A Year 2020 'Twindemic'

Flu vaccine   Postmedia

"Having two circulating respiratory viruses is not a good thing. This is something we can do something about. From a societal perspective, we have to reduce the pressure on our health-care system."

"Everyone should get the flu vaccine this year. It's a no-brainer." 

"We don't want people congregating as they usually do in gymnasium-type programs. We need to do it differently. And well."

"...If you could reduce your risk, why wouldn't you do it? Even in a worst-case scenario [difficulty in matching vaccines with current flu strain, resulting in reduced effectiveness], it's still worth it."

Dr.Kumanan Wilson, scientist, Ottawa Hospital Research Institute

"Most health-care workers would say we're barely managing in a normal flu season. We're always on the verge of collapse. If you add COVID, we're in big trouble."

"The biggest problem with how we view influenza is that there are other respiratory viruses circulating. The flu is a whole bunch of viruses with a whole bunch of different presentations. They're impossible to distinguish without lab tests."

"If people keep having parties, we'll have influenza. But if you can control COVID, you can control influenza."

Dr.Jeff Kwong, epidemiologist, professor, Dalla Lana School of Public Health, University of Toronto

(HealthDay)—Fall is approaching, and so is the possibility of what public health officials are calling a "twindemic"—overlapping epidemics of both COVID-19 and influenza

"We're expecting increased demand. People are already making reservations [for flu shots delivered by pharmacists]."

"If there is one thing you can control this year, it's the flu shot. It's going to be a busy year."

Sheilita Dattani, director, professional affairs, Canadian Pharmacists Association

"[If you protect children, you are protecting everyone around them]. I'm hoping for a milder flu season, but you can't trust luck."

"We need to tell parents to roll up their sleeves ... and the sleeves of their children."

Dr.Ran Goldman, researcher, professor of pediatrics, University of British Columbia

This year's flu shot, according to infectious diseases experts, is crucial to avoid the potential of the northern hemisphere facing the perfect storm in the convergence of COVID-19 with its predecessor, the seasonal flu. Health care systems currently strained to cope with increased calls on their vital services are set to be endangered by the possibility of having to face and begin caring for a double surge in cases; COVID and flu. People who feel they have already been through the wringer in COVID infection avoidance, only just beginning to return to a wan semblance of normalcy will be facing a backtrack.

Having to remove oneself from the workplace because of any type of respiratory symptoms will set people, their workplaces and their communities back to square one. According to the Public Health Agency of Canada, an average of 12,200 hospitalizations and 3,500 deaths related to the flu take place annually. In 2019-2020, 42,541 cases of seasonal influenza surfaced based on laboratory testing. Leading to medical community concerns over the potential of the coming winter season presenting with a clash of COVID and influenza cases striking simultaneously.

Should people -- fed up with compliance over basic steps to avoid infection -- relax on the infection-protective wearing of masks, on physical distancing and hand hygiene, the likelihood of a 'twindemic' looms ahead in the near future. The rare potential to be afflicted with both flu and COVID is quite possible. The Journal of Medical Virology published a paper finding that among 1,103 patients diagnosed with COVID-19 in three hospitals in Istanbul, Turkey, six patients were diagnosed as infected with influenza as well.

THE CANADIAN PRESS/Darryl Dyck

Lest that be dismissed as a one-time quirk, co-infections have been reported in patients out of China, Germany, Iran, Japan, Spain and the United States. In Canada, disturbing reports have surfaced through Health Canada of a shortage of personal protection equipment for staff who are themselves a problem in diminishing availability. In the same token an anticipated increased take-up of flu inoculations will most certainly create a bottleneck situation that must be solved before it becomes reality.

To that end other possibilities are being bruited about by Health Canada such as the use of drive-thru and parking lot clinics, where car washes, arenas, insurance inspection centres and drive-thru tents may become additional venues useful to dispense vaccinations. Pharmacists have in the past been relied upon to administer between 40 and 50 percent of flu shots in Canada, and plans are that they be enlisted to continue in that vein and even increase such services.

The possibility of delivering flu shots by appointment, through dedicated hours for walk-in clinics, special hours for vulnerable patients, off-site services such as home visits and clinics established at community halls or temporary structures are all under consideration. In Australia, a report released on September 6 noted 21,119 cases of laboratory-confirmed influenza and 36 laboratory-confirmed deaths attributed to flu; a lower-than-average count for this time of year. A possible harbinger elsewhere for the coming winter season.

 (THE CANADIAN PRESS / AP / Toby Talbot)

The Journal of Pediatrics published a study of close to 3,000 families, finding that a greater number of parents planned to vaccinate their children this flu season. Researchers interviewed parents who visited 17 emergency departments in Canada, Israel, Japan, Spain, Switzerland and the U.S. of their wish to vaccinate their children and roughly 54 percent responded they would be willing to do so. Those who failed to vaccinate children last year saw 29 percent planning to this year.

Even that the flu shot is not robustly effective since public health authorities must make an educated guess about which strain will be circulating in any given year, thus it becomes difficult to assess vaccine match and effectiveness, the resulting vaccine is still credited with functionality. The flu strain circulating in November, as an example, may not be the same strain in March. "But if you could reduce your risk, why wouldn't you do it? Even in a worst-case scenario it's still worth it", urges Dr.Wilson.