Where Did All the Flu Cases Go?

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flu cases

The CDC recently reported that influenza cases are WAY down. In fact, they have never seen cases so low going back to the earliest days of mid-20th century flu data. Why? I have a different perspective than you’ll read in the media, who all seem to be missing the obvious.

CDC Data

You can find the CDC flu data yourself at this site. Just change the year in the upper left-hand corner to see what each season looks like. The graph below represents the percentage of lab-confirmed influenza cases. If you play with the year, you’ll see a dramatic difference between the 2020-21 winter and every other winter you can input.

I graphed last year’s 2019-20 flu season (which was pretty typical of the last several years). The red dashed line is this year’s season. The 2020-2021 season has an epically low percentage of positive flu tests and cases. Why?

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The Lockdown/Mask Hypothesis

It would certainly seem to make sense that if we lock down parts of the US, add hand washing, social distancing, and masks that the transmission of the flu virus would go down. However, given that influenza and the SARS-CoV2 virus are both primarily transmitted via respiratory droplets, you would expect to see the rates of both go in the same direction. Meaning, as COVID cases rise, so should flu cases and vice versa. This is why public health experts were so concerned about a “Twindemic” of COVID+Flu cases this season.

Below I graphed COVID cases and flu cases for the winter of 2020/21:

The graph on top with the red line is the trend in flu cases from above and the one on the bottom is the CDC COVID case count (stretched to line up the timelines as best possible). As you can see, as COVID went up, 2020-21 influenza cases didn’t. Hence, our social measures aren’t likely to be causing this effect.

COVID Is More Contagious

Another narrative we’ve seen in the media is that since COVID is more contagious and that explains the discrepancy of influenza versus COVID cases. In medicine, this is expressed by a value called R0. This is a great explanation from Medscape:

“Although dynamic, the basic reproduction number (R0 /R naught) is an epidemiologic entity that helps predict the expected number of cases from exposure to a single case, assuming all the individuals in the given population are susceptible. The R0 of measles is 12-18, by far the highest known to humankind. The R0 of seasonal influenza is around 0.9-2.1. Based on the data available so far, the R0 of COVID-19 is 1.4-3.9.”

Hence, Measles spreads much more quickly than influenza or COVID. While COVID is more contagious than influenza, that difference isn’t really enough to explain why both shouldn’t head in the same direction at the same time. Hence we might expect to see some percentage of flu cases versus the rise in COVID cases due to the increased R0 of COVID, but NO RISE in cases can’t be explained.

How About Flu tests Being Run with COVID Tests?

One expert in a news story opined that he thought that this was evidence of the massively increased contagiousness of COVID over influenza because doctors were running flu and COVID tests at the same time which would have caught any rise in flu cases. The problem with this logic is that it’s easy to see that the number of COVID tests we have run has simply overwhelmed the number of flu tests. For example, in the 2015-26 flu season, we ran about 800,000 flu tests. So far, we have run about 350 million COVID tests in the U.S. So it’s very unlikely that with all of the “COVID only” drive-in testing centers out there that we have run anywhere near the same number of flu tests as COVID tests. In fact, we’ve run so many COVID tests that they would swamp any data that could be reported from flu tests. 

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The Most Likely Explanation

Occam’s razor is a problem-solving principle that “entities should not be multiplied without necessity”, or put more simply, the simplest explanation is usually the right one. So what’s the simplest explanation here? Because of the huge false-positive rates of PCR testing that have now been exposed by multiple research articles, we misattributed many influenza cases to be COVID-19 cases. The question is, why won’t anybody state the obvious? I haven’t seen a single expert quoted in a news story this past week who even floated this obvious explanation as a possibility. They all seem to be violating the principle behind Occam’s razor.

A false positive is when a test shows positive for a disease (in this case for COVID-19) when it’s not really there. I’ve blogged on the fact that we were running the COVID PCR tests way too many cycles, amplifying a few strands of dead viral DNA in someone’s nose where these same patients had no evidence of any live virus in their bodies.

COVID is Real and Get Your Vaccine

There is no doubt that we have significant excess deaths. Hence, COVID is quite real and can kill you. The goal of this blog is to add another point of view as to why pneumonia deaths are way down and to further discuss the misattribution death problem I have bogged on numerous times. However, this blog is NOT a reason or invitation to stop listening to public health authorities or to skip the vaccine.

The upshot? The simplest explanation of why influenza cases are down to unheard-of levels is that we have misdiagnosed influenza cases as COVID cases. As always, the simplest explanation is always the most likely.



(1) The Centers for Disease Control and Prevention. FluView Interactive. https://gis.cdc.gov/grasp/fluview/fluportaldashboard.html Accessed 2/25/21

(2) The Centers for Disease Control and Prevention. COVID Data Tracker.https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases Accessed 2/25/21

(3) Medscape. What is the R naught of coronavirus disease 2019 (COVID-19)? https://www.medscape.com/answers/2500117-197541/what-is-the-r-naught-of-coronavirus-disease-2019-covid-19 Accessed 2/25/21

(4) Jester B, Schwerzmann J, Mustaquim D, et al. Mapping of the US Domestic Influenza Virologic Surveillance Landscape. Emerg Infect Dis. 2018;24(7):1300-1306. doi:10.3201/eid2407.180028

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