Last May, Dr. Olga Meave, chief medical officer at Clinica Sierra Vista in California’s Central Valley, was concerned.
“I worry that our health system will collapse in the fall,” she said during a filmed interview that was part of Direct Relief’s Shorty Award finalist video “Fighting Covid On The Farm.” Meave and her colleagues were particularly wary of flu season converging with the pandemic. She also thought the summer months could bring a spike in Covid-19 cases, as the local harvest season concluded.
As it turns out, she was a partially correct, at least for now. The clinic saw a six-week surge just after the video was shot, with an approximate 25% increase in Covid-19 patients. A smaller increase in Covid-19 patients took place at the end of August as well. Many of Meave’s patients are farm workers, and she said they are at an increased risk of Covid-19 complications due to elevated incidences of respiratory illnesses such as valley fever, asthma, and seasonal allergies. She noted the poor local air quality and pervasive use of pesticides as further contributing to the health issues in the area, more generally.
“Community clinics are on the frontlines. We serve these communities that are largely representative of who is contracting Covid first,” she said.
Trying to prevent her other prediction from coming true, Clinica Sierra Vista is running drive-in flu shot and Covid-19 testing clinics, in addition to offering these services at their multiple Kern County and Fresno County locations. Staff members are doing everything they can during in-person and telemedicine medicine, as well as messaging campaigns, to encourage their patients and members of their community to get a flu shot and a Covid-19 test.
“We’re pushing really, really hard for people to get vaccinated, but still some patients don’t want to, so we bring multiple staff members to come and educate them on the importance of it,” Meave said.
CDC data show that receiving a flu vaccine reduces the chance of catching the flu by between 40% to 60%. The CDC also reports that flu vaccinations reduce the number of doctor visits nationally by millions and hospitals visits by tens of thousands. Hundreds of millions of people have received the vaccine over the past 50 years and severe allergic reactions are “rare.” As with any vaccine, the CDC recommends patients consult with their health care provider prior to receiving it.
Though a persistent myth, it is not possible to get the flu from either the inactivated (which is injected) or recombinant (which is a nasal spray) forms of the vaccine.
Despite the data and overwhelming consensus of the medical community, persistent doubt has lingered among Clinica Sierra Vista’s patients and the country at large regarding flu vaccines — leading to concern among Meave and her colleagues that the sentiment will also spill over into the future Covid vaccine. A Gallup poll shows it already has: only about half of all Americans would be willing to receive an FDA-approved, no-cost vaccine if it was available right now.
“There is significant misinformation about vaccines. Patients believe those things, they question it. When a Covid-19 vaccine comes on, were going to be very, very pushy and do a very good job convincing patients to get the vaccine because of all this misinformation,” Meave said.
“We’ve seen it in the past with flu and now we see it with Covid.”
And whereas public health officials have been consistent – for decades – about the safety and importance of flu vaccines, there has been mixed messaging related to Covid-19 testing as the pandemic has evolved over recent months. According to staffers at the clinic, this has led to confusion and complications for both patients and staff members.
“There were a significant public messaging problems when we had to ration tests. We have gone from saying you can only get a test if you were exposed or have symptoms to, now, our metrics to reopening are based on mass testing,” said Tim Calahan, director of public relations for Clinica Sierra Vista.
“There is a need for cohesive public messaging from the top for people to continue to get tested,” he said.
As Covid-19 cases have spiked in the U.S., reaching record highs this month, Meave and Calahan said they have learned lessons that they believe can help them be more effective in providing care for the community.
“It is easier to work with colleagues and competitors than just trying to figure out how to do things on our own. This is a new thing, Covid, we’re learning on the go. The more samples we have to come to a conclusion, the better, just like in any other scientific study,” Meave said.
“The power of public-private partnership has really shown to be massively important in this process, whether it’s donated supplies or other needs within the community,” Calahan said.
Meave said her current focus is on trying to combat three looming challenges: potential coinfection rates with Covid-19 and the flu, general fatigue among the community with regards to Covid-19 precautions, and the potential pitfalls of the upcoming holiday season.
“I don’t want to go back to March when hospitals were full and we were setting up tents, ” she said, even as she knows people will want to gather during the holidays.
“Patients are tired and they want to come to a resolution for this, so the uncertainty is a fear of mine. If patients don’t get vaccinated we’re not going to be able to see results.”
Though she said she feels a “huge responsibility over my shoulder,” Meave feels there is reason for hope.
“Right now we’re getting ready for the third spike and this is going to be nationwide. Fortunately, California is not looking so bad,” she said.