With some encouraging signs California’s summer COVID-19 surge may have peaked, health officials fear a more familiar contagion could further torment a state already reeling from the devastating pandemic: the flu.
Health and Human Services Agency Secretary Dr. Mark Ghaly on Tuesday urged Californians to make sure they get vaccinated this fall against influenza, saying a bad outbreak could only worsen the stress on hospitals already stretched by COVID-19.
“This year, getting your flu vaccine is especially important,” Ghaly said. “Outbreaks of flu and COVID together will certainly cause strain on already scarce health resources.”
California reported 4,636 new COVID-19 cases Tuesday after averaging more than 8,000 daily cases over the last two weeks, bringing the total to a tops-in-the-nation 632,667. Hospitalizations, which dipped below 5,000 over the weekend for the first time since June, climbed to 5,061 Tuesday with 86 new cases. The state saw 100 new deaths from the disease, below the average in recent weeks, bringing the total to 11,342.
The biggest reason for the dropoff: Ghaly said cases have declined in Los Angeles County and other hard-hit areas of Southern California.
Two counties — Santa Cruz and San Diego — have been taken off the state’s monitoring list for troubling coronavirus outbreaks, but others have been added, bringing the total to 41 of the state’s 58 counties.
But Ghaly said the newer counties are less-populated and the overall picture for the state is not getting worse.
“We don’t feel like we are moving in wrong direction,” Ghaly said. “We feel overall the state picture is stabilizing.”
And he said he is confident the state has corrected data problems with its case reporting and testing data system, CalREDIE, and making progress toward a replacement.
But flu season is a looming concern, one shared by doctors throughout the state. Ghaly said the state is “working with health care providers to increase sites where the vaccine is available.”
“Dr. Ghaly is 1,000% correct we should try to diminish influenza morbidity as much as possible,” said University of California-San Francisco epidemiologist Dr. George Rutherford, dreading the possibility of flu patients crowding into intensive care patients full of COVID-19 cases. “The reason is to not have our ICUs swamped with flu patients.”
Rutherford said it’s not clear yet from the experience in the Southern Hemisphere whether the flu is milder or being tempered by more vigilant physical distancing, mask wearing and hygiene practices to avoid COVID-19.
The U.S. Centers for Disease Control and Prevention estimates based on the 2017-18 season that anywhere from 9.3 million to 45 million Americans get sick with influenza each year, 140,000 to 810,000 are hospitalized and 12,000 to 61,000 die.
Nationally, nearly 5.5 million Americans have tested positive for coronavirus and 163,595 have died of COVID-19, according to the COVID Tracking Project.
Ghaly said data for the 2017-18 flu season indicates about 5.6 million Californians were infected, 100,000 hospitalized and 7,500 killed by influenza.
“Flu is not to be taken lightly, and together flu and COVID-19 create a doubly risky situation.” Ghaly said. He added that unlike COVID-19, where children account for about 10% of cases in California but only a fraction of hospitalizations and no fatalities, influenza “has notoriously had a grave impact on our youngest.”
“But unlike COVID-19,” Ghaly said, “we also have a flu vaccine.”
Dr. James D. Cherry, a professor of pediatric infectious diseases at the University of California-Los Angeles’ Mattel Children’s Hospital, said Tuesday that indications from the Southern Hemisphere and Asia suggest this year’s vaccine should be a decent match and there aren’t any particularly virulent flu strains headed our way.
“Even if it’s 50% effective, that’s tremendous,” Cherry said. “Instead of 100 cases there would be 50 cases.”
Rutherford said there’s no reason for people to fear COVID-19 exposure from going to get a flu shot.
“They will be all set up for it and they don’t want to get COVID any more than you want to get COVID and they are at much higher risk,” Rutherford said.
Apart from influenza, what other plagues might menace us? Well, it turns out that plague — that’s right, the great Black Death of medieval Europe — also made a return to California on Tuesday.
El Dorado County health officials said a South Lake Tahoe resident tested positive for plague, California’s first case in five years of the infectious bacterial disease typically transmitted by fleas and treatable with antibiotics. They believe the infected person, now recovering at home, was bitten by a plague-infected flea while taking a dog on a walk.
Ghaly said he was made aware of the case.
“Any time you have a human case which we haven’t had in a number of years, our vigilance goes up,” Ghaly said. That said, it’s not his biggest concern at the moment.
“As I say to my patients, I’ll tell you when I’m worried,” Ghaly said, “so you can worry with me.”
