Dr Colin – Is the “super cold” really as treacherous as you think?

Many of you will have happened upon the widespread panic about the new not-COVID cold set to take the country by storm. Experts warn that flu deaths this winter could be the highest we’ve seen in the past 50 years. Modelling from the Academy of Sciences has in fact suggested that the UK could see between 15,000 and 16,000 flu deaths over the coming months (this can be compared to the average of 11,000 deaths per year in the 5 years preceding COVID-19). These figures risk crippling a health system already under extreme pressure.

But how did this come to be, exactly? Is there really a mutant “super cold” out there, as some people are calling it – and is it really as treacherous as you think?

Rest assured, there is no monstrous, alien flu strain out there waiting to attack at first opportunity. Nor has the COVID-19 virus mutated into some kind of medical mystery. The “super cold” many experts are warning about may be strongly associated with the effects of “immunity debt” (also more accurately labelled “immunity naivety”).

Immunity debt

Immunity debt refers to the attrition done to your immune system from the absence of regular exposure to bacteria and viruses. Under normal circumstances, your daily routine will ensure you come into contact with a wide range of germs, for example through touching everyday objects and surfaces at home or work, and through interacting physically with people (shaking hands, hugging, chatting closely etc). This daily contact and exposure plays an important role in building up our immune systems.

Over the last 18 months, however, lockdowns and social distancing measures have prevented this regular activity. We’ve been wearing masks, avoiding physical contact with others, and sanitising hands and surfaces, meaning that we have been sheltered from the regular exchange of germs that works to keep our immune systems in good health. In other words, while keeping us safe from the spread of COVID-19, social distancing has had the correlative effect of leaving our immune systems vulnerable and exposed.

The occurrence of immunity debt dispels the myth of a mutant “super cold” lurking behind your local street corner (as some news headlines are making it out to be), but it is nevertheless something that should not be taken lightly.

The threat of a high death toll is something we all need to take seriously, and this means taking appropriate measures to ensure we are protected as much as possible. If you are responsible for staff, this includes passing on relevant information, especially to those who are most vulnerable, along with encouraging employees to keep their general health in good order.

What is the flu currently circulating? Is it a super cold?

The common cold that most of us are familiar with is caused by more than 200 strains of the virus. Constant monitoring of the flu plays an important role every year in allowing scientists to detect which strain is most dominant, and hence to decide which strain to target in annual vaccination drives.

The version currently in circulation is likely respiratory syncytial virus (RSV). Most people infected with this virus will have cold-like symptoms (headache, sore throat, runny nose, sneezing), yet in the elderly and babies under 2 years of age, the virus could lead to serious illness.

The RSV version of the virus is fairly common. Just over half of children in the UK will have contracted the virus by the age of one. When they get to 3 years old, this increases to about 97% of children.

RSV also happens to be highly contagious. Unlike COVID-19, RSV spreads widely through hands and surfaces. It is also transmissible through coughing and sneezing. With regards to surfaces, this means that it is highly difficult to control the spread among young children. Easy transmission through surfaces also means that certain hotspots, for example public transport, are bound to facilitate easy spread.

How worried should we be?

A recent polling of 3,000 adults commissioned by the Cabinet Office found that about a third were unaware that it is possible to catch flu and COVID-19 at the same time. Yet this is precisely the reality we are facing.

The threat of flu is compounded by the fact that flu infection could make COVID-19 symptoms considerably worse. COVID-19 and flu are co-circulating viruses, and both viruses are serious: they can spread easily, even more so with the easing of restrictions; they may result in hospitalisation; and both could ultimately be fatal.

So, while our weakened immune systems make us particularly vulnerable to flu this winter, there is the added threat of infection from both flu and COVID-19 at the same time. This is absolutely cause for concern, and it is something we should all be aiming to avoid.

But how exactly?

We have seen numerous experts over the last few months urging us to attend to our non-COVID-19 health and not simply assume that everything is down to COVID-19. This is an important message, and I do not wish to detract from it in any way.

But it is also vital that in the case of the flu, if you are exhibiting COVID-19 symptoms, then you need to treat this seriously and take all necessary precautions. This means following NHS guidelines and taking a PCR test to confirm your COVID-19 status.

If you are not exhibiting COVID-19 symptoms but are sniffling, stay home and take a rapid antigen test immediately.

You may feel safe in the belief that COVID-19 infection rates are lingering below what they were several months ago, but latest figures reveal that the country is still reporting a 7-day average of around 34,500 new COVID-19 infections every day. We are currently the 4^th highest number of daily COVID-19 deaths in Europe.

Naturally, many people are taking regular tests and finding that it really is just the cold. Is this the treacherous cold we are seeing all over the media? Well, most probably not. There may well be a variety of psychological factors at play. In fact, some experts suggest that many of us have forgotten about how the common cold used to bug us over winter, meaning that we are now hypersensitive to the kinds of symptoms we once dismissed prior to the pandemic.

But at the same time, immunity debt is likely playing a significant role in weakening the preparedness of our immune systems.

What is your duty as an employer?

Taking precautions used to be tricky pre-2020, as listening to your body meant staying home and missing out on your busy work schedule. With the increasing normalisation of home and hybrid working, however, this doesn’t have to be the case. Many employees can continue to perform their work remotely.

Depending on how the flu plays out this winter, employers may need to play an active role in encouraging staff to be especially cautious about any exhibiting flu symptoms. You simply cannot take unnecessary risks in the current environment. An employee who feels pressured to come to work in spite of existing symptoms may easily spread the virus.

This may place members of your workforce at risk, especially those who are vulnerable or who have pre-existing medical conditions.

Workplace policies should quickly adapt in light of current circumstances to prevent any unnecessary complications.