Written By: Jason Graziadei

How many cases of flu have been diagnosed on Nantucket over the past year? If you guessed zero, you get an elbow bump. That’s right – it’s been more than a year since a single case of flu has been diagnosed by Nantucket Cottage Hospital. It’s a phenomenon that has been noticed across the globe during the pandemic. As cases of COVID-19 spiked, the precautions that became widespread – hand washing, wearing masks, distancing and avoiding crowds – proved to be extremely effective against a lesser viral foe. That factor combined with school closures, large numbers of people working from home, and a precipitous drop in public transit usage, nearly eradicated the flu. The United States recorded the fewest number of influenza cases – about 2,000 – for any flu season on record. On Nantucket, the last person to test positive for flu was in March 2020, at the outset of the pandemic. That was followed by 12 straight months of zero cases. Of course, the number of tests administered to detect influenza was fewer than in previous years, as health officials focused on COVID-19 testing. But not by much. And island clinicians were still testing for influenza during the normal fall and winter flu season – approximately 150 tests from September 2020 through March 2021 – and diagnosed no cases.

Island health officials said absence of flu is notable, but doesn’t come as a shock given the circumstances and the precautions in place during the pandemic.

“It’s not that surprising to me,” Nantucket Cottage Hospital chief nurse Michelle Epps said. “As nurses, it’s engrained in our psyches that hand-washing is the end-all cure for so many ailments. So the hand washing alone – although I don’t negate mask wearing and distancing – is important to stop the transmission of virus particulate. We stopped shaking hands, which is actually one of the nastiest gestures we have, going back centuries.”

Part of the success may also have been Nantucket Cottage Hospital’s intense push for flu shots last fall. Amid concern over a “twindemic”, the hospital for the first time offered drive-through flu shots on an almost daily basis, providing far greater access than was available in previous years. The initiative resulted in more than 7,000 island residents getting their flu shot during the 2020/21 season, slightly more than double the average number of annual influenza vaccinations on-island.

“It actually makes sense,” Nantucket Health Department Director Roberto Santamaria said of the absence of flu cases on Nantucket. “It doesn’t really surprise us. The flu virus particle is at least three times the size of the COVID-19 particle. So the same masks that filter out 95 percent of COVID-19 are filtering out 99 percent of flu. I’m really happy to see so much cleanliness and precautions out there. The only thing I’m worried about is because we’ve been using so much sanitizer and alcohol (to clean), what super bugs have we created? We’ve done a massive bottleneck event for bacteria.”

Another theory that has been floated to account for the virtual eradication of influenza versus the prevalence of COVID-19 is the public’s previous exposure to various strains of flu viruses over the years that may have provided some natural immunity.

“For something like Covid, where you have a fully susceptible population at the start of a pandemic, it takes a lot more work to slow the spread of the infection,” Princeton University epidemiologist Rachel Baker told The New York Times this week.

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