UIHC warns of severe flu season, further straining already stretched thin health systems

Influenza vaccine is seen in its packaging at a flu shot clinic for employees and volunteers at Mercy Medical Center in Cedar Rapids on Tuesday, Oct. 8, 2019. The hospital mandates flu vaccines for its employees and volunteers and provides them free of charge. (Rebecca F. Miller/The Gazette)

University of Iowa Health Care Chief Medical Officer Dr. Theresa Brennan. (Photo courtesy of UIHC)

IOWA CITY — University of Iowa Health Care has spotted an alarming spike in new influenza cases in recent weeks, establishing a real possibility that hospitals statewide will be grappling with a “twindemic” of widespread flu and COVID-19 cases this winter.

UIHC has begun to see a rapid increase in influenza cases, rising from just one laboratory-confirmed case two weeks ago to over 150 cases between Nov. 16 and Saturday, UIHC chief medical officer Dr. Theresa Brennan told reporters Monday.

The health care system’s announcement follows a warning the federal Centers for Disease Control and Prevention had issued to Americans earlier this fall that the country could be in for an “early and possibly severe flu season” this year.

And with a low flu vaccination rate among Iowans ahead of this week’s Thanksgiving celebrations, Brennan warned an elevated level of influenza cases — coupled with the ongoing surge of COVID-19 infections — “could really impact our community and our health care resources.”

“Our health care system is already strained,” Brennan said.

Brennan urged Iowans to take precautions this week, including getting their flu shot, which is recommended for everyone aged 6 months and older. In addition to getting the vaccine, mitigation strategies include masking, washing hands frequently and staying home when experiencing symptoms. Individuals should also consider taking an at-home COVID-19 test ahead of time to rule out the possibility they may be infected.

“Do everything you can to keep it safe,” Brennan said. “I know everyone wants to see their family and friends. It’s been a long time, but we also want to make sure people are around next year to do the same.”

Iowa’s first influenza-related death in the current flu season was earlier this month, state public health officials said, when a woman aged 81 or older from Central Iowa who had underlying health conditions succumbed as a result of the virus.

No pediatric flu deaths have been reported yet this season in Iowa.

About 22 percent of the state’s population — or about 701,000 individuals — have received the vaccine this flu season, which started in October, according to the latest data from the Iowa Department of Public Health.

That won’t be enough to offset any spread, now that the respiratory virus is widespread in the community, Brennan said. Ideally, the vaccination rate should be at least 70 to 80 percent to reach herd immunity.

In addition to potentially seeing increased hospitalizations, officials with the state’s largest hospital are worried about the strain on its health care workforce, which already has grappled with pandemic response for more than a year and a half.

“If influenza is in the community, a certain percentage of our workers will get influenza in the community,” Brennan said. “ … So when that happens, that takes out of place some of our nurses or doctors or therapists or technicians. It can really hamper our ability to take care of patients.”

Local health care officials reported a similar pattern this past spring and summer in an unusually high occurrence of common respiratory viruses, including respiratory syncytial virus or RSV.

UIHC’s news conference came as the state continues to experience a surge in new coronavirus cases, reaching seven-day positivity rates not seen in months.

COVID-19 immunization rates have lagged in Iowa, with nearly 57 percent of Iowans aged 5 and older and 53 percent of the entire state’s population is fully vaccinated against the coronavirus as of this past week.

UIHC had 22 adult patients with COVID-19 on Sunday, hospital data shows.

Last year’s flu activity — or rather, lack of — highlights that the spread of respiratory viruses is dependent on the community. The widespread use of face masks, social distancing and other COVID-19 mitigation practices resulted in dramatically low influenza activity during the 2020-21 flu season, experts say.

Despite high levels of testing nationwide, only abut 2,000 influenza cases were detected by clinical labs across the nation from Sept. 28, 2020, to May 22, 2021, according to the CDC. That’s a significant drop from previous years, when somewhere between 20 to 40 million Americans got sick with the flu, according to CDC data.

That lead to an all-time low in influenza-related hospitalizations and deaths.

The CDC received only one report of a pediatric flu death during the past season. By comparison, the lowest number reported since federal officials began tracking flu deaths in children was 37 and that was during the 2011-12 season.

This year’s flu vaccines are quadrivalent, meaning they contain components to protect individuals from four different flu viruses, the CDC says.

Certain individuals, including pregnant women, older adults, young children and those with compromised immune symptoms are most vulnerable to becoming seriously ill from influenza. Symptoms include fever, headache, tiredness, cough, sore throat, nasal congestion and muscle aches.

In children, emergency warning signs that need urgent medical attention include trouble breathing, not waking up or not interacting, and flu-like symptoms that improve, but then return with a fever and a worse cough.

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