COVID -19 Plus Influenza: The Perfect Storm?

Influenza is a respiratory virus that is contagious and occurs throughout the year. It is caused by many different influenza viruses and can result in mild to severe illness. The very young and elderly are at increased risk for the development of complications which can lead to death. The best protection for everyone is to be vaccinated on an annual basis. Sound familiar? Mild to severe illness? Impacts certain at-risk populations? This year in addition to annual influenza we continue to weather the ongoing pandemic caused by the SARS-CoV-2 virus.

Signs and symptoms are very similar which may create challenges during patient triage prior to on-site care. It will be very important not to assume a patient has COVID – 19 when in fact they are suffering from seasonal influenza. According to the CDC, the United States experiences epidemics of seasonal flu each year which is often referred to as “flu season.” Flu may be diagnosed as early as October and last until May, but most cases occur during the winter months. This year is no different, vaccination is the best prevention method.

In this potential perfect storm, where workers and/or patients are infected with both viruses, dealing with both the SARS-CoV-2 virus and influenza season will be quite the challenge. At present, there is no vaccination available to provide protection against SARS-CoV-2, but there is the protection afforded by receiving the seasonal influenza vaccine. All healthcare providers should consider receiving the vaccine to decrease the overall risk of illness.

The following vaccines are listed on the CDC’s website as options.

• Standard dose flu shots
• High-dose shots for people 65 years and older
• Shots made with adjuvant for people 65 years and older
• Shots made with viruses grown in cell culture. No eggs are involved in the production of this vaccine.
• Recombinant vaccine shots made using a vaccine production technology that does not require having a candidate vaccine virus (CVV) sample to produce
• Live attenuated influenza vaccine (LAIV) made with attenuated (weakened) live virus that is given by the nasal spray

The timing of vaccination is important, keeping in mind that protection does decline over time. September and October are considered good months for vaccination, but if the viruses are still active, vaccinations can be provided in January or later.

In addition to the protection provided by the vaccine, the importance of diligence in other areas of infection prevention and control measures cannot be overstated.

• Encourage proper hand-hygiene for all workers. Remember that flu is spread by either being in close contact with someone who is infected OR by touching contaminated surfaces. Alcohol hand rubs are an acceptable choice; just be sure to rub all surfaces of the hands until dry, which should take at least 15 seconds.
• Respiratory Hygiene/ Cough Etiquette/Source Control – Continue to remind and enforce the use of masks for any person coming to the practice. Having tissues and hand hygiene products available for patients and visitors can also reduce the spread of the virus. Don’t forget to place waste receptacles in the waiting area so that tissues aren’t left lying around. Visit the CDC website for hygiene-related posters.
• Be sure surfaces are adequately disinfected after patient encounters and routinely throughout the day. This includes any horizontal surfaces or surfaces the patient may come in contact with.
• Consider rescheduling routine appointments if possible, for symptomatic patients.
• Workers should remain at home if they are ill to reduce the likelihood of exposure to other workers and patients.

The CDC has various resources for patients and healthcare providers that are provided at no charge. You may locate these items which include patient fact sheets on flu, vaccination recommendations and information sheets, and posters, at CDC Influenza.

The time is now to vaccinate against the flu. Remember that it takes several weeks for immunity to develop. Perhaps this action will reduce the likelihood of that perfect storm.