[MCOH-EH] Managing influenza season concurrently with COVID-19

[Galaid Edward I]

Cross posting with OEM-L

For the coming flu season, have you figured out how you are going to manage COVID-19 diagnoses along with non-COVID-influenza like illnesses?
We support both our occ med program to community employers, as well as our healthcare system...we have close to 6000 employees, four hospitals, a lot of out patient facilities.
We are pretty fortunate at this point to have decent stockpiles of reagents to do our COVID-19 testing in house.   But we might be at risk at burning through them fast.
I posed the following possibilities to senior leadership of our healthcare system this AM:



  1.  Can we reliably clinically differentiate COVID ILI from other ILI? (I think we all know the answer to this one).
  2.  If we can't differentiate by symptoms to determine the diagnosis,  should we test?
  3.  If we do test, what are our projected stockpiles of reagents and workforce capacity, and how will that drive our options?
  4.  Should we test in a stepwise fashion?
     *   Do Flu A, B, with or without an expanded respiratory pathogen panel; if negative, do a test for SARS CoV-19 (RT PCR vs antigen?)
     *   Do a SARS CoV-19 test first on all ILI;  if negative, send them home for self-care for non-COVID ILI;  if positive for SARS CoV-19,  monitor recovery through our Care Mgt teams?
  5.  Or should we test for everything all at once.

Consider what Andy Grove, the founder of Intel, said.. "Only the paranoid survive."

Thanks for your time to respond.    I will compile answers for the list.

Ed

Edward I. Galaid, MD, MPH, FACOEM
ABIM, ABPM (OM)
Medical Director, Occupational Medicine
Roper Saint Francis Healthcare
Charleston, SC 29401
Member, ACOEM Task Group on Law Enforcement Officer Health
Special Expert, NFPA Fire Service Occupational Safety & Health (FIX-AAA) Committee
843-402-5053



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