Public Health wants more influenza vaccine, assessment centre expansion come fall

Kingston’s Chief Medical Officer of Health, Dr. Kieran Moore, said he is waiting to find out whether Kingston Frontenac Lennox & Addington (KFL&A) will receive critical additional doses of influenza vaccine this fall.

“We have not heard whether the government has purchased any additional influenza vaccine for this coming respiratory season,” Dr. Moore told the KFL&A board meeting Wednesday, Jun. 24, 2020, “so we must be prepared for the worst.”

Taking cues from the southern hemisphere, where it is currently winter, the board heard a presentation on Wednesday about successful initiatives in Australia and New Zealand to manage the co-circulation of Influenza A, B and COVID-19. Officials there are promoting the flu shot.

“Every year, [Australia and New Zealand] go through the flu season from June to August,” said Anthony Li, a Queen’s University medical student working with KFL&A public health. “So it can be a very good indicator for us in North America to take a look at what they’re doing, best practices and what to expect.”

“Australia this year immunized at record-high levels, 237 per cent more [flu vaccination] than last year,” Li said. “New Zealand, 102 per cent more than last year. And they both have record-low incidences of flu-like symptoms.”

“I absolutely think COVID-19 and all other respiratory illnesses will naturally rise in incidence in October and continue to go until March of 2021,” said Dr. Moore.

Because influenza A, B and COVID-19 all present with similar systems, Li and Moore explained that this could overburden Kingston’s emergency departments. They both suggested Ontario needs to maintain and expand the mandate of its 130 COVID-19 testing centres in order to manage a seasonal surge, transitioning them to acute respiratory illness centres that also test for flu.

KFL&A’s two assessment centres are currently located at the Memorial Centre in Kingston, and the Lenadco Building in Napanee.

Expanding and transitioning these assessment centres should reduce the burden on our emergency departments, Li and Dr. Moore said, and reduce COVID-19 transmission in the health care setting.

“We did this before in 2009 for the H1N1 pandemic in KFL&A,” Li noted. “We redirected over 2,000 patients out of the emergency department.”

“Influenza typically causes a 10 to 15 per cent admission pattern, a 20 to 30 per cent increase in emergency department visits, on its own,” Dr. Moore said. “If we don’t have these assessment centres up, the impact on the acute care sector, primary care sector and admissions to hospital and hallway medicine could be significant,” he said.

Dr. Moore said he is working at the highest level of government to advise preparation and on-going support and funding for the centres. “I think it’s an important tool in our tool kit to protect the health care system and minimize spread within the community,” he said.

KFL&A asks for more flu shots, sooner

With direction from the board, Dr. Moore said a KFL&A public health team has also approached the Ontario Chief Medical Officer Health and Public Health Ontario to request additional doses of flu vaccine, and to receive them earlier in the season.

“We were referred to the National Advisory Committee on Immunization,” he told the board. “They are reviewing the issue. I know they had purchased 300, 000 additional doses of vaccine for this coming year.”

Ontario typically sees a provincial immunization rate for influenza around 30-40 per cent, he said. Those additional 300,000 doses, distributed across the whole province, won’t have a big impact on the usual vaccination rate.

“We’ll continue advocate for additional [influenza] vaccine,” he said.

“A prevention strategy, learning from New Zealand amd Australia is key. They are showing very good resistance to influenza through their immunization strategy, hand hygiene, cough etiquette, early testing and masking in public. We’ll have to maintain all of these things.”

Dr Moore added that it is difficult to make these “the community standard” and to make sure people adhere to these practices, but the board would need to keep pushing these concepts in preparation for the year ahead.

“We don’t see a COVID-19 vaccine coming for at least a year,” he said.