The flu is arriving early and threatening Christmas: "We'll arrive at the peak"

PalmIt begins in December, and with it comes the threat of a surge in flu cases in the Balearic Islands, just as it has already happened in the rest of Spain, where the weighted rate has risen to 40 cases per 10,000 inhabitants, above the epidemic threshold of 36. In the Islands, the rate is 18.2%. Although this is not yet a high figure, it marks three consecutive weeks of growth, and the trend is expected to intensify. "It will eventually happen. The flu will reach its peak at Christmas," says Joan Carles March, a professor at the Andalusian School of Public Health. "When people say we're better off than the rest of Spain, that's not correct. The comparison should be made with how the Balearic Islands were a year ago, when the incidence rate was below 10 cases," he continues. Although the rise in the epidemic curve is currently gentle, he warns that this will change. "It will spike, and there will probably be a surge of cases in the week between Christmas Eve and New Year's Eve," which will put pressure on healthcare services. The 'good news' is that in other years the epidemic curve began to decline in mid-February; this year, if everything goes as planned, it will do so sooner, because the duration of the epidemic is usually the same.

The Balearic Islands Epidemiological Surveillance Report highlights a marked increase in specific rates among younger age groups (0-4 years and 5-14 years), "which may indicate an imminent seasonal epidemic wave within one or two weeks." Those wishing to be vaccinated should make an appointment through the Patient Portal, Infosalut Connecta, or directly at health centers. With Christmas approaching, when social gatherings increase, March urges everyone to remember the lessons of the COVID-19 pandemic: "Ventilation, vaccination, clean hands, and masks." "We must get used to face masks becoming more commonplace in our lives. For example, wearing one should be mandatory when visiting a hospital during respiratory virus outbreaks," he says. What is already happening in Spain—and which could be replicated in the Balearic Islands in the coming weeks—is not an isolated phenomenon. Several countries in the Northern Hemisphere are also registering a clear rise in the seasonal flu epidemic curve. In Europe, the European Centre for Disease Prevention and Control (ECDC) has issued an emergency report urging member states to accelerate flu vaccination programs in light of the evolving flu season. The agency warns of a potential antigenic mismatch between the A(H3N2) virus included in the vaccine and the K subvariant, which is now circulating more widely. Despite this mismatch, experts insist that the vaccine continues to protect against severe forms of the disease. In this context, healthcare services fear that the surge in cases could significantly strain healthcare capacity in the coming weeks.

The expert from Mallorca points out that the only clear cause explaining the spread of the flu is the K subvariant, and that, to a lesser extent, the colder and rainier weather this year compared to previous years may have played a role, creating a more favorable environment for the pathogen. "These viruses usually have several subvariants. What has been found now is one that makes the vaccines less effective than before. The vaccine didn't have any problems with previous subvariants; but it's not a perfect fit with this one. It reduces the number of severe cases, but not with maximum effectiveness," explains Marta. "Getting vaccinated is a good decision: if you get the flu, it reduces the possibility of problems and complications. The key is vaccination, and it would be a good idea for it to be universal."

Paradoxically, the expert warns that healthcare professionals—who should be the first to set an example—are not: "They have a much lower vaccination rate than necessary, and that's a problem, because if they aren't vaccinated, it's difficult for them to legitimately recommend vaccination. The low immunization rate in this group has led to the The College of Physicians is calling for them to join it.It's worth remembering that the effects of viruses are most severe in young children, the elderly, those with chronic illnesses, the immunocompromised, and also healthcare professionals.

Pending agreement

This Wednesday, the Ministry of Health and the regional governments are meeting at the National Public Health Commission to try to finalize the response plan to the increase in cases of influenza and other respiratory viruses. The meeting comes after the Ministry of Health and the regional governments—including those governed by the People's Party (PP)—have moved closer to an agreement in recent days to approve a document that establishes only recommendations, not obligations, and that is activated based on four risk levels, from 0 to 3.

Scenario 0, considered very low risk, focuses on strengthening epidemiological surveillance and ensuring vaccination campaigns are ready. Scenario 1, currently in effect, recommends the use of masks in hospitals, especially in areas with vulnerable patients and also in nursing homes. It also proposes relocating healthcare personnel with symptoms to prevent contagion. If the situation worsens to Scenario 2, high risk, the plan expands the mask recommendation to all healthcare facilities and suggests targeted restrictions on visits to nursing homes. In a potential Scenario 3, very high risk, it would be recommended to deploy all available measures and, if necessary, consider more stringent ones. The document also emphasizes that anyone with respiratory symptoms should limit social interactions, wear a mask, and, if possible, work remotely. The Ministry of Health hopes the meeting will allow them to reach a consensus before the flu reaches its peak circulation.