1/8 It& #39;s July 4th weekend https://abs.twimg.com/emoji/v2/... draggable="false" alt="🇺🇸" title="Flagge der Vereinigten Staaten" aria-label="Emoji: Flagge der Vereinigten Staaten">

I just rewrote a textbook chapter on influenza. The textbook will likely come out in January 2021.

How will the COVID pandemic affect the diagnosis and management of influenza in January 2021?

I have some thoughts, but in reality...

2/8 The CDC has guidance that we should prioritize influenza vaccination for essential workers and people who are at risk from complications of influenza or COVID.

https://www.cdc.gov/vaccines/pandemic-guidance/index.html">https://www.cdc.gov/vaccines/...

3/8 When I teach about the flu, I always ask what the SINGLE most important piece of information is.

4/8 The single most important piece of information is the prevalence of influenza among patients with influenza-like illness (ILI).

In the winter it can range from < 5% to over 30%. Here it is for the 2019-2020 season (y axis label on the right).

5/8 A COVID corollary: right now the rate of COVID test positivity in the US is about 7%.

Of course, some people tested are asymptomatic, but this is helpful to know.

Consider someone with ILI in Vermont (0.5% positive rate) versus Arizona (25% positive).

6/8 So what happens when you layer influenza on top of COVID?

The novelty, paranoia, treatments, and prognosis might be different, but the diagnostic approach is the same.

[Prevention is the same as well (distancing, masks, hand-washing).]

7/8 So, just like we& #39;ve always had to keep our eye on the rate of influenza among people with ILI...

...going forward we& #39;re going to have to keep our eyes on the rate of influenza AND COVID among people with ILI this fall and winter.

8/8 What other thoughts or questions do you have about dealing with influenza and COVID simultaneously??