A woman gets a flu shot at a Walgreens drug store in Portland in this Oct. 17, 2019, file photo. Credit: Troy R. Bennett / BDN

With the coronavirus already circulating in Maine, health care providers across the state are urging residents to get flu shots as soon as possible so that they can be protected when the influenza season arrives in the next few weeks, creating what the state’s top public health official called “the possibility of two concurrent epidemics.”

If a large number of people develop respiratory illnesses this fall and winter, it would tie up many of the medical resources that hospitals and clinics need to handle an expected uptick of COVID-19 as students return to school and people spend more time inside, according to those providers.

And a flu outbreak would also create more risk that Mainers need to seek medical care, potentially exposing themselves to the coronavirus.

“This is the single most important year that people can get the influenza vaccine,” said Dr. James Jarvis, the clinical lead for the COVID-19 incident command at Northern Light Health, a system made up of 10 hospitals stretching from Portland to Presque Isle. “We don’t want to have this confusion and we don’t want to see people need hospital care for influenza when we’re expecting people to have COVID.”

Between 9,000 and 10,400 Mainers have tested positive for influenza in each of the past few seasons, according to Maine Center for Disease Control and Prevention data. The number of flu hospitalizations has ranged from 500 to more than 1,700 in a season, and there have also been from 40 to 80 deaths.

By comparison, there have now been 5,079 confirmed COVID-19 cases in Maine, with 439 hospitalizations and 139 deaths, according to Maine CDC. However, the slow ramp up of coronavirus testing across the country means the actual number of cases may be significantly higher.

Maine has successfully kept the virus in check better than almost every other state, with its per capita case rate second lowest in the country, and its per capita death rate fifth lowest, according to data collected by The New York Times. It also has one of the nation’s lowest rates of COVID-19 tests coming back positive.

Experts have attributed that success in part to sound state-level decisions and also to Mainers who have generally been supportive of measures to slow the disease, such as wearing masks and social distancing.

But Maine CDC Director Nirav Shah recently expressed concern that the state could lose its grip on the pandemic as new outbreaks have recently been emerging in southernmost York County and in more rural Oxford and Somerset counties. With flu season coming up, he urged Mainers to take the virus seriously and get flu vaccines.

“As we go into the fall and into the winter, on the doorstep of flu season, a possibility of two concurrent epidemics — one of COVID-19, the other of influenza — arriving in the state of Maine with remarkable force, is a possibility we cannot ignore,” Shah said last week. “If we don’t get a shorter grip on COVID-19 now, the arrival of flu season on top of that will make the fall and winter that much more difficult.”

In the coming months, health care providers will have to treat patients who present with flu and cold symptoms — a sore throat, a fever, muscle aches — as though they have the coronavirus until they can receive test results ruling out that possibility, according to Jarvis.

That means frontline medical workers would have to expend more of the protective equipment and testing supplies that are necessary to treat COVID-19, but that have been difficult to obtain throughout the pandemic.

Given that urgency, Northern Light and other Bangor-area medical providers are already starting to administer flu shots to their staff and patients, with a goal of getting many of them vaccinated by the end of October. In a normal season, they would typically wait a few more weeks to start that push.

While workplaces might previously have held vaccination events in which staff come down to a common area and wait in line, the possibility that coronavirus could be spreading now makes that sort of practice unsafe.

To get around those challenges, St. Joseph Hospital in Bangor is trying to vaccinate all its staff using a push cart filled with the shots, bandages and other necessary supplies that can be wheeled to individual departments, infection preventionist Andrew Donovan said. He noted that’s normally how the hospital has delivered vaccines to patients.

“The goal is the same: to get everyone vaccinated as quickly and efficiently as we can, to get everyone willing and able to take the vaccine,” Donovan said.

Typically, more than 90 percent of staff at each health care organization gets a flu vaccine each year, according to representatives from Northern Light Health, St. Joseph Hospital and Penobscot Community Health Care, a group of primary care clinics based in Greater Bangor.

Those staff who do not get vaccinated have usually been required to wear face masks during flu season, but this year, frontline health care workers have all been wearing masks since last March, according to Dr. Noah Nesin, chief medical officer at Penobscot Community Health Care.

Penobscot Community Health Care is planning several drive-through outdoor flu vaccine clinics this fall, starting with one on Saturday morning. It’ll be held at the organization’s new pediatric center at 6 Telcom Drive in Bangor, but is open to anyone.

Another reason that health care organizations are hoping Mainers will get their flu shots early and in large numbers is to prevent their staff from getting sick. Those organizations all have a policy of screening workers for coronavirus symptoms and sending them home to quarantine if they have them.

But if a large number of employees are sent home to quarantine until they can receive test results showing they don’t have COVID-19, “it could result in very serious staffing challenges in any one or more of our sites,” Nesin said.

If that happened, organizations might have to consider delaying elective services and moving their employees around to the areas where they are most needed, Jarvis said.

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