Since public fear over the coronavirus outbreak began spiking, hand sanitizer has been a scarcer commodity in Toronto than a seat on the King streetcar.

Toronto still only has two cases of COVID-19, the illness caused by the novel coronavirus. Both of the people infected travelled directly from the epicentre of the outbreak, and are recovering in isolation. The risk to the public is very low.

Zero Canadians have died from COVID-19. But at least 46 deaths from seasonal flu have been reported nationally so far this winter, and thousands more people have been hospitalized.

Flu cases in Ontario are mercifully dropping, according to public health data — and that decline coincides with the rise of sometimes-scary COVID-19 headlines, and the city’s sudden diligence around hand hygiene.

Do Toronto’s coronavirus fears have a silver lining?

The answer to that question lies somewhere in between “maybe” and “no,” experts say — but please keep washing your hands anyway.

“It is premature to conclude whether or not increased precautions due to the novel coronavirus outbreak are having an impact on the influenza season,” said Dr. David Williams, Ontario’s Chief Medical Officer of Health.

“Influenza was already peaking at the start of the COVID-19 situation, but the opportunity to reinforce the points of washing hands, sneezing or coughing into your sleeve, not touching your face and staying home if you are sick will hopefully have an impact on all circulating respiratory illnesses.”

Concerns about the new coronavirus outbreak began bubbling up in early January, with the rise in case counts in Wuhan, China, where the disease first appeared. In Toronto, those fears led to a rush on hand sanitizer (which can help kill germs, along with old-fashioned handwashing) and on protective face masks (which are unnecessary, and risk creating shortages for health-care professionals who really need them).

Flu cases in the province have been dropping since early January too, according to a respiratory pathogen bulletin that Public Health Ontario publishes every Friday.

The week of Jan. 4, there were 1,556 laboratory-confirmed cases of influenza in the province. By late January, the number was down to 1,177. Last week, there were 943.

This is nowhere near the true total of flu cases in the province, since most people never become sick enough to show up at a hospital or even their family doctor’s office, where they are more likely to be tested. The 46 flu deaths in Canada are also only a subset of the actual fatalities, because not all provinces and hospitals report data to FluWatch, the federal program that tracks those numbers.

But it still signals an overall decline in flu activity in Ontario, right around the time when coronavirus fears were accelerating.

So are the two trends connected?

Not necessarily, experts say. But any coronavirus-inspired hand hygiene is still a boon to public health. Torontonians, and all Canadians, remain much more likely to be hospitalized or killed by the flu than by COVID-19 — and flu season isn’t over.

Seasonal flu typically peaks at some point every winter and then begins dropping, explains Michelle Murti, a public health physician in the Communicable Diseases, Emergency Preparedness and Response Department of Public Health Ontario.

“It comes on quickly, hangs around for a few weeks, and then goes away pretty quickly,” she says.

There are two strains of seasonal flu virus circulating, influenza A and influenza B. They both make people sick, but influenza A is usually more common. Influenza B usually comes on later in the season, and can result in more severe illness in children, including hospitalizations and deaths.

In Ontario, laboratory-confirmed cases of influenza A hit 1,312 cases in early January, and have since dropped to 632. While it’s still early, Murti says, that virus has probably peaked — though there’s still a lot of influenza A going around. The subsequent natural dip after that peak is more likely to explain the falling flu counts than any knock-on effects from coronavirus fears.

But influenza B is still persisting, with case counts rising from 191 in mid-January to 311 last week, with some dips and rises in between. Public health officials are worried about the impact this year’s influenza B rates will have on children in particular.

“We’re very happy to hear that everyone is doing more around try to wash their hands more often, staying home when they’re sick, and paying attention to the things that might keep them healthy from respiratory viruses,” says Murti.

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“In terms of whether that’s actually impacting (flu counts), I don’t think we really have anything to show that.”

The best thing you can do to prevent illness and death from respiratory sickness is the same as it was back in September, when the world had never heard of COVID-19.

“Getting the flu shot is really important,” says Murti. “It’s still not too late.”

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