Ready or not: Flu season rounding the corner in Southwest Florida

Getting vaccinated for flu this fall is more important than ever as the COVID-19 pandemic continues to bear down on Florida, experts say.

Floridians can expect public health campaigns promoting the vaccine and a push by their doctors to get the shot to stay healthy.

The Centers for Disease Control and Prevention recommends all people ages six months and older get the flu shot. A high-dose vaccine is available for adults 65 and older.

The state health department in Lee County began offering the flu vaccine Thursday at its pop-up testing sites for COVID-19.

The health department in Collier County is considering something similar, spokeswoman Kristine Hollingsworth said.

“Evidence clearly shows that a flu vaccine can reduce the severity of the flu and prevent hospitalizations,” Hollingsworth said. “This is a critical consideration while healthcare systems continue to combat COVID-19.”

Flu season typically starts in October in the U.S. yet often lags in Southwest Florida and doesn’t hit until November.

That’s when visitors and winter residents start arriving and closer contact and co-habitation with others spreads the contagious respiratory illness, said Dr. Mary Beth Saunders, infectious disease expert at Lee Health, the publicly-operated hospital system in Lee County.

The flu season typically is over by the end of April but there are still cases in summer.

“I think people want to get the flu vaccine to decrease risk of getting flu and not risk getting other types of infections,” Saunders said.

Lee Health saw 4,721 cases of flu during this past season. Data from the NCH Healthcare System in Collier County was not readily available.

For the past three years, flu-like illness peaked in late January through February in Southwest Florida, according to Georgine Kruedelbach, director of infection prevention at NCH.

People should get the vaccine by the end of October but it should still be offered as long as flu viruses are circulating locally, she said.  

More: Southwest Florida hospitals allowing patient visitation due to drop in COVID-19 cases

Flu cases are not required to be reported to the state health department, which instead conducts surveillance, while flu and pneumonia deaths are tracked.

There were 2,703 flu and pneumonia deaths statewide among all ages in the 2019-20 flu season. That’s a rate of 8.4 deaths per 100,000 population.

Lee County had 74 deaths for a rate of 5.5 deaths per 100,000 residents, state health data shows.

Collier had 40 deaths and its flu death rate was 4.4 deaths per 100,000 population.

Nationally, the CDC estimates 39 million to 56 million Americans contracted flu from Oct. 1, 2019 through the end of April this year. Deaths stood at 24,000 to 62,000.

Flu vaccinations low in Florida

The National Association of Chain Drug Stores, based in Virginia, is waging a broader public education campaign this year compared to previous years to convince the public how critical the flu vaccine is because of the COVID-19 pandemic.

The CDC is launching a similar campaign to boost vaccination to 65%, way above the national average of 45% during the 2018-19 flu season.

Florida’s vaccination rate was below the national average, at 31%, for this past flu season. Roughly 37% of adults in Lee got vaccinated while 31% in Collier did.

Much of the blame can be placed on young adults ages 20 to 30, who skip it year after year, Saunders said. There often is a spike in flu during spring break, she said.

At the urging of the CDC, private manufactures of the vaccines will churn out 198 million doses this year, 12% more than last year’s record 175 million doses.

More: Collier schools launches COVID-19 dashboard reversing stance on sharing data

The flu shot won’t protect you from COVID-19, which is caused by a different virus, yet the CDC expects both illnesses to spread this winter.

It is possible to have flu and COVID-19 at the same time but experts are still studying how common that may be.

Flu and COVID-19 share many symptoms such as fever, chills, fatigue, muscle aches and shortness of breath. The one exception is loss of taste or smell that is a symptom of COVID-19.

Millions of Americans get the flu each year but this year with COVID-19 creates the potential of a “two-front public health war,” said Steven Anderson, president and CEO of the chain drug store association.

Most chain pharmacies, like CVS and Walgreens, have started offering the vaccine, including in Southwest Florida, with safety measures for protection against COVID-19 exposure.

A recent poll commissioned by the chain drug store association found 67% of adults said getting the flu vaccine is important, but that’s far below the 86% who said the same for wearing a mask because of COVID-19.

Hospitals could face high demand

Some experts worry clinics and hospitals will be overwhelmed with sick patients during flu season and a new wave of COVID-19 infection that will drive up respiratory illnesses and deaths.

“Getting the flu vaccine this fall will be more important than ever, not only to reduce your risk from flu but also to help conserve potentially scarce health care resources,” the CDC says.

There were 18 million medical visits nationwide during this past flu season, 9% more than the 16.5 million visits the year before, federal data shows. Hospitalizations were 16% lower at 410,000 compared to 490,600 hospitalizations the year before.

In Southwest Florida, the way that nurses and doctors adapted quickly to the COVID-19 pandemic will carry over into how they handle flu cases this year, said Saunders, of Lee Health.

“One of the things that came out of COVID is we are better prepared to handle an influx of patients,” she said. “We’ve become much more efficient on how to care for people with respiratory illnesses.”

More: Hospitalizations for COVID-19 declining in Southwest Florida, mirrors the state

Lee Health emergency room staff set up a separate triage area for suspected COVID-19 cases and that practice will be done for other respiratory illnesses during flu season, Saunders said. NCH also has separate triage in the emergency rooms for COVD-19.

NCH's practice will be similar given that symptoms of flu and COVID-19 can be the same, said Chris Raphael, administrative director of critical care and emergency services, said.

"All patients are screened for COVID upon arrival and we have separate waiting rooms for those with suspected COVID/suspected respiratory illness with fever," he said. 

All emergency room patients are given a surgical grade face mask and there is physical distancing in the emergency room lobby, he said

What’s unclear is if the U.S. will see dramatically low flu numbers like countries in the Southern Hemisphere saw during their flu season earlier in the year.  

A best-case scenario is preventive measures, like mask wearing, to slow the spread of COVID-19 caused a slow-down in flu cases in the Southern Hemisphere, Brendan Flannery, a lead CDC investigator for the U.S. Flu Vaccine Effectiveness Network, said in a recent article in The Journal of American Medical Association.

A worst-case scenario is that hospitals were overwhelmed with COVID-19 cases and people with flu did not seek medical care, he said.

Saunders, of Lee Health said she and others don’t know how severe flu season will be in the U.S.

“There is hope that we will not have a severe flu season this year,” Kruedelbach, of NCH, said.

So far, there are no reports of delays in vaccine delivery since it’s just getting started, Saunders said.

It’s also too early to say how effective this year’s vaccines will be.

“Vaccine effectiveness is unable to be determined until the flu season is over,” Hollingsworth, of the Collier health department, said. “It is possible for some flu strains to mutate, which is unforeseeable.”

Lee County free flu vaccinations sites in September.

All times 9 a.m. to 12:30 p.m.

 * Tuesday, Sept. 22,  Karl Drews Park, 18412 Lee Road, San Carlos Park.

* Thursday, Sept. 24, Veteran's Park, 55 Homestead Road South, Lehigh Acres.

* Tuesday, Sept. 29, Kurt Donaldson Park, 180 Hunter Blvd., Cape Coral.