The Current - Dr. Isaac Bogoch’s forecast for this flu season

Episode Date: October 31, 2024

As days get shorter and temperatures drop, flu season is upon us. Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital, tells guest host Susan Ormiston about what to expect this year. 

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On Drugs is available now wherever you get your podcasts. This is a CBC Podcast. Hello, I'm Matt Galloway and this is The Current Podcast. Flu, pneumonia, COVID, it is virus season. Dr. Isaac Bogosh is an infectious diseases specialist at the Toronto General Hospital and an associate professor in medicine at the University of Toronto. Thanks for joining us this morning. My pleasure, Susan.

In the U.S., the Centers for Disease Control says walking pneumonia is surging, particularly in young kids, and doctors in Quebec are reporting an uptick in cases. Remind us, what is walking pneumonia? Yeah, they're referring to a bacterial infection called mycoplasma pneumoniae. And this is actually a relatively common infection. It can cause a number of different syndromes, but we're really interested in the pneumonia that it's causing. There's periodic outbreaks of this as well, where you have more than the expected number of cases. For example, last year, China had a very large outbreak. Look, we don't follow this or have a national tracking for this.

So it's a bit harder to know how many cases of this there are around. But the United States, the CDC reported more cases of this, particularly in kids and teens. And we're very likely having the exact same issue here. Is it contagious? Yeah, I mean, it's transmitted through the air between people. And I was going to say it's not hard to diagnose, but the diagnostics might take a little bit longer. You can do a standard swab of the nose and the back of the nose. There's other methods to diagnose it. Oftentimes, we just treat empirically without confirming a microbiologic diagnosis. If someone comes in and

it's suspected, you wouldn't wait for the diagnostic test to come back. You just put them on an appropriate antibiotic that covers this. The interesting thing here is I know many people are familiar with a lot of different types of antibiotics. Amoxicillin, for example, is a very common antibiotic given to kids, but it doesn't have effectiveness over this particular bacteria. So the antibiotic of choice is from a different class of antibiotics. They're called an antibiotic such as azithromycin would work for this one. Now, walking pneumonia, the name suggests that we can function, have it and keep functioning. That's not good when you're sick. How dangerous is it?

Most people do okay. And if you really want to line up all the infections, you know, this one would certainly, listen, it can pack a punch like anything else, but it's probably not as severe as the other ones. But again, not to take lightly. You don't want to be, no one wants to be sick. And as the name implies, many people will feel crummy, but perhaps not crummy enough to be flat out on the couch, sick with us. Having said that, you know, we respect this infection and treat it seriously, and we don't want anyone to get it. It's flu season. Don't have to tell you that. And I'm sure you're talking about the strains this season. We've got some vaccines again against flu. How effective are they?

Way too early to know. And sadly, we won't even know until probably the tail end of the flu season. Having said that, we know with influenza, again, an infection to be respected. It kills about a half a million people on the planet every year. It can cause significant morbidity as well. And we know we're starting to see some very early signs of uptick across the country. And of course, you don't need a crystal ball to predict the future. We're going to see a lot more of this. Flu shots are now available in most of the country. And of course, you don't need a crystal ball to predict the future. We're going to see a lot more of this. Flu shots are now available in most of the country, physicians' offices, public health clinics, pharmacies, and they're available for everyone

six months of age and older. And again, of course, it's not perfect, but they're still very, very good in either reducing the risk of infection or mitigating the severity of infection if people do get infected. Okay, so moving on to the C word, how much COVID are you seeing? COVID? Yeah. Oh, no point. Not hiding behind that. I think, you know, some people want to pretend that this is over and done with. It absolutely is not. You know, COVID spreads so far year round, but we know there's more of it around in certain times of year, for example, in the late fall and early winter. You know, I'm actually in the hospital right now. I haven't been seeing a ton of it and we're looking, but that doesn't mean it

isn't out there. That could be just a very biased perception of what's happening in the area that I'm currently working in. And like I said, we know this is going to be widespread and there's going to be a lot more of this around over the coming weeks and months ahead. Vaccines are available as well. The NASI, the National Advisory Committee on Immunizations, sort of divides things up into should and may. The should get the vaccine are people over the age of 65, people who live in congregate care settings like nursing homes and long-term care, indigenous populations, of course, people with medical conditions that put them at greater risk for severe infection. And the May category includes basically everybody else. Some people, of course, are running to get this vaccine when it becomes available. Other people might have questions, and that's totally okay.

when it becomes available, other people might have questions and that's totally okay. Have a chat with a doctor, a nurse, a nurse practitioner, a pharmacist, a public health specialist, a lot of different healthcare providers can help navigate questions people might have on these vaccines. Does the should list include international travel? It technically does not. But listen, if you're in the Northern Hemisphere in the winter, there's going to be a lot of COVID around. And we know what the vaccines do.

They reduce your risk of infection a little bit, not nearly as much as they did earlier in the pandemic. But the heavy lifting is really reducing the risk of more severe manifestations of the virus, such as hospitalization and death. And that benefit will be most pronounced in people who are at greatest risk for severe manifestations of the virus, such as hospitalization and death. And that benefit will be most pronounced in people who are at greatest risk for severe manifestations of the virus. Of course, I mean, we can't just talk about vaccines. We also have to talk about other measures that many people became more familiar with during the pandemic, right? You can reduce your risk of infection if you put on a mask in an indoor setting where we know the vast majority of these respiratory infections are transmitted. And you can improve the quality of air in indoor environments to help reduce the

more distant transmission within those indoor settings. Just briefly, Newfoundland and Labrador have already reinstated mask mandates in healthcare facilities. Do you think should other provinces follow their lead? Well, we're doing, you're actually seeing several places do that across the country. You know, it's interesting. I don't know the details of Newfoundland and Labrador, but the way you mentioned it, it sounds like that's a provincial mandate. For example, in Ontario, certain hospitals have done so. Other hospitals have not. Certain hospitals have done so.

Other hospitals have not. Again, we have a duty to ensure our patients who are vulnerable in hospital have protection against transmissible infection. So you'll probably start to see more of that as the flu season and COVID season and RSV season and respiratory virus season progresses. And in 30 seconds, doctor, give us the guidelines. What should you do if you're sick? Stating the obvious, you know, easy to say but hard to do right the easy thing to say is stay home if you're sick or keep your kids home if you're sick but obviously we know that life is perfect for everybody all the

time and we all have paid sick days and we can all stay home if we're sick right of course not i mean it's it's it's it feels disingenuous talking saying that. But if you do have the ability to stay home when you're sick, you absolutely should. So you don't get others sick. And, you know, your health care system. You know, we always hear about how stretched it is, but we are truly here for you. We we if you need us, we will be there. Emergency departments are open. Family physicians are working their butts off. We're all doing our best.

All right. Thank you very much for the update. No problem. Have a great day. Stay well. Dr. Isaac Bogosh is an infectious diseases specialist at the Toronto General Hospital and Associate Professor of Medicine at the University of Toronto.