Dedicated Flu Clinics May Reduce Impact of the Illness

By Linda Carroll

August 10, 2020

(Reuters Health) - Having clinics designed to treat only the flu might reduce the impact of the disease, a new computer model suggests.

By isolating people who have the disease, or think they may have the disease, dedicated clinics may decrease the number of people who become infected, researchers say in a report published in PLoS One.

"Isolating patients with a specific disease, such as the H1N1 strain of influenza, during a pandemic could help reduce infections," said coauthor, Julie Swann, department head and A. Doug Allison Distinguished Professor of the Fitts Department of Industrial and Systems Engineering at North Carolina State University. "We built this specific model for influenza, but I do think the general insights hold for other diseases, such as COVID-19."

"We now see lots of drive-by testing areas where patients are tested for COVID in an area where they can't expose other patients," Swann said. "That is what prompted us to look at this issue."

Swann's team developed a computer model that accounted for many factors. For example, disease progression was handled using a Susceptible-Exposed-Infectious-Recovered model. Social networks were considered to include households, communities, peer groups, hospitals and, in runs that included it, a dedicated influenza clinic.

The researchers found that opening dedicated clinics reduced disease spread and hospitalizations, particularly when they were open during the peak of prevalence. More specifically, they found that if disease-specific clinics were open for the entire duration of the pandemic, the clinics would have reduced the overall number of influenza infections from 55.82% of the population to 54.64%, a difference of 1.18 percentage points.

"For the states of Georgia or North Carolina, which have approximately 10 million people, that 1.18% would translate to over 100,000 fewer infections," Dr. Swann said. "The hospitalizations and peak prevalence also drop."

In fact, the peak prevalence would drop from 3.4% to 3.19% of the total population and hospitalizations would drop from 3.07% to 3.01% of the total population.

Swann and her colleagues also looked at the impact of mask wearing. "If you have 50% of people in a healthcare facility always wearing N95 masks, it's approximately the same as opening a designated clinic for the whole year," Swann said. "And if people wear surgical masks 100% of the time it's equivalent to wearing a N95 mask 50% of the time."

"Another key finding is that you can get most of the benefit from disease specialty clinics even without having them open for the entire duration of a pandemic," Swann said.

Dedicated specialty clinics are a great idea, but the logistics might be problematic, said Dr. Waleed Javaid, director of infection prevention and control at Mount Sinai Downtown in New York.

"This is a good, timely study," Javaid said. "It's something that needs to be considered."

But it's probably not something hospitals can do, Javaid said. "You can make all these plans, but who is going to staff these clinics? Hospitals run on very minimal budgets, thin margins."

Dedicated clinics might be the purview of public health entities, Javaid said. "This is something that public health groups might want to consider for future pandemic plans," he added. "This highlights the fact that public health needs a lot more money."

SOURCE: PLoS One, online August 6, 2020.