COVID-19 and the flu: Avoiding the double whammy

The news is filled with reports of overwhelmed health care providers, ventilators at capacity, and hospitals in crisis mode due to the continuing coronavirus pandemic in the U.S. As we look ahead just a couple months, we could be facing a far more grim scene when COVID-19 and influenza are both circulating in our communities. Data released last month showed patients co-infected with influenza B and COVID-19 have a higher risk of poor health outcomes.

At present, we do not have a COVID-19 vaccine, and yet we have one of the most effective tools to prevent another deadly respiratory disease: influenza (flu). According to the Centers for Disease Control and Prevention (CDC), the annual disease burden of influenza in the U.S. has ranged from 12,000 to 61,000 deaths, 140,000 to 810,000 hospitalizations, and 9,300,000 to 45,000,000 illnesses. Since 2004, close to 2,000 children in the U.S. have lost their lives to flu and flu-related complications. Sadly, due to reporting limitations, that number is likely an under-representation of the true pediatric burden. 

The irony is that flu vaccines, which are available to all Americans, could help reduce this burden of disease, but less than half of the U.S. population gets an annual flu vaccine. We only have to hear the stories from families who have suffered devastating flu-related losses to appreciate the importance of vaccination. The simple act of receiving a flu vaccine could have prevented the loss of a four-year-old girl who went to bed with mild flu-like symptoms, never to wake up; a six-month-old baby boy who died only 30 hours after showing his first symptoms of being sick; and a 33-year-old woman who survived flu, but was hospitalized for three months and suffered an amputation above the knee as a result of her illness.

Flu vaccination can also preserve health care system capacity for those with COVID-19 this fall. According to a recent survey by Families Fighting Flu, 41 percent of Americans do not agree that the potential convergence of flu and COVID-19 is an important reason to get a flu vaccine. Sadly, the survey also showed that 59 percent of respondents would likely not seek a flu vaccine if shelter-in-place orders are in effect this fall. But just like the coronavirus, flu knows no boundaries, and the virus persists over several months. The best way to avoid the COVID-flu double whammy, prevent co-infection, and reduce the burden on the health care system is to increase flu vaccination rates for children and adults in this country.  

We believe policymakers, Congress, health officials, health care providers, scientists, pharmacies, and families must rally to ensure that every American gets a flu vaccine. Increasing vaccine uptake within the constraints of social-distancing requirements may require modifications of timing, locations, and providers. We believe vaccination rates must especially increase among populations at higher risk of COVID-19 and/or flu-related complications, including older adults, health care workers, underserved communities, people with chronic health conditions, and school-aged children.  

To do this, we need more funding to bolster the country’s immunization infrastructure, especially in underserved communities. Funding is also needed to the procurement of diagnostic tests, personal protective equipment, and medicines to meet the expected increased demand during the fall flu season. Without these tools, health care providers will struggle. For example, antivirals are a critical second line of defense for treating and preventing influenza spread. The U.S. stockpile serves to backfill shortages in commercial supply during a severe flu season, further exacerbated by COVID-19, so we must ensure sufficient supplies.

We also need public outreach to ensure a robust season-long flu vaccination campaign. Clear and succinct communications designed and coordinated by multiple stakeholders are needed and must be delivered cohesively and with repetition — beginning as soon as the first dose is available. 

Congress should act now by providing the increased funding needed by the CDC and the Strategic National Stockpile. Proactive planning, creative, outside-the-clinic thinking, and proactive public outreach in partnership with state and local health departments are required this summer.  

Organizations like the Coalition to Stop Flu are working to make sure policymakers understand the urgency of acting now to avoid the double whammy of COVID-19 and flu this fall. Let us work together to ensure that every American gets a flu vaccine and has access to the testing and treatment they need. Not every American will be able to get a ventilator.

Stefano Bertuzzi is the chief executive officer of the American Society of Microbiology. Serese Marotta is the chief operating officer of Families Fighting Flu. David Gollaher is the head of policy and government affairs at Vir Biotechnology and a senior fellow at the USC Schaeffer Center for Health Policy and Economics. All are Executive Committee Members of the Coalition to Stop Flu.


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