Doctor and senior woman wearing facemasks during coronavirus and flu outbreak. Virus protection. COVID-2019..

Influenza, once the respiratory scourge that nursing home residents and professionals feared the most each year before COVID-19 hit, should be back on providers’ radar in a big way, experts warn. Early indications point to a flu season far more dangerous than the last two winters, when pandemic precautions helped nearly eliminate cases, they noted.

As with most viruses, the youngest and oldest are hit hardest by infection, so nursing home staff and residents should be on highest alert to continue what COVID-19 fears jump-started: extreme source control and hand hygiene, said APIC consultant Deborah Burdsall, PhD RN-BC, CIC, Wednesday.

This is not a time for mask fatigue to win, she emphasized to McKnight’s Long-Term Care News

“When people focus on one organism, like SARS-Cov-2, they forget that core principles of infection prevention are important to prevent other infectious organisms as well,” said Burdsall, who added that the bugs RSV and Adenovirus can also be hazardous for seniors.  

“While we were in the height of the COVID pandemic and people were staying home and masking, the number of cases of other respiratory illnesses dropped precipitously. We didn’t have a normal flu season, we didn’t have a normal RSV season, we didn’t have a lot of the respiratory virus that we see that causes major outbreaks in congregate settings,” Burdsall explained.

During Tuesday’s panel discussion on flu season hosted by the National Foundation for Infectious Diseases, experts cautioned that flu infection indicators elsewhere this year are ominous and that everyone older than six months should get one of the three new flu vaccines available.

“Based on what we have seen in parts of the Southern Hemisphere, flu has the potential to hit us hard this year,” said NFID Medical Director William Schaffner, MD. “On a positive note, we have more preventive behaviors in our toolbox than we did before the COVID-19 pandemic. We are more accustomed to wearing masks and staying home when sick.”

Burdsall said the danger this year is people dropping their COVID guard. The CDC recently loosened its masking guidelines for nursing homes, telling them it’s their call based on their surrounding area’s transmission data. 

“Because people have mask fatigue and PPE fatigue, people aren’t as careful as they were in, say, 2020 and in the 2020-2021 flu season,” Burdsall said. “If masks are not used, we’re back to a situation where it’s easy to transmit respiratory infection, especially in congregate settings.

“Make sure policies and procedures align with best evidence,” she advised providers. “People aren’t going to be stuck in masks forever but when there’s a lot of viruses floating around out there, people should do what they need to do to protect themselves and their residents.”