Normally when there’s a B.C. election campaign underway, Adrian Dix spends tons of time knocking on doors. But this is not a normal time. And Dix, the health minister, has type 1 diabetes, which makes him far more susceptible to complications should he contract COVID-19.
“I am in…a high-vulnerability group, you know, with a chronic disease,” Dix recently told the Straight by phone. “I used to be younger as well.”
As a result, the 56-year-old politician is doing almost all of his campaigning by telephone as he seeks reelection in Vancouver-Kingsway.
But he’s also paying close attention to another matter of great concern: the overlapping of the coming flu season with the COVID-19 pandemic.
“We put together a plan months ago to try and deal with the situation, but it is a mammoth challenge,” Dix conceded. “It’s a pandemic around the world, and I think the biggest mistake one can make in these things is to be in any way smug about our previous successes.”
According to Dix, the number of respiratory illnesses in B.C. could climb sharply as soon as next month, putting additional pressure on hospitals already treating people with the novel coronavirus.
“There are things we know and there are things we don’t know,” Dix said. “We’ve never had a November with COVID-19. We’ve never had a December with COVID-19.”
He described the confluence of seasonal flu and COVID-19 as a “known unknown”.
In addition, there are other considerations, including more time spent inside buildings at this time of the year rather than outside, in the fresh air.
“There’s a reason why, when you have more indoor activities, influenza spreads,” Dix said.
At the same time, there is encouraging news from Australia, which has already endured a winter with COVID-19 and the flu. Dr. Ran Goldman, a professor in the UBC faculty of medicine’s department of pediatrics, told the Straight by phone that the recent flu season Down Under was relatively mild.
One reason is that Aussies were washing their hands more frequently this year and wearing masks in public. Goldman also noted that physical distancing, which has become de rigeur in the COVID era, helps reduce transmission of the seasonal flu.
“So, in general, it looks like there’s a good potential that influenza isn’t going to be as severe as in other years,” Goldman said.
Vaccine demand remains high
In addition, people can be immunized against the seasonal flu, which isn’t the case for COVID-19. He described flu vaccines as “safe and effective”.
“In our research in 17 emergency departments in six countries—led by UBC—we found that there’s a significant increase in the number of parents who planned to give the influenza vaccine to their children this year,” Goldman said. “We found that it’s correlated to their concern about COVID-19.”
At the same time, Goldman remains concerned about the B.C. health-care system’s capacity to deal with the seasonal flu and COVID-19 simultaneously.
He pointed out that it will be “really hard” for some people to differentiate whether they have the flu or COVID-19 because they share similar symptoms. One difference is that the flu tends to come on very quickly, whereas there’s a more gradual onset of symptoms with COVID-19.
Any confusion that may exist over self-diagnoses is another reason why he’s an ardent proponent of flu vaccinations and maintaining public-health measures to contain COVID-19.
“We can’t trust luck,” the UBC professor cautioned. “We have to be active to make sure we don’t see an uptick in influenza illnesses nowadays, as well as COVID.”
Like Goldman, Dix is optimistic that physical distancing and more frequent handwashing will curtail the number of seasonal flu cases. But to improve the odds, the provincial government approved hiring 608 more contact tracers in the summer, essentially doubling their numbers.
“That will be key as we deal with the pressures of November and December and January on COVID-19,” Dix said. “I think that’s something the other jurisdictions in Canada are wishing they had done.”
In addition, the province placed orders for two million seasonal flu vaccine doses in April and May, up from the norm of 1.4 million.
When asked if these vaccines will reach the public in time for seasonal flu season, Dix replied: “I think so.”
Pharmacists face higher risks
The B.C. pharmacy operations manager for London Drugs, Shawn Sangha, told the Straight by phone that he’s already seen very high demand for the flu vaccine as the company is obtaining consent forms and conducting online prescreening.
When he was reached on October 9, vaccines had just arrived in some stores in Vancouver, the Okanagan, and on Vancouver Island. But for pharmacists, it’s also more complicated than in past years because people receiving immunizations need to maintain physical distance from other customers.
“We can’t have huge lineups or big groups of people getting vaccinated at the same time,” Sangha said.
Secondly, London Drugs must ensure that there’s sufficient personal protective equipment—including masks, shields, gowns, and gloves—for the staff who administer vaccinations.
“Then the other factor is once that patient leaves, we have to clean down the room, disinfect it,” he added.
In September, the Lancet reported that physical distancing and hygiene protocols are stemming the spread of COVID-19. However, other factors, including altered infection-testing priorities and the behaviour of the public during the pandemic, also need to be considered.
“We need to bear in mind that the measures we’re putting in place to control COVID-19 may have some benefits for the flu as well, but with the resurgence of COVID-19 there may also be a double epidemic of flu and COVID-19 during the [northern hemisphere] winter,” WHO official Richard Pebody told the medical journal. “All that we can do about it is to be ready and prepared with a range of measures we’ve got in our community ammunition box.”