October 14, 2022, 1:30 p.m. News Staff — As influenza season approaches, the Academy is taking new steps to ensure family physicians are prepared not just for the flu but also COVID-19, which can present with similar symptoms and is still infecting tens of thousands of people each day.
The AAFP’s latest efforts include free resources on the Academy’s Immunizations & Vaccines webpage to help family physicians and their care teams deliver the best patient care, including
“Nearly every family physician is likely to care for patients exposed to or ill with the flu or COVID, and we know that older adults are among those that face higher rates of severe complications and death from these diseases,” said Julie Wood, M.D., M.P.H., the Academy’s senior vice president for Research, Science and Health of the Public. “Family physicians are well positioned to provide care for older adults in many different settings. Our goal is primary prevention with vaccines and other preventive measures, but it is also important for the patient or their caregiver to be aware of testing and treatment options, ideally before they become ill. The new guidance documents the AAFP has developed facilitate family physicians getting those action plans in place for their practices and patients.”
The new resources come as health care professionals across the United States brace for a potentially severe flu season. Surveillance reports from Australia, where the flu season typically runs from April to October, indicate that the country experienced its worst season since before the COVID-19 pandemic. The rate of influenza cases was about three times higher than average and the number of cases peaked about two months earlier than usual.
Data from the CDC, meanwhile, show that for the week ending Oct. 8, the latest date for which information is available, clinical laboratories reported 1,766 cases of influenza to the agency — a 39% increase from the previous week.
While anyone can become sick from the flu, older adults are considerably more likely to experience severe influenza-associated illness, hospitalization and death compared with younger, healthier people. Children younger than 5 years, pregnant people, and those with weakened immune systems or chronic medical conditions such as asthma or diabetes are also at increased risk.
The clinical guidance sheet is divided into three sections.
Vaccinating Your Patients encourages FPs to strongly recommend all eligible recommended vaccinations during routine or preventive office visits. It includes detailed recommendations for COVID-19 and influenza vaccination, advice on coadministration of the vaccines, and links to the AAFP’s Seasonal Influenza Prevention & Control webpage and the CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States.
Diagnosing and Testing Your Patients explains the importance of testing to distinguish between influenza and COVID-19; gives a rundown of symptoms that may occur in both diseases; discusses the use of telemedicine for patients who have acute respiratory illness and those at high risk; and addresses infection prevention and control measures, and collection of respiratory specimens for testing; and reminds members that people can be infected with SARS-CoV-2 and influenza virus concurrently, and that testing for both viruses is needed to exclude one or the other.
Treating Your Patients features links to NIH treatment guidelines for influenza and COVID-19, a clinician summary on antiviral medications from the CDC and the agency’s interim clinical considerations for COVID-19 treatment in outpatients.
The guidance sheet notes that empiric antiviral treatment should begin immediately, without waiting for lab confirmation of influenza, for patients who are hospitalized; have severe, complicated or progressive illness; or are at high risk for complications.
For patients with suspected influenza who are not at high risk, the CDC recommends that clinicians use their professional judgment about starting outpatient, early empiric antiviral treatment, if it can be done within 48 hours of illness onset.
The medical history form and patient action plan complement the guidance sheet and are both designed for use with older patients. Patients can complete the medical form to list their most recent influenza and COVID-19 vaccinations, test results, symptoms, complications and treatments all in one central location, while the action plan helps patients and their family members make decisions and prepare for unexpected illnesses that may result from COVID-19 and/or influenza.
The new clinician and patient materials reflect an ongoing Academy campaign to provide members with concise, up-to-date information on vaccines and immunizations.
In August, the CDC’s Advisory Committee on Immunization Practices revamped its influenza vaccine recommendations for the 2022-2023 flu season by issuing “preferential” recommendations for three vaccines in older adults — Fluad Quadrivalent, Flublok Quadrivalent and Fluzone High-Dose Quadrivalent — without a preferential recommendation for one vaccine over another. If none of these vaccines is available, then any other age-appropriate influenza vaccine should be used. The AAFP endorsed the modified recommendations following a review and approval by the Academy’s Commission on Health of the Public and Science, and updated its Seasonal Influenza Prevention & Control webpage to reflect these changes.
Other resources the Academy rolled out for members in time for flu season include
Make sure to visit AAFP.org for the latest information on influenza and COVID-19.