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Burke medical community expects second wave of flu in February

Jan. 26, 2024, 10:15 a.m.

Original article published in The Paper

Vaccinations still urged for flu and COVID


Health Care and Special Assignment Reporter

Welcome to 2024 and a return of familiar respiratory symptoms – a runny nose, coughing, aches, congestion, and maybe even a fever. And the season is far from over. 

The CDC (Centers for Disease Control and Prevention) and local healthcare providers predict a second wave of the flu in mid-February.

Historically, February is almost twice as likely to be the peak of the flu season, far exceeding the combined months of December and January.

Tracking flu seasons from 1982-1983 through 2021-2022, the CDC found that February was the peak of the flu season 42% of the time.

Together, January and December ranked at 32.5% of the peak months and March was the peak month six times or 15% of the last 40 years reported.

So the flu season probably isn’t over. If you’ve not been vaccinated, get vaccinated, say local healthcare providers. There’s still time to prevent the flu or at least lessen its symptoms. The same holds true for COVID. 

“I would say it is never too late to get vaccinated, whether that’s flu or COVID,” said Anthony J. Frank, Jr., MD, MBA, FACEP, CPE, FAAPL, Senior Vice President Medical Affairs, System Chief Medical Officer, Designated Institutional Official for UNC Health Blue Ridge.

“This comes back to the whole thing of flu and COVID. People will say ‘I got a COVID vaccine and I still got COVID.’ Right, you did.”

“‘I got a flu shot and I still got the flu.’ Right, you did.”

“The vaccines don’t prevent the disease, the vaccines lessen the disease. The fact that your body has already immunologically seen those viruses and your infection cells have developed a response to it, means that you are not going to have, in most cases, severe disease,” said Dr. Frank.

“That was one of the problems with COVID, we had never seen that previously, which is why a lot of young folks had really severe disease,” he said.

Jill Ryan, CPHQ, CPPS, Executive Director, Accreditation, Quality & Performance Improvement for UNC Health Blue Ridge, emotionally recalls working about 15 miles outside of New York City during the early months of the pandemic. 

“We went from no patients with COVID to an overflowing hospital with parking lot clinics and all the things you’ve seen in about five to seven days in mid-March 2020.”

“If you could have seen (and I still get emotional talking about it), if you could have been in that conference room in December 2020 when my teammates, nurses and respiratory physicians, were able to get that vaccine, you’d never deny the impact of it,” said Ryan.

“They had watched patient after patient die. They watched colleagues become ill. If you could have been in that room, you’d never argue about a vaccine again,” said Ryan. “It’s never too late.”  

Burke Primary Care, medical practices throughout the community, and most drug stores offer flu, COVID, and RSV vaccinations. In most cases, insurance will pay for the immunizations but even without having to pay for the vaccines, this year people are not responding at the same rate of previous seasons. 

“Burke Primary Care typically performs thousands of vaccinations each year and this is the first year that we did not use up our supply. Statistically it (flu vaccination rate) is about 50% in North Carolina which is down 5% across the country and we see that here,” said Scott Gallagher, Chief Operations Officer for Burke Primary Care.

“Availability is everywhere but we’re not seeing the population take advantage of it,” he said. 

And it isn’t just the flu hanging around as we start the new year. 

Across the nation, the healthcare community is also reporting high levels of COVID and respiratory syncytial virus (RSV), as well as other “flu-like illnesses” that cause similar symptoms. 

According to a January 19, 2024 article, Virus Soup: Many Respiratory Viruses Peaking in Early 2024 by Carolyn Crist for, the common cold, other coronaviruses, and parainfluenza viruses all hit patients with respiratory symptoms that can include a fever, runny nose, coughing, sneezing, and a sore throat. 

Often called the tripledemic, the flu, COVID, and RSV, are a perfect storm of wintertime illness but they aren’t the only illnesses going around.

While rates of viral respiratory illnesses are down from December reports, locally, almost 7% of emergency room visits are for respiratory symptoms. Of these 3.8% are determined to be flu, almost 4% COVID and  6% RSV. North Carolina is considered to have a HIGH level of respiratory illness activity. [, January 13, 2024] 

Dr. Katherine Liddle, M.D., a Board Certified Allergist at Allergy Partners of the Blue Ridge, treats allergy and asthma patients in Burke and Caldwell counties. She regularly sees patients with weakened immune systems. 

“People with asthma or environmental allergies are not necessarily at higher risk for developing a severe respiratory illness, it is more likely that people with asthma, COPD, or those with poorly controlled symptoms, will need to step-up their medications to manage a respiratory illness,” she said. 

According to Liddle, the flu can be contagious one day before symptoms appear and those with the flu are most contagious three to four days after symptoms begin. “Tamiflu helps improve symptoms but does not decrease the contagiousness,” she said.

Liddle continued explaining that RSV can be contagious one to two days before symptoms begin and can last three to eight days. COVID positive patients are most contagious the first five days. 

“Inflammation of the lungs can cause damage which cannot be reversed. I am more concerned about the very young and elderly because of their weak immune systems which puts them at risk for poor outcomes if they get sick,” said Liddle. 

Testing is key

“Without testing for exactly what it is, you won’t know. We saw a surge of all three in the fall, up to about Christmas time. We typically get a second surge in the February/March timeline,” said Gallagher.

 “It’s all respiratory, chesty, some have body aches. Is it the flu? Is it COVID? It’s best to be tested to find out exactly what it is so if it is early, we can get you on certain meds. If you test too late then it’s too late for meds,” he said.

“So it is really important to either quarantine or to see a provider and get tested to see what it is,” said Gallagher. “If you're coughing, spreading the virus, masking is the first line of defense,” said Gallagher. 

According to Miranda Smith, MPH, CHES and Public Information Officer and Public Health Education Supervisor at Burke County Public Health, the agency does not track flu and COVID numbers locally. However, North Carolina flu and COVID rates have declined in the last week. 

For the week ending Jan. 13, 2024, there was a slight decrease in reported cases of the flu with 1,717 reported in North Carolina. The previous week there were 2,377 cases reported. 

COVID also showed a decrease state-wide with 1,521 cases reported the week ending Jan. 13, 2024 and 1,693 cases the week prior. People testing positive using at-home tests are not typically included in the State’s data.  

Is it time to wear a mask?

While wearing a mask (or not wearing one) has often shifted into a political statement, it is widely recognized as a critical part of preventing and spreading airborne illnesses.

Healthcare providers have different masking rules for their patients and staff based on patient contact and personal preferences. 

“I do not require staff to wear masks unless they have been exposed or tested positive for RSV, COVID, or flu,” said Dr. Liddle.

“They (staff) wear masks for five days after being exposed, and when they test positive, they isolate for five days then mask for five days more. 

“I feel wearing masks is a personal decision but encourage mask wearing for their protection when they are around very ill patients,” she said.


Pam Walker is the Health Care and Special Assignment Reporter for The Paper. She can be reached at 828-443-6103 or [email protected]

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