Flu takes 122 lives, sets record in state

Season deadliest in 17 years of tallying

The head of the state’s Health Department told legislators Monday that this flu season is the deadliest in at least 17 years and urged Arkansans to get vaccinated.

An additional 28 flulinked deaths were reported to the state in the span of about seven days, bringing the death toll this season to 122 as of Monday, which made the current flu season deadlier than any since 2000, when the state began closely tracking such deaths.

That total is likely to rise over the next several weeks, Arkansas Department of Health Director Nate Smith told the Legislature’s House and Senate public health committees in a joint meeting Monday.

Typically, he said, twothirds of the deaths from a flu season are reported after the peak of transmission, a point that hadn’t arrived as of Monday.

“This will be by far the deadliest flu season we’ve had in at least the last two decades,” Smith said.

The deaths as of Monday included two children between age 5 and 18, two

people age 25-44, 16 people between 45 and 64 and 102 people who were 65 or older.

Before Monday, the deadliest season since 2000 had been the 2014-15 season, when 110 people died.

During that season, as in this one, the dominant type of flu was one known as H3N2, which tends to cause more severe illness than other types.

Although the vaccine tends to be less effective against H3N2 than other kinds of flu, it is still the best way to protect against infection, Smith said.

“I’m surprised to continue to meet people who have not yet gotten their flu shot,” Smith said.

The 2010 Patient Protection and Affordable Care Act requires insurance plans to cover the vaccine at no charge to the policyholder.

The shot is available at the Health Department county offices, which will administer it at no charge to the uninsured. The department has administered about 216,000 of the shots so far this year, compared with 217,121 during the 2016-17 season.

Those who haven’t gotten it should do so “immediately,” Smith said.

Transmission of the illness started earlier and has stayed at a high level for a longer period this season than in past seasons, he said.

Over the past few weeks, the percentage of emergency room visits by patients with flu-like illness has continued to climb, while the percentage of doctor’s office visits involving such patients has fallen.

The U.S. Centers for Disease Control and Prevention reported last week that the number of flu-related hospitalizations this season is on track to exceed the estimated 710,000 people who were hospitalized during the 201415 season.

As of late January, transmission was starting to slow down in the western part of the country but remained high in the south and was increasing in the east, the CDC reported.

Dirk Haselow, state epidemiologist, said the season is likely to last at least 10 more weeks.

At another legislative committee meeting last week, pharmacists complained that the reimbursements for antiviral drugs and other medications provided to many Arkansas Blue Cross and Blue Shield customers, including Arkansas Works enrollees, were slashed starting Jan. 1.

Scott Pace, chief executive of the Arkansas Pharmacists Association, said Monday that some pharmacists started refusing to dispense the

generic version of the flu drug Tamiflu after Arkansas Blue Cross and Blue Shield’s pharmacy benefits manager, CVS Caremark, dropped what it would pay for a fiveday supply to about $36.

The cost for pharmacies to buy the drug from wholesalers is about $90, Pace said. In mid-January, CVS Caremark increased its reimbursement to about $75, but some pharmacies are likely still refusing to dispense it when the reimbursement is below their cost, Pace said.

“It’s a real tough situation,” he said.

Smith told lawmakers he hadn’t heard of pharmacies refusing to dispense the medication.

“They’re not very happy about reimbursement rates, but to my knowledge, they’re still stocking it and dispensing it,” he said.

People at high risk of developing complications from the flu should consider seeking a prescription medication as soon as they start having symptoms, Smith said. That high-risk group includes young children, the elderly, pregnant women, smokers, people with weakened immune systems and those with chronic health conditions such as heart disease and diabetes, he said.

“The sooner that’s started after the onset of symptoms, the more likely it is to prevent those serious complications,” he said.

Sen. Missy Irvin, R-Mountain View, who is the marketing director for her husband’s medical practice, said some Medicaid enrollees have had trouble getting the program to pay for more than one prescription for antiviral medication.

She noted that different strains of flu circulate at the same time, and it’s possible for someone who has already been infected by one strain to be struck by another one during the same season.

Smith agreed, adding that people with weakened immune systems might need more than a five-day supply for a single bout with the flu.

Jason Derden, the Medicaid program’s pharmacy administrator, said after the meeting that the program requires a doctor to seek permission from the program when prescribing more than one course of antiviral treatment for the same patient in a 23-day period. Permission is granted for patients who have the flu, he said.

“I would envision that if you need the drug, you get the drug,” Derden said. “We don’t want to put barriers there.”