1/8 It's July 4th weekend

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

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've always had to keep our eye on the rate of influenza among people with ILI...

...going forward we'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??