Flu Death Toll Continues To Rise In San Diego County

>>> This is KPBS Mid-Day Edition, I am Maureen Cavanaugh. San Diego County health officials are downplaying the significance of the rising influenza cases, but the numbers themselves are eye-opening. According to data released by the county this week, the number of diagnosed flu cases this season now stands at 10,324. That is about age times higher than the number -- eight times higher than the number last year. The number of deaths stands at 91, which is already higher than last year's total, and we are only halfway through the traditional flu season. Joining me is Dr. Jonathan Graham, director of Hospital epidemiology at Cedars-Sinai Hospital in Los Angeles. We are speaking to him via Skype. And Dr. Graham, welcome. >> Thank you for having me. >> This flu season is not only that in San Diego, this is happening all over California, isn't it? >> Well, it has been our experience here in Los Angeles, that we are certainly seeing a high level of flu activity in our community. Absolutely. >> There is speculation that this is only the flu season peaking early, could that explain it? >> It certainly could be the case of course, it is always hard to predict with any flu season, so it is hard to know when we are going to peek, but what I can say is -- over the last couple of weeks, we have certainly seen a very high volume of activity, higher than we see in most typical years. >> What is -- for a typical year, what is the flu season? When does it start and Southern California specifically, and sort of when does it trail off? >> Well, every year is, of course, a little bit different. It is not unusual for flu activity to really begin to pick up in December or January, and we will often see activity continue or peak in January, February. But, we will also see cases extend into March or April or sometimes later. Every year is little bit different. >>> Most people coming down with the flu have what is called the H3 letter and to strain. Can you tell us about that? >> That strain is well known from prior flu seasons to cause the most severe disease in those at the extremes of age, the very young or old. And also those with underlying medical conditions. I think that that is reflective of what we are seeing in our medical center as well. >> Is it a more dangerous strain of the flu than usual? >> I think it is a little early to say if that is the case or not. What I can say, is we have seen a high volume of flu patients. The good news at least is that the vast majority of people that we are seeing do not have illness. We certainly have seen some severe cases, which would be in the types of patients that we would expect, those who are more elderly and with underlying medical conditions. >> This year's flu shot is said to be only about 30% effective against this strain of the flu. Is that unusual? >> Well, we know every year that of course, the flu shot is not 100% effective. It is still possible to get the flu even if you have had the shot. I have not seen any data from the US, in terms of the effectiveness this year. It is literally to say. What I would emphasize though, even though the flu shot may not prevent you completely from getting the flu, it can reduce your risk of getting more severe illness. For that reason, even though it may not be completely effective against preventing illness, it is certainly helpful in preventing or reducing how severe of an illness you can develop. >> Since we seem to be right in the middle, if not peaking for this flu season, is it too late to get the shot? >> Absolutely not. Although we see a high volume of flu activity at this time, it is important to remember that the flu will continue to circulate for several more weeks, and perhaps into April or May. So, it is not too late to get vaccinated if you have not been already. >> What other precautions can people can -- take to avoid getting the flu? >> It is important to wash your hands frequently, particularly, before or after touching your mouth or face. Of course, stay away from others that are sick that may have the flu. And of course, if you are sick, please stay at home, and do not be around others if you do not have to be. >> To that point of staying away from people who have the flu, when are people most contagious? Is it when they actually have symptoms, or is it before? >> The challenge with the flu is that you can be contagious even slightly before you develop symptoms, so it has been well described that you can be infectious about a day before symptoms develop. This is why getting vaccinated is one of the most important things you can do. People are probably the most infectious for those first 2-3 days during the illness when they have the most severe symptoms. >> I have been talking to Jonathan Graham who is director of epidemiology. Thanks a lot. >> Thank you for having me. >> No flu health crisis has been declared, but San Diego hospitals are seeing more and more people coming in with the flu. In some areas of the state, pharmacies have run out of flu medicines. ERs are packed and ambulances in Riverside face severe backlogs. We will find out what it is like in local hospitals, joining me is Sammy Toda, he is chief operating officer and former director of pharmacy at Kaiser Permanente. And Sammy, welcome. >> Thank you for having me. >> How bad does this year's flu season look in your emergency room? >> Well, it is certainly one of the worst flu here's we have had in quite a while. Certainly, in my 20 years in San Diego, this is among the worst we have seen. Just the virulence of the flu strain that we are seeing predominantly, and just the number of people seeking help is exceeding capacity in multiple hospitals and clinics around the county. >> How is Kaiser Permanente physically dealing with this influx of patients? Is your ER crowded? Are you triaging patients? What is happening? >> Well, we have a surge plan. And most hospitals do have some sort of a surge plan. And, that prepares us for what we would normally expect during a cold and flu season. This year, it is more severe and we just escalate our surge plan to higher levels. So, we do have opportunities to create beds, or do some things to be able to accommodate more patients. Our emergency departments are very busy, we are asking people that if they know that they have the flu, the best thing to do -- and it is mild for them, just stay home. They feel like they are in an emergent situation to visit the emergency room. But, you can expect a long wait. We have also restricted visitors in an effort to contain the outbreak of the flu. So, anyone who has active flu, or flulike symptoms, so fever, coughing, chills, things like that. We are asking them to stay out of the hospital and not send their patients. >> We have seen reports from Riverside and San Bernardino that ambulance services have been overwhelmed, in part because ERs are so busy, there is no room to drop off the patients. Is San Diego seen any of that? Is Kaiser Permanente seeing any of that? >> We have not seen that in San Diego. I will say the ambulance services are extremely busy. And as emergency departments become more impacted, the offload times become higher. But, we try to address those as quickly as we can. So, we have not seen specifically what they are seeing in Riverside and San Bernardino here in San Diego yet. >> Want to ask you specifically about something you mentioned earlier. If a relatively healthy person comes down with the flu, is there any reason for them to go to the hospital? >> Not specifically. I mean, we would tell them to treat their symptoms at home. Probably the best thing for them to do is rest. If they have a fever, they would take acetaminophen or Tylenol, if they have body aches or muscle pain, Motrin or ibuprofen. Just fluids and rest. It is a virus, so there is no antibiotic that we would be able to give to treat the flu. And, at Kaiser Permanente we have the option of telephone appointments, or being able to have the doctor call them back within an hour. In most cases, if any Tamiflu, or one of those medications, we can prescribe it right over the phone, and have them be able to pick it up at the pharmacy. >> When it comes to Tamiflu, there are some areas in California where pharmacies are saying they have run out basically. Do your family seek -- to your pharmacies have enough Tamiflu? >> We do. We have been tracking our Tamiflu inventory daily. We have multiple calls per day to track and manage the surge of patients. While we are seeing about five times more prescriptions than normal, we are still able to manage and provide an ample Tamiflu supply to everyone who needs it within Kaiser Permanente. >> Suppose someone is sick in their home resting. They are taking their acetaminophen and so forth -- what might they look for as a sign that the flu is getting worse? >> Certainly, if they are experiencing severe vomiting or diarrhea, we primarily see that in children. If they are getting dehydrated, if there temperature is elevated above a certain level. Or, if they just feel that they cannot take care of themselves at home, they said -- should take treatment. >> The flu usually resolves itself fairly quickly, within three days or so, but we are asking people if they have had the flu, you want to be symptom three -- free for three days before you visit anyone, because you can still be infectious. >> I have been speaking with Sammy Toda Emma chief operating officer and former director of the pharmacy with Kaiser Permanente. Sammy, thank you. >> Thank you. [ Music ].