Hawaii’s new health director Libby Char is urging the public to stay alert during the upcoming flu season that health experts predict may be the worst in years due to the prevalence of COVID-19 in the community.
In his most challenging role to date, Char, an emergency physician who previously served as the state EMS district medical director for Oahu, joined the Department of Health on Sept. 16, ahead of a potential third wave of coronavirus infections that could be even more devastating with the flu in the mix.
Across the nation, health experts are concerned that the collision of the two potentially deadly viruses could result in increased hospitalizations and mortality. Getting a flu shot is even more critical this year to prevent hospitals from being overwhelmed by both the flu and COVID-1
“What I hear is that this year is going to be a particularly bad flu season,” said Char, who has been running the Honolulu City and County EMS system for years. “When you pair a bad flu season with COVID-19, it gets worse. It is entirely possible that we could see another wave of COVID-19. I’d tell people to be prepared for … another peak. If we’re in that mindset, maybe it will help us be diligent and help us prepare. “
The coronavirus has killed 131 people and sickened more than 12,000 since it reached the islands earlier this year. The DOH estimates that the upcoming flu season could result in up to 1,000 deaths in Hawaii from pneumonia and flu and about 10,000 cases.
This compares with 686 deaths from pneumonia and flu in the 2019-2020 flu season that ended Saturday, according to the department’s flu / respiratory disease surveillance report for the week ending September 5.
Both viruses have almost the exact same symptoms and are transmitted in the same way: through airborne droplets from coughing or sneezing. According to the Centers for Disease Control and Prevention, influenza and pneumonia were among the top five causes of death in the state from 2014 to 2017.
“COVID-19 is bad and the flu is bad, and if you catch both of them you will find yourself in serious trouble,” said Dr. DeWolfe Miller, a professor at the University of Hawaii and a colleague at the American College of Epidemiology, adding that the mortality rate could increase exponentially with double infections. “It could absolutely be devastating. If we get co-infection with one of these viruses it will be deadly, “he said.
Although it is rare to contract two viruses at the same time, coinfection is possible and both respiratory viruses target the lungs and can cause viral pneumonia.
“Even if it’s just a normal flu season, it’s going to get worse,” Miller added. “And if people don’t get the flu shot, it will definitely be worse. This is part of a disaster we can avoid if we take our flu shots.”
Miller argues audiences need to be cautious and should stay inside, for the most part, and avoid crowds during flu season. While the flu can be especially severe in younger children, COVID-19 has mostly affected older adults and those with underlying medical conditions.
Char has replaced Bruce Anderson, the former medical director who has been criticized for failing to build a robust COVID-19 response. He is now on a mission to restore public confidence and persuade Hawaii residents to heed the warnings of public health experts to get flu shots, continue to wear face masks and good hygiene, and practice social distancing while on vacation. despite quarantine fatigue.
“It has the problem of having to catch up with the public’s confidence or convince people that they’re tired of this (on board),” Miller said. “We are seeing a very serious situation.”
With flu season, reopening of businesses and quarantine waivers for transpacific travel and combined in-person and online school programs starting next month, officials are closely monitoring for signs of another wave of coronavirus infections. they impoverish the health resources of the state.
“At least for many, many months we will still be dealing with COVID-19. I can’t tell you when it will end,” Char said. “What worries me is that the flu season is just around the corner. The best thing we can do is work on the prevention side so that we never get sick. “
Hawaii’s “very social” culture makes it even more important to “convince each other and convince our friends and family that everyone has to do their part, and at some point we hopefully get consensus and we as a community change. our behaviors, “she said.
Hospitals in Hawaii have already started seeing the first fall flu season patients, with case numbers typically continuing through March, said Jill Hoggard Green, president and CEO of Queen’s Health Systems.
“The combination of coronavirus spreading and flu at the same time could greatly increase the number of people who are sick,” he said. “The flu in addition to the coronavirus could amplify the pandemic and make it much worse. For me, this is just too much pain and suffering that we can prevent. “
On the flip side, if up to 80 percent of the population gets the flu shot, the community could actually see a better-than-normal flu season and create a larger reduction in transmission, according to Hoggard Green.
Lt. Governor Josh Green, an emergency room doctor on the island of Hawaii, said he expects that as people wear masks and socially distance themselves from COVID-19, there will be fewer cases of the flu, “but you never know. how strong a flu strain is going to be. “
He added that he gets a flu shot every year and has only contracted the virus once in the past 20 years. “You can tell that COVID-19 is more serious for us and we don’t have immunity, so that’s why we’re trying to prevent it,” he said.
Hawaii had 787 total coronavirus hospitalizations out of 12,018 cases, a rate of 6.5%. Nationwide, there have been about 600,000 hospitalizations from 45 million flu cases, a rate of about 1.3%.
“People have been hospitalized (for COVID-19) at five times higher rates … and death rates are 15 times higher,” Green said, adding that the state is working to put more safeguards in place. to ensure any future COVID-19 vaccine is safe and voluntary in Hawaii.
“We have to get herd immunity. If people don’t understand this, they will be very vulnerable to contracting the coronavirus and it will have an impact on opening up the state. “
Honolulu GP Jennifer Frank said the flu shot is “flying off the shelves” this year and even people who don’t normally get it ask for the injection. Although last year’s flu shot was only 30 percent effective, none of his patients who contracted the virus ended up in hospital or died, so it may have prevented complications, he said.
While there is no cross-protection from the flu shot, “one of the best things you can do to prevent COVID-19 for yourself and everyone around you is to get a flu shot” to stay healthy, he said.