When f lu meets COVID
Public health officials worry yearly influenza season on top of pandemic could strain hospitals
Walgreens ordered extra flu vaccines. The Houston Health Department will administer flu shots at drive-thru clinics. And Baylor College of Medicine has created an influenza task force to develop strategies for vaccinating its workforce.
From the trenches of a monthslong war against the new coronavirus, health care providers are turning their focus toward a known enemy: one they can hold at bay with vaccines.
And they’re hoping an additional emphasis on flu shots could prevent a flu and COVID-19 surge this fall and winter.
Both Gov. Greg Abbott and Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, recently emphasized the importance of flu shots that public health officials are stressing.
“There is significant concern with other viruses increasing and prevalent in the community in the fall and the winter that we’ll be maybe not overwhelmed but quite busy,” said Dr. Peter Bigler, chief medical officer for Baylor St. Luke’s Medical Group.
Last flu season, between October and April, the CDC estimates there were 410,000 to 740,000 flu hospitalizations. Between 24,000 and 62,000
people died, according to the CDC.
COVID-19 has claimed more than 160,000 lives in the U.S. since March.
“Certainly, I think everyone is concerned because we are still dealing with the COVID-19 pandemic,” said Dr. S. Wesley Long, medical director of the Diagnostic Microbiology Laboratory at Houston Methodist, “and we fully expect that until we have a COVID-19 vaccine, we will likely continue to see the virus sort of ebb and flow based upon human behavior.”
The relevant behaviors — wearing a mask, working from home, maintaining a healthy distance from others, obsessively washing hands — are humanity’s only protection against COVID-19.
They happen to protect against the flu, too. In temperate regions of the Southern Hemisphere (where the typical flu season is April to September), the World Health Organization says the influenza season has not commenced.
“Globally, influenza activity was reported at lower levels than expected for this time of the year,” WHO reported Aug. 3 using data from mid-July.
That’s providing local experts with some hope that Houston’s flu season might not be too bad.
“This will be a really unpredictable season,” said Inyang Nora Osemene, professor and interim chair for the Department of Pharmacy Practice and Clinical Health Sciences at Texas Southern University. “We are hoping for the best, but we don’t know.”
However, she’s concerned there might not be enough vaccines to meet this year’s likely heightened demand.
Vaccine manufacturers have projected creating 194 million to 198 million doses. That’s roughly 20 million doses more than the record 175 million during the 20192020 flu season, according to the CDC.
But there are 330 million people in the U.S.
Redfield of the CDC said in a
Wednesday interview with WebMD that getting the flu shot is crucial. Last year, fewer than 50 percent of people got the flu vaccine. His goal this year is 65 percent.
“So by getting that flu vaccine, you may be able to then negate the necessity to have to take up a hospital bed. And then that hospital bed can be more available for those that potentially get hospitalized for COVID,” he said.
To help with an expected uptick in demand, the CDC is providing additional flu vaccines to be administered nationwide. This includes 200,000 doses for Houston and Harris County, a portion of which will be administered by the Houston Health Department, said LaTasha Hinckson Callis, administration manager for the department’s Immunization Bureau.
These doses, which are in addition to what the city of Houston buys each year to administer at its four health centers, are being prioritized for adults with higher risk. They will be administered to seniors, groups with historically low flu vaccination coverage (including African American and Hispanic adults), in areas that
“Unfortunately, there’s so much overlap in symptoms. There’s certainly not just a science but an art to diagnose the patient accurately.”
Dr. Peter Bigler, chief medical officer for Baylor St. Luke’s Medical Group
have seen a higher number of COVID-19 cases and to the uninsured/underinsured.
“We don’t want to overwhelm the hospital systems,” Hinckson Callis said. “We don’t want to see outbreaks of diseases that could be prevented by vaccines.”
While it’s possible to get sick with the flu even after receiving a flu shot and developing antibodies — to be clear, you cannot get the flu from the vaccine itself but rather may still get sick after coming into contact with an influenza virus — Long said people who get the shot are less likely to be hospitalized.
But with symptoms so similar to COVID-19, including fever, cough, body aches and a sore throat, it’s going to be initially difficult (prior to receiving test results) to determine if patients have COVID-19, the flu or even a head cold.
“How sure will we be?” Long asked. “Because it’s going to affect treatments.”
Dr. James McDeavitt, senior vice president and dean of clinical affairs for Baylor College of Medicine, said not knowing if patients with respiratory symptoms have COVID-19 could mean health care providers continue their practice of donning and duffing protective equipment between each patient. This practice can add 15 minutes per patient, though McDeavitt added that drive-thru testing sites could be a way to decrease the need for repeatedly changing protective equipment.
“Unfortunately, there’s so much overlap in symptoms,” said Bigler, with Baylor St. Luke’s Medical Group. “There’s certainly not just a science but an art to diagnose the patient accurately.”
What worries him is a report that roughly 20 percent of people who tested positive for COVID-19 also had another pathogen, according to an article published in the JAMA medical journal. Bigler hopes none of his patients catch both the flu and COVID-19.
“That would be quite worrisome,” he said. “I would be concerned for even the healthy patients.”
To help prevent this, Bigler said Baylor St. Luke’s Medical Group is considering drive-thru vaccinations.
Walgreens and CVS, with about 195 and 190 locations in Greater Houston, respectively, are having pharmacy team members wear masks and face shields. Customers must also wear masks, and they will have their temperature taken prior to receiving a flu shot.
The CDC recommends getting the flu vaccine in September or October (August is generally too early because the recipient will have less protection later in the flu season), though getting a flu shot late is better than never. It takes about two weeks for antibodies to develop to help protect against the flu.