COVID and the flu could create a perfect storm of American sickness. We need to be ready.
- There have been nearly 200,000 COVID-19 related deaths in the US.
- Because of distancing and quarantines, it's going to be more difficult for people to get flu vaccines.
- The combination of both viruses could lead to terrible results.
- Beth R. Smolko, DMSc, PA-C, is the founding program director and current department chair for Frostburg State University’s PA Medicine Program in rural western Maryland.
- This is an opinion column. The thoughts expressed are those of the author.
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Counting the cost of COVID-19 will take years, possibly decades. But the aftershocks of the pandemic are coming sooner.
These second-order effects will be first felt by our children in the re-emergence of vaccine-preventable diseases and vulnerable adults who have abandoned preventive health maintenance and chronic care management.
As flu season starts to come into focus, worries over visiting medical offices to get the annual vaccine could exacerbate our medical emergency — leading to a perfect storm that could leave many more Americans sick.
COVID-19 is only going to complicate flu season
I know firsthand the toll that a bad flu season can take on our already strained healthcare system. As a physician assistant, or PA, I've provided care to patients where there is little buffer between the patient and the onslaught of disease. This year we are facing catastrophic conditions for our healthcare system.
When patients believe they have the flu, they often go to an urgent care clinic or to their primary care provider's office. Some patients, with mild to moderate symptoms, can recover at home while others require emergent treatment.
This fall – similar to the spring when we first experienced staggering death tolls from COVID-19 – we will have two deadly diseases, influenza and COVID-19, infecting the population. Last spring there was a difference though; many people had gotten their annual flu vaccine in the months prior to the onset of COVID.
I know, all too well, the impact COVID-19 has on the body. I was diagnosed with the virus in March. I had headaches, muscle tension, difficulty breathing, and fevers that climbed to 106 degrees. I went to an urgent care clinic and eventually, the emergency room. I was one of the fortunate patients who did not require a ventilator and was not admitted to the hospital for care and treatment. With access to quality care via telemedicine, I continue to recover at home with lingering fevers, headaches, cough, and shortness of breath.
Approximately 30% of patients diagnosed with COVID have prolonged symptoms – the so-called "long haulers" – are already bodily compromised and can't take the hit that may come from influenza.
As both a patient and as a healthcare provider, I feel compelled to highlight the absolute necessity for everyone to get an influenza vaccine this year. It may well represent the difference between life or death for you and others. Vaccines are crucial to protecting public health. Unfortunately, due to COVID-19, we know many people are skipping or delaying them.
A combination of lockdowns, social distancing, and extreme caution have led to a sharp decline in vaccinations rates across the country during this pandemic. Many patients have chosen to stay home and skip medical appointments because they are cautious and concerned about exposure to the virus. They missed necessary appointments for themselves, their children, and new babies – who are particularly vulnerable -- in the hopes of staying safe.
The decline in rates of childhood immunizations is particularly troubling. New York City, which was overwhelmed by the coronavirus in March and April, reported that in the two months following the shutdown, vaccinations for children older than two declined by 91%. In August, a national study by Orlando Health found that two in three parents are afraid to take their children in for routine vaccinations – even though 84% of those parents say they know vaccines are necessary to protect their children from a host of diseases.
As the flu season overlaps with COVID-19, the disruption to the usual distribution methods for the flu vaccine are a major cause for concern. During a normal flu season, universities and offices hold flu shot clinics; providers talk to their patients about the vaccine at wellness visits; and pharmacies offer quick and easy walk-up flu shots.
Because of COVID-19, there will be fewer convenient options for patients to get their flu shots as people's everyday routines and behaviors have changed. We are all simply staying away from places where flu vaccines are routinely organized, advertised, or administered.
During the 2018-2019 flu season, according to the Centers for Disease Control and Prevention, influenza caused an estimated 43 million symptomatic illnesses and 650,000 hospitalizations. Preventing hospitalizations this year is particularly important to help make sure that as many beds as possible are available for patients with severe illness. Plus, fewer cases of the flu will help to take some strain off an already overworked and exhausted healthcare workforce.
Now more than ever, vaccines are essential. Americans must hold the line against vaccine-preventable disease. Our healthcare system cannot afford an outbreak of measles, mumps, rubella, polio, hepatitis, tetanus, diphtheria, pertussis, meningitis or a worse-than-usual flu season on top of a pandemic, especially as many children will be heading back to school in the coming months.
The healthcare workforce has felt and deeply appreciated all the expressions of support for frontline healthcare workers. Beyond gratitude though, we need you to help prevent the spread of disease. On behalf of my PA colleagues and healthcare workers across the country, please ensure that you are getting the vaccines you and your family need to stay well.
Beth R. Smolko, DMSc, MMS, PA-C is the president and chair of the American Academy of PAs Board of Directors. She is the founding Program Director and Department Chair for Frostburg State University's PA Medicine Program in Maryland.
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