I evaluated the patient in one of our designated exam rooms for persons under investigation (PUIs) for COVID-19, fully doffed in personal protective equipment (PPE): an uncomfortable, resonant face shield over my surgical mask, looking like Big Bird in a bright yellow gown. It was a false alarm. But like many other clinic visits these days, we ended up talking about COVID-19.
“I can’t wait until we have a COVID vaccine and can get back to normal life,” the patient lamented.
“Well, there are several vaccine trials starting in Los Angeles this month if you want to volunteer,” I offered.
The patient’s face contorted as if I had sworn in church. “Oh, I never get vaccines, ever. Not even the flu shot, and I’m a schoolteacher!”
I sighed, “If there was ever a year to get your flu shot, this is the one.”
Every year around this time, a not-so-novel viral infection brings patients in droves to clinics and hospitals. Between November and January of last year, I saw hundreds of adults and children with nasal swab-confirmed influenza virus: sometimes as many as 20 patients a day. Their illnesses ranged from mild—sniffles and a cough—to severe: admitted to the hospital and critically ill. Admittedly, I did see people with influenza who had received their flu shot; last year, the flu shot was only an estimated 39 percent effective at preventing influenza, according to the CDC. But that was not the majority. And the vaccinated patients tended to have milder courses than those who had not received the influenza vaccine, consistent with CDC data.
My clinic was at capacity throughout the entire flu season last year, so we developed an informal system to keep up with the volume. If a patient had upper respiratory symptoms or a fever, the nurse would obtain a flu swab before I even saw them. I could triage a positive case home or to the hospital-based on their vital signs and a quick exam. Despite our highly efficient system, I could not possibly have seen more patients each day, and by late December, I was running on fumes. So was our clinic staff. A vacation refreshed me for the next month of influenza season, which led directly into the COVID-19 pandemic. Like many health care workers, I have not taken a significant break since. We have all felt the added weight of caring for patients during a pandemic.
While we don’t know if current social distancing practices or the circulation of COVID-19 itself will decrease the burden of influenza this respiratory season, one truth remains certain: we cannot afford to have a dual surge of COVID-19 and influenza cases. Health care workers like myself already feel stretched thin as we head into this flu season: a dual surge would push us to the brink, not to mention our patients and communities. We all need to do our part to prevent this from happening. Beyond following social distancing and masking recommendations until we have a more permanent solution, that means getting a flu shot. No vaccine is perfect, and each year’s flu shot is a best guess, but it does work on a population level to decrease influenza morbidity and mortality. Decreasing the burden of influenza infections this year translates to preventing critical surges of patients, saving lives, conserving health care resources, and protecting health care workers who are risking their own health every day.
While we appreciate the generous discounts offered to health care workers, PPE donations, and the nightly celebrations of our work during the first wave of the pandemic, we need more than that from the public. So, give a genuine thanks to health care workers this year. Don’t just clap. Go out and get your flu shot.
Russell Johnson is an internal medicine-pediatrics physician.
Image credit: Shutterstock.com
