Warning of ‘twindemic’ with flu season approaching

A patient receives a flu shot from a healthcare professional as The CHP (Community Health Program) Mobile Health Unit parked at South Street Congregational Church, Thursday, Sept. 24, 2020, in Pittsfield, Mass. Flu shots are strongly encouraged this year due to COVID-19. (Ben Garver/The Berkshire Eagle via AP)

RALEIGH — The ongoing COVID-19 pandemic is grabbing all the headlines, but the risk of a bad flu year should not be ignored, UnitedHealthcare’s chief medical officer in North Carolina, Dr. Michelle Bucknor, told North State Journal in a Sept. 24 interview.

“I think the biggest concern is that if people don’t get the flu vaccine and we also have COVID, that having both of those viruses that significantly affect people’s health circulating at the same time could result in everything from resource challenges to more impact on the people who become infected,” Bucknor said.

She said they do not have reason to believe this year will be a particularly bad year compared to other years, but health officials like Bucknor and NC Department of Health and Human Services secretary Mandy Cohen worry people may forget to get their flu vaccine this year because of the shutdowns and a greater focus on COVID-19. A lack of flu vaccines could then lead to a worse than usual season, overwhelming the hospitals and other health resources.

“You do worry that people may be in their homes, especially those at risk, so they don’t want to go to a provider’s office to get the flu vaccine because they’re worried,” Bucknor said. “They’re doing virtual visits, which we encourage, but at some point they should go out and get that flu vaccine.”

She said, ideally, everyone that is eligible, which includes all those 6 months old and up, would get the flu vaccine. People can get the vaccine at their primary care office, and many pharmacies even offer the vaccine.

The health care system being overburdened is one concern, but another is an individual’s immune system being unable to handle both illnesses.

“You can,” Bucknor said when asked if you can have both COVID-19 and the flu simultaneously. “So whether you get them at the same time, or you get the flu first and then get COVID, because COVID is a new virus for us, we don’t know what that looks like. We assume though that because they’re both viruses with a significant impact, that it would not be a good combination.”

North Carolina’s state health director, Dr. Elizabeth Cuervo Tilson, expressed a similar concern in a recent press release: “This flu season, it is more important than ever to get vaccinated against the flu. We will have both the flu and COVID-19 widely circulating this fall and winter, and we are learning that people can get both infections at the same time. We want people to protect themselves from the flu and also avoid overwhelming our hospitals so people can get care if they need it.”

Some people worry about taking vaccines, but Bucknor said, “It’s a really safe vaccine.” There was a time when those who had extreme egg allergies could have adverse reactions because of how the vaccine is manufactured, but this issue has been largely resolved. 

Bucknor says the hospital system is prepared, but they don’t want to push too hard on an already-stressed system.

“I think we’re in a good place, and we pretty quickly reduced the number of elective procedures to make sure that we had enough equipment and staff available to support folks. So I think our state would modify as needed, and hospital systems as well, if we had a high flu season and high COVID rates at the same time.”

While these negative effects of the pandemic are one possibility, Bucknor also said that social distancing precautions may actually make it a less intense year for the flu, as evidenced by data she’s seen from the southern hemisphere.

“In some countries where they’ve done really good job social distancing and using precautions, they’ve had less flu. We’re hopeful that that’s the case,” Bucknor said, while reiterating that North Carolinians should make sure to get the flu vaccine this year.

UnitedHealthcare has over 1.4 million members in N.C.