Why is protecting yourself against the flu this season more important than ever before? How will the combination of influenza and COVID-19 cases strain our healthcare system? Can you get the flu and COVID at the same time?
Get answers to these and other questions as Dr. Jonathan Fialkow hosts Dr. Maria Ordonez, primary care physician with Baptist Health, Dr. Ladan Pourmasiha, medical director of Baptist Health Urgent Care and Dr. Aileen Marty, a professor of infectious diseases at the Herbert Wertheim College of Medicine at Florida International University.
(This episode contains excerpts from Baptist Health's Resource Live program, which can be viewed in its entirety here.)
Go to BaptistHealth.net/Flu for information about free flu shots at Baptist Health Urgent Care and Urgent Care Express locations while supplies last.
Why is protecting yourself against the flu this season more important than ever before? How will the combination of influenza and COVID-19 cases strain our healthcare system? Can you get the flu and COVID at the same time?
Get answers to these and other questions as Dr. Jonathan Fialkow hosts Dr. Maria Ordonez, primary care physician with Baptist Health, Dr. Ladan Pourmasiha, medical director of Baptist Health Urgent Care and Dr. Aileen Marty, a professor of infectious diseases at the Herbert Wertheim College of Medicine at Florida International University.
(This episode contains excerpts from Baptist Health's Resource Live program, which can be viewed in its entirety here.)
Go to BaptistHealth.net/Flu for information about free flu shots at Baptist Health Urgent Care and Urgent Care Express locations while supplies last.
Announcer:
At Baptist Health South Florida it's our mission to care for you when you're injured or sick and help you stay healthy and fit. Welcome to the Baptist HealthTalk podcast, where our respected experts bring you timely, practical health and wellness information to improve your family's quality of life.
Dr. Jonathan Fialkow:
Hello Baptist HealthTalk podcast listeners, I’m your host Dr. Jonathan Fialkow. I’m a preventative cardiologist and certified lipid specialist at Miami Cardiac & Vascular Institute and chief population health officer at Baptist Health South Florida
Each fall, health experts urge us all to get vaccinated for the flu. This year, in the midst of the COVID-19 pandemic, that message is more critical than ever. Listen up: if you’ve never had a flu shot before this is the year to get one, and get it soon.
The upcoming flu season was the focus of Baptist Health’s Resource Live program, which I recently had the pleasure of hosting. The information contained in the program is so important. To share it far and wide, we’ve put together some excerpts of that discussion for today’s podcast.
The panel of experts featured are Dr. Maria Ordonez, a primary care physician with Baptist Health, Dr. Ladan Pourmasiha, Medical Director of Baptist Health Urgent Care and Dr. Aileen Marty, a professor of infectious diseases at the Herbert Wertheim College of Medicine at Florida International University.
Let’s listen in…
Dr. Jonathan Fialkow:
Let's start the conversation with Dr. Marty. Aileen, broad question. We could spend hours, probably weekends of conferences, but for the purpose of our viewers, what is the difference between flu and COVID-19?
Dr. Aileen Marty:
The thing that most people need to understand is that while flu can be a deadly disease and cause very significant respiratory and sometimes gastrointestinal, and sometimes in an aspect of systemic disease, COVID-19 which is caused by the SARS-2 virus, is a lot more intense and causes a lot more complications in a very high percentage of people who get infected. And it also has a lot of post-infection complications. In fact, many people continue to live with those complications after they come out of the hospital. In fact, Boris Johnson from the UK who was hospitalized for COVID-19, is one of these long-term suffers. And of the mortality rate, the death rate, is also a lot higher with COVID-19.
Dr. Jonathan Fialkow:
Can you add a little bit about how the flu is a burden to our healthcare system, but not as much as COVID-19 has been shown, especially in pockets where it's been more prevalent?
Dr. Aileen Marty:
We have had a much higher incidence of hospitalizations, people in ICU, very severely ill with the SARS-2 virus than we ever have with influenza. Even in our worst seasons, we would never get in just a few months to over 200,000 deaths like we've had with COVID-19. Also, of course we do have effective antiviral treatments that work specifically, many different ones actually, for influenza, whereas we're still experimenting and have only one, Remdesivir, that's an actual antiviral that has some effect on some patients with COVID-19 and then some ways to mitigate. Another factor which makes the COVID-19 very different from influenza is the extent of the overactivity of the immune system. And this ridiculously over-activated immune system is what we try to calm down when we use steroids like dexamethazone.
Dr. Jonathan Fialkow:
Thank you. So while we want to impress upon people the seriousness of this COVID-19 pandemic, we don't want to be equated to the flu, but now let's talk about why influenza remains a major concern and why we want to message our viewers to take it seriously and get the vaccines and et cetera.
Dr. Jonathan Fialkow:
So Ladan, maybe I can ask you your experiences working in an urgent care, person comes in with symptoms. How would that person know whether it's influenza or COVID-19? How would you as the provider who's interviewing or evaluating the patient? And then the third question, if it's not too much, is do you handle them differently? If your suspicion is it's influenza, what would you do? If you're suspicious it's COVID-19, what would you do?
Dr. Ladan Pourmasiha:
Well, to be quite honest, right now, with the pandemic and everything going on, we have to be safe. The patients have to be safe, we have to be safe. So at this point, we have to assume, especially in an urgent care setting where everybody's coming in, that everyone may have COVID. So we always have to wear our personal protective equipment. We're always prepared to treat patients in a very safe setting. We always want to adhere to the social distancing. So in that note, we kind of treat every patient as are they a potential COVID?
Dr. Ladan Pourmasiha:
Now as far as telling the difference between the two or the similarities, unfortunately they're both respiratory viruses so they kind of present very similarly. So this is where we need to do some testing and testing may be required. Luckily at our urgent cares, we have urgent cares in the Miami area. We have it in the Broward area and so forth. And all of our urgent cares are able to do both the influenza testing as well as the COVID-19 testing.
Dr. Jonathan Fialkow:
So if an individual is at home with symptoms or family member has symptoms, is there a way for them to almost make an appointment or they have to just go to the urgent care and wait.
Dr. Ladan Pourmasiha:
Absolutely.
Dr. Jonathan Fialkow:
Ways to kind of anticipate and help them? Yeah.
Dr. Ladan Pourmasiha:
Absolutely. So like I said, we've been trying very, very hard to kind of social distance, keep the waiting rooms as empty as possible. A lot of times we even have people wait inside the car to keep them safe, to keep other patients safe. And so there is a Save My Spot that they can actually get online and you go ahead to Save My Spot. You schedule a time, a date, and you're able to come in, be seen and hopefully quickly in and out.
Dr. Jonathan Fialkow:
Right. And I think the point you mentioned, which is something we've iterated and reiterated, is with the social distancing, with the proper precautions, people are not getting sick by coming to urgent cares, emergency rooms, doctor's offices.
Dr. Ladan Pourmasiha:
Absolutely.
Dr. Jonathan Fialkow:
In fact, the risk in the community is higher. So if you're sick, get yourself taken care of. Thank you.
Dr. Aileen Marty:
Can I mention something real quick?
Dr. Jonathan Fialkow:
Oh, of course.
Dr. Aileen Marty:
Yeah. So one little clue that it's more likely to be COVID and less likely to be flu is this, anosmia, this sense of loss of taste and smell. That's particularly common in coronaviruses, other coronaviruses too, but it's just a little hint that that's what's going on. And by the way, it's interesting. Now some of the people who have recovered from COVID, if they recover their smells, seem to have an off smell. So things that used to smell delicious now smell horrible. And so there's a continuing problem with smell involved with [crosstalk 00:00:08:24].
Dr. Jonathan Fialkow:
Is there an age-related component to that, or it can happen to anyone with COVID? I see it more in our younger folks, twenties, thirties, forties, so younger than me, but does it happen in older people? But they have other symptoms that may be become more prominent, or is it just in the younger people?
Dr. Aileen Marty:
No. It is seen more in younger individuals than in older individuals. And it's often the only symptom in people who are otherwise asymptomatic or they think they're asymptomatic.
Dr. Jonathan Fialkow:
Right.
Dr. Aileen Marty:
Although we can detect changes if we do films and other studies.
Dr. Jonathan Fialkow:
So Dr. Ordonez, Maria, why is this flu season something that we're more concerned about than the average flu seasons, which we know are dangerous and take lives and lead to morbidities? Which about this one?
Dr. Ordonez: (This) coming flu season, we're going to see this year both COVID and the flu come. And so, especially for everybody, but also people that are at risk will be at higher risk. And then on our healthcare system, Dr. Marty spoke about the impact it'll have on health care and the higher morbidity and mortality. So it's more important for everybody to do their part, right? Starting with washing their hands, social distancing, everything, all the precautions, and also getting the vaccine, which is our main method for prevention on the flu.
Dr. Jonathan Fialkow:
Can you each speak for a second about the importance of not just the message to the listener, we don't want you to get sick, but the reason that we as a system and as a society really have to control this, is to not overwhelm our healthcare system where there's no beds for sick people or people are sitting on ventilators for long periods of time. I'll start with Dr. Marty, Aileen. Can you comment on that
Dr. Aileen Marty:
Yeah. The stress on the healthcare system is absolutely paramount. If we have too many cases for the number of staff that we have, the number of beds that we have, the number of equipment that we have, number one, we cannot give the attention per patient that each patient deserves because there are so many extra people. Number two, our staff get fatigued. Right now there's a tremendous problem with staff fatigue because of how many months we've been dealing with this horrible pandemic. Number three, things can get confused, right? So you have this situation where you have multiple viruses coming in that look similar and mistakes can be made when there are a great number of cases. This is a complicated problem and for our wellbeing, for the wellbeing of society, we need to put a damper on this.
Dr. Jonathan Fialkow:
Ladan, do you want to comment a little bit about that? What the stresses you've seen, especially in your experiences when we're at the peak and hopefully won't have that similar second wave come through.
Dr. Ladan Pourmasiha:
Absolutely. So the way that I see it is if you help protect us, we can protect you. So the whole point of social distancing and the whole point of everybody staying home was to give us enough time to be able to not just learn about COVID because it's such a new thing to us, but also prepare our facilities. Also be able to get that equipment so that we could properly take care of the patients and give them what they need.
Dr. Ladan Pourmasiha:
And so, of course there was a point in the urgent care where we were very, very overflowed with patients and luckily we were able to do what we needed to do. And we were able to come up with new ideas every day as to how to keep the patients safe, how we could keep the facility clean. But yes, it's definitely a stress on the healthcare system. And when I say protect us so we can protect you, our healthcare professionals may have gotten sick. And so we did have to have other people fill in. And so it just made things a little bit more difficult.
And I think we're right on track now. And I think that that's where we need to be. We need to continue to just be very mindful of the things we've learned and to abide by those rules that we've made thus far to keep us on the right path.
Dr. Jonathan Fialkow:
Thank you. And Maria, anything to add on that? I know it's all been well said. What you've seen as the impact on our health care providers physically, emotionally. [crosstalk 00:15:46]
Dr. Maria Ordonez:
Yes, no. And I wanted to make a comment, yes, on the impact. For us, as we learn also and try to get the patients, right. To give them the guidance and give them the education. And also what I see a lot is people, and you mentioned this a little, trying to wait a long time before they're seen or before they get medical care because they're scared, right. They're scared of getting it. So we're trying to be as safe as possible, right. In our facilities, in the hospitals.
Dr. Maria Ordonez:
But there were a lot of people waiting with maybe chest pain or waiting with other concerns. And so that also overwhelms the healthcare system, because then you come in with more complicated conditions, right. Abdominal pain or something else. If it's something that needs to get looked at, we urge patients if you need some education or you want to talk to one of us, do initially a TeleHealth visit or getting to an urgent care or call your primary care provider or talk to us or come in. If you need to go to the ER, go. They're taking all the precautions to not wait till the end when you can have something more complicated.
Dr. Jonathan Fialkow:
Thank you. Let's get to vaccines a little bit more specifically now, since of course the goal for the flu season is for people to be vaccinated for the reasons we discussed. Aileen, I'm going to ask you about public health policy and recommendations. Then go to Ladan specifically on resources at Baptist Health we'll offer to the community. And then Maria, I'll go to you more specific towards our employees and what we're doing, and maybe some other community opportunities. So Aileen, what is the public health recommendation for [crosstalk 00:17:21]?
Dr. Aileen Marty:
Yeah, for many years now, the public health recommendation is everyone six months or older should get an annual influenza vaccine. There are actually many different kinds of influenza vaccines. There are egg-based vaccines, there's cell culture vaccines, there's recombinant vaccines. There's one that is a live attenuated vaccine that we halted the use for a couple of years while it was improved, but that attenuated vaccine is available for people who won't don't take a shot. Because there are vaccines for influenza that are not egg-based, having an egg allergy is not a reason not to take a flu vaccine. You simply take either a cell-based or recombinant vaccine instead.
Dr. Jonathan Fialkow:
So I hate to ask these questions, but we have to. Can you get the flu from getting the vaccine?
Dr. Aileen Marty:
No. You cannot get influenza from getting [crosstalk 00:19:07] the vaccine.
Dr. Jonathan Fialkow:
End of story. Everyone- [crosstalk 00:19:10] everyone should get it over the age of six months. It's not only sick people, not only people with other medical problems. It's for everyone, both so they don't get it, but they also don't give it to other people.
Dr. Maria Ordonez:
Even if you get the flu, the vaccine can prevent from having a lower severity of illness. So even if you do get it, it does give you protection to not get such as severity of disease. Studies show even if you are admitted to the hospital, you have less of a hospital stay, less of ICU stay. So still, even if you get sick from the flu, you still have more protection, better protection, than if you didn't get the flu shot.
Dr. Jonathan Fialkow:
Thank you. So Ladan, if you can tell us, what is Baptist Health doing and what are the resources available for the community and as regards to flu vaccines?
Dr. Ladan Pourmasiha:
So our goal and our mission is to just tell everyone to be very proactive about their health. At the end of the day, that's the most important thing that we have. And so to take part in that, and to also let people know that we care about your health, we decided to offer the flu shots ourself, and we're going to start offering them starting September 29th. And as long as they are available, we're going to have them in our 24 urgent cares. And this is our Urgent Cares as well as our Express Cares. And this is in Miami. This is in Broward and Palm Beach.
Dr. Ladan Pourmasiha:
And we're going to go ahead and have you guys just come in and get those shots. Now it's a very seamless process. We're trying to, like I said, safety is one of the biggest things that we're trying to make sure that we can have handled. And all you have to do is go to BaptistHealth.net/flu and you go to Save My Spot. You get an appointment, you schedule your time and your date, and you're able to come in and be seen and get that vaccination.
Dr. Ladan Pourmasiha:
And I'm just going to piggyback off of what we were talking about as far as the vaccines. We are actually vaccinating children as young as six months old up until our senior citizens. We do have vaccines that are high dose vaccines and preservative free vaccines as well. And so the key message here is we've got the vaccines, we're in the middle of a pandemic. This is something that we have to protect you against the flu. And one of the complications from the flu are pneumonia and in the urgent care with my COVID patients, lo and behold, it always comes back as the individuals that are higher risk are getting the pneumonia. So if we can do something like giving the flu vaccine that we have out, then maybe we can prevent any complications if people end up getting both.
Dr. Jonathan Fialkow:
So free flu vaccine starting September 29th at all Baptist Urgent Care facilities.
Dr. Ladan Pourmasiha:
As well as the Express Cares.
Dr. Jonathan Fialkow:
And Express or Urgent Cares. Appointments can can be made, which really lowers the threshold one has to cross to be able to get the flu vaccine.
Dr. Ladan Pourmasiha:
Absolutely. And the idea is people are so scared to come to an urgent care because they think, okay, urgent care, ER. It's exactly the same thing. So, but in reality, like I said, we're taking a lot of measures to try to see if we can get you in and out like an appointment, just in and out so that you can get what you need to get and stay safe and protect yourself, protect your family and protect the community.
Dr. Jonathan Fialkow:
Great, great information. Maria, why don't you let the listeners know, just to get some perspective of the scope and scale of the Baptist policies for our employees and what other support that might be for flu vaccines?
Dr. Maria Ordonez:
Yeah, definitely. So at Baptist everybody gets a vaccine. So the whole team, the entire workforce, there's mandatory flu shots. We all get our yearly vaccine, about more than 23,000 people. Baptists also-
Dr. Jonathan Fialkow:
23,000 employees [crosstalk 00:25:17].
Dr. Maria Ordonez:
Yes, 23,000. [crosstalk 00:25:19] So everybody getting the flu vaccine. Also Baptist is passionate about donating and making sure we have it available to the community as much as we can. So you, in our urgent cares, in our primary cares, in our express centers about making it accessible to everybody because of their big role in prevention. Vaccine [inaudible 00:25:37] prevention of the flu.
Dr. Jonathan Fialkow:
Great information. For the last few minutes, just I'll go through with a couple of you, some other quick questions that we tend to get in our practices or from the lay public. I'll open it first to Dr. Marty. Can pregnant women get a flu shot?
Dr. Aileen Marty:
Yes, they can get a flu shot and they should.
Dr. Maria Ordonez:
They should. [crosstalk 00:25:55]
Dr. Aileen Marty:
In fact pregnancy is one of the things that puts you at higher risk for complications from flu and from COVID-19.
Dr. Jonathan Fialkow:
If someone has COVID-19 or they've had COVID-19, should that mean they don't need the flu shot?
Dr. Aileen Marty:
Absolutely not. Those are not related. Very different viruses have a different immune response completely.
Dr. Jonathan Fialkow:
And you had mentioned, and we're quite concerned, people can get both at the same time, which would be a really more serious condition for either one of them by themselves.
Dr. Aileen Marty:
That's right. And actually we've been tracking that, what's going on with COVID and dual infections in the United States. Not just flu, but also bacterial infections become more complicated if you also have COVID-19.
Dr. Jonathan Fialkow:
Fair enough. Maria, if someone is staying at home in the bubble, do they still need to get a flu shot?
Dr. Aileen Marty:
Yes. And it's a question we get here in the primary care office. Yes. Because one, people can still pass viruses and pass the flu before they get sick. Before we know they have symptoms. Some people say a bubble, but maybe they see one or two family members, right. Maybe they go out for errands. And still, even if you're avoiding people that are sick or if you're avoiding everything, right. People that even before they get sick, they can pass the virus. The first few days of illness, some people are asymptomatic or have very mild symptoms and never know they're sick. And then also we know sometimes it can be transmitted through objects as something you grab and then you touch your face. So still because of the big role in prevention, yes. Everybody should get a flu vaccine.
Dr. Jonathan Fialkow:
Ladan, when should people get the flu vaccine and is now a good time to do it?
Dr. Ladan Pourmasiha:
Absolutely. Right now is a very good time to get the flu vaccine. We usually want the patient to be asymptomatic when they're getting that flu vaccine. So that's one of the things that we ask. But as far as the flu vaccine, like we mentioned earlier, this is something that's going to help us, especially in this time that we are in a pandemic. And we urge people to go out and get that flu vaccine. And don't worry about all the myths that are out there. It will help you in the long run.
Dr. Jonathan Fialkow:
Thank you very much. You guys have all been fantastic. In the interest of time, I'll ask if any of you have any final comments, either bring up points that we didn't get to, or emphasize something that we did get to. I'll start with dr. Marty, Aileen.
Dr. Aileen Marty:
Hey, the same things that apply for prevention of COVID-19 apply for influenza. So wash your hands, use your masks for now, keep that six foot distance, avoid crowded places and indoor spaces.
Dr. Jonathan Fialkow:
Great. Ladan?
Dr. Ladan Pourmasiha:
Same thing. That social distancing, wearing the mask, washing your hands. We really, really would love for you guys to abide by that. And as far as in the urgent care, like I said, we do do these testings. And if you guys have fevers, or if you have been exposed to somebody that may have the flu or in a household that someone may have the flu, please, please, please come in and see us. The antiviral medications that we do have work best if they are given within the first 48 hours of symptoms. And so that's a very crucial time for us to be able to evaluate you and possibly treat you.
Dr. Jonathan Fialkow:
Well said, thank you, Maria?
Dr. Maria Ordonez:
Yes. No, what everybody has said. Social distancing, wash your hands. Also six months and older, get your flu shot. And if you have any symptoms of respiratory illnesses or anything else, don't wait till the end. Let us see you beforehand. Reach out to your health care providers. And we are here at Baptist.
Dr. Jonathan Fialkow:
And I will add, and think of the healthcare providers who remained at the front lines for all medical problems, but specifically COVID-19 pandemic and influenza.
Dr. Jonathan Fialkow:
I you’d like to watch the full episode of Resource Live there is a link in the notes for this podcast. As always, if you have any comments, questions or suggestions for topics, email us at Baptisthealthtalk@baptisthealth.net.
Thank you for listening. Stay safe and mask up.
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