Texas doctors await Labor Day, school, flu season with mixed hope and dread amid COVID
Health care professionals are crossing their fingers as Labor Day approaches.
It’ll take a couple of weeks to get the test results back on new COVID-19 cases that crop up after Labor Day weekend. If Labor Day works out OK, doctors will proceed to cross their fingers as the Thanksgiving, Christmas and New Year’s Day holidays get closer.
They will cross their fingers with the hope that public resolve does not wane over time, that lessons learned from the Memorial Day holiday will persist, that people will not become complacent and go without masks, or get too close to friends and strangers or gather in large crowds.
Disease trends are down and Fort Worth-area business owners and school officials are struggling to stay open or to re-open. Tarrant County officials, in the midst of declining COVID-19 spread this past week, urged residents to stay home and celebrate with only close family members during the Labor Day holiday. Those officials stressed the need to lessen the spread of coronavirus in the near future.
But COVID-19 is a marathon to an uncertain destination, not a sprint, health care professionals say.
“This is something that we will, more likely than not, continue with through the rest of this year and more likely a little into next year,” said Dr. Shawn Riley, CareNow regional medical director.
As of Friday, the number of dead reported in Texas was nearly 14,000. Nationally, the death toll approached 187,000.
If people modify their behaviors and incorporate the public health messages of what works into their daily habits, the numbers of COVID 19 cases will continue to decline, and the flu season and holiday gatherings will not be a big problem, experts say.
If people have not or will not change, hospitals, health care facilities, medical personnel and morgues are in danger of being overwhelmed.
Labor Day and the holidays beyond, school re-openings, parties, family gatherings and big indoor crowds are points of concern.
Flu season could be mild if people get vaccinated
The flu is coming, and the willingness of people to get vaccinated is also a concern for health professionals.
According to polling conducted in May published by Reuters, about 60% of Americans said they plan to get the upcoming flu vaccine.
We will all have to become more adept at risk assessment, Riley said.
Going to the grocery store and most types of situations that involve intermittent contact with others can be characterized as negligible risks, according to Riley.
“Being in an elevator with someone who is incessantly coughing, well, maybe that’s a greater risk,” Riley said.
Not getting the flu vaccine, particularly this year with the combined danger of COVID-19, is a big risk, he said.
“Many people are worried about getting the flu vaccine,” Riley said. “But the more people who get the vaccine, the safer everyone will be.”
Changes in community behavior are slowing the spread of COVID-19 and there are things we all can do to minimize the risk of greater spread of both diseases, Riley said.
“We are cautiously optimistic,” Riley said. “I want people to worry enough so that they take precautions and think about their activities and be mindful of harming others, but not worry so much that they are paralyzed.”
COVID-19 is the big threat
By July 15, Texas had reported more than 280,000 COVID-19 cases and 3,400 deaths, according to state data. The state’s seven-day positivity rate for testing at the time was at 16.81%.
Around that same time, Tarrant County reported a record 857 new coronavirus cases while Dallas County reported at least 1,000 new cases for the 13th consecutive day.
Dallas County Judge Clay Jenkins predicted that the weeks following the Fourth of July could be one of the deadliest times in the county since the pandemic began.
“After Memorial Day we definitely saw a surge in cases,” said Dr. Priya Subramanian, an infectious disease consultant who works with North Hills Medical City Hospital and other medical facilities.
Texas Gov. Greg Abbott seemed worried about the flu in early August, when during a roundtable discussion with medical professionals at the University of Texas Southwestern Medical School, he urged everyone to get a flu vaccine early.
By the time Abbott spoke, a decline in COVID-19 cases was evident. Many medical professionals are betting that most people will follow Abbott’s vaccination advice, and also hope that an inoculated population will help lead to a mild flu season.
“I anticipate less flu,” Subramanian said.
The flu is a known quantity and the health care system is prepared for it, she said. Flu arrives about the same time every year, there is a vaccine which is typically at least 60 percent effective and there are treatments for the flu, Subramanian said.
And luckily, the same behaviors — like wearing masks and social distancing — that have curtailed the spread of COVID-19 will decrease the spread of most any other virus, including the flu, Subramanian said.
Health care workers said they gained added confidence that the U.S. is in for a mild flu season after looking at countries where the flu season has already started and where they see evidence of a decline in flu infections when this year is compared to prior years. As it turns out, the same precautions that have helped slow the spread of the coronavirus also help slow the spread of the flu.
Based on mid-August data that the World Health Organization characterizes as too early to draw conclusions from, forecasts for the upcoming United States flu season are mild.
Globally, influenza activity was reported at lower levels than expected for this time of the year, the WHO report said.
“Despite continued or even increased testing for influenza in some countries in the southern hemisphere, very few influenza detections were reported,” according to the WHO report.
‘No room for complacency’
Hospital capacity in the Dallas-Fort Worth region is in good shape, but many health care workers are under stress from the events of the previous months, health professionals report.
Like others in his field, Dr. Nicholas Rister, an infectious disease physician at Cook Children’s Medical Center, says the precautions being taken for COVID are serving equally well to decrease the incidence of flu infections.
“If there was ever a season that we are prepared for flu, this is it,” Rister said.
“I’m concerned, but not extremely worried,” he said. “We are at high alert with COVID. This is the first year with COVID and you want to make sure you are making the right decisions and hope in the end it all pays off.”
Life cannot go back to normal, not back to the completely normal we all lived before the virus arrived, according to Rajesh R. Nandy, associate professor of biostatistics and epidemiology at the University of North Texas Health Science Center School of Public Health.
Things can go south very quickly, Nandy said.
“Even though the numbers of new COVID cases seem to have fallen, they are still at a very high level,” Nandy said. “So we cannot handle any type of surges from say a bad season with the flu.”
The numbers are about where they were in mid-June, and epidemiologists are keeping a close eye on those numbers, Nandy said. May numbers were good but by mid-June, by the time a spike was detected, the region was already in mid-surge, he said.
“There is no room for complacency,” Nandy said. “If the numbers go up, the schools will have to start closing again. If we want to keep our economies open, we have to pay attention to this. I expect that people will modify their behavior based on the current data.”
