediatric hospitals strained 

All this comes at a time when Alberta hospitals are under extreme pressure due to a number of factors, including staffing shortages.

"I'm a little more fixated on where we're at right now," said Dr. Stephen Freedman, a professor of pediatrics at the University of Calgary and an ER physician at Alberta Children's Hospital.

"The emergency departments right now in Alberta and across Canada, especially the pediatric emergency departments, are extremely busy and doing our best to cope with volumes and acuity of illness that we're currently seeing."

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While Freedman is still treating a lot of kids for COVID-19, respiratory syncytial virus (RSV) and influenza, he said the numbers are easing and he's hoping for a further drop in viral illnesses in the coming weeks.

However, he expects that decline will be countered by an uptick in COVID-19 cases driven by the BA.4 and BA.5 variants.

"I think we'll start to see that here probably just as some of those other viruses are tapering off. And then at some point in time we probably will see a surge in flu cases akin to what is being seen in Australia," Freedman said.

"It's just all a matter of timing and how those things overlap that will determine and dictate the severity of the upcoming viral respiratory season that we're going to see."

In an effort to protect the healthcare system in the fall, Gregson said a number of key steps should to be taken, including messaging from government that masks may be needed if hospitals are at risk of becoming overwhelmed.

"The best we can do is prepare for it," he said.

"And make plans for, number one, trying to reduce the people who are going to need hospitalization and really ramp up our influenza immunization campaigns [and] ramp up our COVID boosting at the same time for people who are eligible."

Alberta's flu vaccine uptake is traditionally quite low and Freedman agrees a strong immunization campaign should be a priority.

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"One of the most important things that we need to do, and probably more so than prior years, is to really promote vaccination and ensure that children who are eligible get vaccinated," he said.

Freedman is urging Albertans to continue with health practices such as staying home when they're sick.

And, he said, work needs to be done to ensure there are enough healthcare staff in hospitals to deal with another potential onslaught of patients this fall.

"We continue to deal with short staffing due to individuals being sick as well as ... there's burnout in frontline healthcare staff for sure. So we need to make sure that those resources are in place, bolstered and ready to go."