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My dw and I are going out this week to get our flu vaccines.  Who knows if there might be a shortage this year or a run on the vaccine.  Anybody care to join us?


It is best and recommended to wait until late September or October for flu vaccine. If you get it too early it may not be effective the entire flu season.


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On 8/20/2020 at 8:38 AM, WrittenOnYourHeart said:

 

Bingo! I think that is the primary reason the flu shot will be highly recommended and encouraged everywhere. (Along with hoping they get the right strain for the flu shot this year!) Symptoms can be so similar, anything that can lessen one will only help with identifying the other.

That is the primary reason. Even if it is a normal flu shot (ie, not the greatest effectiveness as vaccines go), that protection, plus handwashing, masks and social distancing, should make flu a rarity - that's what was seen in South Africa this summer (I read the article, but sorry, no link) and we actually saw some of it during the lockdown.

You get symptomatic, is it flu or Covid, off to the urgent care or ER because the implications are dramatically different. Everyone will need testing for flu and Covid and RSV (at least kids and elderly) - guess what, the reagents for the those tests, the manufacturers are all the same. In fact, Covid testing was built on a flu platform in a sense, and some manufacturers are working on a combo test where we can get all 3 viruses from one swab.

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On 8/22/2020 at 5:53 PM, npcl said:

The data has changed since the article was written in may.  The inflammation syndrome and other impacts of COVID are recognized now.

 

Using the latest counts in the US for under 18  you have  the mortality with COVID in that age group at .0015%  vs Flu at .0011%.

HHmm, where did your data for flu come from Npcl? I was checking it because I really thought there was a small blip of flu mortality in the very young, like 5 and under and of course most mortality is over age 65, overwhelmingly.

I found data on CDC website for the 2017-2018 flu season (likely the most recent numbers they have), but it presents the data much differently and I'm too lazy to try to do the math, ;). That data does not show a blip in young children by the way, it shows very low mortality with a big increase at age 65.

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24 minutes ago, cangelmd said:

 

You get symptomatic, is it flu or Covid, off to the urgent care or ER 

Actually if someone has "symptoms" they are urged NOT to run to the ER unless the symptoms are serious.  They've been saying this for months and it hasn't changed.

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9 minutes ago, bouhunter said:

Actually if someone has "symptoms" they are urged NOT to run to the ER unless the symptoms are serious.  They've been saying this for months and it hasn't changed.


I’ll defer to a physician, but once we’re in flu season, that may be bad advice. You’ve got about three days once symptoms develop to start influenza antivirals or their effectiveness drops dramatically.  And the flu patients will do better with treatment in that window. 
 

And as cangelmd mentioned, at that point you need to rule in/out multiple respiratory viruses. It’s not going to be a fun flu season. Trying to control a pandemic without compromising patient care will be a balancing act. 

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4 hours ago, bouhunter said:

Actually if someone has "symptoms" they are urged NOT to run to the ER unless the symptoms are serious.  They've been saying this for months and it hasn't changed.

That may well change with flu season. As Markeb points out, there are specific antivirals for flu with a short window to administer them. 

 I think this advice will be in flux for awhile after flu starts cropping up, and I have no idea how it will finally shake out. People will need to be tested or at least call their providers to report symptoms. Usually flu activity is monitored by the CDC both through labs reporting positive tests and through the reporting of ILIs (influenza-like illness) visits to providers. Both are used to extrapolate out influenza activity. That’s not going to work this year, but how reporting will separate flu and Covid, I don’t know.

LOL, it will likely give us something to argue about on the internet, how the numbers are over or underreported 

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2 hours ago, cangelmd said:

That may well change with flu season. As Markeb points out, there are specific antivirals for flu with a short window to administer them. 

 I think this advice will be in flux for awhile after flu starts cropping up, and I have no idea how it will finally shake out. People will need to be tested or at least call their providers to report symptoms. Usually flu activity is monitored by the CDC both through labs reporting positive tests and through the reporting of ILIs (influenza-like illness) visits to providers. Both are used to extrapolate out influenza activity. That’s not going to work this year, but how reporting will separate flu and Covid, I don’t know.

LOL, it will likely give us something to argue about on the internet, how the numbers are over or underreported 

 

I really, really, really don't envy you. I've been involved with a lot of weird emerging diseases (not a researcher) over the years. I remember one of the biggest complaints of the global response to Ebola in 2013-14 was the diagnostic systems were geared to identifying Ebola cases, in a part of the world where there were dozens of significant febrile illnesses (malaria, Lassa, etc.) and the whole testing protocol boiled down to Ebola/not Ebola. Wasn't as useful as it could have been for actual patient management. Moving to multiplex PCR with multiple targets, including influenza, RSV, etc., should help, but how to manage that will be a challenge.

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Getting a bit off topic now, but one thing we are trying to do in the hospital setting is to get as many different platforms as we can up and running for both flu and Covid (we don’t see or test  very many kids, so RSV is less of an issue), so that we can move tests around. That’s the exact opposite of what we do in normal times, where we would consolidate down to one platform that fits our patient population best for many financial and logistics reasons.

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20 hours ago, bouhunter said:

Actually if someone has "symptoms" they are urged NOT to run to the ER unless the symptoms are serious.  They've been saying this for months and it hasn't changed.

 

That's changed where I live. In fact, we do daily health screenings at work and with my employer if you report any symptoms of an upper respirator infection, you are ordered to get a covid test. Because if you test positive we have to do contract tracing on your co-workers to see if anyone needs to be quarantined and you are monitored to make sure you don't return to work until you are symptom free. If you test negative, no contract tracing, no quarantines, and you are free to return to work when you feel well enough. In the beginning there were doctors who were not onboard with this. But since June we haven't seen anyone who was ordered to get a test not be able to get one.

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5 minutes ago, sanger727 said:

 

That's changed where I live. In fact, we do daily health screenings at work and with my employer if you report any symptoms of an upper respirator infection, you are ordered to get a covid test. Because if you test positive we have to do contract tracing on your co-workers to see if anyone needs to be quarantined and you are monitored to make sure you don't return to work until you are symptom free. If you test negative, no contract tracing, no quarantines, and you are free to return to work when you feel well enough. In the beginning there were doctors who were not onboard with this. But since June we haven't seen anyone who was ordered to get a test not be able to get one.

My post had nothing to do with testing.  It was in response to someone who said people need to run to the ER if they had any "symptoms".....

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1 minute ago, bouhunter said:

My post had nothing to do with testing.  It was in response to someone who said people need to run to the ER if they had any "symptoms".....

 

We have been discussing differentiating between the flu or covid and the person said that if you have symptoms its off the "urgent care or ER". Which I took to mean for  testing. Urgent cares here are the quickest place to respond for testing, and we drive through testing sites outside of some of our ERs. No, I agree, you don't need to be checked into the hospital for minor upper respiratory symptoms - but, it may be appropriate to respond to a testing site at an ER or urgent care. So, that's how I interpreted that post, I could be wrong. 

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23 hours ago, Charles4515 said:

 


It is best and recommended to wait until late September or October for flu vaccine. If you get it too early it may not be effective the entire flu season.


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I agree and the CDC says this in particular for adults 65 and older.  I generally go early September and have not had the flu in many years.  I am more concerned about getting a flu vaccination early this year(before there is a run on them) vs worrying about waning immunity to influenza next April or May.  Just my thoughts.

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3 hours ago, sanger727 said:

 

We have been discussing differentiating between the flu or covid and the person said that if you have symptoms its off the "urgent care or ER". Which I took to mean for  testing. Urgent cares here are the quickest place to respond for testing, and we drive through testing sites outside of some of our ERs. No, I agree, you don't need to be checked into the hospital for minor upper respiratory symptoms - but, it may be appropriate to respond to a testing site at an ER or urgent care. So, that's how I interpreted that post, I could be wrong. 

Yes,  that is what I meant. Patients experiencing Covid symptoms should seek evaluation and testing from somewhere (reserving the ER for life-threatening symptoms). If a person is in quarantine for a known exposure they should have received instructions on what to do if they begin to feel ill. In flu season, especially early on, it will be important to delineate who has flu and who has Covid and (God forbid) who has both. It may become less necessary as flu season goes along.

2 hours ago, TeeRick said:

I agree and the CDC says this in particular for adults 65 and older.  I generally go early September and have not had the flu in many years.  I am more concerned about getting a flu vaccination early this year(before there is a run on them) vs worrying about waning immunity to influenza next April or May.  Just my thoughts.

I agree with this. I think the next surge is coming about 5-6 weeks after schools start, or roughly mid-Sept to mid-Oct, and that’s usually we start seeing flu (we tend to get it a little early in the South). 
I think that particularly for people who get flu shots regularly, it will be more important this year to get vaccinated as soon as possible, rather than worry about waning immunity to flu.

 

fFlu basically disappeared 2 weeks into the lockdown and I’ve read where flu season in the Southern Hemisphere was very mild, presumably because of lockdown and masks and other hygiene measures, so I have hope that flu vaccines will just be added protection.

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11 hours ago, cangelmd said:

Yes,  that is what I meant. Patients experiencing Covid symptoms should seek evaluation and testing from somewhere (reserving the ER for life-threatening symptoms). If a person is in quarantine for a known exposure they should have received instructions on what to do if they begin to feel ill. In flu season, especially early on, it will be important to delineate who has flu and who has Covid and (God forbid) who has both. It may become less necessary as flu season goes along.

I agree with this. I think the next surge is coming about 5-6 weeks after schools start, or roughly mid-Sept to mid-Oct, and that’s usually we start seeing flu (we tend to get it a little early in the South). 
I think that particularly for people who get flu shots regularly, it will be more important this year to get vaccinated as soon as possible, rather than worry about waning immunity to flu.

 

fFlu basically disappeared 2 weeks into the lockdown and I’ve read where flu season in the Southern Hemisphere was very mild, presumably because of lockdown and masks and other hygiene measures, so I have hope that flu vaccines will just be added protection.

No disrespect meant, but if the health experts advise waiting until late September or October to get the flu vaccine, I don’t understand why someone would not follow that advice.  They are the experts, not us.  I do share the concern that availability could be an issue, and I hope they are planning ahead to avert that.

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10 hours ago, phoenix_dream said:

No disrespect meant, but if the health experts advise waiting until late September or October to get the flu vaccine, I don’t understand why someone would not follow that advice.  They are the experts, not us.  I do share the concern that availability could be an issue, and I hope they are planning ahead to avert that.

My thoughts only.  The influenza vaccine needs several weeks to develop immunity.  I personally will take the opportunity to get the vaccine earlier this year (Sept) before the rush starts.  And hopefully I will be protected for the initial emergence of Flu.   I am not worried personally about waning immunity next spring.  That might happen in some and perhaps more of a concern in the 65+ age group.   In fact there are higher dose Flu shots for that age group.  As we get into later Sept and October I think the hype to get Flu shots will put great pressure on the system and even shortages.  Again just my thoughts.

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10 hours ago, phoenix_dream said:

No disrespect meant, but if the health experts advise waiting until late September or October to get the flu vaccine, I don’t understand why someone would not follow that advice.  They are the experts, not us.  I do share the concern that availability could be an issue, and I hope they are planning ahead to avert that.

No disrespect taken at all.

My opinion is colored by experience in the Deep South, where our flu season typically peaks a little earlier than in the Northeast. This is going to be a year unlike any other, however, and I stand behind the rec to get a flu shot as soon as you can (it’s not that long until mid-September, truly).

I completely agree with Teerick, this year is going to be more about is this Covid or is this the flu, and if some individuals have less immunity to flu at the tail end of flu season in 2021, that won’t be as big a problem as Oct, Nov and Dec.

 

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I am hoping that the new Abbott 15 min simple COVID-19 test just approved by the FDA this week will be a platform that perhaps can be modified to do both COVID and Influenza tests simultaneously from a single nose swab.  Presumably the $5 Abbott test uses the same technology as the influenza test.

https://www.cnn.com/2020/08/27/investing/abbott-labs-rapid-covid-test/index.html

 

The US government has prepurchased 150 million of these tests.

https://www.hhs.gov/about/news/2020/08/27/trump-administration-will-deploy-150-million-rapid-tests-in-2020.html

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5 hours ago, TeeRick said:

I am hoping that the new Abbott 15 min simple COVID-19 test just approved by the FDA this week will be a platform that perhaps can be modified to do both COVID and Influenza tests simultaneously from a single nose swab.  Presumably the $5 Abbott test uses the same technology as the influenza test.

https://www.cnn.com/2020/08/27/investing/abbott-labs-rapid-covid-test/index.html

 

The US government has prepurchased 150 million of these tests.

https://www.hhs.gov/about/news/2020/08/27/trump-administration-will-deploy-150-million-rapid-tests-in-2020.html

 

Lol, It better perform better than those influenza cards.  Those are more or less worthless.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137576/

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19 hours ago, UnorigionalName said:

 

Lol, It better perform better than those influenza cards.  Those are more or less worthless.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137576/

Excellent article.  It was conducted in 2013 and 2014.  The tests today are way different.  Similar to the useless COVID tests that came out early this year; the next generation of tests are much better.

The Abbot test showed to be about 97% accurate.

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On 8/28/2020 at 7:47 AM, TeeRick said:

I am hoping that the new Abbott 15 min simple COVID-19 test just approved by the FDA this week will be a platform that perhaps can be modified to do both COVID and Influenza tests simultaneously from a single nose swab.  Presumably the $5 Abbott test uses the same technology as the influenza test.

https://www.cnn.com/2020/08/27/investing/abbott-labs-rapid-covid-test/index.html

 

The US government has prepurchased 150 million of these tests.

https://www.hhs.gov/about/news/2020/08/27/trump-administration-will-deploy-150-million-rapid-tests-in-2020.html

It’s BinaxNOW, oh... it will be a reasonable solution for symptomatic persons being seen by a physician or NP. It will be ok for triaging symptomatic kids at school or workers if done with careful protocols by trained people. The advantages are it is fast and simple and can take some of the load off of strained resources (we are struggling to get supplies for MRSA and some prenatal infectious disease testing because the manufacturing capacity is going to Covid). It may help in nursing homes, even though it’s not really sensitive enough because right now most nursing homes only do blood glucose, maybe a urine dipstick. NHs are more home and less nursing than people think. Having something they can turn around in 15 minutes  would be better than what they have now.

It will not work to screen asymptomatic people boarding a ship unless the test is repeated every day or every other day. Maybe ships could use it like nursing homes.

But I question how many kits Abbott will have left after they ship 150 million to the govt

Edited by cangelmd
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17 minutes ago, cangelmd said:

It’s BinaxNOW, oh... it will be a reasonable solution for symptomatic persons being seen by a physician or NP. It will be ok for triaging symptomatic kids at school or workers if done with careful protocols by trained people. The advantages are it is fast and simple and can take some of the load off of strained resources (we are struggling to get supplies for MRSA and some prenatal infectious disease testing because the manufacturing capacity is going to Covid). It may help in nursing homes, even though it’s not really sensitive enough because right now most nursing homes only do blood glucose, maybe a urine dipstick. NHs are more home and less nursing than people think. Having something they can turn around in 15 minutes  would be better than what they have now.

It will not work to screen asymptomatic people boarding a ship unless the test is repeated every day or every other day. Maybe ships could use it like nursing homes.

But I question how many kits Abbott will have left after they ship 150 million to the govt

OK thanks for letting me know it is the Abbott BinaxNow platform. So it is an antigen test and not an RNA PCR test. That makes sense to me now.  I had not put the pieces together.  The platform already has an approved Influenza A & B test.  RSV test too.  It used to be Alere until Abbott acquired them a couple of years back.  I think the tests have improved under Abbott.

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1 hour ago, TeeRick said:

OK thanks for letting me know it is the Abbott BinaxNow platform. So it is an antigen test and not an RNA PCR test. That makes sense to me now.  I had not put the pieces together.  The platform already has an approved Influenza A & B test.  RSV test too.  It used to be Alere until Abbott acquired them a couple of years back.  I think the tests have improved under Abbott.

You know your lab tests. I think Abbott has struggled a bit with fitting the Alere piece into their business. That’s what the first press release says and it makes sense. 

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On 8/27/2020 at 3:52 AM, phoenix_dream said:

No disrespect meant, but if the health experts advise waiting until late September or October to get the flu vaccine, I don’t understand why someone would not follow that advice.  They are the experts, not us.  I do share the concern that availability could be an issue, and I hope they are planning ahead to avert that.

Our. Doctors( in UK) have already sent a text inviting us to make an appointment for the flu jab. Mine is booked for 10/10/20.

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