Seasonal flu cases have nearly evaporated in the time of COVID-19, due in large part to pandemic-related safety measures such as masking and physical distancing in public.

Nearly three-quarters of the way through the 2020-21 flu season, there have been just 136 total cases of influenza and only three hospitalizations, according to the most recent data from the Maine Center for Disease Control and Prevention. There hasn’t been a single outbreak or death.

Last year at this point – just as the pandemic was starting to take root – there already had been 36 deaths, 81 outbreaks, 494 hospitalizations and 10,000 cases. By mid-March of 2018, which was Maine’s worst flu season in recent memory, there were 6,973 seasonal flu cases, 1,326 hospitalizations, 122 outbreaks and 71 deaths.

Dr. Jodie Hermann, chair of the University of New England’s Department of Osteopathic Manipulative Medicine and an internist at Maine General in Augusta, said the significant drop in flu cases is indeed surprising and likely attributable to more than one thing.

“But I think the overall take-home point is the way we’re changing our habits,” she said. “Everyone’s not sneezing in people’s faces or wiping their noses.”

Hermann said she can’t remember admitting a single patient for the flu this season.

Dr. James Jarvis of Northern Light Health, the parent company of Eastern Maine Medical Center in Bangor and Mercy Hospital in Portland, among others, said that although experts predicted flu cases would decline, no one expected these numbers. He said he’s talked to plenty of people who haven’t had so much as a cold in more than a year.

“I think it certainly lends credence to the fact that masking helps prevent respiratory illnesses,” he said.

The number of cases reported by the state reflects only those confirmed by a lab test. The actual number is much higher than those reported because many people recover at home and are never tested.

Over the last five years, flu-related deaths have ranged from a high of 82 in the 2017-18 season to a low of 29 in 2018-19.

Other states are reporting similar dramatic reductions in flu cases, hospitalizations and deaths. New York’s Department of Health, for instance, reported last week that there have been 3,914 lab-confirmed cases of influenza this year, compared to more than 147,000 this time last year. Nearby New Hampshire has seen just two flu-related deaths this season, after averaging around 50 for the last several years, according to the Concord Monitor.

National data on the seasonal flu won’t be compiled until well after the season is over, which is typically late May, but already there are remarkable data points. During the 2019-20 flu season, there were 196 pediatric flu deaths. This season, only one child has died from the flu.

Pandemic-related restrictions likely played a huge role in low transmission, but so too did a massive public health campaign last fall to encourage people to get a flu vaccine.

Hermann said she certainly encouraged more patients than ever last year to get a flu vaccine, in part to provide a layer of protection against COVID-19.

“It’s a lot harder for a body to fight two things at the same time,” she said.

It’s not known yet how many people got a flu vaccine this season, but vaccination rates have been increasing after bottoming out in 2017-18. That season, the U.S. CDC found that only 37 percent of adult American were vaccinated against the flu, one of the lowest rates in years. That season saw record numbers of cases, hospitalizations and deaths. In February 2018, churches across Maine took the then-unusual step of suspending traditional rituals, such as sharing communion wine and shaking hands – measures that are now widespread. For the 2019-20 flu season, the percentage of adults vaccinated increased to 48.4 percent and Maine’s rate was about 53 percent, which ranked 16th among states.

Jarvis said Northern Light’s flu vaccination campaign last summer and early fall was aggressive, and people responded.

“I think if we look at success for influenza, that sends a strong message that vaccination is the way through this pandemic,” he said.

The flu might seem tame compared with the COVID-19 pandemic, but it can still be quite serious, especially among children, the elderly and people with diminished immune systems. Pregnant women also are at high risk. Flu symptoms include fever, chills, cough, sore throat, muscle and body aches, and fatigue – all similar to COVID-19 symptoms.

Early on in the pandemic, some falsely compared the severity of COVID-19 to the flu, even though COVID is far more transmissible and deadly.

For comparison, the highest death total attributed to the flu in Maine in recent years – 82 in the 2017-18 flu season – has been dwarfed by the number of people who have died with COVID-19 in the last year – 729. Put another way, COVID-19 is nine times more deadly than the state’s deadliest recent flu season.