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Health Leaders in California say get a Flu Shot to Prevent ‘Twindemic’

“(With) the levels of COVID-19 that we are faced with and addressing now, if we add on the potential for more flu patients, we will again be stretching our inpatient hospital capacity to its limits, and we would like to do everything we can to keep us from getting there.”

by Cathie Anderson, The Sacramento Bee / September 25, 2020
TNS
(TNS) - California’s physicians, hospital leaders and public health officials came together on a media call Thursday morning to urge Californians to get their flu shots to help prevent what they described as a “twindemic,” in which the COVID-19 pandemic and seasonal influenza overwhelm medical facilities.
 
“(With) the levels of COVID-19 that we are faced with and addressing now, if we add on the potential for more flu patients, we will again be stretching our inpatient hospital capacity to its limits, and we would like to do everything we can to keep us from getting there,” said Carmela Coyle, chief executive of the California Hospital Association. “We’re also all quite concerned about another surge in COVID-19 itself. We’re seeing what’s going on outside the United States as we are looking at ... reopening the economy. That will mean that we are mixing and mingling and at risk of an increase again of coronavirus positivity and COVID hospitalizations.”
 
Also on the media call Thursday, Dr. Mark Ghaly, the secretary of California’s Department of Health and Human Services, said Californians with common cold symptoms already are coming into hospitals and other medical facilities to get tested because they think they might have COVID-19.
 
In a separate interview, Dr. David Lubarsky of Sacramento’s UC Davis Health expressed concern that if people don’t get flu vaccines there will be a surge of individuals at hospitals seeking diagnostic testing for COVID-19 at a time when supplies needed for testing kits remain scarce.
 
“It will be very difficult to distinguish, and hopefully we won’t see what we saw just months ago, which is overwhelming the nation’s laboratories because there are too many people seeking a test all at the same time,” Lubarsky said. “I think that’s the biggest challenge that we face. That’s why it is so important to get a flu shot this year. We really need to tamp down on the flu so that we can better deal with patients who have COVID because we don’t have a vaccine for COVID.”
 
In an interview Tuesday, Dr. John Belko, a pediatric infectious disease expert at Kaiser Permanente Roseville Medical Center, said immunizing a broad swath of Californians against the flu would help health systems manage not only the number of people coming down with the flu. It also could reduce the numbers low enough that providers may not have as hard a time differentiating between who has flu and who has COVID-19.
 
In Australia, where fall arrives in March, the citizenry broadly adopted measures to stop the spread of COVID-19, including masking and social distancing, Belko said. Those measures, along with vaccinations, helped to ensure a mild flu season.
 
Last year, 42.9% of adult Californians and 63.5% of children ages 6 months to 17 years old got the flu shot, according to statistics from the U.S. Centers for Disease Control and Prevention, but Ghaly and the other leaders on the conference call said they hope to see big increases in those percentages this year.
 
If California residents ramp up vaccinations, it’s entirely possible the Golden State will duplicate the success that countries in the Southern Hemisphere had, Ghaly said.
 
Everyone over the age of 6 months should get a flu shot, all the health care experts said. Belko noted that preschool- and school-age children can be vectors for the flu, spreading it not only to the people in their immediate family but to grandparents, aunts and uncles who assist working parents with their child care.
 
“We definitely have very good data and there’s multiple studies published that show getting the influenza vaccine does result in fewer admissions not just in the pediatric world, but it’s 71% fewer hospitalizations for all ages and almost 60% fewer hospitalizations for people over the age of 50,” Belko said.
 
Older adults have a slightly increased risk of death from influenza, he said, but even if they don’t die, they risk debilitating medical complications.
 
When you get infected with influenza in your nasal pharynx, Belko said, you start to produce secretions that drain into your chest. Then you start making phlegm. Anyone who has difficulty clearing their coughs or feeding themselves will have a harder time fighting off the flu.
 
“If you have poorly controlled diabetes or chronic obstructive pulmonary disease, or COPD, (a flu shot) can result in as much as a 55% decrease in the number of hospital admissions,” Belko said. “There’s a 64% decrease in the incidence of heart attacks and strokes. Part of that has to do with if you’re sick and your system is stressed and you don’t have much of an oxygen reserve, that can push your heart over the edge. That can manifest in a number of ways, including a heart attack.”
 
People will say the flu vaccine isn’t very effective because they got the shot and then came down with the flu or a respiratory illness with symptoms like the flu, Belko said. If people judge the efficacy of the vaccine in this way, then clearly the flu vaccine won’t be deemed the most effective vaccine ever made, Belko said.
 
However, he said, if you look at efficacy as the CDC does, which is by the decrease in hospitalizations, the prevention of lost productivity at work, and the decrease in deaths, the vaccine is actually more effective than people give it credit for.
 
Companies now are conducting human trials for COVID-19 vaccines, but in the absence of a widely available vaccine, some political leaders and everyday citizens have advocated allowing people to just get sick with this novel virus so they can acquire an immunity, much like the chicken pox parties families used to have in the 1960s and 1970s.
 
Chicken pox, however, was far less fatal than COVID-19, said Belko said, and having that disease typically conveyed a lifetime of immunity against it.
 
Researchers have been monitoring people who have recovered from COVID-19, he said, and they’ve found that those with mild cases get an immune-boosting effect for only about six months after the infection. Those sick enough to land in intensive care, however, have maintained their immunity, he said, and researchers believe they may keep it for a year to 18 months.
 
COVID-19 is part of a family of pathogens known as coronaviruses, Belko said, and in any given cold season, 10 to 30 percent of cases of the common cold are caused by these viruses.
 
“We know from them that you can see re-infections with different strains in different years,” Belko said, “so we think that immunity doesn’t last forever with respect to preventing you from getting infected, but what we also have noted is that when people get infected the second time around, it seems to be milder. We don’t have enough of that data with COVID actually yet.”
 
He said the medical community is wondering: Are we going to see people who were infected last winter come back and get re-infected this winter, and what is that going to look like?
 
Coyle said the website fightflutogether.org has a link to a CDC-run flu shot locator program along with facts and news about influenza. CHA partnered with the California Department of Public Health, the California Medical Association and a number of other state organizations to develop the site.
 
Every year, Coyle said, the seasonal flu epidemic drives up usage of hospital emergency departments, but this year, that capacity needs to be saved for COVID-19 patients, wildfire survivors and other critically ill people.
 
“This year, it’s more important than ever for everyone to get their flu vaccines,” Coyle said. “With the ongoing COVID-19 pandemic, it’s just critical that California’s health care system remain available and ready to handle any potential and expected surges in COVID-19 disease.”
 
How you can help prevent spread of flu and COVID-19
 
* Get a flu shot. El Dorado County is partnering with hospitals and the community health center to offer flu vaccinations for $10, but no one will be refused service due to inability to pay. In Sacramento County, free flu clinics are open to all who are over 6 months of age and are without medical contraindication from Sept. 26 to Nov. 21. Learn more at dhs.saccounty.net.
 
* Wear a mask when out in public. If you aren’t wearing one, cover your mouth when sneezing or coughing.
 
* Wash your hands with soap and water for at least 20 seconds. That’s long enough for two choruses of the “Happy Birthday” song.
 
* Stand 6 feet, about two arm lengths, from people when in public.
 
How the flu affects Sacramento-area residents
 
Health officers in El Dorado and Sacramento counties shared statistics on how flu affects their residents:
 
In El Dorado County between 2016 and 2018, there were about 30 deaths due to influenza or pneumonia on average each year. Also during that period, for every 10,000 residents 18 and over, about 14 sought emergency room care for pneumonia or influenza and about 1.5 were hospitalized annually.
 
Sacramento County Public Health confirmed a total of 129 influenza cases among all ages for the 2018-2019 season, 98 of which resulted in admission to an intensive care unit and 31 of which resulted in death.
 
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©2020 The Sacramento Bee (Sacramento, Calif.)
 
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