State and County Flu Guidance

Flu season is underway in Arizona. As health care professionals prepare for a potential new wave of influenza that will coincide with the COVID-19 pandemic, the engagement of all Arizona physicians with the community will be critical in order to robustly respond to these current and emerging health threats. Organizations such as the Arizona Department of Health Services (ADHS) and the Maricopa County Department of Public Health (MCDPH) are both taking steps to ensure adequate resources are available for physicians to fight the flu, and both departments are making recommendations to help guide health care professionals over the coming months.

As ADHS Director Dr. Cara Christ mentioned in a press conference in September,

“Every flu season, our hospitalizations increase due to influenza. Getting your flu shot will help prevent hospitalizations from influenza, keeping more hospital beds open.”

As we enter the fall and winter months, ADHS has requested that Arizona physicians continue to actively promote flu vaccination to their patients, families, and friends. MCDPH has ordered 10 times the vaccine it normally orders for a typical flu season so that every resident can get vaccinated, regardless of insurance status or ability to pay. MCDPH has partnered with non-profits, pharmacies, hospital systems, homeowners associations, fire departments, and faith-based communities to make sure the vaccine is as widely available as possible. Access to vaccination services is critical, because while roughly 95% of Arizonans vaccinate their children, the number of vaccine exemptions has been rising in recent years.

Understanding which populations are most vulnerable will be important to be aware of as the flu season progresses through the end of the year and into 2021. Vaccination of high-risk persons is especially important to decrease their risk of severe flu illness, and people at high risk of serious flu complications include young children, pregnant women, people with certain chronic health conditions and people 65 years and older. The Centers for Disease Control and Prevention (CDC) notes that many people at higher risk from flu also seem to be at higher risk from COVID-19, and although flu vaccines will not prevent COVID-19, vaccination will reduce the burden of flu illness, hospitalizations and deaths on the health care system and conserve scarce medical resources for the care of people with COVID-19.

MCDPH is also exploring options to use flu vaccination efforts as an opportunity to exercise mass vaccination for COVID-19. While it is anticipated that the demand will likely exceed the supply, MCDPH is working with university partners to develop a mathematical model for the rapid and equitable distribution to those who are at highest risk and most vulnerable. There are also partnerships between

MCDPH and various Maricopa County healthcare systems to make sure that prioritized groups across the county have access to the vaccine. As soon as more information is available about a COVID-19 vaccine it will be communicated to Arizona physicians so that safe, evidencebased recommendations can be made to patients, families, and friends.

Arizona providers who offer seasonal influenza vaccine are encouraged to register for VaccineFinder at https:// locating.health/register as this site will be the primary source that public health departments will utilize to alert the public of where to get flu vaccinations. Additionally, in an effort to provide a uniform flu vaccination message statewide, the ROLL UP YOUR SLEEVE social media campaign found through www.azdhs.gov can be shared with public and private partners. Arizona physicians looking to stay up to date on the state’s flu and COVID-19 case counts can also access this information through dashboards on the ADHS website.

As the pandemic continues and our daily routines are disrupted, Arizona physicians must remain vigilant in supporting their patients and advocating for healthy communities.

Until a COVID-19 vaccine is widely available to those who want it, we all need to continue to encourage our patients and families to stay 6 feet away from others, wear masks, wash and sanitize hands, avoid touching their face and to stay home when they are sick. Routine counseling and encouragement to adhere to health practices by Arizona physicians will help keep transmission down, and while these interventions have been messaged widely for the control of both influenza and COVID-19, they will also help control the spread of many other common illnesses.

This pandemic has stressed our healthcare workers and our entire healthcare system far beyond what we thought we could handle, and we must all continue to collaborate and work together as we enter the flu season. Know that you all play a vital role in the public health system and we appreciate everything you have sacrificed for the health or our Arizona communities. Stay safe!

By William Floor, MPH Candidate, Class of 2020, A.T. Still University, sa201263@atsu.edu