Flu In An ERA of COVID-19 Town Hall Presentation

On September 23, 2020 Commissioner Lorraine Cochran-Johnson in partnership with Kaiser Permanente hosted the Flu In An Era of COVID-19 Town Hall to share with DeKalb County residents information on how to combat the flu and COVID-19. Topics included: Flu vs. COVID-19, Women’s Health & Pregnancy, Mental Health and Children’s Health. Featured speakers included: Dr. Chris Griffith (Kaiser Permanente), Dr. Fatu Forna (Kaiser Permanente), Dr. Belkis Pimentel (Kaiser Permanente) and Dr. Lynette Wilson-(Kids-Doc on Wheels).

Transcript

12. FLU IN AN ERA OF COVID-19 DEKALB COUNTY DISTRICT 7 COVID-19 TOWN HALL SERIES Wednesday, September 23, 2020 Belkis Pimentel, MD Physician Program Director, Quality Performance and Population Health Chris Griffith, MD Psychiatry and Obesity Medicine Fatu Forna, MD Physician Program Director, Perinatal Safety and Quality True health equity means that everyone has a fair opportunity to live a long, healthy life – and that includes equal access to quality health care. The core message in health equity
13. 13 Agenda • Current state of COVID-19 • High Risk Populations for COVID-19 • Staying Healthy • Burden of Influenza • FLU vs COVID • Benefits of Flu vaccine • Flu vaccination disparities and Myths • Closing the Gap – A Call to Action
14. 14 Coronavirus in Georgia: COVID-19 Dashboard Graph source: AJC.com
15. 15 © 2019 The Southeast Permanente Medical Group 1406 currently hospitalized Coronavirus in Georgia: COVID-19 Dashboard Graph source: AJC.com
16. 16 HIGH RISK CONDITIONS 65+ Heart Disease Heart Failure Diabetes Stroke High Blood Pressure Chronic Kidney Disease Immunocompromised Obesity Pregnancy <5yo INFLUENZA
17. 17 © 2019 The Southeast Permanente Medical Group Prevent Infectious Disease Optimize your Health Social distancing, hygiene, masks. Sleep, nutrition, hydration, exercise, relaxation. Have a plan if you get sick. Do not delay getting emergency care for your underlying condition because of COVID-19. Get your flu and pneumonia vaccines. Have at least 2-week supply of needed items so you can stay home. Continue your medications! Continue to monitor chronic condition and keep it under control. Call your doctor if you have any concerns about your medical conditions or if you get sick.
18. Coping with stress during a Pandemic Take care of your body – Try to eat healthy, well-balanced meals – Exercise regularly – Get plenty of sleep – Avoid alcohol and drugs Take care of your mind – Take breaks from watching, reading, or listening to news stories and social media. – Take deep breaths, stretch, or meditate to reduce anxiety – Make time to unwind – Connect with others Call your healthcare provider – if stress gets in the way of your daily activities for several days in a row. Resource from CDC website: If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself: • Substance abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746
19. 19 © 2019 The Southeast Permanente Medical Group 2019-2020 U.S. Flu Season: Preliminary Burden Estimates https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm
20. 20 © 2019 The Southeast Permanente Medical Group The Benefits of Flu Vaccination 2018-19 https://www.cdc.gov/flu/about/burden-averted/2018-2019.htm
21. 21 © 2019 The Southeast Permanente Medical Group Who should get the flu vaccine? Everyone 6 months and older unless contraindication to the vaccine • Especially those High Risk for flu related complications, hospitalizations and death: • 6m to 5y.o., especially <2y.o. • Pregnant • 50 or older, especially 65y.o. • People with chronic conditions • Asthma/COPD, Diabetes, Heart Disease, Stroke, Kidney Disease • Weakened immune system, i.e. cancer or HIV • Obesity, especially BMI >40 • Nursing Home or Assisted Living Facility • Healthcare Workers • People who are around any of the above, babies <6m, or those who cannot get vaccinated
22. 22 © 2019 The Southeast Permanente Medical Group Why Vaccines are Important for You • Heart Disease: Black/AA have the highest rate of Heart Disease • Flu illness doubles the risk of a heart attack and increases 6x in those who already have a history of Heart Disease • Flu vaccination effectiveness research has shown: • 29% in preventing heart attacks • 36% in preventing major cardiac events with existing heart disease • On par or better than accepted preventive measures: • Cholesterol meds or statins (36%) • Blood pressure meds (15–18%) • Smoking cessation (26%) • COPD or Asthma: Black/AA have high rate of Asthma • Airways to swell and become blocked with mucus, which can make it hard to breathe • Certain diseases that are vaccine preventable can also increase swelling of your airways and lungs Influenza vaccination is recommended by American College of Cardiology and American Heart Association to prevent heart attacks in persons with heart disease
23. Why Vaccines are Important for You • Diabetes: Black/AA have the highest rate of Diabetes • Diabetes, even if well managed, can make it harder for your immune system to fight infections. • If you’re sick your blood sugar can rise to dangerously high levels. • People with diabetes are at increased risk for death from pneumonia, bacteremia (blood infection) and meningitis (infection of the lining of the brain and spinal cord). • Pneumococcal disease is a deadly infection that can come on quickly. • Those age 65 and older and adults of any age with underlying medical conditions are at higher risk of death. • People who get pneumococcal disease may face hospitalization, long recovery time, and devastating life-long problems. • Pneumonia vaccination can help protect you from pneumonia, meningitis, and bacteremia. Immunization provides the best protection against vaccine-preventable diseases.
24. 24 © 2019 The Southeast Permanente Medical Group Why Vaccines are Important for You Flu vaccination helps protect women during and after pregnancy. – Vaccination reduces the risk of flu-associated acute respiratory infection in pregnant women by about one-half. – A 2018 study that included influenza seasons from 2010-2016 showed that getting a flu shot reduced a pregnant woman’s risk of being hospitalized with flu by an average of 40 percent. – Several studies have shown that in addition to helping to protect pregnant women, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when he or she is not old enough to be vaccinated. One study showed that giving flu vaccine to pregnant women was 92% effective in preventing hospitalization of infants for flu. Flu vaccination is safe for pregnant women and their unborn child. – Flu shots have been given to millions of pregnant women over many years with a good safety record. There is a large body of scientific studies that supports the safety of flu vaccine in pregnant women and their babies. CDC continues to gather data on this topic. – Multiple studies have shown that women who have gotten flu shots during pregnancy have not had a higher risk for miscarriage. The recently published study covered three flu seasons (2012-13, 2013-14, 2014-15) looking for any increased risk for miscarriage among pregnant women who had received a flu vaccine during their pregnancy. The study found NO increased risk for miscarriage after flu vaccination during pregnancy. – the Advisory Committee on Immunization Practices (ACIP), the American College of Obstetricians and Gynecologists (ACOG) and CDC continue to recommend that pregnant women get a flu vaccine during any trimester of their pregnancy because flu poses a danger to pregnant women and a flu vaccine can prevent serious illness, including hospitalization, in pregnant women. Flu vaccine can be lifesaving in children. – A 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from flu. – A 2014 study showed that flu vaccine reduced children’s risk of flu-related pediatric intensive care unit admission by 74% during flu seasons from 2010-2012.
25. “I had a flu vaccine a few years back, and it gave me the flu. I won’t be making that mistake again.” “I know people who got sick after getting a flu vaccine.” “I am pregnant and I am afraid the flu vaccine may hurt my baby.” Flu Myths – Fact or Fiction 25
26. Flu Myths – Fact or Fiction “I am healthy and never get sick. I don’t need a flu vaccine.” “Getting a flu vaccine is my personal choice – why can’t people just choose to protect themselves and leave me alone?” 26
27. “I heard the flu vaccine is not safe and it can make it easier to get sick with COVID-19…” “The flu vaccine doesn’t work. Why bother?” Flu Myths – Fact or Fiction 27
28. © 2019 The Southeast Permanente Medical Group
29. US Survey Data: Disparities by Race for Flu Vaccination 2018-19 season CDC data reveals the following groups have disparities in flu vaccination leading to a disproportionate amount of pneumonia, hospitalizations and deaths caused by influenza. – AA/Blacks – Hispanic/Latinx – American Indian/Alaskan Native For Georgia, rates are even lower in all races, the lowest in AA/Blacks (6-8%) Flu Survey by Race USA 2018-19 GA 2018-19 ALL 49.2% 43.1% OTHER 47.3% 45.9% BLACK/AA 44.7% 38.7% HISPANIC/LATINX 46.4% 40.1% WHITE 51.0 % 46.4%
30. 30 © 2019 The Southeast Permanente Medical Group Why the disparity? Research have shown gaps: – Knowledge • Beliefs about safety and effectiveness of vaccines – Cultural and other psychological factors • Mistrust of healthcare has historical roots and contributes to health disparities – Social Norms • More likely not to get the vaccine due to the beliefs of friends and family – Physician Implicit Bias (which can often be unintentional) • More likely to have missed opportunities when seeing a healthcare provider – Lack of Health Care Access and Financial barrier
31. 31 A CALL TO ACTION Be a Flu Champion! • Acknowledge there are disparities in Health and Health Care Systems • Hold policymakers accountable • Be advocates of change • Share your knowledge or invite an expert to talk to your group • Get the Facts and Dispel Myths about the flu vaccine • Encourage people to educate themselves and talk to their health care providers • Don’t forget the past, but let‘s foster trust and heal to save lives • The FLU is serious, potentially deadly disease, but preventable. • You can prevent the flu from negatively impacting you or someone you love…  • Don’t Delay! Get your Flu shot today!
32. Questions? 32 © 2019 The Southeast Permanente Medical Group
33. Appendix
34. 34 Flu Myths – Fact or Fiction Can you get COVID and FLU at the same time? – Yes, it can also be difficult to determine if you have Flu or COVID-19 since the symptoms are similar. Does a Flu vaccine increase your risk of getting COVID-19? NO Flu Vaccine makes me sick! – The flu shot has a “dead“ virus so it cannot cause the flu illness I don’t need to be vaccinated because I am healthy and never had the flu. – Even healthy people can get serious complications, including death. Also, you can protect the people around you and your community. Vaccine is not safe; I don’t trust it! – Flu vaccines have been shown to be safe for decades Flu vaccine doesn’t work, what’s the point? – VE varies annually, but even when there is not a good match, those who are hospitalized or end up dying are not vaccinated. Even if the VE was not great, which most of the time it is 40-60%, you’re likely to have only mild symptoms. Not to mention it can be lifesaving to children. Flu is not serious, it’s like a bad cold, I’ll get over it! – Flu is very serious, can cause complications leading to hospitalizations or worse, death. I can’t get a vaccine when I am pregnant, it may hurt my unborn child! – A pregnant woman with flu is more likely to be sicker, hospitalized and poses a risk to the unborn fetus. Getting vaccinated protects the baby! It’s too late to get a flu vaccine! – It’s not too late to get a flu vaccine, flu vaccines can be given through end of May or later for children <9yo I had a vaccine last year; I don’t need another one – A flu vaccine effectiveness decreases over time and there are changes made to the vaccine annually
36. Influenza Division Estimated Influenza Disease Burden, by Season United States, 2010-11 through 2017-18 Influenza Seasons https://www.cdc.gov/flu/about/burden/index.html
37. Influenza Division 21 52 37 41 56 60 47 49 52 19 48 40 38 29 0 10 20 30 40 50 60 70 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 2017-18 2018- 2019* PERCENT EFFECTIVE FLU SEASON Effectiveness of Seasonal Flu Vaccines from the 2005 – 2019 Flu Seasons Source: https://www.cdc.gov/flu/professionals/vaccination/effectiveness-studies.htm *Vaccine effectiveness estimates for 2018-2019 were presented to ACIP on June 27, 2019.
38. © 2019 The Southeast Permanente Medical Group Confirmed COVID-19 cases by ZIP Code
39. 39 Belkis Pimentel, MD • Family Physician at The Southeast Permanente Medical Group since 2009. Lead physician for several providers for 5 years in the Adult Medicine Department. Since 2014 have been in my current role as Physician Program Director for Quality Performance and Population Health at Kaiser Permanente • Lead programs and projects for improvement of the health of KP members by prevention and treatment of chronic diseases, immunizations, cancer screenings and promoting evidence-based care. • B.S. Biology - Rutgers University – Cook College, New Brunswick, NJ 1/1991 • M.D. - Rutgers University and Medical School in New Brunswick, NJ 1990-1995 • Family Practice Residency at Emory University in Atlanta, GA1995-98 • Asst. Faculty - Emory University Family Practice Residency Program in Atlanta, GA 1998-2000 • Fellowship in Obstetrics in Sylacauga, Alabama 2000-2002 • Private Practice in Atlanta 2002 – 2009 • Contact Info: • Email: belkis.x.pimentel@kp.org • Admin Assistant: Maxine Conwell -- Email: maxine.noble@kp.org