Here Comes the Double Whammy: Flu Season on Top of COVID

With much of the sunbelt struggling against coronavirus disease 2019 (COVID-19), our attention has been on the dozens of states with high percent positive rates and stressed healthcare systems. As we begin August and discussions regarding school re-openings intensify, now is also the time we have to truly start looking toward an impending season when hospitals are overwhelmed—respiratory virus season (“flu season”).

Saskia v. Popescu, PhD, MPH, MA, CIC

Currently, the Southern Hemisphere is seeing low influenza activity for this time of year, which will hopefully bode well for the Northern Hemisphere. Last year, the United States saw a significant flu season, which is what many worry will occur again. The Centers for Disease Control and Prevention (CDC) estimated that between October 1, 2019-April 4, 2020, there were between 39 to 56 million flu illnesses, resulting in 18 to 26 million medical visits. Moreover, this resulted in 410,000 to 740,000 flu hospitalizations and 24,000 to 62,000 flu deaths.

Should the 2020/2021 influenza and respiratory virus season carry a heavy burden, the concern is that this will amplify the challenges we are already facing with COVID-19. Moreover, with more people visiting urgent cares, medical offices, and hospitals, with respiratory virus symptoms like a cough, fever, body aches, etc., it is likely that testing demand will increase for SARS-CoV-2. The attention surrounding COVID-19 means that most will be worried about the disease first, due to infection prevention and public health concerns, but this shouldn’t translate to decreased usage of respiratory virus panels.

The concern is not only that COVID-19 significantly increases the burden to healthcare facilities during an already busy season, but that the potential for more testing in patients with non-specific respiratory virus symptoms could further strain testing capacity. From backlogs to delayed result notification, the current situation is already severely affecting patients and public health efforts alike. “The United States is testing about 755,000 people a day, up from about 640,000 per day a month ago, and far more than in April and May, according to the Covid Tracking Project. But numbers alone do not tell the whole story. With testing chemicals and other equipment in short supply, and a surge in coronavirus cases nationwide leading to skyrocketing demands, many Americans are still having to wait many days for results, effectively rendering those tests useless.”

For infection prevention efforts, we already anticipate respiratory virus as a stressful time by working to ensure adequate personal protective equipment (PPE) supplies, processes for ensuring staff vaccinations and efforts to offer them to patients, and signage for visitors regarding flu season and potential visitor restrictions. It is likely though, that at least the visitor restrictions will continue from our COVID-19 work. Now more than ever though, flu vaccination will be important to not only reduce the risk for disease, but also avoid hospitalizations and potential exposures. More emphasis on isolation precaution, proper donning and doffing of PPE, hand hygiene, and staying home when sick, will be imperative.

Lastly, now is the time we should try to take a moment to breathe. While most are anticipating this winter will be rough with the mixture of COVID-19 and flu season (and the potential for schools to be back in session), now is when taking the much-needed break is important. Infection prevention efforts are year round and while we’re still reeling from the first few surges of COVID-19, we must prepare and anticipate the potential stress of respiratory virus season.