Our Superpower.. Preventing a Twindemic

As our country approaches cooler weather, and thereby our seasonal flu season, every measure needs to be taken to lessen the impact of two respiratory viruses, COVID-19, and influenza. The U.S. Food and Drug Administration (FDA) took a major step today toward continuing our progress out of this COVID-19 pandemic. On November 19, 2021, the FDA expanded the Emergency Use Authorization (EUA) for both the Moderna and the Pfizer-BioNTech COVID-19 vaccines. A booster shot of either can be used for every American, age 18 and over. This half dose vaccine booster should be given at least 6 months after the initial series of the two dose Pfizer or Moderna vaccines or at least two months after the completion of the one dose Johnson & Johnson vaccination. This new EUA expansion for these two remarkable vaccines clears the air of confusion regarding who is eligible for a booster. It represents clear acknowledgement that COVID-19 continues to be a threat and protecting the public is of primary importance. Cases are increasing in twenty-four states and the 14-day case change is up 25% over the last 2 weeks. Michigan and Minnesota are leading the country in cases per capita. The National Guard has recently been requested to assist in Michigan. Even states with the highest vaccination rates are suffering significant outbreaks. Deaths in the US are over 770,000 and the incidence of death is fourteen times (14X) higher in the unvaccinated. The good news is that deaths and hospitalizations are not increasing across the nation.

One of the exceedingly rare positives from the Covid-19 pandemic experienced during the last flu season (fall of 2020 until the winter of 2021) is that our country lost less than one thousand citizens to influenza. Historically, between 2010 and 2020, the flu has killed between 12,000 and 52,000 yearly, including an estimated 20,000 in the 2019-2020 season. As a result of the successful push for flu vaccinations last fall and winter, as well as the mitigation measures of social distancing, limiting hand to face contact, hand washing, and covering up coughs and sneezes, we escaped the profound effects of the seasonal influenza. The “we” referred to consists of America at large. African Americans and ethnic minorities remain disproportionately affected by influenza. It remains true that when “America catches a cold, black folks get pneumonia.” The impact of the influenza that African Americans catch is both more severe and more deadly. The statistics from the CDC are that for the ten flu seasons between 2009-2019, the flu-related hospitalizations per 100,000 were 69 for African Americans, 49 for Non-Hispanic American Indian or Alaska Native people, 45 for Hispanic or Latino individuals, 38 for Non-Hispanic White folks, and 32 for Non-Hispanic Asian people. Both flu-related ICU admission rates and death rates were highest among Black people during the aforementioned ten-year timeframe. 

This discussion regarding the flu is relevant in this age of COVID-19 because flu is already on the upsurge. The CDC initiated an epidemiologic analysis at the University of Michigan (Ann Arbor) because of an outbreak of 528 cases on campus since October 6, 2021. There were actually 313 cases during the week of November 8. Of note is the fact that 77% of those who contracted the flu were unvaccinated. The penetrance of the flu vaccines is 11% less in Michigan this year compared to last. This failure of our citizens to get the flu vaccine goes hand-in-hand with the aversion of tens of millions of unvaccinated Americans who continue to drive our COVID-19 pandemic. Only three out of five Americans have been fully vaccinated against COVID-19. It is essential to emphasize that the flu vaccine and the vaccination against COVID-19 can indeed be administered at the same time. 

Mitigation measures have proven to be effective in lessening COVID-19 cases as well as seasonal influenza. Vaccinations, especially the initial series necessary for full Covid vaccination, Covid boosters for those eligible, and one against the seasonal flu, are our primary ticket for avoiding these two phenomena. Hand washing, staying at home when sick, washing hands, and covering the nose and mouth when sneezing and coughing are sage messages. If we just heed the advice, we can prevent a twindemic!