Winter is coming and while figures so far suggest a quiet flu season, Cathy O’Leary explains it’s too soon to be complacent.


It is one of the few upsides of the COVID-19 pandemic apart from a resurgence in jigsaws and homemade sourdough bread – an all-time low number of flu cases.

Thanks to infection-suppressing hygiene and physical distancing measures, the flu has been largely missing in action for 18 months, but experts warn it is no time for complacency amid concerns that people who have not got around to having their seasonal flu jab might miss out on it altogether in the flurry to have their two shots of the COVID-19 vaccine.

Recent figures from the crowd-sourced FluTracking public health surveillance system show how the pandemic dramatically affected the 2020 flu season, with the number of laboratory-confirmed cases of flu in January 2021 just one per cent of those seen in January 2020.

Developed by Hunter New England Health and the University of Newcastle, FluTracking started in 2006 with 400 participants but by 2020, the number of Australians and New Zealanders providing weekly data peaked at more than 150,000.

So far this year, there have only been 235 lab-confirmed flu cases in Australia, compared to more than 20,000 cases at the same time last year, and 44,000 at the same time in 2019. 

In the week ending May 2 this year, almost 60,000 people had taken part in the FluTracking online survey – including 5895 West Australians – with only two participants reporting having laboratory-confirmed flu.

FluTracking founder Dr Craig Dalton

Keeping track

FluTracking founder Dr Craig Dalton, a Hunter New England public health physician and Conjoint Associate Professor at the University of Newcastle and the Hunter Medical Research Institute. said the typical flu season in Australia resulted in about 60,000 infections nationally in peak months.

In 2020, that dropped to less than 200 cases a month in July and August. 

“Ask any flu expert and we would say it’s not easy to stop flu transmission. What 2020 taught us is that physical distancing, hand washing and mask wearing can dramatically reduce the incidence of flu in the community,” Dr Dalton said.

“The days of turning up to work with a cold or flu are probably gone forever, and masks may become part of our winter wardrobe. It will be interesting to see whether these behavioural changes will continue to keep flu in check this season.”

Taking only 15 seconds to complete, the weekly web-based survey collects data about flu-like symptoms, harnessing the power of the Internet and community spirit to detect the potential spread of influenza.

Participants who record a symptom are asked further questions about time absent from normal duties, visits to health care providers, results of laboratory tests for influenza or COVID-19, and current vaccine status. 

Dr Dalton said FluTracking had evolved over time to help health professionals monitor seasonal influenza, pandemic influenza and now COVID-19. 

“FluTracking can fill in the gaps in information not captured by hospitals and health services because many people with flu-like symptoms don’t enter the health system and therefore aren’t counted,” he said. 

“With FluTracking we can measure the community impact of these diseases, capturing information about people who showed symptoms but did not consult a doctor or present for a COVID test.”

With the low number of flu cases so far this year, public experts remain cautiously optimistic but a drop off in flu vaccines is still possible. 

Professor Paul Effler

Spacing the jabs

According to the Australian Technical Advisory Group on Immunisation (ATAGI), people should ideally receive their annual flu vaccination before the start of the season – typically June to September in most parts of Australia. And the current advice is to have the COVID-19 and flu vaccines at least two weeks apart.

Professor Paul Effler, senior medical advisor at the WA Health Department’s Communicable Disease Control Directorate, told a recent podcast that there was no reason to think the vaccines would interfere with one another because they were inactivated viruses.

“The major issue is if there is an adverse event, we will know which vaccine caused it,” he said.

ATAGI says that if flu cases began to soar, giving the COVID-19 and flu vaccines together or within less than  the currently recommended 14-day period could be considered in certain circumstances but more research was needed. 

ED: Anyone can take part in FluTracking through www.flutracking.net. It takes 30 seconds to join and 15-20 seconds a week to do the survey. Participants receive a link to a weekly report and an updated map of the latest respiratory symptom activity in their area.