So, more people are ‘virus naive’. Now what?

Winter has just begun, and many of us are already flinching every time we see – or even worse, feel –someone let out an explosive cough.

How can we not be? Many of us are gun-shy about getting sick again after being laid low by COVID-19. And the flu is returning with a “vengeance” after the pandemic rendered it virtually non-existent until recently, thanks to border closures and public health measures.

As a result, say doctors, babies and toddlers who were born after the beginning of the pandemic are “virus naive” to the flu and the rest of us likely have waned immunity to protect ourselves from it.

“A good proportion of the population would be below the levels required to protect yourself [against influenza],” says Professor Ian Barr, deputy director of the WHO Collaborating Centre for Reference and Research on Influenza.Credit:iStock

The Doherty Institute’s Professor Ian Barr, deputy director of the WHO Collaborating Centre for Reference and Research on Influenza, says two- and three-year-olds who have never seen the flu are “completely virus naive”, meaning their immune systems will respond more slowly to infection.

For the rest of us, immunity wanes after usually a year or two of being exposed to influenza. “So my guess would be a good proportion of the population would be below the levels required to protect yourself,” Barr says.

He urges anyone who hasn’t already vaccinated against the flu to do so as soon as possible. For a “virus naive” child, this is especially vital.

“It makes a difference between hospital admission or not,” says Dr Rod Pearce, chair of the Immunisation Coalition. “It’s a nasty disease for children.”

Common flu symptoms include a runny nose, sore throat, fever and muscle aches, but serious complications include swelling of the heart and brain, and lung and kidney failure.

As with any respiratory infection, people should seek emergency treatment if they are struggling to drink fluids or breathe, says Dr Sarath Ranganathan, a respiratory physician at the University of Melbourne.

But it’s not just young children, the elderly, and those with preexisting conditions who must take all necessary measures to ward off respiratory diseases this winter.

It’s rare for a young, well person to die of the flu but “it does happen”, warns Dr Karen Price, president of the Royal Australian College of General Practitioners.

“Look, there was a quite lovely, brilliant doctor from our year who died when he was 28, a fit, well young man, from influenza, with no comorbidities,” Price says. “It was shocking and awful.”

On top of this, Barr says many people in the community have become blasé about illnesses “that have had a bit of a holiday and [have now] come back in various forms”.

“COVID’s taken all the limelight,” he says, overshadowing not only the flu, but respiratory syncytial virus, which frequently leads to bronchiolitis and pneumonia in young children and is now spreading fast.

Not to mention whooping cough, adds Pearce, otherwise known as the “100-day-cough”. “I just did a study showing whooping cough is probably six times more common than reported,” he says. “We do not tend to test for it.” The virus is potentially fatal for babies in the first few months of life. He urges all Australians to be vaccinated against it.

What else can we do, to help ourselves this winter?

You might want to use a high-efficiency particulate absorbing (HEPA) filter in your home or office “appropriate for the volume of the room”, Barr says, to help reduce the viral load of particles in a room. “But they need to be running constantly so they can filter enough of the air to make a difference,” he says.

If you’re “particularly unwell”, don’t just assume you’ve got COVID and test only for it, but instead ask your doctor for a respiratory multiplex text, says Barr. This will test you for COVID plus other viruses.

Because if you do have the flu – and it’s detected within 48 hours of the onset of symptoms – you can be prescribed antiviral medication that can reduce the severity and length of the illness. Antivirals, says Barr, are vastly underused in the community.

And if you do get sick, regardless from what virus, it also wouldn’t hurt, says Price, to clean your toothbrush, inhaler or cosmetics with soap and water or an alcohol wipe to help prevent germs from re-entering your system.

And, she adds, people should know that all the measures we’ve become used to during COVID – like masks and coughing into your elbow – are also useful to protect us from other respiratory viruses.

“We’ve all noticed the open-mouthed cough in a closed space with people; do we not understand germ theory yet?” says Price, with a note of exasperation.

And don’t forget the simple but effective measure of disinfecting your hands, especially before touching your mouth or nose.

“There’s not one occasion when I touch a surface that I won’t use a bit of alcohol on my hands,” says Ranganathan.

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