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How will COVID-19 impact the 20/21 influenza season?

Insights into infection rates, vaccination and EMS volumes from COVID-19 surges and areas already experiencing influenza season


As EMS providers this fall, have a high suspicion for COVID-19 and wear your full PPE, because there is no way to say for certain whether it is or isn’t until tests come back.

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To better understand EMS agency vaccination mandates and provider practices, and how these might impact influenza and COVID-19 vaccination amongst frontline personnel, we surveyed EMS providers, supervisors and chiefs. More than 500 responses have provided insights into EMS vaccination policies, practices and perceptions. Read the results and weigh in: will you be vaccinated?

Although we don’t know for certain what this fall and winter will bring, it’s pretty clear we will be dealing with both influenza and the novel coronavirus. Here are some answers about how COVID-19 may impact the upcoming flu season.

How to differentiate between influenza and COVID-19?

Is it COVID-19 or the flu? The short answer is that you can’t distinguish without testing. Both viruses share similar symptoms and have a range of presentations. Both influenza and COVID-19 can present with fever, cough, fatigue, headache, sore throat, congestion, myalgias and GI upset.

One characteristic finding in COVID-19 is a loss of smell and taste which can be helpful in distinguishing between the two.

Be familiar with your community’s rates of infection. If COVID-19 cases are rising, your patient is likely to be COVID-19 positive. If you’re in a rural area with few or no coronavirus cases, the flu may be more likely. Regardless, as EMS providers this fall, have a high suspicion for COVID-19 and wear your full PPE, because there is no way to say for certain whether it is or isn’t until tests come back.

How will COVID-19 affect flu season?

As in the past, we can look to Australia and other countries who are experiencing their flu season earlier than the U.S. to get an idea of what ours will look like. Currently in Australia, influenza rates are lower than average for this time of year. Social distancing and face mask wearing has not only helped decrease COVID-19 but influenza rates as well.

Compliance with social distancing, hand washing and face mask wearing could not only decrease COVID-19 spread, but decrease influenza infections as well.

How will the 2020 influenza season impact EMS volume?

It will depend on your area, a recent study showed that nationally, EMS calls decreased by about 26% in March when the pandemic started gaining speed. Many patients were hesitant to utilize EMS services and this will most likely continue until there is a vaccine. That being said, there have been stories from Texas and other hard-hit areas that are experiencing huge surges in call volume due to COVID-19. Expect to have more respiratory/COVID-19 related calls and fewer non-COVID-19 calls.

How will COVID-19 impact influenza vaccination rates?

During the pandemic, amidst various shut downs, the CDC has noticed a decline in vaccinations and other routine preventative medical visits. It’s likely that this trend will continue and fewer individuals will receive the flu shot this fall because they will be afraid of increasing their risk of COVID-10 exposure.

That being said, it is even more important this year for individuals to receive their flu shot in the hopes of decreasing the number of people who will need higher care from influenza.

Weigh in: Participate in this brief survey: EMS influenza and COVID-19 vaccination practices and perceptions

Marianne Meyers, BS, is a third-year medical student at the University of Washington School of Medicine interested in pursuing emergency medicine. Previously, she was a member of the Santa Clara University collegiate EMS squad where she received her B.S. in Public Health Science. Additionally, she has worked with the King County Public Health Department in Seattle, Washington studying EMT naloxone administration.