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Transcript of JoCo on the Go Podcast 09/10/2020

Theresa Freed [00:00:00] On this episode, find out why it's important to get a flu shot. Learn when and where the vaccine is available and the level of protection from illness you can expect. Also, find out why a trip to the doctor's office with flu-like symptoms might involve extra testing. And we'll talk about the many tests available to check for the coronavirus. Finally, find out how allergy, flu and COVID symptoms may look similar and different.

Announcer [00:00:24] Whether you live in or just love Johnson County, Kansas, JOCO on the Go has everything Johnson County. Here's what's happening and what's coming up in the community you call home. Thanks for joining us for JoCo on the Go.

Theresa Freed [00:00:39] Thanks for joining us for JoCo on the Go. I'm your host, Theresa Freed, a Johnson County resident and employee of Johnson County Government.. The illness that's had people worried is COVID, but we're also about to enter the flu season that can have some very serious complications, including death. That's why it's important to stay as healthy as you can. As we head into fall. Here to talk more about the upcoming flu season is Johnson County local health officer Dr. Joseph LeMaster. First off, when is the flu season and why should we get that annual vaccination?

Dr. Joseph LeMaster [00:01:06] We see it every year during the flu season, which starts about the beginning of October and through to March. Every year we see a rise in the number of flu illnesses and deaths among especially among our older and more vulnerable populations. This year, more than ever, it's important to get a flu shot. The reason for that is that flu is often a cause of hospitalization and stretch on our resources and also a risk factor for our more vulnerable populations, such as people in nursing homes, older adults, those with chronic illnesses such as lung disease or other types of immune diseases that are that are more vulnerable to infection.

Theresa Freed [00:01:56] And who should get the flu shot?

Dr. Joseph LeMaster [00:01:57] So everyone who is over six months of age, with certain very rare exceptions, should be vaccinated for the flu. We particularly give emphasis to health care workers, those who are working around populations where they're serving the public, those who are working in nursing homes or other health care facilities, in particular, those who have got the chronic illnesses themselves, should be vaccinated as soon as they possibly can. In particular, children who have neurological condition should be vaccinated. If you have some question about whether your child or an adult that you're caring for or if you yourself or an adult with a illness which needs to be protected from the flu, contact your primary care physician to ask about your particular situation and when will the vaccination be available. So the flu shot should be available here at the Department of Health and Environment and the county from next week. Most of our larger pharmacy chains have got it already available. It will be available in hospital and health care, other organizations sometime this month, most of them from next week. We strongly encourage everyone, even if you're not required to get the vaccination for the flu, to get your flu vaccinations as early as possible this year. Remember that the COVID can look a lot like the flu. This is another benefit of the flu if you've been vaccinated against the flu. It's very much less likely that you would present in the way that COVID does with a full on flu like infection. That gives us one way of being able to differentiate between the flu and COVID if you've been vaccinated. That's very helpful information for your health care providers to know. The flu shot does not protect you from COVID. Unfortunately, they are totally different immune type responses. And the receptors and cells that are involved in the response that protects you against the flu in the flu vaccination process is a totally different one from what is happening with COVID. If the flu vaccination protected you against COVID, we would just be providing the flu vaccination everywhere. The fact that we're developing vaccinations for COVID is evidence that we're we're working with a very different sort of situation. On the other hand, flu vaccination will reduce your likelihood of being of having a severe flu related complications, such as pneumonia, which sometimes happens to people, especially those who are older, who have chronic illnesses or who are have other problems that make them vulnerable medically that happen sometimes to those people.

Theresa Freed [00:04:51] So if you test positive for COVID, should you still get a flu shot?

Dr. Joseph LeMaster [00:04:55] So we recommend that if you have COVID, if you've been tested and you're positive for COVID, that you should not get the vaccination until after you are completing have completed your isolation period for COVID. Generally, that lasts for 10 days after your test is positive or three days after you have got over your symptoms, whichever is longer. You should, however, get your flu vaccine as soon as possible after you get over COVID. It is possible to have COVID and the flu in the same in the same season. So having the flu does not protect you from getting COVID at a later point. If you think that you might have COVID or you have symptoms which are flu, like even if you have had the flu vaccination, make sure and go get tested for COVID.

Theresa Freed [00:05:51] Can you actually have both illnesses at the same time?

Dr. Joseph LeMaster [00:05:54] So it is an important thing to realize that it is possible, although very rare, to have both the flu and COVID at the same time. So just because you have COVID right now doesn't mean you couldn't get the flu or that you couldn't have the flu. Also, when you present for an illness that looks like COVID or looks like the flu. Generally this year your doctors will be testing you for both. Sometimes we test for the flu first before we test for COVID. So it is important to be able to realize that both those things can happen, although that is very rare.

Theresa Freed [00:06:28] So if I'm feeling sick, pretty miserable, typically I just go to the doctor. They might test for strep or the flu. What will be different this year?

Dr. Joseph LeMaster [00:06:35] So if you are a health care provider, I have a special message for you. Last year in a number of health care providers would test for flu before they tested for COVID. If the person was positive for the flu, then they would not go ahead and test for it. With the amount of COVID infection that we have around now and the possibility that there can be co infection between the flu and COVID at the same time, we would definitely recommend that people who present with flu like symptoms should be tested for both. Well, there is an assumption that when you've had the flu vaccine that that will work and you will not get the flu. But remember that there are different strains of flu as well. And so it's important if you get flu like symptoms, even if you've been vaccinated against the flu, that you should present and get tested.

Theresa Freed [00:07:22] We're taking a lot of safety precautions against COVID. Will that help with this year's flu season as well?

Dr. Joseph LeMaster [00:07:27] Theoretically, we might expect that the flu season could be somewhat better this year because we're all wearing masks, washing our hands, maintaining social distance that you would like to hope that that would reduce the amount of flu transmission. At the same time as it's reducing the amount of IT transmission, that remains to be seen. Last year we did have a about the same amount of flu and flu related deaths, as usual. There were a few places where it was a little bit less. However, generally speaking, we haven't seen a lot of decrease in the last year of the incidence of flu or flu hospitalizations, which is why we were strongly want to emphasize the importance of wearing the masks and and social distancing practices during this coming flu season because it is so important that we do try all we can and do everything we can to reduce the incidence of the flu. And how can I get a flu shot? You can get a flu shot at your pharmacy. Most pharmacies will provide that. Sometimes your health insurance will pay for that to happen at your pharmacy without even a doctor's order. So that is the first thing to do if that is easy for easier for you to do. Most doctor's offices, if you have an established care relationship with a doctor's office, they will provide the flu to you, the flu shot to you without even a doctor's appointment. You can call up the doctor and ask when the flu shot is available, if that doctor's office. And when you can come in to get it. If you are an employee in a large employer, all of an all employee health organizations or the majority of them either provide the flu shots directly to their employees through their employee health offices, or have an arrangement where you can get that or how you're going to get that. Health care organizations all require their employees to have the flu shot, and that is generally made available through your employer. If all of those opportunities or ways of getting the flu shot are unavailable to you, we provide it and we'll provide it from next week here at the health department. The cost is thirty dollars for those who don't have insurance. We strongly encourage you to get your flu shot as we talk about the flu and konbit.

Theresa Freed [00:09:47] Another problem that comes around each fall for many people is seasonal allergies. So how do you tell the difference between all this?

Dr. Joseph LeMaster [00:09:54] Well, we know that COVID can be nearly asymptomatic. So there may be difficulties in being able to differentiate between whether your child has allergy type symptoms or COVID type symptoms. Kofod can sometimes look just like a cold and especially in children can not look very symptomatic at all. Or it can present a little bit like the flu that is with headache. Fever, cough, shortness of breath, nausea, vomiting, diarrhea, the same sort of things that we would see with the flu, if you see those sorts of symptoms. Definitely you should not assume that your child has the flu and not COVID. Similarly, if you have a child who's going back to school and they start showing signs of allergies where they normally were not showing that or that's not what normally happens to them during the year, something that's outside that normal, then it's definitely worth contacting the people at the school to determine what is happening there. It is important to make sure that your child understands the importance of social distancing procedures, that they if they are of an age where they can be wearing a mask. Washing hands and maintaining social distance, that they understand the importance of that and that they are following those guidelines. Maybe one difference that you might notice between allergies and COVID would be that the symptoms of itchy eyes or sneezing or allergic type symptoms, rashes that are itchy, those sorts of things are not things that you see so much with COVID but runny nose, cough, any of those other type of respiratory symptoms could be in common.

Theresa Freed [00:11:45] Finally, we want to bring on Johnson County Department of Health and Environment director. Dr. Sanmi Areola would like to talk about the many kinds of COVID tests that are available and, if needed, testing for the flu and COVID.

Dr. Sanmi Areola [00:11:55] You could collect saliva, you could take nasal sample go for that for that down what we call the nasopharynx and the nasopharyngeal sample. You can also take the oral pharyngeal samples. Those are different ways of collecting samples. Now you can take those samples to the lab and the key diagnostic processes that is used is what we call the RT-PCR. Basically taking if you have virus samples in that which are really what we call RNA strands that process causes them to multiply in a way that, they can be detected. That's the key diagnostic test. So both the saliva test that is available as well as the nasopharyngeal sample that we take eventually end up in the lab where it's analyzed using the RT-PCR. Those are called diagnostic tests. Now, there's a second type of test that is called antibody test, which is really, really looking for antibodies, which are proteins that our bodies will produce when we have foreign materials coming in. It's how it fights those infections. Now, the antibody test generally can not tell you about whether you are clearly infected. It will tell you whether you've had previous infections before. And there's a third type of test that is around largely for rapid testing, which are called the antigen tests. And again, those ones are not necessarily as as accurate as you get it in a PCR test, which is most of the time greater than 95 percent accurate. And there's been several studies of them done this COVID-19 period, and they've been consistently accurate. So antigen test for the most part. Right now, the the the direction is if it's a positive test, then it's less likely to be false positive. And then you accept and you, as I say, probable cause, not quite as the diagnosis diagnostic test that RT-PCR test is if it is negative, then they recommend that you take the person through the outright diagnostic test, either you take a saliva test or a nasopharyngeal sample and send it to the lab to confirm that it is more likely that the negative test is a false negative than it is for the false positive to be a false positive. So that those are the things to keep in mind. Now there are other variables there that may impact whether the test, even the very sensitive RT-PCR test, whether the test picks up the virus. Number one, the RT-PCR test is so sensitive that it will pick up really viral samples as few as a hundred per milliliter and pick them up and analyze those. The question is when the sample was was is taken. For example, I could be exposed to the virus today. It will take a few days for the virus to multiply in my body while my system is trying to fight this infection. So some people may never show symptoms. We call that asymptomatic. Even when the virus multiplies in their body, they won't show up. But if you take my sample in a day or two after my exposure, when the virus is still multiplying what we call the incubation period, it may not necessarily pick up enough that it knows enough virus sample to detect. So so it might mean that I was tested a little too early for the system to pick up the virus. And that's why wearing mask continues to be to be very important. It is also, again, there are people that will show symptoms later, those those people before they they showed the symptoms is what we call pre symptomatic period. And it is possible also at those time that they're not showing symptoms yet, but the virus is already building up in their system. And we know that people are actually I live more likely to spread the virus two to three days before they show symptoms. And so, again, very important to to wear a mask. There are variables to the to the testing processes. Most of the time, it's more likely there's a false negative than it is that you have a false positive. So if you are told that you are positive, unless it's a serological test or the antibody test, you should know with a fairly high degree of confidence, unless there's a lab error, that you are positive and take the necessary step to isolate yourself and tell your contacts to quarantine.

Theresa Freed [00:17:04] To get more information about the flu shot. You can visit the Johnson County Department of Health and Environment Web page and get more about COVID-19 in Johnson County, visit jocogov.org/coronavirus. You can also subscribe to a daily e-newsletter for the latest information from the county and state.

Announcer [00:17:23] You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCo on the Go. For more on this podcast, visit jocogov.org/podcast. Thanks for listening.