Flu Is Rising...Isn't It?

ALWAYS Look To The Data, Not The Narrative

In the latest exhibit of why data matters more than narrative, we have three news articles. All three are from local newspapers focused on the news relevant to their respective regions. All three are current, with the oldest having been published on December 15. All three talk about “rising flu” in their respective areas.

All three are wrong.

In an article dated December 15, Hannah Mackay of The Detroit News reports that flu cases are on the rise and, coupled with a prior surge in respiratory syncytial virus (RSV), are overwhelming the hospital systems in the Detroit area.

Two Metro Detroit health care leaders said Thursday influenza is on the rise in Michigan while cases of the respiratory syncytial virus (RSV) have been trending down.

The region is experiencing the "triple demic" of influenza, RSV and COVID-19, said Matt Sims, director of infectious disease research at Corewell Health East, formerly known as Beaumont Health.

"It started with RSV ... a few weeks ago where it was really peaking with really overloading hospitals, especially pediatric units," Sims said during a Zoom call. "RSV is finally starting to trend down, but flu has been coming up."

The article date is relevant, because when we look at the Michigan Flu Focus surveillance report for the week ending December 10, we immediately see that, until the week ending December 3, percentages of visits for Influenza-Like Illnesses (ILI) did not exceed the regional baseline percentage.

Moreover, the SouthEast (SE) region of Michigan—where Detroit is located, had a total of 55 reports of ILI during that week. Based on the chart, the previous weeks have had even fewer cases of ILI reported.

There has been no “surge” of ILI in the state of Michigan—not RSV, not influenza, not even COVID.

It is true that influenza-associated hospitalizations are on the rise, with 74 for the week ending December 10, for a total of 191 influenza-associated hospitalizations for the 2022-2023 flu season to date.

Did those 191 influenza-associated hospitalizations “overwhelm” Detroit area hospitals? According to the hospital data reported to HHS, probably not. As of December 2, only two hospitals were at 100.00% utilization. Far more are reporting utilization rates below 90%.

191 influenza cases in hospital is not a “surge” in hospitalizations, especially when only two hospitals show 100% utilization.

In Sacramento, California, Cathie Anderson, writing for the Sacramento Bee, on December 17th reported that flu activity and flu hospitalization were “soaring”.

Flu activity and hospitalizations are soaring to levels not seen since before the COVID-19 pandemic, spurring public health officials and emergency room doctors to issue public pleas this week to Californians to get vaccinated.

However, influenza detections in California have been declining for the past two weeks, according to the California Department of Public Health’s latest weekly report regarding influenza, RSV, and other respiratory viruses.

“Soaring” cases typically implies case levels which are rising, not falling.

While doctor visits for Influenza Like Illnesses are significantly above the seasonal threshold, they too are declining at the moment.

The most recent peak isn’t even the highest level, that being the percentage recorded at the start of the 2017-2018 flu season.

Percentages of hospitalizations at Kaiser Permanente facilities in Northern California for influenza also declined in the most recent reporting week.

If flu cases were truly “soaring” in California, we would rationally expect to see a greater proportion of hospitalizations be for influenza or ILI. Instead, we are seeing a declining proportion of hospitalizations for influenza—the antithesis of “soaring”.

In the December 19th edition of the Lafayette Daily Advertiser, Ashley White reports on the burden high flu cases are placing on Louisiana hospitals.

Region 4, which covers most of the Acadiana parishes, including Lafayette, was registering at the highest level of flu activity and has slowly started to decrease in the past few weeks, Stefanski said.

“That’s all relative because we’re still at high flu activity,” Stefanski said “When you consider our outpatient visits, so like emergency department visits, 8% of outpatient visits have flu or flu-like illness. That’s about double the baseline.”

However, according to Louisiana’s Influenza Surveillance Report for the week ending December 10, only 6% of outpatient visits were for influenza-like illness.

Additionally, COVID-19 surveillance indicates that COVID cases are below the regional baseline, and, as with ILI, are currently declining.

Further undermining the narrative of “soaring” ILI activity, the number of visits are down in the week ending in December 10 across all age groups.

Hospital admissions are likewise on the decline in Louisiana.

One can, with a little bit of research, find similar articles pushing a similar narrative regarding rising flu cases and increasing hospital burden for just about any major metropolitan area in the United States.

To be sure, in California and in Michigan, certain metrics regarding ILI did rise significantly in recent weeks, but have since retreated. Even when the media accurately describes that increase in ILI cases, it is disappointing (although not surprising) to note that the media is relatively silent on the subsequent decreases.

When case counts are decreasing, it is impossible for any virus to “soar”, “surge”, or otherwise increase to a degree that at all noteworthy, which invalidates the narrative arc for all three articles, and however many hundreds of thousands are of tests are performed each year.

Cases of ILI have overall risen earlier than has been the case during previous years. However, the peaks reached thus far are nowhere near the peaks reached during previous flu seasons, and if current trends hold, in at least these three states the overall public health burden of all Influenza-Like Illnesses the early start to the flu season will be matched by its equally early retreat, a reality that is distinctly at odds with the media narrative.

That reality merely underscores the supreme importance of actual data over media narrative. Regardless of what is reported in either local media or nationwide corporate media, it is always the data which tells the actual tale. The data is what will confirm or reject the media’s narrative, which is what the data effectively does in Michigan, California, and Louisiana.

Which is why you should never trust the narrative, and always verify the data. The data is out there—never hesitate to scrutinize it for yourself.