Viruses, like COVID-19 and influenza, can be totally unpredictable — even to people like Richard Zimmerman who have studied them for decades. 

“I’ve been around and have gotten to [eat] my prediction so many times in flu, that you just have to be a little humble. You really don’t know,” Zimmerman, a professor of family medicine and the principal investigator for the CDC’s U.S. Influenza Vaccine Effectiveness Network location at Pitt, said. 

The COVID-19 Medical Response Office said in a Nov. 8 update flu season is “in full swing” on Pitt’s campus much earlier than its typical peak, raising concerns about the combined impact of the flu and COVID-19 on vulnerable populations.

“Those more vulnerable for increased illness, including older folks, young children and immunocompromised individuals, are at risk,” the CMRO said. “It’s more important now than ever to prevent further spread of respiratory illness ahead of the holidays.”

The increase in flu cases on Pitt’s campus follows national trends, as tracked by the Centers for Disease Control. According to CDC data, the flu is already reaching levels typically only seen in January and February. There are a few causes for this phenomenon, Zimmerman said.

“This is due to a combination of first [the] relaxing of some of the social distancing measures that were used during the height of the pandemic, in combination with a loss of population immunity … because influenza was not — the incidence of it was not high last year and negligible the year before, so we really didn’t have a lot of influenza and people’s immunity waned,” Zimmerman said. 

The CMRO’s message said Student Health Services on the Pittsburgh campus currently see many more cases — and more severe cases — of the flu than of COVID-19. An unnamed spokesperson for the University declined to share case numbers of the flu or COVID-19 on the Pittsburgh campus, but confirmed that on-campus flu cases were more prevalent and severe than COVID-19 cases as of Nov. 19. 

In light of the heightened flu season, the University spokesperson emphasized the importance of preventative steps, including vaccination and hand-washing. 

“We encourage all students to take steps to stay well, like getting flu shots and COVID-19 boosters now and practicing good hand hygiene,” the spokesperson said. “Prevention is the best strategy.”

Many Pitt community members have already gotten their shots from the Pitt Vaccination and Health Connection Hub, which distributes flu and COVID-19 vaccines. According to Ian Montelius, a first-year graduate student at the School of Pharmacy and the lead intern at the Hub, the vaccination center distributed 4,916 flu shots between Sep. 14 and Nov. 28 — almost double the amount of last fall semester, when the Hub distributed 2,739 flu shots. 

Montelius said the Hub distributed 3,695 COVID-19 shots between Sep. 14 and Nov. 27. He added that he was surprised flu shots outnumbered COVID-19 shots this year. 

“If you asked me, I would have expected there to be more COVID shots just in general, you know, the bivalent booster’s out [and] a lot of people haven’t really gotten a shot for a year, but the flu has been very prevalent,” Montelius said.

Montelius has seen students’ motivations for getting their flu shot change over the course of the semester, he said, as the flu season begins to worsen on campus. 

“Initially, a lot of people coming in were like, a health science student that needed to fulfill a requirement or like, work in a hospital, they would get it [the flu shot],” Montelius said. “But we’ve seen over [time], especially in October, people are like, ‘Yeah, I’m coming in because I know someone who got the flu and it was, like, really bad.’”

The Pitt spokesperson said students, faculty and staff should stay home if they don’t feel well and the CMRO instructed this in nearly all of its campus-wide updates this academic year. However, sick students who miss class could receive a grade reduction, depending on their professor’s individual attendance policy.

Pitt’s faculty handbook states that Pitt has no general policy on class attendance, though some schools at the University may create their own policies. The University spokesperson did not respond to questions about what accommodations, if any, Pitt requires professors to provide for students who are sick with the flu or COVID-19. According to the SHS website, it’s up to professors to decide how to accommodate sick students, as SHS does not provide medical excuses. 

“The clinicians at SHS are not able to function as independent arbitrators regarding whether a student feels too ill to do their work,” the SHS website reads. “It is the purview of faculty to determine if a student will be excused from class, an exam or assignment.”

SHS can provide documentation of a patient visit, but will only include information regarding the date and time of the visit due to medical confidentiality policies, according to the SHS website. 

A significant proportion of COVID-19 cases may go unreported to health departments because they are detected by at-home rapid tests, U.S. News reported in May 2022. The CMRO said in October they noticed a decrease in students coming in for testing on the Pittsburgh campus this semester. COVID-19 testing is available at the O’Hara Student Center five days a week or through SHS, which can also test for the flu and RSV. 

The University spokesperson said in November there is “no evidence of under-reporting of COVID-19” at Pitt, and that in addition to contacting MyHealth@Work or SHS, Pitt affiliates can now report positive COVID-19 tests online. 

Zimmerman did feel comfortable making at least one prediction — while it may not have the spotlight right now, COVID-19 hasn’t gone away for good. 

“All these viruses mutate,” Zimmerman said. “Once there’s enough mutation to escape the vaccination coverage with the bivalent vaccine and the residual immunity from infection, it’ll come back. When will that be? I don’t know. But we will see SARS-CoV-2 return.”