Local doctors speak out on flu season and COVID cases
By Stephan Drew, Editor
Recently, we recognized National Influenza Vaccination Week and the South Carolina Department of Health and Environmental Control (SCDHEC) urged all residents of our state to get their annual flu shot as soon as possible. Currently, South Carolina is having its most active flu season of the last decade, making it more important than usual to get a safe and effective vaccine.
Currently, there have been approximately 33,000 cases reported in South Carolina with an average of 3,200 per week. The total hospitalizations for flu reached over 1,500 and 5 people died by December.
Adding to the increased flu activity is the low vaccination rate across the state. Only about 51% of residents age 65 and older have received their flu shot this season. Just 16.4% of eligible residents age 18 and younger, and 16.1% of those 19 to 64, are vaccinated. People who are older than 65 or younger than 5 years of age are similarly at higher risk of complications from the flu.
S.C. State Epidemiologist Dr. Linda Bell said, “A high level of flu activity started much earlier this flu season than it usually does and its impact on South Carolina communities has been compounded by the rise in Respiratory Syncytial Virus or RSV cases. As a result, we’re seeing extraordinary rates of respiratory illnesses contributed to by widespread flu activity across our state and the rest of the nation.”
Bell stressed the importance of flu vaccines in easing the severity of infection among the general populace. “These vaccinations save lives and prevent severe cases of the flu, which means fewer hospital visits and more time at home and healthy, with your loved ones. We strongly encourage everyone to include a flu shot in their plans.”
Not only the flu but COVID and its many variant strains seem to be on the rise again as well. Often, when people feel badly, they attribute it to a cold or the flu. Since both affect the respiratory system and, sometimes, have similar symptoms, it can be difficult for people to realize how soon they need medical treatment.
Dr. Stephen Smith, Chief Medical Officer at CareSouth Carolina explained why the difference is so important, “With the flu, there is a sudden onset of fever, chills and body aches. It’s so sudden that you can usually pinpoint the time. You’ll hear people say, ‘I was fine all morning and then, about 2:30, I started really feeling bad. When they can tell you the exact time of day it started, it’s usually the flu. With COVID, it comes on slower. A cough, headache or runny nose will develop over 2 or 3 days,” Smith said.
Dr. Smith also discussed the differences in rapid treatments to ease the effects of the flu. “Since the flu comes on quickly, people seek medical attention sooner. Tamiflu is most effective if started within the first 24 to 48 hours,” he stated, “With COVID, it takes longer to recognize the symptoms so, people usually wait to get treatment. Paxlovid is not as effective if you’ve had COVID for three days or more.”
Dr. Brian Sponseller, Chief Medical Officer at Carolina Pines Regional Medical Center also spoke on how Darlington County currently rates in the state for new COVID infections. Even with the rise in cases, at present, we are 41 out of 46 counties in South Carolina. “That’s not bad at all,” Sponseller said. “We usually see a rise coincide with spikes during the holiday season but, this year, it was higher than expected.” When asked what he thought contributed to that, Sponseller said, “New variants account for about 40% of new COVID cases. Just a slight mutation with how the infection enters the cell.”
Of the many variants the one most prevalent in November was BA-5. Sponseller explained that there is a newer one on the rise in Darlington County. “It’s XBB.1.5,” Sponseller said, “There’s a slight mutation with how the infection enters the cell. These new variants account for about 40% of new COVID cases.” Sponseller endorsed Paxlovid as the best available treatment for COVID at the present time and suggested Xofluza (a single dose medication) as a stronger flu-fighting treatment.
Somewhat alarming to the general public is the practice of positioning patients face down while on a ventilator. Dr. Smith stated, “It’s not that common because it’s uncomfortable for the patient. But, when you put them on their stomach, there’s a better distribution of airway pressure to inflate the lungs.” Dr. Sponseller also agreed, “When a patient is in prone position, the internal organs aren’t pressing on the lungs and it allows for 9% more lung expansion. It’s usually done to prevent Acute Respiratory Distress Syndrome (ARDS).”
When asked about vaccination rates during the pandemic and now, Smith stated, “People were enthusiastic about the vaccines during the pandemic when hospitals were filling up. Now that things are calming down, they’re ‘open to it’ but not enthusiastic about it.” Sponseller reported on their vaccination rates as well. “During the pandemic, we operated our vaccine clinic 7 days a week and were immunizing between 2,000 and 5,000 people per day. Now, we have it open 2 days a week and we have to schedule several appointments together to use one vial of vaccine.”
Dr. Linda Bell of SCDHEC also expressed concern about public disinterest in the vaccines. “Almost everyone can play a role in curbing these alarming numbers and preventing more hospitalizations and deaths,” said Dr. Bell, “We really need our children and young adults to get their flu shot since it not only protects them, but their loved ones who may be older or immunocompromised.”
Dr. Smith of CareSouth and Dr. Sponseller of Carolina Pines both suggested continuing reasonable safe distancing, masks and handwashing/hygiene measures to try and prevent further spread of COVID and the flu. Both also agreed that, in the next 5 years, COVID will most likely become more contagious but the cases should be less severe.