SIOUX FALLS, S.D. — The Upper Midwest should be deep into influenza season right now. This year, to a remarkable degree, it's not.

Give credit to the steps people have taken to reduce the spread of COVID-19, such as washing hands, mask-wearing and social distancing, medical experts say. As it turns out, those same steps have slammed the door on the spread of that "other" virus, influenza, in Minnesota, North Dakota and South Dakota, mirroring the national situation.

Pandemic-fighting measures have drastically cut the the number of influenza cases have been "vanishingly low" compared to previous years, said Jeremy Cauwels, chief physician for the South Dakota-based Sanford Health system, which has major medical centers in Minnesota and the Dakotas.

“In our Bismarck medical center, our Fargo medical center, and our Sioux Falls medical center, up to this point in the year, we’ve had one total admission for the flu,” Cauwels said. "That number is absolutely astounding considering what we normally start to see, even in a late flu season."

The numbers tell the tale. Minnesota had 981 people hospitalized due to the flu at this point last year. As of Jan. 16 this year, the state has seen only 26 hospitalizations. In North Dakota at this point in the season last year, 103 people had been hospitalized due to the flu. This season: 13. In South Dakota last season, 74 people had been hospitalized with the flu by this point. So far this season, six people.

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"We haven’t really increased much at all for this time of year,” said Karen Green Martin, senior epidemiologist at the Minnesota Department of Health. "We’re essentially flat right now. Now that doesn’t mean we can’t see increased activity and have a later season, but again it’s pretty atypical to see such little activity at this time."

Both Cauwels and Martin credit pandemic-resisting moves -- washing hands, wearing masks and social distancing -- with dampening this flu season.

"It’s the reason the antibacterial hand sanitizer industry existed before COVID, we know those things could help out. What we don’t think we really knew is what would happen when lots of people started following that advice all at once," Cauwels said. “What we’ve conducted is an international study on how to short-circuit the flu transmission."

Martin noted that, beyond the current quiet influenza season as evidence, the measurements of the previous 2019-2020 flu season -- positive tests, hospitalizations and the like -- simply cratered in March 2020 as people stayed home and reduced contact with each other.

"We just saw almost a drop off the cliff right around March, which is at the same time COVID hit in Minnesota and a lot of these restrictions were put in place," Martin said.

Early and widespread vaccinations helped too. Sanford Health and other health systems were quick to promote early flu shots, hoping to reduce the chance of a "twindemic," in which influenza would join COVID-19 in ravaging the nation's population.

"We did a much better job of rolling out that flu shot early and saying, 'Hey, this is one thing you can fight against on your own,'" Cauwels said. "People showed up in relative droves, considering the restrictions on them, to make sure they got their flu shots."

The battle, of course, is not over. The virus tends to peak in early to mid-February in the Dakotas and anywhere from December to March in Minnesota, and could be spread as COVID-19 restrictions ease, more people attend schools in-person and warmer spring weather arrives.

Even with greatly reduced number of cases this year, medical experts are encouraging those who haven't yet to get the influenza shot.

“It's not too late, not too late at all," Martin said. "They think it’s done and it’s not. Some people are predicting an increase of flu in the spring, so I’d definitely recommend if you’ve not gotten vaccinated, you do so.”

Still, says Cauwels, a throttled influenza virus is a welcome relief as the COVID-19 pandemic stretches into year No. 2.

"I would call this a win, and I hope everybody else does as well,” he said.