The number of active COVID-19 patients is dropping but the threat of a second wave looms large. It will be months at least before a vaccine is approved, while the virus might never be eradicated and develop into one of the many illnesses that form part of our everyday lives, much like seasonal influenza.

Seasonal influenza infects millions of people every year and causes over 600,000 deaths. In Malta, at least 50,000 people catch the virus, with WHO estimating that there are around 130 deaths every year from influenza and pneumonia. That’s about one in every 16 deaths.

So what can we learn from how Malta deals with the yearly outbreak?

It’s easy to see why people find it easy to compare COVID-19 to seasonal influenza.  Both cause respiratory diseases, which can emerge in a wide range of severity that can sometimes lead to death.

Meanwhile, the virus is passed on through contact, respiratory droplets and infected surfaces. And just like the flu, people who catch COVID-19 often develop no symptoms.

It’s a big reason why people believe that the actual number of infected cases of both COVID-19 and the flu is a lot higher than what is reported in official statistics.

In January 2020, Superintendent for Public Health Charmaine Gauci revealed that 10% of people in Malta had contracted seasonal influenza, slightly lower than the 16% who got it the season prior. 

During the winter months, seasonal influenza can infect up to 20% of the population.

Global studies have found that 650,000 people a year die because of seasonal influence, while the WHO places around 72,000 within Europe. The virus usually lasts from around October to June, typically spiking between December, January, and February.

When influenza first emerged, the world was not so lucky. The Spanish Flu, a deadly influenza pandemic, infected 500 million people (almost a third of the world’s population then) and killed anywhere from 17 million to 50 million people. It is one of the deadliest pandemics in human history and has caused several pandemics since.

There have been over 3 million confirmed cases of COVID-19 over four to five months, with around 205,000 deaths and 888,000 recoveries. In Malta, we’ve seen over 458 cases, 303 recoveries and four deaths.

As a result of the scale of the outbreaks, the same public health measures often apply, such as hand hygiene and good respiratory etiquette (coughing into your elbow or into a tissue).

There is one key clear difference, however, we know far more about influenza than COVID-19, gaining decades of experience and crucial knowledge on vaccinations.

Yearly, authorities do warn of how influenza outbreaks have fatal consequences of hospitals.  However, Gauci and Health Minister Chris Fearne often conduct promotional drives to urge people to get the vaccine. Influenza often mutates from season to season and regular vaccinations are required. Who is to say the same will not apply to COVID-19?

It works. Around 55% of Maltese people take the influenza vaccine, just shy of the 60% required for herd immunity to take full effect. Treatments also help, with years of experience doctors across the world have vital know-how into how to combat the virus in severe cases.

Currently, our best line of defence against COVID-19 is to limit its spread, reducing the strain on healthcare systems. It’s known as “flattening the curve”, which is avoiding major spikes that would likely create an impossible demand for oxygen, ventilators and ITU beds.

Malta has has only been able to drop its rate of infection below one because of drastic but necessary measures imposed by the government. Influenza has been able to do this through years of developing vaccinations and building up natural immunity.

Malta faces an outbreak every year, but it never results in nationwide lockdowns and, more importantly, large numbers of fatalities.

Italy, for example, is often plagued by major outbreaks of influenza. There were over two million cases of flu between October 2019 and January. However, just 240 people died.

COVID-19 was far more deadly, claiming thousands of lives in the span of a few weeks.

“It’s just like the flu”, some might say with the nation growing more and more eager to lift some measures just as the number of cases begins to drop. However, with many warning that COVID-19 will likely become one of five seasonal prevalent illnesses, it’s important to proceed with serious caution without the presence of a vaccine and decades of building up immunity.