Possible COVIDflu coinfections a concern
As weather cools, activities move inside making health risks increase
With the ongoing COVID-19 pandemic, Dr. Russell Faust is concerned about rising cases with the cold weather on our doorstep. All outdoor activities enjoyed in the warmer months, move inside where the health risks increase.
However that is not the biggest concern for Faust, Oakland County’s medical director.
“The big one is COVIDfluco-infection. Herewe are entering the cold-flu season. Now it’s cold-f lu- COVID season. It’s a real problem,’’ Faust said.
Yes, it’s quite possible to get both at the same time.
It gets worse. For anyone over age 60, a co-infection doubles the risk of dying.
Since COVID and the flu share symptoms — fever, chills, cough, shortness of breath, difficulty breathing, fatigue, sore throat, running, stuffy nose, muscle
aches, headaches, GI kind of diarrhea — it becomes a diagnostic dilemma.
Faust said emergency rooms and physician’s offices are going to be challenged since it’s virtually impossible to distinguish between the two.
“Do you isolate and protect others? Do you give them Tamiflu or an antiviral that can knock down their flu symptom profile? So that’s the first real problem,’’ Faust said.
It’s also going to place a big demand on testing.
“Despite what our president says we just don’t have enough tests. We do not. When we do order tests there are many labs that will take two or three weeks to get your results back. You just can’t conduct epidemiology if you don’t have real surveillance and that requires immediate turn-around within 48 hours,’’ Faust said.
Hospitals do most of their COVID testing internally which gives them the ability to turn around the results quickly.
Since the pandemic started last February or March at the end of the flu season, this is not all new.
“The standard of care was if you went to the ER and it looked like you had the flu but significant distress they would do a respiratory panel test which looks for a whole bunch of respiratory viruses. ... If those were all negative they would try to get a COVID test. Even if they couldn’t get a COVID test because they didn’t have it back then, they would admit as a presumptive COVID patient. That was standard back then.’’
Now he says it’s likely they’ll still start with the respiratory test and if negative move on to the COVID test.
“What I’m a little worried about is hospitals or ERs will run a respiratory
panel and see that you have the flu and stop there. You don’t want them to stop there because you may have both,’’ Faust said. “You want themto also test for COVID. You don’t want to miss the co-infection, co-infection is a big deal.’’
He said he has not seen a co-infection case yet.
“I’m very, very hopeful that if people will stop their quarantine fatigue, their burnout and return to being vigilant about wearing masks, we’re going to have a great flu season,’’ Faust said. “That is if everybody’s wearing a mask and maintaining their distance, we’re going to have a lower number of flu infections this year, we’ll have a reduction in the COVID and we won’t see those co-infection fatalities.’’
In a 40-minute interview he mentioned the importance of getting a flu shot several times, along with wearing a mask.
“This year more than any other time in history you must get your flu shot,’’ Faust said.
For people over 65, he recommends the high-dose flu shot.
Also he suggests abiding by the three Ds:
• Distance: Staying 6 feet from others
• Duration: Less than 15 minute exposure if you’re going to be less than 6 feel
• Density: Fewer than 10 people in a congregation if indoors, and fewer than 100 outdoors.
While nationally COVID vaccine studies are underway, Faust is not surewhen we will see a vaccine.
“We have been instructed, and I don’t know what to make of this, we have been instructed by the federal government to prepare our vaccination plan,’’ Faust said. “Every state and every county health department has received the same instructions. We’ve all submitted our plans and everybody is ready. When it happens we are ready. As soon as we receive it, we’re ready.’’