Flu hospitalizations trend down nationwide as COVID-19 continues to overwhelm hospitals

Health care workers process patients at a new COVID-19 testing site in the parking lot of Rice-Eccles Stadium in Salt Lake City on Monday, Oct. 12, 2020. The testing site is open Monday through Friday, 8 a.m. to 4 p.m., and Saturday and Sunday, 8 a.m. to noon. Appointments are required.

(Scott G Winterton, KSL)


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SALT LAKE CITY — As COVID-19 cases continue to overwhelm health care systems nationwide, with Utah's current hospitalizations hitting 389 as of Thursday, flu cases have been reportedly low across the nation.

There are no patients currently hospitalized in the Beehive State with the flu, according to the most recent Utah Department of Health data from Oct. 24, and seasonal influenza activity across the U.S. remains low, according to the Centers for Disease Control and Prevention.

"If somebody has signs and symptoms of COVID-19 and they test negative, in my mind, that's still COVID-19," Intermountain Healthcare Dr. Eddie Stenehjem said in a recent Q&A.

Respiratory virus surveillance across Utah within the Intermountain Healthcare system has shown there aren't any other viral respiratory pathogens — like influenza and rhinovirus — widely circulating, Stenehjem said.

"So if somebody has a viral respiratory illness with fever, cough and myalgia and things like that, that's COVID, regardless of what your test says because there's nothing else circulating," he said.

Stenehjem further explained that testing accuracy can vary depending on what type of test is administered and when the test is completed. Typically, tests are most accurate when the person has the highest viral burden in their upper respiratory tract which will be two days before and after symptom onset, he said. It's possible if a person is tested seven days after getting symptoms their test could come back negative since the viral load is lower.

The coronavirus is novel and experts are still trying to find the best treatments available and develop a vaccine, Stenehjem noted.

However, the influenza virus is not new and treatment plans and vaccinations are widely available — meaning it's important for doctors to know which one people have in order to treat patients with the best care.

That's why Rebecca Ward, health educator with UDOH, says it's important to get tested for COVID-19 if you have any symptoms.

"Very few people, if anybody, has any immunity to (COVID-19) and in order to continue our efforts toward mitigating this pandemic, we need to know, we need to test we want people to be tested for COVID if they have symptoms," she said. "We want to know if it's flu versus COVID, so that we can take the appropriate steps."

Whether or not anybody is immune from the novel coronavirus remains to be seen, according to Stenehjem. Repeat infections are common with most seasonal respiratory coronaviruses, he added.

"The issue with coronaviruses is you can get repeat infections," he said. "So, herd immunity by having everybody get this infection, with SARS-CoV-2, knowing that you can get it again, is not a logical way to move forward."

So-called herd immunity would mean everybody would get COVID-19 and later still be at risk to get it again in a year or two, Stenehjem explained.

"We just don't know enough about the immunology of this virus to just say how long are you protected and are you at all protected," he noted.

Intermountain Medical Center has already seen COVID-19 reinfection cases at the facility, Stenehjem said.

In June, the hospital saw a positive asymptomatic patient who later tested positive for COVID-19 again and this time was hospitalized with the disease.

"That herd immunity approach is not one we even need to be considering right now in Utah," Stenehjem said.

Flu testing in the Intermountain healthcare network increased by 450% in October compared to October of last year, according to Stenehjem.

"Are we looking for it? Yeah, absolutely we're looking for it," he said. "It's really a hot issue right now and one that we're monitoring aggressively."

Intermountain is tracking viral testing results on a daily basis and sending the data to caregivers weekly, Stenehjem said.

Once flu cases are found in a community, Stenehjem said care centers will know to routinely check symptomatic patients for influenza.

"We have set up a system … for them to know when we start seeing influenza in our community and that's going to be a trigger for them to say 'OK, in the community, I need to either be testing for flu or treating empirically for flu.'"

Flu season usually runs from October through May and for months health officials have pleaded with the public to follow public health guidelines and get a flu shot. As Utah continues to shatter records for hospitalizations and new cases, that plea has turned more desperate.

"We still want people to know that the (influenza) vaccine is available and to get vaccinated if they're not acutely ill," Ward said.

The Salt Lake County Health Department offers free flu shots while supplies last Monday-Friday.

More information about the free influenza vaccinations is available here.

With Utah hospitals already close to being completely overwhelmed, Ward said it's possible flu-hospitalizations could put an even greater toll on the system.

"We deal with many different types of infectious diseases," Ward said. "Influenza can be deadly. COVID can be deadly. Either one can cause severe hospitalization and even death."

While no vaccine is 100% perfect, Ward said a flu shot does decrease the likelihood of a person getting seriously ill if they catch the flu and makes it less likely they will be hospitalized.

On Thursday, a record-breaking 2,807 new COVID-19 cases was reported in Utah along with seven new deaths.

Since the pandemic began, Utah has seen a total of 5,830 coronavirus hospitalizations with the total number of confirmed cases at 124,292 with 89,837 considered recovered.

"We are going to continue to have increased (COVID-19) hospitalizations," Stenehjem said. "It's at pace to be an unsustainable rate for us to handle all these cases."

Of the 389 currently hospitalized COVID-19 patients, 158 are in the intensive care unit. Stenehjem noted that the load on hospitals is directly because of COVID-19 patients — not delayed care from previous temporary closures. He also said if numbers continue to increase, it's possible another pause on non-urgent surgeries could be necessary.

"That day is coming for us to have to do that again to be able to accommodate the patients," he said. "Many people have surgery, then stay overnight in the hospital. Well, that takes up a bed and that bed is potentially going to need to be used for a COVID-19 patient."

When looking at occupancy in hospitals and intensive care units, Stenehjem said Intermountain is at about 130% occupancy right now when compared to this time last year, with non-COVID cases down about 80%.

In a new Q&A released Thursday, Stenehjem said the numbers are taking a toll on Utah's health care workers.

"Our nurses, our doctors, everybody is tired. They're exhausted, they're mentally and physically spent and there's no end in sight."

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Lauren Bennett is a reporter with KSL.com who covers Utah’s religious community and the growing tech sector in the Beehive State.

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