Why aren’t there flu burden estimates for the 2020-21 flu season?

December 30, 2021 in News by RBN Staff

 

Source: CDC.gov
United States CENTERS FOR DISEASE CONTROL AND PREVENTION (The CDC)

LINKS:

2019-2020 U.S. Flu Season: Preliminary In-Season Burden Estimates 

 



 

Why aren’t there flu burden estimates for the 2020-21 flu season?

 

… During the 2020-2021 season, however; the number of people hospitalized with influenza was too low to generate stable burden estimates as is done for a typical flu season.

 

Flu Burden 2020-2021

Every year, CDC usually generates estimates of the number of illnesses, medical visits, hospitalizations and deaths that happen during a flu season—these estimates are used to collectively describe the annual burden of flu. To produce these estimates, CDC uses a mathematical model that is based in part on the number of people that are hospitalized with flu in our hospitalization surveillance network. During the 2020-2021 season, however; the number of people hospitalized with influenza was too low to generate stable burden estimates as is done for a typical flu season.

We do know that flu activity last season was the lowest it has been since current reporting began in 1997. We also know that flu illnesses, hospitalizations and deaths were very low last season, probably well below the estimates for the 2011/2012 season, which was the mildest flu season in the decade between 2010 and 2020.




2019-2020 U.S. Flu Season: Preliminary In-Season Burden Estimates

 

NOTE: April 4, 2020 was the last week in-season preliminary burden estimates were provided. The estimates below are not the final 2019-2020 cumulative season burden estimates. The preliminary cumulative burden estimates for the 2019-2020 season have been released. In-season preliminary burden estimates are scheduled to resume for the 2020-2021 season this winter.

Update as of December 3, 2020: The model used to generate influenza in-season preliminary burden estimates uses current season flu hospitalization data. Reported flu hospitalizations are too low at this time to generate an estimate.

CDC estimates* that, from October 1, 2019, through April 4, 2020, there have been:

39,000,000 – 56,000,000
flu illnesses

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18,000,000 – 26,000,000
flu medical visits

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410,000 – 740,000
flu hospitalizations

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24,000 – 62,000
flu deaths

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NOTE: The week of April 4 was the last week in-season influenza burden estimates will be provided for the 2019-2020 season.

*Because influenza surveillance does not capture all cases of flu that occur in the U.S., CDC provides these estimated ranges to better reflect the larger burden of influenza. These estimates are calculated based on CDC’s weekly influenza surveillance data and are preliminary.

**Influenza testing across the United States may be higher than normal at this time of year because of the COVID-19 pandemic. These estimates may partly reflect increases in testing in recent weeks and may be adjusted downward once the season is complete and final data for the 2019/20 season are available.

This web page provides weekly, preliminary estimates of the cumulative in-season numbers of flu illnesses, medical visits, hospitalizations, and deaths in the United States. CDC does not know the exact number of people who have been sick and affected by influenza because influenza is not a reportable disease in most areas of the U.S. However, CDC has estimated the burden of flu since 2010 using a mathematical model that is based on data collected through the U.S. Influenza Surveillance System, a network that covers approximately 8.5% of the U.S. population (~27 million people).

 

Limitations

The estimates of the cumulative burden of seasonal influenza are subject to several limitations.

First, the cumulative rate of laboratory-confirmed influenza-associated hospitalizations reported during the season may be an under-estimate of the rate at the end of the season because of identification and reporting delays.

Second, rates of laboratory-confirmed influenza-associated hospitalizations were adjusted for the frequency of influenza testing and the sensitivity of influenza diagnostic assays. However, data on testing practices during the 2019-2020 season are not available in real-time. CDC used data on testing practices from the past influenza seasons as a proxy. Burden estimates will be updated at a later date when data on contemporary testing practices become available.

Third, estimates of influenza-associated illness and medical visits are based on data from prior seasons, which may not be accurate if the seriousness of illness or patterns of care-seeking have changed.

Frequently Asked Questions

What does the cumulative burden of influenza for the 2019-2020 season mean?

The cumulative burden of influenza is an estimate of the number of people who have been sick, seen a healthcare provider, been hospitalized, or died as a result of influenza since October 01, 2018. CDC does not know the exact number of people who have been sick and affected by influenza because influenza is not a reportable disease in most areas of the United States. However, these numbers are estimated using a mathematical model, based on observed rates of laboratory-confirmed influenza-associated hospitalizations.

How does CDC estimate the cumulative burden of seasonal influenza?

Preliminary estimates of the cumulative burden of seasonal influenza during the 2019-2020 season in the United States are based on crude rates of laboratory-confirmed influenza-associated hospitalizations, reported through the Influenza Hospitalization Surveillance Network (FluSurv-NET), which were adjusted for the frequency of influenza testing during recent prior seasons and the sensitivity of influenza diagnostic assays. Rates of hospitalization were then multiplied by previously estimated ratio of hospitalizations to symptomatic illnesses, and frequency of seeking medical care to calculate symptomatic illnesses, medical visits, and deaths associated with seasonal influenza, respectively.

Why does the estimate of cumulative burden change each week?

The estimates of cumulative burden of seasonal influenza are considered preliminary and may change each week as new laboratory-confirmed influenza-associated hospitalizations are reported to CDC. New reports include both new admissions that have occurred during the reporting week and also patients admitted in previous weeks that have been newly reported to CDC.

How does the number of flu hospitalizations estimated so far this season compare with previous end-of-season hospitalization estimates?

The number of hospitalizations estimated so far this season is lower than end-of-season total hospitalization estimates for any season since CDC began making these estimates. This table also summarizes all estimated influenza disease burden, by season, in U.S. from 2010-11 through 2017-18.

Preliminary Cumulative Estimates of Hospitalizations in the U.S. 2019-2020 Flu Season

Preliminary burden estimates*These estimates are preliminary and based on data from CDC’s  weekly influenza surveillance reports summarizing key influenza activity indicators.

Estimated number of influenza-associated hospitalizations

The y-axis extends from 0 to 1 million.

The x-axis is a timeline starting October 5, 2019 and extending to May 30, 2020.

There is a single blue-shaded curve labeled with “2019/20”.

There are several other lines on the right side of the graph under Total hospitalizations at end of past seasons. The lines are labeled, from top to bottom, as 2018/19, 2017/18, 2014/15, 2016/17, 2012/13, 2013/14, 2015/16, 2010/11, and 2011/12 and represent the estimated burden for these seasons.  This allows for the comparison of the current season to past seasons.