More people are dying from flu than from COVID in California this winter for the first time since the novel coronavirus started flooding emergency rooms in 2020.
Since then, COVID had been by far the most deadly respiratory virus in the state, though each year it has killed fewer people. But before the pandemic, flu had long since established itself as an annual threat.
“Prior to COVID, influenza was the only epidemic infectious disease in the developed world that every year significantly changes the mortality rates,” said Dr. John Swartzberg, clinical professor emeritus at the UC Berkeley School of Public Health.
Since late December, however, the percent of deaths coded as flu-related has surpassed the percent of deaths coded as COVID-related, according to data from California’s Department of Public Health.
During the first years of the pandemic, elevated precautions mostly suppressed the perennial flu outbreaks that typically kill between 10,000 and 50,000 people annually in the United States. Social distancing, mask-wearing and avoiding indoor crowds helped stop the spread of COVID and flu at the same time.
As COVID vaccines became available and the virus became less deadly, people let their guard down more, and influenza returned to its annual pattern. But this year, the spike in deaths is steeper, with the percent of deaths attributed to the flu reaching 2% of deaths around the state in early January, higher than it has been in the last two winters — when it peaked at just under 1.5%.
Since July 1 there have been at least 561 influenza deaths in California, mostly among people over 65 years old.
“This may become the worst influenza season we’ve had so far in the 21st century,” Swartzberg said, noting that testing data shows about an even split between H1N1, aka swine flu, and H3N2, both subtypes of influenza A. Influenza B tends to come along later in the season, he said.
Swartzberg added that there is no evidence this unusual flu season is related to the bird flu, which is in the news because of a concerning spread among birds, cows and other species.
Unlike the past several winter seasons, COVID has yet to surge this year after a late summer surge that ended in the fall. Since June 30, there have been at least 10 flu-related pediatric deaths in the Golden State, while COVID has contributed to three pediatric deaths in the same time.
Swartzberg notes that one reason why this year’s flu rates are so high is because flu vaccination rates have been lower since the pandemic, especially among children. According to data from the U.S. Centers for Disease Control and Prevention, 45% of children 6 months to 17 years old had been vaccinated against the flu as of the end of January 2025, compared to 58% in January of 2020.
If your goal is to avoid illness, “you should go back to taking the same precautions you used against getting COVID,” Swartzberg suggests, saying he has gone back to masking indoors.
And it’s not too late to get vaccinated against the flu, if you are among the majority of people who did not get the annual flu vaccine this year.
California is far from the only place dealing with a surge in influenza cases. School closures have been announced in more than 10 states in response to high levels of the virus. According to data from the CDC, 57 pediatric flu deaths have been reported so far this season nationally.
Just over 1% of death certificates in California mentioned COVID in the last week of January, after hovering between 0.6% and 0.8% since October, the lowest the rate has been since the first months of the pandemic.