Flu Shots in the Year of Covid-19

Does it really matter if I get a flu shot? The short answer is YES !!!!

The flu is dangerous in its own right, hospitalizing and killing tens of thousands of people each year and sidelining millions more for days to weeks. On average, 17 million work days and 38 million school days are missed every year as a result of the flu.
This great article from NPR explains…

Emergency rooms and urgent care clinics are often flooded with flu patients during winter months. So getting a flu shot can help prevent those visits — and thereby prevent the co-mingling of flu patients and COVID-19 patients, who can infect each other and spread their viruses to other ER patients.
In most years, some who get the flu would reasonably choose to ride it out, feeling miserable for a week or so says Dr. Steven Pergam, an associate professor in the Vaccine and Infectious Disease Division at the Fred Hutchinson Cancer Research Center in Seattle. But this year, “even people who never see a doctor for the flu might be prompted to book an appointment or head for the ER if they feel flu-like symptoms coming on,” Pergam says. That’s because the flu and COVID-19 can share many (though not all) symptoms, including fever, chills, cough, sore throat, muscle or body aches, headaches and fatigue.
“And even if you might only have a few days of feeling poorly,” Pergam says, “transmitting the flu to babies, older people and people with compromised immune systems risks severe illness or death for them.”
Public health experts are also concerned about people having both the flu and COVID-19 at the same time. “We don’t know yet whether that could compound either illness, but why take the risk?” says Dr. Ashish Jha, director of the Harvard Global Health Institute.
“No year is a good year to get the flu, but this year — with COVID-19 also raging — it’s especially bad,” says Mark Thompson, an epidemiologist in the Influenza Division at the Centers for Disease Control and Prevention. “People who can avoid the flu will help reduce the burden on a U.S. health care system already overwhelmed by COVID-19,” Thompson says.
Flu Facts

  • Flu sickens between 9 – 45 million people in the US each year.
  • Between 140,000 to 800,000 people in the US are hospitalized each year due to Flu.
  • You can infect other people up to 7 days after becoming sick with the flu?
  • The rate of heart attacks increased 10 X 1-3 days after flu infection
  • The flu shot isn’t perfect, but its a whole lot better than not taking it
  • You cannot get the flu from the flu shot – it can make you feel crummy, that is true. But those symptoms come because your immune system is responding to the vaccine, not the flu.
  • There are now several types of flu vaccines that are NOT made in eggs and thus cause less side effects for many people
  • If you take your flu vaccine early (e.g. Aug/Sep), you can get a booster in January if the flu season is particularly bad

Are You Prepared for a Disaster?

Plan Ahead Sign

With all the wildfires raging in California, Oregon and Washington (and the Valley Fire in San Diego county), it’s a potent reminder that we live in Disaster Country. Whether it’s a pandemic, earthquake or wildfire, we all need to be prepared.

  • Have a plan: Essential services may not be available for the first few hours or days following a disaster. We must be ready to act on our own and planning makes a huge difference. Start here.
  • Build a kit: If you have to survive on your own after an emergency, you’ll need the right supplies including food, water, and other items for at least 72 hours. Find a list of what you need for your supply kit here. And keep your kit where its easily accessible for quick evacuation.
  • Take additional steps: For wildfires, this means creating a 100-foot radius from all combustible vegetation around your home. For earthquakes, secure heavy items in your home and consider an earthquake insurance policy. Prepare now for various disaster scenarios.
  • Get the app: San Diego County has a great emergency app – SD Emergency. It will send you warnings about fires or other safety issues and has great maps showing emergencies and shelters. Find it by searching ” SD Emergency” in the app store.

How to Sanitize your Phone and other Devices

Since Coronavirus can be transmitted on inaminate objects, it’s important to sanitize things. We’ve all heard about sanitizing our hands. But what are we to do with our phones – especially since we put them close to our face! The FCC has these suggestions:

  • Unplug the device before cleaning.
  • Use a lint-free cloth slightly dampened with soap and water.
  • Don’t spray cleaners directly onto the device.
  • Avoid aerosol sprays and cleaning solutions that contain bleach or abrasives.
  • Keep liquids and moisture away from any openings on the device.

While it is safe to use disinfectant wipes on many devices, keep in mind that those containing alcohol, bleach or vinegar may wear down the protective coating on a smartphone’s screen.
CDC suggests using alcohol-based wipes or sprays containing at least 70 percent alcohol to disinfect touch screens.
You can also take steps to minimize your mobile device’s exposure to germs and the coronavirus.

  • When outside of your home, keep your phone in your pocket, purse or car.
  • When shopping, use a written shopping list, not a list kept on your smartphone.
  • Use a credit card for payment, preferably a contactless one, and not the mobile pay option on your smartphone.
  • After being in public places, only touch your phone after you have washed or sanitized your hands or removed gloves you have worn.
  • Use a hands-free device when making calls so that your phone is not pressed against your face or face mask.

Coronavirus Scams

The COVID-19 pandemic is now in its 6 month in the US, and there are still a lot of unanswered questions and fear. Unfortunately scam artists are praying on that fear and uncertainty. Wearing a mask and social distancing help protect you from COVID-19. But how do you protect yourself from COVID-19 scams? Learn what to look for and what common scams look like!

  1. COVID-19 Text Scams: Scammers use links in texts to put malicious code on your phone or link to a phony website that tries to get your personal information. NEVER click a link in a text about COVID. There are scams touting cures, warnings about the need for a test, or “special offers.” Some specific scams:
  • Claiming to be from the “FCC Financial Care Center” and offering $30,000 in COVID-19 relief.
  • Impersonating the U.S. Department of Health and Human Services. Recipients are told they must take a “mandatory online COVID-19 test”
  • “IRS COVID-19 News” includes a link and instructions for recipients “to register/update your information in order to receive the economic impact payment regardless of your status.” 

2. Posing as a Contact Tracer: These are the most scary in my opinion. True Contact Tracers work for state health departments to try to track anyone who may have been exposed to COVID-19, and they are an important part of our road to recovery. It differs from state to state, but they may contact you by call, email, text or even visit your home. They may ask for your name and address, health information, and the names of places and people you have visited. They WILL NOT ask for:

  • Payment of any kind
  • Your Social Security number or financial information. 
  • Immigration status
  • you to click on a link or download anything. Real tracers will only send you texts or emails that say they’ll be calling you

3. Stimulus payment scams: These are less common now, but if there is a second round of stimulus payments, these scams will certainly return. Tips to avoid these scams:

  • Use only IRS.gov/coronavirus to submit information
  • The IRS won’t contact you by phone, email, text message, or social media with information about your stimulus payment
  • The IRS will not reach out to you to ask you for your Social Security number, bank account, or government benefits debit card account number.
  • You don’t have to pay to get your stimulus money.
  • The IRS won’t tell you to deposit your stimulus check then send them money back because they paid you more than they owed you. 

4. Robocall scams: phone scammers have seized the opportunity, using robocalls and call-back scams to offer free home testing kits, promote bogus cures, sell health insurance and promise financial relief. Some current Robocall scams include:

  • Purporting to be from WHO and asking for account information or money
  • Offer free virus test kits in an effort to collect consumers’ personal and health insurance information. One pernicious version of this scam targets higher risk individuals with diabetes, offering a free COVID-19 testing kit along with a free diabetic monitor. 
  • Marketing fake cures and asking for payment over the phone. If you get a call that says a product can prevent, treat, or cure COVID-19, stop. Think to yourself: if there’s actually been a medical breakthrough, am I really going to hear about it for the first time from an ad or sales pitch? The answer is clearly “no.”
  • COVID-19 themed work-from-home opportunities, debt consolidation offers, and student loan repayment plans. (For legitimate information about the coronavirus-related interest rate deferral on student loans, check FSA’s website.
  • Small businesses are also getting scam calls about virus-related funding or loans and online listing verification.

5. COVID mask exemption cards:  There are cards circulating online and on social media that say the holder has a disability that prevents them from wearing a mask, and that it’s illegal for any business to ask them to disclose their condition. Variations of the card include the seal of the U.S. Department of Justice (DOJ), one of the federal agencies responsible for enforcing the Americans with Disabilities Act (ADA). These cards aren’t issued or endorsed by DOJ, or any other federal agency.

6. Free COVID-19 money offers on WhatsApp and Facebook: Have you seen a message on WhatsApp or Facebook offering you free help during the pandemic? These messages all offer money to people who need it — through grants, coupons for food support, or other giveaways. But they’re all fake. The message may tell you to click a link to get your money. If you click, you might find a survey to take. Or they might ask you to enter your name, address, phone number, or other information. And they might ask you to forward the message to several friends to be eligible to collect. DON’T CLICK ON ANY LINKS in these messages.

7. Coronavirus Charity Scams: Opportunistic scammers are using fake appeals or sham charities to swindle donations from good-hearted people. Before you give, do some research. Search online for the charity’s name and the words “scam” or “fraud.” Review ratings of the charity by organizations like BBB Wise Giving Alliance, Charity Navigator, CharityWatch, or GuideStar. Here are some tips to make sure you’re not talking to a scammer:

  • Donate using a credit card. It’s the safest way to donate.
  • Double check the name of the organization. Many fake charities try to trick you by using names similar to those of well-known organizations, but with one word different or a misspelled.
  • Ask lots of questions. What’s the charity’s website, address, and mission? How much of my donation will go to the program I want to help? How many people does the charity help, and how? If you get vague answers, it’s probably a scam.
  • Don’t assume a donation request on social media is legitimate just because a friend liked it or shared it. Call your friends or contact them offline to ask them about the post they shared.

8. Scams targeting older Americans:

  • The US Securities and Exchange Commission posted a warning about fake stock offers pitching a nonexistent biotech company developing a vaccine for COVID-19.
  • The Social Security Administration posted an alert about a scam claiming that benefit payments may be suspended or decreased due to office closures related to the COVID-19 pandemic. Any call, text or letter offering to “maintain regular benefit payments” if you make a payment is FAKE.
  • Another scam offers investment gains while protecting against losses — a coronavirus twist on a classic phony investment offer.
  • Pandemic versions of the “grandparent scam,” where a scammer poses as a relative, often a grandchild, in a desperate situation and urgently in need of money. 

If you see a scam, report it to ftc.gov/complaint or fcc.gov/complaints.

All About Coronavirus Testing

There is a lot of confusion about Coronavirus testing – should I get tested? When? How often? Which test? What do the results mean?

One reason for so many questions is that we still don’t know very much about COVID-19, although we’re learning new information every day. So I’ve tried to explain testing and what it does (AND DOESN’T) tell us.


Virus Test – The test for active Coronavirus infection is done by PCR (polymerase chain reaction) which picks up even very tiny amounts of viral RNA. This is usually done by deep nasal swab. Yes, this can be uncomfortable, but that’s where the virus lives in large amounts, so it is the best place to sample. Throat swabs are less sensitive so you might get a negative result but still be infected.
       Rapid test – Results within 15-30 minutes. This requires an expensive machine to run, so it’s often only available in ER or hospitals.

       Standard test – Is done by most labs, turnaround is usually 2-5 days

Antibody test – this test tells is if we’ve been infected in the past. These antibodies develop about 4 weeks after the acute infection. This test requires a routine blood draw and turnaround time is about 1-2 days.

We’ve heard a lot about various tests with some being better than others. The FDA has given Emergency Use Authorization to a number of tests and click here for a good explanation of their findings. All of the tests they’ve “approved” are performing reasonably well, so I’ve personally decided not to get lost in this discussion (sensitivity, specificity, positive predictive value, negative predictive value, etc).

For this discussion, I’m assuming the test is accurate. But remember that no test is always 100% accurate.

Virus test (nasal swab):
     A positive test means there is virus RNA in your body – you are actively infected, even if you don’t have symptoms. You are infectious to other people and should self quarantine. There is a caveat here – people who get infected with COVID-19 can remain positive on this test for up to 12 weeks. Since we do not believe people are infectious this long, it may be that the test is picking up dead virus. But this remains an area of significant uncertainty.

     A negative test means there is no virus RNA present – you are not actively infected. You are not infectious

Antibody test (blood test):
     A positive test means you’ve been infected with Coronavirus at some point in the past. This is very helpful to Public Health professionals to know what percentage of the population has been infected and how close we are to “herd immunity”. It is less helpful for a specific individual and questions remain:
  –  it doesn’t tell us when you were infected.We do not know how long these antibody tests remain positive – a few months, a few years or forever?

  –  We do not know if these antibodies protect us from getting infected again. With some viruses (e.g. cold viruses), antibodies protect us for a short while, but we can get infected again and again. With some viruses (e.g. chicken pox, measles) antibodies protect us and we only get infected once in a lifetime. And with other viruses (e.g. herpes, HIV), having antibodies doesn’t help at all – we remain chronically infected.

   A negative test means you’ve not been infected with Coronavirus in the past. One caveat: If you’re recently infected with Coronavirus, the antibody test will not become positive for about 4 weeks.

With symptoms – Always test if you have symptoms suggestive of Coronavirus.
After an exposure – Not everyone gets infected even if exposed. But when (and if) to test is an area of debate . The incubation period of Coronavirus is 2-14 days. If you test negative on day 2, unfortunately you can still turn positive on day 3, 4, 5 up to day 14. So regardless of the results, you should self isolate for 14 days. One recommendation is to test on day 14 – if negative you can safely return to life.
Before visiting a high risk person – Ideally get a rapid viral test right before you’re planned visit. A negative result means you can visit Grandma without concern you’ll spread it to her. This is limited by the availability of the rapid test (see “where to get tested” below). If you are planning on visiting Grandma for a week, however, you’ll need to test every day which is often not feasible.

WHERE TO GET TESTED (San Diego County):
  –  I offer standard virus and antibody testing in my office. I do not have rapid virus testing.

  –  County testing sites can be found here. These sites are free and some require an appointment.

  –  Scripps is only testing patients with symptoms. If you are a Scripps patient, Call the Scripps Nurse line (888-261-8431) to get scheduled. They offer standard virus testing, they are not doing rapid virus testing.

  –  Many CVS locations offer standard virus testing with 2-4 day turnaround. Cost is usually covered by insurance. Register in advance at CVS.com.

  –  CovidClinic.org In downtown San Diego offers rapid virus testing and antibody testing for about $150

  –  QuestDirect allows people to request an antibody test and pay for it online ($130). An appointment is then made for a blood draw at a Quest lab.

  –  At Home testing – this is a rapidly expanding area with many unknowns currently. I will provide more information in the next newsletter.