Approaching flu season could overwhelm health care systems

COVID-19, respiratory viruses also on the rise


In 2020, talk of flu season was overshadowed by the rapid rise of COVID-19 and cases were low. In 2021, the story surrounding flu season will be different altogether.

With a third wave of COVID-19 beginning to surge in Arizona and across the U.S., largely among the unvaccinated, health experts warn that this year’s influenza won’t be tamped down the way it was last year.

“I think certainly nationally and locally in Arizona that we’re going to see a more significant flu season than what we did last year. Last year was really an anomaly,” said Joan Ivaska, senior director of infection prevention at Phoenix-based Banner Health. “We had a lot of restrictions in place to control COVID And that really suppressed flu activity.”

A typical severe flu season will see about 60,000 influenza- related deaths. Last year, Ivaska said Banner Health facilities across multiple states saw little-to-no flu activity or hospitalizations.

Now, with kids back in school, businesses fully open and mask requirements a thing of the past, infectious diseases are once again on the rise. Ivaska said there’s already been an increase in respiratory syncytial viruses, or RSV.

While flu activity and pediatric deaths were extremely low last year, Ivaska said “we’re anticipating a pretty significant flu season potentially” in 2021. 

Experts like Ivaska say vaccinations — for both COVID and the flu — will be critical this year, as will continued prevention efforts such as hand washing, staying home when sick and the use of masks, especially when in large indoor spaces. Ivaska does not anticipate there being a shortage of flu vaccines this year and they are proven to be effective at preventing serious illness or hospitalizations, so everyone who wants one should get one.

With RSV, COVID and the flu hitting all at once, there is a concern that health care systems, already bogged down by a long and exhausting pandemic, will be even further burdened this fall.

“I think certainly we’re concerned about the burden on the health care system being able to take care of that volume of patients all at the same time,” said Ivaska. “When the hospital systems get overwhelmed like we have seen before, we don’t have beds available to do regular care that needs to happen as well. So not only are people impacted with COVID, but people that need other types of care can really have adverse outcomes as well because the health systems have been overwhelmed, so it can really impact our communities really in a widespread way.”

Dr. William Ellert, chief medical officer for Abrazo Health, echoed Ivaska’s concerns, but said that preventing the flu and preventing COVID go hand-in-hand.

“As the flu season approaches, the severity of the season will continue to be directly related to our success in achieving community compliance with the flu vaccination, continued rigorous hand hygiene, and staying at home when symptomatic,” he said in a statement. “Many of the behaviors that we learned with COVID-19 are applicable to protecting our community against the flu. We anticipate that there will be an overlap of COVID-19 and flu this season. Encouraging vaccinations for both COVID and the flu, as well as proper community precautions including what we learned with this pandemic, will help keep us safe from both infectious diseases.”

Arizona reported approximately 2,286 new coronavirus cases and seven additional deaths on Wednesday. The state’s percent positivity rate, or the number of COVID tests returning positive is 9.7%. It was close to 4% a short while ago. ICU hospitalizations are nearing 20%. 

“We’re going in the wrong direction,” said Dr. Frank LoVecchio, a Valleywise Health Hospital emergency room physician, who added the same could be said for the upcoming flu season, which is set to begin around October and conclude in March. “I think it’s a good thing to remember that flu cases being down were most likely related to people doing things that they’re supposed to do, which is wash their hands, stay home when sick, wearing masks,” he said. “Obviously, the opposite is going to occur now that we’ve loosened up regulations.”

Dr. LoVecchio said he is personally not allowed to work at his hospital without a flu shot and sees it as a simple fix to avoid an unnecessary problem. Hospital staffers are gearing up for another long road as flu season approaches and COVID is on the rise.

“There’s a shortage of nurses and a shortage of critical care nurses for a number of reasons,” he said. “Many of them are tired and burnt out, some have retired. COVID has beat a lot of people up.”

Dr. LoVecchio said it is not a question of ‘if’ when it comes to a more severe flu season.

“It’s going to happen, it’s just a question of how severe,” he said.