Pharmacy Daily | What to expect for the rest of the flu season

THE 2025 flu season is now in full swing, and with case numbers high and vaccination rates concerningly low (PD 07 May), experts have outlined what we might expect from the rest of the season.

As the COVID pandemic fades from the collective memory, many Australians now think of influenza as the more serious of the winter respiratory viruses, said Associate Professor Joel Rhee, Head of Discipline of General Practice at UNSW Sydney.

However, the national data tell a different story.

"When I ask medical students, 'what do you think is more serious - influenza or COVID?' almost 100% say influenza," A/Prof Rhee said.

"But the statistics say otherwise - COVID is still causing more deaths than flu."

The most serious impacts of COVID, including hospitalisation and death, affect mostly older adults and those with chronic health conditions.

A/Prof Rhee sees the impact firsthand through his work in aged care homes, and while COVID does not seem to be a serious disease in young children, the flu can affect all age groups, including infants.

In 2024, children under nine years old had the highest rates of flu.

Vaccination remains the first and most effective line of protection, and A/Prof Rhee said it is not too late to get a flu shot this season.

Vaccine recommendations for COVID have evolved post-pandemic, with most people unlikely to benefit.

"We're no longer recommending an annual booster for most healthy people," A/Prof Rhee said, although those who are caring for vulnerable relatives might consider one.

"But those over 65 or with underlying health conditions may need annual or more frequent boosters," he noted.

While some antiviral medications can help when started soon after infection, those hit by a flu-like virus can expect a rough ride - and a potentially long one.

Professor Andrew Lloyd, an infectious disease physician at the Kirby Institute, who also leads the UNSW Fatigue Clinic, pointed out that while a flu can wipe people out for a week, for many, it is just the beginning.

"Lingering symptoms like fatigue, brain fog and sleep disruption can persist for weeks, sometimes months," Prof Lloyd said.

These symptoms are typical for what is now termed 'long COVID', but Prof Lloyd's research shows they are not unique to COVID.

These symptoms also follow glandular fever, Ross River virus and Q fever, with data showing 30% of people with these infections still experiencing symptoms three months later.

And while the symptoms from the acute infections were very different, the lingering symptoms were remarkably similar.

"Long COVID has drawn attention to these post-viral fatigue syndromes - but they've always existed," Prof Lloyd said.

Most people do get better with time, and "careful, structured rehabilitation - not just rest - is the best path forward", he advised.

The good news is that the severity and duration of long COVID may be decreasing, experts say, partly due to different strains of the virus, and also vaccination and prior infection improving immune response. KB