Can we beat influenza

Unless we get a perfect vaccine, it’s likely that we will be dealing with both Covid and influenza for the foreseeable future. So, I’m going to assume we maintain social distancing, at levels sufficient to keep Covid suppressed – that means lots of handwashing, crowd limits based on 4sq m per person, and continuous testing and tracing.

Coming back to influenza, the lockdown against Covid-19 has ensured that, for all practical purposes we wont have our usual winter influenza epidemic this year. That’s another thousand or so lives saved, to set against the rightwingers and contrarians who advocated letting thousands die from coronavirus in the interests of business as usual.

Influenza has several big differences from Covid. First, we know how to make an annual vaccine, even if it’s not perfectly effective. Second, kids are hugely effective spreaders of flu. Finally, infectious people mostly have symptoms.

That implies several features of the response. We need to aim at universal vaccination, and make it compulsory for those likely to come into contact with vulnerable groups and children. That includes not only health care workers and teachers but also other children. Having established the principle of “no jab, no play” for the standard “childhood diseases” we should extend it to influenza.

For the rest of the population, we need free provision of the vaccine and constant advocacy, including remorseless shaming of antivaxers, deniers and do-nothingers. These groups should be treated like drunk drivers and speeders, and their advocates in the rightwing media should be treated as the monsters they are. This will lay the ground for an even more vigorous response if we get a Covid vaccine.

Because asymptomatic influenza is less common, ensuring that everyone has access to sick leave, and that occupation health and safety laws require employers to send sick workers home would make a big difference. We need to end the culture of “presenteeism”, under which taking a “sickie” is considered a far bigger problem than turning up sick.

In this context, Johnson and Johnson (makers of Codral) should be required to run a long term advertising campaign repudiating their old slogan of “Soldier On”. In the new post-globalist world, I’d see no problem with shutting down their Australian operations if they refuse. We’ve imposed stringent border restrictions on individuals to suppress this pandemic, and we should be much tougher on corporations.

Finally, masks. Because we suppressed the virus so successfully, Australian policymakers have dodged the issue. But it’s pretty clear they reduce transmission of all kinds of respiratory disease.

Would this package work? Universal vaccination by itself would get close. The flu vaccine is said to be about 60 per cent effective, and this is also the immunity rate required for herd immunity. So, if we added hygiene, social distancing and testing/tracing, suppression should be a feasible strategy.