This document discusses considerations for flu season during the COVID-19 pandemic. It provides information on CME credit for physicians attending webinars on this topic. It then compares the symptoms of influenza and COVID-19. It reviews current COVID-19 case and death counts in the US and past influenza activity. It discusses antiviral and vaccine options for influenza and COVID-19. It also provides updates on COVID-19 reinfections and impacts on schools and the economy. Resources on influenza, COVID-19, and both from CDC, WHO and others are listed. The remainder discusses CHC's flu committee and subcommittee planning for the upcoming flu season, including supplies, staff vaccination, and patient volume comparisons from prior seasons. Leadership

1. Flu Considerations During COVID-19
August 26, 2020

2. CME Credit
• Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State
Medical Society to sponsor continuing medical education for physicians. The
Bridgeport Hospital Yale New Haven Health designates this live activity for a
maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only
credits commensurate with the extent of their participation in the various
activities.
• This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and
the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited
by the Connecticut State Medical Society to provide continuing medical education
for physicians.
• The content of this activity is not related to products or services of an ACCME-
defined commercial interest; therefore, no one in control of content has a relevant
financial relationship to disclose and there is no potential for conflicts of interest.
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3. Flu Considerations During COVID-19
https://jamanetwork.com/

4. Department of Medical Microbiology, Edinburgh University
“There will be droplets”
http://www.3dscience.com/Resou
es/Influenza_Virus.php
www.newscientist.com/t
erm/coronavirus/

5. Two viruses – double trouble?
• SARS-CoV-2
– Fevers/Chills
– Cough, ST
– HA, myalgias
– N/V/D
– Anosmia, taste
– Slower onset
• INFLUENZA
– Fevers
– Cough, ST
– HA, myalgias
– N/V/D
– Rapid onset

6. COVID-19 in the United States
5,746,940 cases on 8/25/20 up from 5,481,795 cases on 8/18/20
177,536 deaths https://coronavirus.jhu.edu/map.html

7. Influenza Activity Feb 29, 2020
https://www.cdc.gov/flu/weekly/usmap.htm

8. Influenza burden of disease 2019-2020
• https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm

9. Antivirals and Vaccines
SARS-CoV-2
– Remdesivir
– Plasma
– No vaccine (yet)
INFLUENZA
• Oseltamivir
• Baloxavir
• Vaccines
• High dose
• Adjuvenated

10. COVID-19 News updates
• Reinfections?
– 33 yo M Hong Kong -first confirmed reinfection with
SARS-CoV-2
• Different strain
• Mild disease first time; ‘asymptomatic’ 2nd time
“natural infection created immunity that prevented disease but not
reinfection”
– Netherlands: older pt with a weakened immune
system
– Belgian woman -only mild symptoms in March;
reinfected in June

11. News updates
• South Korea -closing schools in Seoul
– 280 new cases on Tuesday, the 12th-straight day
of triple-digit daily increases in virus infections
• Jobs and the economy:
– American Airlines – to furlough 19,000 employees
this Fall when Federal aid restrictions end Oct 1.
• The total number of employees cut -40,000

12. Resources
• Nuvance health 1000+ articles reviewed:
https://spark.adobe.com/page/qrH7iY0Gi0hU9/
• CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• Johns Hopkins:
https://coronavirus.jhu.edu/map.html
• Others
https://www.thelancet.com/coronavirus
https://covidactnow.org/

13. Flu Considerations
During COVID-19
Mary Blankson, DNP, APRN, FNP-C; Chief Nursing Officer,
Community Health Center, Inc.
Natalie Bycenski, RN, MSN; Nurse Manager, Chair of the
Infection Control Committee, Community Health Center, Inc.
Lucy Golding, RN, MSN; Nurse Manager, Chair of the Flu
Subcommittee of the Infection Control Committee,
Community Health Center, Inc.

14. Flu Season
• Timing and duration (can vary)
• Increase in October
• Cases can continue through end of May
• CDC statement on:
– Who should receive
– When to receive vaccine
– Who needs 2 doses
– Types of flu vaccines
• Flu + COVID ? Concerns and CDC Guidance
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15. Flu Committee
• Subcommittee of the Infection Control
Committee
• Planning tool
– Clinical Preparation
• Standing Orders
– Marketing
– Supply
– PPE
– Location
– Staff Vaccination
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16. 16
20,180
32,229
17,243
60,381
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
19-'20 Received 20-'21 Eligible
CHC Flu Season Patients
’19-’20 Received vs ‘20-’21 Eligible
Age 6mo-18 years Age 19+ years
Total: 37,423 patients received
Total: 92,610 patients eligible

17. Leadership Perspective
• Ingredients for success
– Data review
– Advanced planning
– Flexibility (aka ongoing performance
improvement)
– Ongoing communication
– Optimism and grit
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18. 18 * This initiative is supported by 18

19. Thank You!
www.weitzmaninstitute.org/coronavirus
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