A double-whammy of COVID-19 and the upcoming flu season has health professionals worried there will be a large surge in hospitalizations and that some people could contract both diseases.
They are urging people to get vaccinated for influenza, while preparing to administer the vaccines in ways they haven't done before.
"It's never good to have two infections circulating at the same time that affect the lungs," Dr. Yvonne Maldonado, Stanford professor of pediatric infectious diseases and health research and policy, said during a recent interview. "Clearly, we are worried. Influenza is another pandemic. It's a pretty significant health problem.
"This is a year when you clearly want to get a vaccine," Maldonado said.
This fall and winter "are going to be probably one of the most difficult times that we've experienced in American public health," Robert Redfield director of the U.S. Centers for Disease Control and Prevention warned during a July webinar with the Journal of the American Medical Association.
At Palo Alto Medical Foundation (PAMF), Dr. William Isenberg, chief quality and safety officer for parent organization Sutter Health, said teams are tracking the flu virus. There is cause for concern when two major viruses attacking similar body systems converge.
"Flu always affects the respiratory system and COVID-19 mostly does. Either one can lower the immune system and will be a setup to have a weakened immune system," he said.
There is evidence that people can contract both diseases. Very early in the pandemic, a patient in the Philippines had contracted COVID-19, influenza and pneumococcal disease, he said. And anytime someone is hospitalized, the risk of contracting another infectious disease goes up, he said.
Isenberg said that's why it's critical for everyone to be vaccinated this year. To that end, PAMF's pharmacy ordered influenza vaccines as soon as they were available and is well-stocked. He cautioned people not to get the vaccinations too early, however, which would cause people to lose immunity later when the flu season is still active.
PAMF plans to start rolling out its vaccinations sometime after Labor Day. The best time to get that shot is from September through December.
To keep people safely socially distanced, PAMF will be handling its flu-shot clinics by appointment, Cecilia Aviles, operations executive for Sutter's Peninsula care centers, said. Appointment can be made either by phone to set up a visit with a patient's physician or by filling out a form online.
Depending on the location, some vaccinations will be given in parking lots and other outdoor locations.
The clinics are also scaling up to meet the greater demand. They are gauging how many patients they can see in an hour while maintaining social distancing.
"It's also a dress rehearsal for when COVID vaccines become available," she said.
"We have looked at if vaccination rates were to increase 10%, 20%, 30% and how to meet those numbers. We could be open longer; we would be available from 8 a.m. to 6 p.m. or on weekends or later, even," she said.
The clinics will have contactless consent forms. When patients arrive, they can also use their smartphones to check in through a new app, HelloPatient, which is accessible through their My Health Online account, she said.
Contrary to some rumors, the flu shot will not lower a person's immune system response to COVID-19, Maldonado said. Stanford also has "a pretty aggressive flu program" for vaccinating its employees, and it tracks and sends data on vaccinating its units to the state.
Like PAMF, Maldonado said Stanford will use more spacing to allow for social distancing and is currently working out plans to be more creative with its clinics.
This year's flu season could turn out to be weaker than in prior years. Influenza strikes the southern hemisphere about six months before it spreads north, and so far reports show there aren't many cases, Maldonado said. But that could also change as the virus moves north, she said.
Social distancing, quarantines and wearing masks against COVID-19 might be contributing to the lower number of flu cases.
"We're starting to wonder if masks are having an impact. Does it make a difference if there is only a small inoculum of the virus that gets through? So far I feel it's a good deterrent, but not 100%. Most likely, it is reducing a degree of the disease," she said.
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.