Hawaii has so far dodged what health experts feared could be a “twindemic,” with COVID-19 combined with the flu, which has virtually disappeared since last summer.

The last case of influenza in Hawaii detected by Diagnostic Laboratory Services was in July, said Chris Whelen, DLS vice president and technical director of microbiology.

“This is a particularly bizarre influenza season in that it’s nonexistent,” Whelen said at a news conference Tuesday, adding that between 600 and 800 tests a month are yielding negative flu results. “Historically we should be peaking with influenza right about now with post-holiday travel, but we are just not seeing it.”

Health experts say COVID-19 precautions — mask-wearing, social distancing and hand-washing — have been effective in keeping other respiratory illnesses like influenza from widely circulating. Nationally, flu cases are also at historic lows.

In addition, the curtailment of travel in and out of state, more of the workforce working from home and a substantial number of children currently not in school also are keeping the flu at bay.

Dr. Edward Desmond, administrator of the Department of Health State Laboratories Division said only three flu cases were detected out of between 10,000 and 20,000 samples over the past six months, which is a “silver lining” in the pandemic.

However, Dr. Erlaine Bello, an infectious disease specialist at The Queen’s Medical Center, warns that “definitely we’re not out of the woods.”

“In fact, we may be at the very beginning (of flu season),” she said, adding that Queen’s has not seen an influenza case since last summer. “At Queen’s, this is unprecedented. It could be a late flu season because we’ve had later flu seasons before, or the interventions that we’ve all done for COVID have greatly reduced the transmission of influenza.”

Health experts early on feared that people would contract both the flu and the coronavirus at the same time — which would potentially increase the severity of illness and complications.

Hawaii Pacific Health, parent company of Kapiolani Medical Center for Women & Children, Pali Momi Medical Center, Straub Medical Center and Wilcox Health on Kauai, also has seen zero cases of influenza since the fall, said Dr. Shilpa Patel, physician liaison for quality and patient safety.

In 2020, Hawaii Pacific Health recorded about 600 influenza-positive tests, over 99% from January through March. By comparison, the hospital system had about 1,050 flu cases in 2019.

While the flu is almost nonexistent, COVID-19 continues to be the focus of health officials.

On Wednesday the state reported four new coronavirus deaths on Oahu and 74 additional infections statewide, bringing Hawaii’s totals since the start of the pandemic to 414 fatalities and 26,081 cases. The fatalities included a man in his 50s, and three women — one in her 60s, one in her 80s, and the other in her 90s. Also Wednesday the Department of Public Safety said a Halawa prisoner died of COVID-19, the third virus death of an inmate from Hawaii.

“Our bodies when they’re exposed to different viruses we tend to make antibodies, that’s why this novel coronavirus is a big deal, because our body has never seen it and it takes longer to generate an immune response,” Patel said. “If we continue to not see influenza, essentially it acts like a relatively new virus. We could theoretically be more susceptible for more flu. Not that we would have a flu pandemic per se, but we might see more people that are suffering from flu symptoms. We want people to take these same measures they are doing to prevent COVID … to also help in the future against influenza.”