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A fall 'twindemic'? As US nears 200,000 coronavirus deaths, experts fear COVID-19, flu may be a deadly combo

the University of California-Berkeley
the Centers for Disease Control and Prevention
The University of Alabama
New York Times
UC-San Francisco
the Federal Drug Administration
the FDA.Barbara Koenig
the University of Washington’s
Institute for Health Metrics and Evaluation
the White House

Julita Mir
John Swartzberg
Donald Trump
Robert Redfield
George Rutherford
Anthony Fauci
Deborah Birx
Matt Lambert


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San Francisco
Washington, D.C.

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Positivity     42.00%   
   Negativity   58.00%
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Mir also knows of people taking Tylenol before a temperature check so they can pass and get the OK to work that day.But as the U.S. approaches 200,000 deaths from COVID-19, more than any other country, what really troubles Mir is not so much what she has seen but what she envisions for the upcoming months as a combination of factors threatens to negate recent gains – and result in a deadly fall.“My main fear is we will see cases of maybe influenza, maybe COVID, maybe some of the other respiratory viruses,’’ Mir said, “and because rapid testing is not available on a widespread basis, we will be in front of the people and we won’t know what they have.’’Many in the medical community share her concerns.The return of students to schools and colleges amid the coronavirus prevalence, mixed with the approaching flu season and easing of restrictions after a second round of tightening, makes for a worrisome scenario for public health specialists.Coronavirus toll:Pandemic likely to leave legacy of fear and uncertainty that holds back economy for decadesIn California, which has the most people and COVID-19 cases of any state, the daunting challenges ahead may be further complicated by the smoke-filled air from an already hyperactive fire season that still has two months to go.Dr. John Swartzberg, professor emeritus of infectious diseases and vaccinology at the University of California-Berkeley, said he expects the current national trend of decreased coronavirus-related deaths to continue through September, but then pick up gradually in October and even more so in November. Dr. George Rutherford, an infectious disease specialist at UC-San Francisco who heads California’s contact tracing program, calls middle schools, high schools and universities “big incubators of COVID-19,’’ pointing out they have been the sources of massive outbreaks in other parts of the world.Given the early results in the U.S., the prospects for the coming months are not encouraging.“To have the fate of the western world resting in the hands of 12- to 22-year-olds, it’s a little scary,’’ Rutherford said.However, Rutherford finds a sign of hope in reports out of Australia, whose flu season precedes and often serves as a harbinger for the one in the U.S. Australia’s winter concluded Aug. 31, and Rutherford said the country of 25 million experienced its mildest flu season in five years.There might be other reasons at play too, but it appears measures taken to keep the coronavirus at bay were a contributing factor.“The smart money says there’s been much less circulation of influenza in Australia over this winter and it may well be a secondary effect of increasing respiratory precautions, like wearing masks and social distancing,’’ Rutherford said.What you should know about flu shots:It's crucial to get a flu shot this year amid the coronavirus pandemic, doctors sayThe Australian government also launched an aggressive immunization campaign, increasing the number of flu vaccines it secured from 13.2 million in 2019 to 18 million and promoting the free shots. Redfield told WebMD last month that the CDC has procured an extra 10 million doses and he’s hoping 65% of Americans will get the vaccine, thereby blunting the impact of the flu coinciding with COVID-19.Mir, the infectious disease doctor in Boston, said many families have failed to come in to have their children vaccinated this year out of fear of being exposed to the coronavirus.She has also heard of pushback against a COVID vaccine once it’s available, which is consistent with a Gallup poll released Aug. 7 that showed 35% of Americans would not get the vaccine even if it were free and approved by the Federal Drug Administration.Vaccine rejection has become a major issue for public health officials, part of what Dr. Anthony Fauci, the nation’s top infectious disease specialist, has referred to as an “anti-science bias.’’ The problem may have been exacerbated by increasing evidence of political pressure on the CDC and the FDA.Barbara Koenig, a bioethics expert at UC-San Francisco who served on the advisory committee to the CDC’s director, notes that there’s a social dimension to the pandemic response that’s reflected in the public’s attitudes toward wearing face masks, maintaining social distance and accepting vaccinations.“In some cases the idea that freedom is the most important value is very, very powerful,’’ Koenig said.

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