Is ‘twindemic’ looming? COVID-19 and flu cases could hammer hospitals

As if the COVID-19 pandemic isn’t enough to keep doctors and hospitals busy, here’s another whammy: Flu season is here and Indiana is lagging much of the country in residents getting flu vaccinations.

Some public health officials say the combination of flu and coronavirus illness could lead to a “twindemic” of both diseases that puts a stress on hospitals and health providers. Public health officials in Indiana are urging Hoosiers to get their flu shots. Already, some hospitals are reporting that they are filled up or nearing capacity due to cases of COVID-19.

Dr. Virginia Caine, director of the Marion County Public Health Department, predicted that central Indiana could get a “double whammy” with the flu and COVID-19.

“We may have more hospitalizations—filling up our hospitals that’s already occurring in some of the hospitals here in the state of Indiana,” she told IBJ. “Some were filled to capacity back in April and May with just only the COVID-19. It is scary. How many cases we could see with influenza, overwhelming hospital systems? It’s going to require almost double the amount of personal protective equipment. The very last thing, from a staffing standpoint, do we have enough staff to handle this increased load that we’re expecting from the flu? So, there are so many issues that are related to this, that we need to turn the corner, we need to turn the corner really quickly.”

Flu season typically runs from October through spring, with a spike in cases in the winter months of December, January and February. As of October, the state had reported just 63 flu cases reported from hospitals and clinics. But officials say the numbers could rear up if Hoosiers don’t get vaccinated.

And that’s a challenge even in good years: Indiana ranks 38^th among states for flu vaccination rates over the past three years, at just 45.2% of the general population aged six months and older, according to analysis by insurance consultant AdvisorSmith, using figures from the U.S. Center for Disease Control and Prevention. The CDC recommends that “everyone 5 months and older should get a flu vaccine every season with rare exceptions.”

This year is an even bigger challenge, as many workplaces that typically offer flu shots in the office or shop are virtually empty, due to the pandemic that has sent tens of thousands of Hoosiers to work from home.

Getting both diseases is a nightmare scenario for health officials.

“You can be infected with influenza and COVID-19, which would just be disastrous, because they’re both respiratory diseases,” said Thomas Duszynski, a former epidemiologist for the state health department and now director of epidemiology education at the Fairbanks School of Public Health at IUPUI. “So your outcome would be very poor if that were to occur.”

William Schaffner, medical director of the National Foundation for Infectious Diseases, said last month at a press briefing: “This is going to be a diagnostic area of confusion this entire winter season, what with these two viruses and other respiratory viruses that are out there.”

In September, the CDC issued preliminary estimates from the 2019–2020 flu season showing 38 million illnesses, 18 million medical visits, 400,000 hospitalizations, and 22,000 flu deaths, including 189 children, according to Axios.com.

The states with the highest flu vaccination rates are Rhode Island (57.1%), Massachusetts (56.4%), Maryland (54.7%), Connecticut (54.6%) and Virginia (53.9%).

The states with the lowest flu vaccination rates are Florida (40.3%), Nevada (40.4%), Wyoming (41.1%), Louisiana (41.5%) and Idaho (41.8%).