As of Oct. 16, the county of San Diego confirmed 215 cases of influenza with no deaths. At the same time in 2020, with COVID-19 precautions in place, there was only one case
“Our concern is that no one is really requiring masking at this point and if you go outside, anywhere you go there a very few people wearing masks. We are at risk at having a large flu outbreak this year on top of COVID-19,” said Dr. Ghazala Sharieff, Scripps Health Chief Medical Officer for acute care, clinical excellence and experience. “If you look back at 2019, the county reported 20,711 cases of flu with 108 deaths. Last year because of all the masking and social distancing, in total through the entire season, we had 701 cases and two deaths. We are already at 215 this year and we are only in October, and this is very early in the flu season.”
Sharieff said in predicting flu season, it normally tracks what happens in the southern hemisphere in Australia, but due to Australia wearing masks and following COVID restrictions, it is difficult to predict with any type of modeling, but that there is already an uptick in flu cases.
“The concern is that you add flu on top of COVID,” she said. “Today (Oct. 21), at Scripps alone, we have 79 patients with COVID in the hospital, 27 in ICU, with 23 of those on ventilators. They are the sickest of the sick. We have the lowest COVID patients on extracorporeal membrane oxygenation, a heart/lung bypass machine today at one. We have been at capacity pretty much the entire season.”
Sharieff said COVID is still active in the community and adding the flu on top, hospitals are worried about what will happen with the upcoming holidays. With Halloween, Thanksgiving, Christmas, and New Year’s, right around the corner, she said last year it led to a huge spike in COVID cases in January.
“Scripps alone had 500 COVID positive patients in the hospital on Jan. 8. That was our peak,” she said. “The other thing to keep in mind is that kids are back in school. Last year, we did not see much illness in kids because they were all staying home. There is another virus in kids, respiratory syncytial virus, on top of influenza that we should keep our eye on. Kids get sick and bring it back to everyone else who is at home.”
Sharieff said now, it is seeing younger ages with COVID deaths which shows that this is a different virus than it was a year ago.
“This past week we had a 35-year-old pass away with no underlying comorbidities, and a 45-year-old, so we are seeing deaths in younger patients now, some that have no underlying comorbidities, so COVID can hit younger ones, and we are seeing that in our pediatric data as well,” she said.
With flu shots this year they have a quadrivalent, two influenza A, two influenza B, said Sharieff. The problem is that this is only a best guess because it is usually modeled what is happening in Australia.
“I am getting asked from people why they should be getting their flu shots, and the answer is that it is the best protection that we know right now, and with everyone getting out, getting together, at least it gives you some protection, because you can absolutely get COVID and the flu at the same time,” she said. “We have not seen much of that before, so that would be another management that we have to think about. How will we treat you at the hospital when you have a double whammy on your lungs, and we must deal with both of those viruses. It is very important this year to get the flu vaccine along with the COVID vaccine boosters.”
Sharieff said for those who have not had their first COVID vaccination series, she highly encourages it and there is now plenty of data about the vaccine. She said she realized many people were hesitant that it was a new vaccine, but they should understand that the technology behind it has been around for a long time.
“As we head into this next holiday season, it is a really good time to get started,” she said. “The data is very robust now with almost two years of experience with millions of people getting vaccinated. Then get the flu vaccine on top of that. The FDA approved Moderna boosters, and we are just waiting for the CDC to confirm that, and we will be offering the Moderna booster as well as the Pfizer. The Moderna is a half dose this time, so those that had the fever, chills, and minor side effects, it should be a bit easier.”
Sharieff said it is “absolutely safe” to have both vaccinations at the same time, and that comes down from the CDC. She said to think back as people usually get multiple vaccines at the same time, and that this is no different.
Sharieff said the importance of masking and social distancing with the holidays coming up is just as important this year. She said just because there were only two deaths from the flu last year, it does not mean the same will happen again this year.
“Just imagine flue on top of COVID,” she said. “I know people are going to do social gathering anyway, but it you can masks with people you do not know, and frankly with people that you do know, taking those safety precautions, I really hope that we can get through this holiday season without seeing the suffering and deaths that we saw last year. It was very, very hard on our healthcare workers.”
Sharieff said right now they are seeing a high number of “extremely irritable” patients and families that are taking out their frustrations on hospital staff. She asks that patients and their families be patient with staff who have been on the frontlines of the pandemic since its beginning.
“With the burnout that is real, be kind to healthcare workers,” she said. “We understand that you are frustrated because you are not vaccinated and now you have COVID, but you must be kind to the people who are trying to take care of you. It is adding another level of burden of the staff right now.”