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What is a Twindemic?

By Karen Kier, pharmacist on behalf of the ONU HealthWise team

A New York Times reporter in August of 2020 coined the term twindemic to describe the concern for an increase in both flu (influenza) and COVID-19 during the winter months of 2020.  The good news is that a twindemic never occurred in 2020 but the word stuck. Twindemic is a portmanteau word. A portmanteau is when words are blended together to form a new meaning. The words are not combined together like starfish but rather are a mash of words. The word smog is a portmanteau mash up of smoke and fog that has become part of our vernacular. It is believed that the famous author, Lewis Carroll, was the first to use portmanteau words in his writings.  In 1871, he used portmanteau in his book Through the Looking-Glass. This book was his sequel to Alice’s Adventures in Wonderland released in 1865. In Through the Looking-Glass, Humpty Dumpty explains to Alice the making of new words such as mimsy, which is a mashup of miserable and flimsy.  Lewis Carroll continued to use portmanteau words in his writings including his famous poem titled Jabberwocky.  

In 2020, the predicted twindemic never occurred and many felt the social distancing, the use of face masks, the start of COVID-19 vaccines and handwashing limited influenza and COVID-19.  However, the prediction for the winter of 2021-2022 is not as cheery. There is significant concern for a twindemic this season. Is there evidence that this may be coming true?  

Remember when Ohio Governor DeWine in March of 2021 indicated that he would lift COVID-19 restrictions when our case load dropped below the critical number of 50 cases per 100,000 people in the population. We reached this goal in 2021 and restrictions were lifted. So how does this number compare to where we are right now? Over the last two weeks in Ohio, our average number of COVID-19 cases is 718.5 per 100,000. This number is alarming especially since this number is still strongly influenced by the Delta variant and not the newest Omicron mutation. We can comfortably say that one-half of the twindemic is with us relating to COVID-19 based on these numbers. In addition, most of our surrounding counties COVID-19 case numbers are in the top 50% in the state. Marion County tops the list at #3 with 1037 cases per 100,000. Hardin County is #7 with a report of 1007.5 cases per 100,000. Following close behind is Allen at #9 and Auglaize at #10 with 1006.3 and 994.4 cases per 100,000, respectively. Wyandot (#18), Putnam (#21), Hancock (#24), and Logan (#36) counties still have an average of 800-900 cases per 100,000. These numbers may reflect a sense of COVID-19 fatigue. Are we just tired of hearing the warnings? 

What about the other half of the twindemic? Influenza infections and hospitalizations are tracked by the CDC and the Ohio Department of Public Health. The numbers only reflect those cases that are reported to healthcare professionals via office visits, emergency room visits, hospitalizations, and deaths. Many cases of the flu, as well as COVID-19 are never documented. However, flu is on the rise in Ohio. For four straight weeks, the number of cases has risen with a 20.11% increase during the week of November 28th to December 4th.  Emergency department visits are up 5.75% with the hospitalization rate increasing by 164.28%.  It is probably not enough to call it a pandemic but we are certainly heading in the wrong direction. It is not too late to get a flu shot. Just remember, similar to COVID-19, it takes 2 weeks to get the full effect of a flu vaccination. The flu shot and COVID-19 shot can be given at the same time. The shots can even be given in the same arm if so desired or one can be given in each arm. Vaccinations do not need to be separated. When we first started to give COVID-19 vaccines in December of 2020, we did not know the safety of giving these vaccines together.  So many still have the misconception that these vaccines need to be separated from each other.  

Help us control COVID-19 and the flu by talking to your health professional about the science. Feel free to call the ONU HealthWise Pharmacy. The ONU Drug and Health Information Center offers a service to job sites or community organizations to speak about the vaccines. ONU HealthWise is offering COVID-19 and flu vaccines Monday through Friday from 4 pm to 6 pm. Call the pharmacy for an appointment for other time slots. The ONU HealthWise pharmacy offers Moderna, Pfizer, and Janssen (Johnson & Johnson), as well as flu shots and high-dose flu vaccines for those over the age of 65. Pediatric Pfizer vaccines (5 to 11-years) are available by appointment through the state Vaccine Management Solution (VMS) system. Call the pharmacy to get more information on getting vaccinated.

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