To members of the Baylor College of Medicine community:
It has been a while since I put pen to paper. To be honest, after more than a year of weekly commentary on COVID-19, I was running short of new things to say. Get vaccinated. Don't let your guard down just yet. Keep up your good viral control practices. I got a little tired of writing, and I suspect many of you got a little tired of reading – or just stopped reading altogether.
I resolved I would not write again until it could be about something non-COVID related. Something new and different. This week, I think I finally hit on it:
Flu.
OK. I admit exchanging one highly infections and dangerous viral respiratory pathogen for another does not get me too far out of my COVID rut, but it is a start, and it is important.
Over the coming weeks, you will see Baylor College of Medicine giving substantial time and attention to influenza protection, at a level very similar to our approach to COVID-19. We take flu very seriously, and I would like to explain why I think you should take it seriously too.
It is still a serious disease. True, influenza is not as infectious as COVID-19, nor is it as deadly. Hurricane Harvey was a more damaging and deadly storm than Hurricane Ike, but I do not want to live through either again if I have a choice.
The impact of flu varies from year to year, based on characteristics of the virus and effectiveness of the vaccine. In the most severe season over the past 10 years, flu caused 41 million illnesses, over 700,000 hospitalizations, and 52,000 deaths.
This could be a "bad" flu year. Last year was an extremely mild year for flu, likely driven by our interventions to prevent the spread of COVID-19 – masking and physical distancing. It is likely, at this point, that the public will be less compliant with viral control practices than last winter, which will facilitate spread of flu.
Although no one knows with certainty if this will be a "good" or "bad" flu season, some are predicting a rebound resurgence of flu this year, as our immune systems were not exposed to flu last season, leaving us theoretically more susceptible.
Flu disproportionately impacts vulnerable populations. Like SARS-CoV-2, the influenza virus is not an equal opportunity pathogen. Who is more likely to have a bad outcome from a bout with the flu? The elderly. The very young, especially those under two years old. People with disabilities and chronic diseases. Racial and ethnic minorities.
Getting your flu shot not only helps protect you personally, but by limiting the community spread of the virus you are helping to protect at-risk people in our community.
The flu vaccine is safe and effective. I remember back in the Spring of 2020, when we were trying to predict when and if there would be an effective vaccine against COVID-19. At that point effectiveness was roughly defined as greater than 50% success in preventing infection. Now we have multiple vaccines for COVID-19, which are remarkably effective. We are also a little spoiled, sniffing at any effectiveness numbers that dip below 90%.
The flu vaccine is manufactured annually in advance of the flu season and requires a degree of prediction to match the vaccine with the yet-to-emerge flu variant of the season. Over the past 15 years, vaccine developers have been right more than they have been wrong. On occasion, they swing and miss (the 2004-05 vaccine was particularly ineffective). But more often than not, the vaccine effectiveness surpasses the 50% threshold. On an annual basis, flu vaccination is estimated to save up to 12,000 lives and prevent up to 105,000 hospitalizations.
A bad flu year will feel like a 5th wave of COVID-19. If predictions are correct, and the influenza outbreak is severe, our health system will need to care for hundreds of thousands of patients. Tens of thousands will have extended intensive care stays and many will not survive. Sadly, with over 700,000 COVID-19 deaths in the United States, we have become somewhat inured to the constant threat of death or severe illness from respiratory infection.
Keep in mind, those 700,000 deaths have occurred over almost two years. Flu season is a few months. If we see a spike of flu admissions and deaths concentrated over a few months, from the perspective of our health systems, it will feel very much like a continuation of the COVID-19 pandemic. Getting your vaccination will help limit spread of influenza and protect our hospitals and health care workers.
Influenza will disrupt holiday plans and our attempts to reconnect with family. Remember what happened back in the old days when you got a cold? You got together for your family Thanksgiving, sniffling and coughing, while apologizing that you have a "little cold." This year will be different.
Because of the huge overlap in symptoms between COVID-19, flu, and the common cold, "the sniffles" will not be taken lightly. Respiratory symptoms will result in trips to the doctor, COVID-19 testing, debates about the reliability of home tests, flu testing, extended family anxiety around exposure to unvaccinated children, cancelled trips, family conflict, hurt feelings, and missed opportunities to connect.
Getting your flu vaccine is not a guarantee of health during the holidays, but it will lessen the likelihood that a viral grenade will be lobbed into the center of your holiday gathering.
Flu vaccination is most effective when people are vaccinated early – ahead of an actual outbreak. Today is the right time. Please get your flu vaccine as soon as possible and encourage your family and friends to follow your lead.
Stay well.
Please feel free to share this message using the following link: https://bit.ly/3ACPvb4
James T. McDeavitt, M.D.
Executive Vice President and Dean of Clinical Affairs
