Two epidemics this season?

As the U.S. enters its annual flu season, public health officials are bracing for the possibility the country may have to contend with two epidemics this fall.

The 2019-2020 flu season had ended by the time the U.S. was engulfed by COVID-19 earlier in the year. Health officials are not counting on being lucky again. North Carolina’s state health director Elizabeth Tilson, also co-chair of the state’s coronavirus task force, has been working with health systems to develop plans for increasing surge capacity by converting unused facilities, procuring extra beds, or hiring extra staff.

“Thankfully, we haven’t had to pull the trigger on any of our emergency med surge plans. But we have all those plans in place, whether it be COVID-19 or COVID-19 and flu,” she commented to Scientific American.

Even without other threats, the annual flu season is a formidable adversary, causing between 12,000 - 61,000 deaths annually and between 140,000 – 810,000 hospitalizations, according to the Centers for Disease Control and Prevention. But despite ongoing appeals by public health authorities, the percentage of adults vaccinating against the flu has hovered around 45% for the last 10 years.

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Perhaps surprisingly, given the gloom and doom over COVID-19, employers are not making a particularly strong push to encourage their employees to take flu shots. A recent survey by Mercer LLC found that only 62% of employers responding are emphasizing the importance of flu shots this year, and 60% of employers will pay all costs for flu shots at provider’s office, pharmacy, or other offsite location.

While public health officials fear another surge of COVID-19 infections in the colder months, there are some indications preventive measures against the pandemic may ward off the flu. As has been widely reported, flu all but disappeared this year in several countries in the Southern Hemisphere. Science notes Australia reported 33 documented cases of the flu this year, compared to 9,933 in 2019. Chile reported 12 cases, compared to 5,007 last year. Argentina and South Africa also reported dramatically smaller numbers of flu cases.

Employers who may be motivated to make vaccinations mandatory for their employees should consider that the requirement may be difficult to enforce unless the vaccinations are job- related, as is the case in hospitals. Regardless, employers must be mindful of workers who decline vaccinations for medical reasons or sincerely held religious beliefs since such refusals are covered under Title VII of the Civil Rights Act and the Americans with Disabilities Act.

The CDC says flu vaccinations will be particularly important this year because they can help reduce the overall impact of respiratory illnesses and lessen the burden on the healthcare system during the ongoing pandemic. The agency adds vaccine manufacturers expect to ship a record number of doses this year.