What happens when COVID-19 and influenza collide? Can hospitals handle the strain?

Flu season is just around the corner, and the United States still hasn’t contained the coronavirus. That sets up an unsettling challenge this fall: how to minimize the impact of the simultaneous spread of COVID-19 and seasonal influenza so hospitals aren’t overwhelmed.

As pandemic policy experts, we understand the strain that the combination of COVID-19 and influenza could have on our health care system. Our new report, COVID-19 and Seasonal Influenza: Preparing for a Collision, just published by the Scowcroft Institute of International Affairs at Texas A&M University, explains the risks and offers 10 recommendations.

The numbers suggest a risky fall and winter

Close to 5 million people in the United States have been infected with SARS-CoV-2, and more than 170,000 have died. In some hospitals, such as Starr County Memorial on the Texas-Mexico border, the caseloads overwhelmed capacity.

Given that both COVID-19 and influenza are respiratory viruses requiring similar supplies and equipment, hospitals that are already struggling to accommodate COVID-19 patients may not be able to manage the additional flu patients.

In recent years, influenza-related hospitalizations ranged from a low of around 280,000 in 2015-2016 to a high of 810,000 in 2017-2018. According to data from the American Hospital Association, as of March 2020 the U.S. had 924,107 total staffed hospital beds. If a city or state becomes both an influenza hot spot and a COVID-19 hot spot simultaneously, that would almost certainly overwhelm hospital capacity.

Additionally, some of the measures that have been effective in managing hospital surge capacity, such as Houston’s use of Texas Children’s Hospital for adult COVID-19 patients, might not be possible since children under 5 years of age are one of the groups most likely to have severe outcomes from seasonal influenza, including hospitalizations and deaths.

How to reduce the risk of a double whammy

To reduce the risk of a bad season of both COVID-19 and influenza overwhelming U.S. hospital capacity, our report offers 10 recommendations.

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