Doctors watch surge in pediatric flu, Covid cases

A surge in children testing positive for influenza has doctors at Johns Hopkins All Children’s Hospital puzzled, as the season typically runs from October to May.

The spread of respiratory viruses, such as the flu and common cold, dropped during the height of the pandemic. Dr. Fernando Bula, a pediatric infectious disease specialist at All Children’s, credited Covid restrictions such as social distancing and masking for the dramatic decrease in people testing positive for other viruses.

However, over 1,200 children tested positive for the flu in May, when the season is typically winding down.

“We tend to see that second (influenza) peak mainly around the end of the winter into springtime,” said Bula. “So, it is very rare – very odd right now to see a peak when we are almost fully entering summer.”

In addition to social restrictions and mask mandates ending, Bula also credited in-person classes and people anxious to gather and travel at the onset of summer for the recent increase in respiratory viruses.

Despite that hypothesis, Bula said the medical community is still without a definitive answer for the abnormal timing of the flu surge.

“We look at things retrospectively and learn from them,” he explained. “Once we pass this peak … and see if that was just like an odd thing from the virus, where we would go back to our normal behavior of the virus.”

Also concerning doctors is a recent uptick in Covid cases. While All Children’s recorded over 1,200 flu cases in May, the hospital only diagnosed 116 kids with Covid throughout the month.

All Children’s saw 59 kids test positive for Covid during the first week of June. At that pace, the hospital would double its monthly total from May. While the rise in respiratory illnesses is concerning, All Children’s discharged most children testing positive without hospitalization.

Dr. Fernando Bula, a pediatric infectious disease specialist at All Children’s, said there are no definitive answers for the unseasonal surge in flu cases.

The pediatric trends, especially regarding Covid, mirror the surrounding community rates.

According to the latest data from the New York Times Covid tracker, Pinellas is averaging 392 daily cases, an increase of 40% over the previous 14 days. The state releases new county data once every two weeks. The county reported 5,489 new cases from May 30 to June 12.

Last week, the Pinellas County Sheriff’s Office announced it extended the county jail’s lockdown due to an ongoing Covid outbreak. The lockdown, which began in May, was scheduled to end on June 6. The sheriff’s office extended the measure until June 20, after 40 inmates tested positive.

According to the Florida Department of Health, flu numbers are also rising across the state, with 11 new influenza or influenza-like illness outbreaks reported between May 21 and June 4. The DOH classifies Pinellas as having moderate flu activity.

“This increase is a complete oddity in what we have been seeing in previous years with influenza,” said Bula. “With Covid, what we are seeing now after like two years of being in the pandemic, is that roughly around every six months, we are having a new strain that is starting to emerge …”

Bula noted that many countries lack the resources to vaccinate all of their citizens, and the government recently lifted mask mandates when flying. He said that increases the chance of spreading the new variants, and health officials expected to see an increase in the U.S. after watching similar upticks in Europe.

Both Covid and influenza cases continue to spike through June, said Bula. However, health officials are not seeing a significant number of co-infections – or patients experiencing the flu and Covid simultaneously.

“We’re seeing patients with one or the other,” he said. “The flu is the one that has more cases right now and has sounded the alarms.

“But for sure, influenza may start going down as we see that Covid continues to go up. We’ll see what kind of curve or behavior of these two viruses … in the next couple of weeks.”

Bula said comparing the severity of the two illnesses was like comparing “pears to apples” and that both are serious viruses in their own right. Doctors see the significant impact of influenza annually, and, similar to Covid, the most at-risk kids are those with chronic conditions like asthma or immunodeficiencies, said Bula.

While Covid also poses a serious risk to pediatric patients, he said, “most of the kids do well,” and most do not require hospitalization.

“But we certainly have seen an increase,” he added. “And we have seen kids dying, like every time there’s a Covid wave.”

Bula said society has become complacent with influenza, and not enough people get the annual flu vaccine. Despite the known risks, he said the medical community is lucky to see 40% of the population receive vaccinations.

Like many other doctors, Bula believes that the country will see periodic upticks in Covid, and people should remain vigilant when outbreaks occur. He said people should start increasing their mask usage in public spaces and stated he would never fly or take a bus without wearing a mask.

Bula said that personal rule protects him from Covid and has also decreased his frequency of getting sick from other respiratory viruses.

Parents, said Bula, should ensure their children receive flu vaccines annually as soon as it is available. He noted it is approved for anyone six months and older. He also suggested wearing masks in crowded places and skipping events like birthday parties if someone is feeling ill or coughing.

“It’s also important to wash hands and wash hands before eating – to not only prevent flu or Covid but also other respiratory viruses,” said Bula. “That’s how we start preventing the spread of these viruses.”