The next flu season can exacerbate the pandemic. Is Canada Ready?

“The virus attack on our country next winter could be even more difficult than the attack we just made,” warned CDC Director Robert Redfield this week.

The success of this year’s influenza vaccination campaign will be important to Canada’s ability to control the novel coronavirus for three reasons. It is the hospital’s capacity, comorbidities (both conditions can occur at the same time and their effects can be exacerbated), and the supply of COVID test kits is limited.

Need to plan ahead

CBC news suggests that if (possibly) countries have global scrambling similar to what is currently seen, as nations are competing for scarce medical supplies during the next wave of flu, it catches a nap I asked Health Canada what I am doing this year to get rid of it.

The CBC also asked if the Government of Canada would launch a more aggressive vaccination campaign than usual.

“The Canadian Public Health Department is predicting a simultaneous influenza and COVID-19 infection in Canada this fall,” spokesman Geoffroy Legault-Thivierge told CBC News.

“To minimize the challenges this can pose to the healthcare system, the 2020 influenza campaign will place particular emphasis on high-risk populations, such as the elderly and those with compromised immune systems or underlying illnesses. to place.”

The goal of annual vaccination promotion is usually to reach 80% vaccination coverage in vulnerable populations, such as those over the age of 65. Over the past three years, this rate has fluctuated It is between about 65% and 71%.

However, the immunization rate for people aged 18 to 64 is much lower. Normally, only about a quarter of the people in that population are vaccinated against influenza. Less than half of people with chronic illness are vaccinated.

“Double whammy”

The flu season is usually the busiest time in Canadian hospitals. To some extent, Canadian hospitals are designed to handle that seasonal surge.

However, according to virologist Jason Kindrachuk of the University of Manitoba, the second wave of COVID-19 could lead to system disruption during the flu season.

“You have an overwhelming medical professional problem,” he said. “The risk groups that are likely to be hit very hard with COVID-19 are at high burden of severe influenza illness. This includes people over the age of 65 and people with chronic respiratory illness. However, the children also participate in the play. “

Little is known about how the two diseases interact, but we know that both COVID-19 and seasonal flu can occur at the same time. Both diseases attack the respiratory system and both develop fever. Some infectious disease specialists, such as Dr. Greg Poland of Mayo Clinic, Minnesota, have warned that having both conditions at the same time can have a “double whammy” effect.

Kindrachuk said there are few apparent side effects of the flu season that could undermine efforts to control the COVID-19 pandemic. As a result of the fact that people with the flu can assume that they have COVID-19 and waste a large amount of COVID test kits.

“At least in the early stages, there are two diseases that are quite similar,” he said. “When someone has flu-like symptoms, one of the things we can do is rule out the possibility of flu.”

But Mr Kindrachuk said doctors’ ability to get rid of the flu depends primarily on patients who have been vaccinated against the flu. It also depends on whether the influenza vaccine is suitable for the influenza strains that are prevalent at the time.

“Flu is a beast”

The virus that causes COVID-19, SARS-CoV-2, appears to be more deadly than most influenza strains, but coronaviruses are relentlessly deficient in the ability of influenza to constantly mutate.

“The flu is a beast,” said Kindrachuk. “We know that influenza changes frequently each year.

“Because we have multiple circulating strains, we’re trying to get a universal influenza vaccine that delivers nearly 100% efficacy in coverage. It’s all virologists doing infectious disease research of all kinds. But we’re not there yet. “

The annual influenza vaccine design is the result of a global effort. First, the World Health Organization collects data from influenza centers in over 100 countries. The data will then be analyzed at five virology centers (Atlanta, London, Tokyo, Beijing, Melbourne, Australia) to propose a vaccine consisting of 3 or 4 strains of influenza A and B.

Last year’s vaccine was a mixture of strains first detected in Kansas, CO, Brisbane, Australia, and Phuket, Thailand.

It costs money to start early

Canadians usually don’t see the flu vaccine from fall to mid-autumn, but preparations start much earlier, Kindrachuk said.

“Being in the Southern Hemisphere, this is their winter season, so I start to get ideas from Australia during the summer,” he said. “At that time, there is a tendency to see signs of what the flu season is like.

“The problem is that it’s all predictive, so certain flu strains that might hit Australia quite a bit may not be what we hit, and here in North America last year I saw it when there was overexpression B. ”

Private companies that produce influenza vaccines need a lot of time to grow them. The process usually involves injecting it into chicken eggs, breeding it, then extracting and processing.

“It takes at least 6 months to produce a large amount of influenza vaccine.” Say the CDC document on the problem. “In order for the vaccine to be delivered in time for vaccination to begin in the fall, manufacturers will be basing their January guesses on their best guess of which viruses are most likely to be included in the vaccine. It may start multiplying one or more vaccine viruses. “

Sometimes their best guess is very good. Sometimes not. Doing it right this year will be especially important.

Shortage risk

Last winter in Canada, Lack of full mist, Nasal spray influenza vaccine for people who have a bad reaction to injections.

Geoffroy Legault-Thivierge of Health Canada said there is still time to order a flu shot.

“In light of the COVID-19 pandemic, local and territorial governments are reviewing vaccine supply orders for next year’s flu season to determine if they are sufficient or should be increased.” “We still have the opportunity to increase orders before we need to make a final commitment.”

But clocks are ticking and demand seems to be stronger than usual around the world.

As Australia heads for the flu season, The government has already warned the public to be vaccinated. But Australia has enough vaccine doses for about half of its population.

South Africa also reports that there are not enough doses this year, I ordered it a year ago.

“I think we need to be proactive and send messages early,” said Kindrachuk. “COVID-19 will not go away by the fall … but we can do everything we can to reduce that stress on both our test and healthcare networks.”