Bracing for a collision between the novel coronavirus and influenza, health care professionals across Southern California are beginning to stockpile flu vaccines and preparing to launch public outreach campaigns encouraging everyone — children, adults and the elderly — to get their shots this fall.
The upcoming flu season threatens to tax hospitals just beginning to thin the ranks of COVID-19 patients after coping with an early-summer surge.
The Centers for Disease Control says it’s likely influenza viruses and the virus that causes COVID-19 will both be spreading during flu season. According to the CDC, an influenza vaccination can help reduce the overall effects of respiratory illnesses on the population and lessen the resulting burden on the health care system.
Each year, millions of people across the U.S. are afflicted with influenza. From October 2019 through April 4, 2020, the CDC estimated that 39 million to 56 million Americans contracted the flu and 24,000 to 62,000 people died from the virus.
Additionally, 18 million to 26 million people sought medical treatment for the flu, and 410,000 to 740,000 Americans were hospitalized with it, according to the CDC.
More vaccines available this year
To maximize influenza vaccinations during the COVID-19 pandemic, the CDC will increase the availability of the vaccine, including purchasing an additional 2 million doses of pediatric flu vaccine and 9.3 million doses of adult flu vaccine.
Vaccine manufacturers have projected that they will supply 194 million to 198 million doses of influenza vaccine for the 2020-21 season, a 9.7% to 11.6% increase compared to the record 175 million doses distributed for the 2019-20 flu season, according to the CDC.
The CDC recommends all people 6 months old and older get a yearly flu vaccine.
“If you’re 6 months of age and you’re breathing, you need a flu shot, with very few exceptions,” said Dr. Robert N. Glazer, medical director of the Torrance Memorial Physician Network.
Torrance Memorial Medical Center and its affiliated outpatient offices already have begun receiving shipments of influenza vaccine, Glazer said.
“We put in our request early. We don’t anticipate running out,” Glazer said. “I think we’ll be able to accommodate every person.”
The infrastructure to handle an influx of both COVID-19 and influenza patients is already in place at Torrance Memorial, and the hospital plans to launch its public outreach campaign encouraging everyone to get the flu shot in early September, Glazer said.
“We have various methods of getting the word out. All our patients are either connected via email or patient portals, so we’ll be communicating that way,” Glazer said. “Senior citizens will be getting direct calls from our office centers inviting them for in-person flu vaccines.”
‘Prepare for the worst’
Dr. Rodney Borger, emergency room director at the second busiest emergency department in the state at Arrowhead Regional Medical Center in Colton, said influenza vaccinations, coupled with COVID-19 best practices already in place since March — hand washing, mask wearing, social distancing and sheltering in place — might be helpful in minimizing ER visits and freeing up hospital beds during the flu season.
But he remains wary.
“I don’t think anybody is sure what’s to come, but we need to prepare for whatever’s coming,” Borger said. “We need to prepare for the worst and hope for the best, and the best is that we have a very mild flu year. We certainly need a break. But if it goes the opposite direction, we’re going to continue to do our best and work nonstop to help get through it.”
He said the hospital, which is operated by San Bernardino County, is preparing for a 30-40% increase in Emergency Department patients during the flu season and a 20% increase in hospital admissions. A 32-bed alternate care site is set up in the hospital’s north parking lot to accommodate any influx.
“When hospitals are full, that can make things very difficult,” Borger said.
Flu shots key to hospital capacities
Dr. Jennifer E. Gerber, a Baltimore-based epidemiologist with RTI International, a nonprofit research institute, believes influenza vaccines are the best tool to ensure hospitals have the capacity to treat patients with the coronavirus.
Gerber has been speaking out publicly on how policymakers need to increase access to influenza vaccines and fund communications and education campaigns to create demand for the vaccination.
“It’s important that everybody get the influenza vaccine to protect themselves, their families and those in their communities,” Gerber said. “Getting vaccinated against influenza is one way to try to keep people out of our hospitals, so we can save hospital beds and other resources for people with COVID-19.”
Dual epidemics of influenza and COVID-19 likely will occur this fall and winter, so people need to brace for it, Gerber said, adding that the best time to get an influenza shot is in late September or early October.
“I will be doing the same and getting my influenza shot as well. Sometimes it hurts a little, but it’s worth it to be protected against influenza, because it’s a very serious disease,” Gerber said.
St. Joseph Hospital in Orange, which has the highest number of COVID-19 patients in Orange County, is awaiting shipment of 2,750 doses of the flu vaccine. In a typical flu season, the hospital disperses about 1,850 doses, said Dr. Glenn Raup, executive director of critical care, emergency services and behavioral health services at St. Joseph.
During a typical flu season, Raup said, the hospital promotes flu shots by posting signs around the hospital and campus and by partnering with its affiliates across Southern California to host public education campaigns.
“This year we expect to build upon this by adding how prevention of flu through vaccinations is complemented through the use of social distancing, hand hygiene, and masking and that anytime someone feels ill, they need to stay home or seek treatment,” Raup said.
Drive-thru sites, walk-in clinics
Dr. Michael Mesisca, medical director for the Emergency Medicine Department and Disaster Medicine Team at Riverside University Health System, said RUHS is actively working with its affiliated partners throughout Riverside County to promote vaccines and access options, including drive-thru sites and readily accessible walk-in clinics.
He said RUHS already has received half of its pre-ordered supply of 12,000 doses, secured multiple suppliers of influenza vaccine, and has the ability to order more once flu season is underway.
Dr. James Kim, medical director of the department of emergency medicine at Pomona Valley Hospital Medical Center, said on Wednesday that 10,000 units of influenza vaccine were in transit to the hospital, with 3,000 of those units expected to go to low-income people or those from disadvantaged communities.
Kim said Pomona Valley’s ER sees a 15-17% percent increase in patient volume during a typical flu season. “I’d say a fair number of those are patients who are presenting symptoms of influenza illnesses,” he said.
While Mesisca believes that hand washing, wearing masks and social distancing also can help fight off influenza and possibly limit the number of hospital visits this flu season, he said that is contingent upon people strictly engaging in those best practices.
Additionally, businesses, faith-based groups, and schools need to strictly adhere to masking and social distancing safety guidelines when they reopen.
“Supporting a shift in culture to embrace these measures is key to not only reopening but to staying open and minimizing the impact of local outbreaks that prompt reclosures,” Mesisca said.
Source: Orange County Register