In the ICU at Massachusetts General Hospital, nurses use Gatorade to combat flu-related dehydration (due to shortages of intravenous fluids)

“This winter’s flu season is turning into a “moderately severe” one that might get worse because of an imperfect vaccine and steady cold weather, flu experts and public health officials said this week…
About 80 percent of cases are of the H3N2 strain, which caused many hospitalizations and deaths this year in Australia, where winter comes in July and August.
“H3N2 is a bad virus,” Dr. Jernigan said. “We hate H3N2.”
Compared to H1N1, the other seasonal Type A strain, and to B strains that usually arrive late in the season, H3N2 tends to kill more of the very young and very old, he said…
The H3N2 component of Australia’s flu shot was reported to be only 10 percent effective at preventing infection and is the same as in North American shots. But both Dr. Jernigan and Dr. Fauci said they expected to see roughly 30 percent effectiveness when data is collected at season’s end, in part because more healthy people get their shots.
The vaccine mismatch was not caused by a genetic shift in the circulating flu, as happens in some years, but by changes in the “seed virus” used in the vaccine; as it grew in eggs, it picked up mutations foreign to human flu.” (A)

“The flu season is straining resources at hospitals nationwide with the Centers for Disease Control and Prevention reporting the flu is widespread in 46 states. Some hospitals are setting up emergency tents to handle the high volume of patients while others are dealing with a shortage of IV bags after Hurricane Maria cut power to manufacturing plants in Puerto Rico.
IV bags hold the medicines and fluids administered by IV and now nurses and doctors are being forced to find other ways to care for their patients, reports CBS News’ Michelle Miller.
In the intensive care unit at Massachusetts General Hospital, nurse Hannah Owens-Pike uses Gatorade to combat dehydration. It now takes her four times as long to administer treatment that would normally be delivered intravenously. Hospital staffers are forced to conserve supplies. (B)

Here is what you should know about this flu season:
1. It’s shaping up to be one of the worst in recent years
2. This season’s flu vaccine is likely to be less effective than in previous years
3. You should get the flu shot anyway
4. Basic precautions may spare you and your family from days in bed
5. Don’t mistake flu symptoms for those of a common cold (C)

“You’re going to be really annoyed, if after spending 12 hours waiting in the ER, we just say “you have the flu, go home.” But that’s all we’ll be able to say to you. Because we cannot cure the flu. It is a virus. We can try to make you feel better. But lots of the things we do for the flu, you can do at home. Flu care mostly consists of supportive measures like fluids and rest and over-the-counter medications.
Ibuprofen (like Motrin) usually makes people feel better than Tylenol. “Prescription strength” ibuprofen is 800 mg (four over-the-counter 200 mg tablets) taken every eight hours, and that’s the best thing to take, unless you have an ulcer. Take with food or milk or an antacid.
If you cannot hold anything down, we can give you IV fluids and anti-nausea medicine.
You may have heard of Tamiflu, the flu medicine. Tamiflu reduces symptoms by an average of one to one and a half days and can have side effects. It is also ineffective after 24 to 48 hours of symptom onset. We will give it to you if we think you really need it, but if we don’t give it, trust us that it’s because it’s not going to help you.
Do not request a Z-Pack. Antibiotics do not help a virus and risk giving you antibiotic-associated diarrhea, and you don’t want that…
There are other ways to get help beyond an unsatisfying trip to the emergency department. Here are our best suggestions:
Call your primary care doctor. Often your primary care doctor can offer advice over the phone or get you in her office. Give your doctor a chance to take care of you!
Urgent care centers: Wait times are considerably less at urgent care centers than emergency departments, and they’re usually able to estimate times over the phone. Many can administer all the treatments described above, even the IV fluids and X-rays.
Telemedicine: Consider finding out if your insurance pays for telemedicine services. This is a perfect use of telemedicine, and you won’t be exposing anyone else to the flu.” (D)

““What should you do if you have the flu?
Often the only response required for treating the flu is rest and staying hydrated, according to the CDC, since most people who get the flu do not need medical care or medication. Infected individuals should not go to the emergency room unless they have very severe symptoms, including being unable to eat, having trouble breathing, and severe vomiting.
Alas, Antibiotics are only helpful for treating bacterial infections, but influenza is caused by a virus.
People who are at high risk for complications — young children, people 65 and older, pregnant women and people with certain medical conditions — may consider taking an antiviral treatment to shorten the length of the illness. If you are in that group, contact your health care provider, the CDC suggests.
Should you go to work if you feel up to it?
Another important measure to take if you have the flu is staying home. More than one-quarter of American workers admit to going to work when they are sick, largely because of their work load, according to a survey released Tuesday by the public health nonprofit organization NSF International.
Being a martyr at work is highly discouraged by the CDC. “Stay away from others as much as possible to keep from infecting them,” the CDC said. “If you must leave home, for example to get medical care, wear a face mask if you have one, or cover coughs and sneezes with a tissue.” (E)

“At the Palomar Medical Center near San Diego, the new year ushered in a brutal flu season.
“The day came when we had extended waits in the emergency department up to eight or nine hours for a patient to be seen,” said Michelle Gunnett, emergency room nursing director. “We need to figure out other space to see patients.”
That space ended up being a triage tent set up right outside the ER.” (F)

“We are not prepared. Our current vaccines are based on 1940s research. Deploying them against a severe global pandemic would be equivalent to trying to stop an advancing battle tank with a single rifle. Limited global manufacturing capacity combined with the five to six months it takes to make these vaccines mean many people would never even have a chance to be vaccinated. Little is being done to aggressively change this unacceptable situation. We will have worldwide flu pandemics. Only their severity is unknown.
The only real solution is a universal vaccine that effectively attacks all influenza A strains, with reliable protection lasting for years, like other modern vaccines. Although the National Institutes of Health has publicly declared developing a vaccine a priority, it has only about $32 million this year specifically for such research. The Biomedical Advanced Research and Development Authority, the other federal agency responsible for developing and making available new vaccines for emergency response, has in fiscal year 2017 only a single project for $43 million supporting game-changing influenza vaccines….
The next few weeks will highlight how ill prepared we are for even “ordinary” flu. A worldwide influenza pandemic is literally the worst-case scenario in public health — yet far from an unthinkable occurrence. Unless we make changes, the question is not if but when it will come.” (G)

“In 2009, former President Barack Obama released a photo getting his H1N1 (swine flu) vaccine. President Gerald Ford got his swine flu vaccine back in 1976 on television. Plenty of governors and senators also release photos of their influenza vaccinations. In 2010, Obama officially declared Dec. 5-11 as National Influenza Vaccination Week. “I encourage Americans to get vaccinated this week if they have not yet done so, and to urge their families, friends, and co workers to do the same,” he wrote.” (H)

“Did President Donald Trump Get the Flu Shot? Some public health experts are hopeful that he will—and that he’ll talk about it” (I)

Note: This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.

(A) Already ‘Moderately Severe,’ Flu Season in U.S. Could Get Worse, by DONALD G. McNEIL Jr., https://www.nytimes.com/2018/01/08/health/flu-season-cdc.html
(B) Hospitals struggle to battle peak flu season amid widespread IV bag shortage, https://www.cbsnews.com/pictures/notable-deaths-in-2017/
(C) What You Need To Know About This Year’s Flu Season, by BARBARA FEDER OSTROV, https://www.npr.org/sections/health-shots/2018/01/09/576772534/facing-down-flu-5-things-to-know-now
(D) What to Do if You Have the Flu, by Dara Kass and Brian Thomas Fletcher, http://www.slate.com/articles/health_and_science/medical_examiner/2018/01/how_to_handle_the_flu.html
(E) The flu costs Americans $10.4 billion in medical expenses and another $7 billion in lost productivity, by Kari Paul, https://www.marketwatch.com/topics/journalists/kari-paul
(F) Hospitals grapple with brutal flu season that could get even worse, by JONATHAN LAPOOK, https://www.cbsnews.com/news/hospitals-grapple-with-brutal-flu-season-that-could-get-even-worse/
(G) We’re Not Ready for a Flu Pandemic, MICHAEL T. OSTERHOLM and MARK OLSHAKERJAN, https://www.nytimes.com/2018/01/08/opinion/flu-pandemic-universal-vaccine.html?_r=0
(H) Did President Donald Trump Get the Flu Shot?, by Alexandra Sifferlin, http://time.com/5093600/president-trump-flu-shot/
(I) Did President Donald Trump Get the Flu Shot?, http://global.breaking.quwa.org/news/did-president-donald-trump-get-the-flu-shot