Influenza is here. What can Albertans expect?

Influenza has arrived in Alberta and while its gaining traction later in the season than last year, some are concerned that with COVID-19 hospitalizations remaining high, hospitals could struggle under the increasing pressure.

The two most recent weeks of data show that Alberta's influenza cases have more than quadrupled, from a total of 87 cases during the week of Oct. 22, to 389 cases the week of Nov. 5.

Positivity rates have spiked, with the latest provincial numbers hovering just under 14 per cent. While it's variable by region, wastewater influenza levels are rising too.

"We're seeing a rapid rise in influenza in the community, "said Dr. Dan Gregson, an infectious disease physician with the University of Calgary.

"We're just at the very beginning of our influenza season."

Experts often look to the southern hemisphere for a sense of what Canada's influenza season will be like.

"In Australia they had a very bad flu season in their winter so we're worried there's going to be a bad flu season here," said Gregson.

Calgary hospitals, Gregson noted, are already dealing with high numbers of COVID-19 patients.

"And then we're now piling on influenza and RSV on top of that so it's a lot of people in the system that weren't there before."

159 people have been hospitalized due to influenza so far this season. There have been 18 ICU admissions and six deaths.

The majority of influenza cases reported so far this season are the H1N1 subtype of influenza A, which the province hasn't seen much of in recent years.

RSV is showing early signs of increases as well.

Calgary hospitals

Alberta's respiratory dashboard shows more than half of the people hospitalized for influenza so far this season have been in the Calgary zone.

Dr. Eddy Lang, the head of emergency medicine in the zone, said it's important to note these are early days for influenza and there are currently far more people hospitalized due to COVID-19.

1,822 Albertans have been hospitalized due to COVID since the end of August.

"We certainly expect the amount of influenza to increase over the next several weeks," said Lang.

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He's  particularly concerned about the elderly who can experience complications such as pneumonia, and require oxygen and hospitalization.

"Right now our hospitals are running way over 100 per cent capacity," Lang said, noting Calgary ER beds are often filled with patients who are already admitted but are stuck there because there are no beds free for them on the wards.

"As we see more and more patients needing in hospital beds, we know that unfortunately the emergency department often functions as the overflow department for when the hospital can't take these admitted patients upstairs. This will make it very difficult to provide emergency care in a timely manner and it will mean increased waiting times."

According to Lang — under the current Alberta Health Services system — a number of steps can be taken if hospitals become overwhelmed including postponing scheduled surgeries. 

"It's not optimal. Some of these patients have been waiting months and months for knee replacement or hip replacement. But when the situation is completely unsafe in the emergency department, those measures have to kick in."

Low vaccination rates

Meanwhile, Alberta's influenza immunization rates are a concern to both physicians.

So far this season, 17.8 per cent of all Albertans have received their annual influenza shot.

Lang calls that "disappointing."

"Those people in the low risk group are at risk of transmitting influenza to the higher risk groups."

When you look at Albertans 65 and up, the number jumps to 50 per cent. 

According to Gregson,  in addition to secondary bacterial infections, there is also an increased risk of heart attack and stroke in people over 50 after influenza. 

"Ideally we'd like people who are at higher risk of admission to get vaccinated because it really reduces your risk of admission by half," he said.

"That takes some of the burden off of the health care system."