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Physicians, public health experts recommend flu vaccine to avoid strain on already stressed health care system this winter

A box of influenza vaccine, Fluzone Quadrivalent 2020-21 Formula, made by Sanofi Pasteur Inc., is opened for use.  (Damian Dovarganes)

Flu seasons are typically deadly, but last year proved altering behavior can change that.

With schools not in session, limitations on gathering size and capacity limits in restaurants and stores, as well as a mask mandate, Washington saw zero flu deaths in the 2020-21 flu season.

In the years prior, Washington reported dozens if not hundreds of flu deaths every year.

In addition to taking extra precautions including wearing a mask and avoiding large gatherings or group settings, getting a flu shot is your best way to protect yourself and those around you from spreading and getting the flu this fall and winter.

“Flu is highly contagious, and it’s critical that everyone 6 months and older get vaccinated against the flu,” Dr. David Ward, a family physician at Kaiser Permanente in Spokane, said.

Vaccines, he added, are important to avoid the potential for a dual-virus situation with COVID-19 case rates already high in the community.

“With an already stressed hospital system overwhelmed by COVID patients, we can’t stress this enough,” Ward said.

Symptoms from the flu are similar to COVID-19 symptoms, and providers are gearing up to increase testing for both the flu and COVID-19 this fall and winter.

It’s possible to get flu and COVID-19 together, Ward said.

If you haven’t received your COVID-19 vaccine yet, you can get it at the same time as the flu vaccine, Ward said.

Flu vaccines are available at pharmacies and health care providers throughout the county, and providers recommend getting vaccinated in October to be protected in time for when flu season typically ramps up from November to March.

Most flu shots are free or low-cost.

Hospitals already strained

Some providers are concerned there might be more flu outbreaks this season due to relaxed virus protocols and people gathering in larger groups than they were at this time last year.

This year, unlike last year, there are no reopening phases in place. Kids are back to school full time. Concerts, weddings and sporting events are happening.

Simultaneously, COVID-19 case rates are as high as they’ve ever been. At this point last year there were 40 people in Spokane hospitals with the virus. Currently there are 204 patients hospitalized for COVID-19 in Spokane County.

And while case rates and hospitalizations appear to be plateauing, the greater concern is that if hospitalizations do not decrease enough to create capacity, the health care system will continue to be stretched well into winter.

State Secretary of Health Dr. Umair Shah said he does not want to see the current COVID-19 rates and hospitalizations as a starting point for the system to go into winter. It’s a race against time, however, he said.

The delta variant made up 100% of the most recent sequencing done in Washington. Delta is more effective at finding unvaccinated people, making some of them critically ill.

There are still 1.7 million eligible Washington residents who have not received a single vaccine dose. While those people are at risk, others who are fully vaccinated will experience waning immunity with their own two-dose vaccines as time goes on.

Currently, Spokane hospitals are not performing elective and nonurgent procedures, including some for cancer patients.

If they have to add on the stress of flu patients, already tight capacity could get even tighter.

Rural hospitals, which rely on larger medical facilities to treat their sickest patients, might find themselves unable to transfer patients just as they have in recent weeks with the current COVID-19 surge.

“If we end up where we are right now or maybe a week past (it) with hospital capacity in Spokane and our ability to transfer to them being zero at times, if we added flu on top of that it would be very tough,” said Aaron Edwards, CEO of Ferry County Hospital and Health in Republic.

How delta changed the risk

There is a statewide mask mandate in place in Washington, but not across the border in Idaho. Kids are back in schools full time and masked in Washington, but not in Idaho.

Restaurants are open with no capacity limits. Sporting events continue, and large gatherings with fewer than 500 people outdoors don’t require masks in Washington.

Despite the current surge of COVID-19 cases being worse than ever before, the restrictions and limitations in place are much different than last year.

The decision to not have certain restrictions in place is still a decision, albeit sometimes made implicitly, epidemiologist and WSU professor Eric Lofgren said.

He and other epidemiologists are concerned about what the fall and winter will bring, especially with relaxed lockdowns and the delta variant still circulating.

Lofgren said the same reasoning that went into closing schools in March 2020 still applies today.

The difference, of course, is other factors, from political will to economic consequences to other health and education concerns, which all took precedence, whether that was explicitly stated.

“We as a society have effectively made a decision that there’s a cost measurable in human deaths that is acceptable for us to go back to in-person dining, and whether or not we had that conversation or explicitly made that decision, we’ve made that decision,” Lofgren said.

“There’s a quantity of sick kids that’s an acceptable threshold for having in-person classes – no one wants to talk about it, but that’s the decision we made.”

Vaccines for both COVID-19 and the flu are the way forward, physicians and public health officials say, in order to keep the health care system afloat through the end of the year and into 2022.

And while COVID-19 might be circulating for the foreseeable future, vaccinations can keep the vast majority of people protected and out of the hospital, so that the health care system can begin to provide care widely again.

A year and a half into this pandemic, health officials continue to point to the strategies that have worked over and over again to stem the tide of the virus.

Masks work for flu; masks work for COVID-19.

“I’m hopeful that the flu won’t be as bad,” Christina Wagar, chief operations officer at Newport Hospital, said. “But I guess we’ll have to wait and see.”

Arielle Dreher's reporting for The Spokesman-Review is primarily funded by the Smith-Barbieri Progressive Fund, with additional support from Report for America and members of the Spokane community. These stories can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.