A winter with twin threats of COVID-19 and flu will require adjustments to daily life, says former FDA commissioner

By Madeline Holcombe, CNN

The US is bracing for a combination of threats this winter as both the flu and COVID-19 spread, and the country will likely have to change daily life to cope with both, an expert said.

“I think the twin threats of this pathogen and the flu circulating every winter, as coronaviruses settle into a more seasonal pattern, is going to be too much for society to bear,” former US Food and Drug Administration (FDA) commissioner, Dr. Scott Gottlieb, told CNN’s Jake Tapper. “I think we’re going to have to readjust how we live our lives.”

COVID-19 cases have been driven up by the more transmissible Delta variant, but Gottlieb said last week that this could be the last major wave of infection the country sees. But that depends on enough people obtaining protection from either infection or vaccination, he added.

Currently, 55.8% of the US population is fully vaccinated against the virus, according to data from the US Centers for Disease Control and Prevention (CDC). And Dr. Anthony Fauci has said that the “vast majority” will likely need to become vaccinated to control the spread, though experts don’t know what exact percentage that will be.

“When you don’t know what the number is, what do you do? You vaccinate as many people as you possibly can, as quickly and as expeditiously as you possibly can. That’s what we should be concentrating on, not any particular number,” Fauci, the director of the National Institute of Allergy and Infectious Diseases, said during a White House COVID-19 briefing.

Some businesses, workplaces and schools have implemented vaccine mandates for customers, employees and students in hopes of managing spread. And the evidence shows vaccine mandates do get more people vaccinated, CDC Director Dr. Rochelle Walensky told ABC News Monday.

From the public, opinions are mixed about general employer vaccine mandates, but most support vaccination mandates for health care workers, teachers, government employees and college students, according to data from the Kaiser Family Foundation’s Vaccine Monitor published Tuesday.

As COVID-19 eventually develops into a seasonal occurrence, Gottlieb said schools and workplaces will have to make changes.

“We’re going to have to improve air filtration and quality indoors. People will be wearing masks — I think, optionally,” he said. “We’re going to probably try to de-densify offices in the wintertime to try to reduce the risk, probably move conferences that might be held in the wintertime to the fall (or) the spring.”

“We’ve been too complacent about the spread of respiratory diseases in the wintertime,” he said. “With a twin threat of flu and COVID circulating, we’re not going to be able to enjoy that complacency anymore.”

Request for children’s vaccine authorization not made yet

Cases among children are making up a greater proportion of new COVID-19 infections reported in the US, and health experts are hoping a vaccine for children will soon become available.

The American Academy of Pediatrics on Monday reported 206,864 new cases of COVID-19 among children during the week that ended September 23, making up 27% of all cases reported nationwide.

Pfizer and BioNTech said Tuesday they have submitted COVID-19 vaccine data on children ages 5 to 11 to the FDA for initial review, but they have not formally submitted a request for an emergency use authorization.

“This is sort of typical of a rolling submission, where you submit the data that’s available,” Gottlieb, who sits on the board of Pfizer, told CNN.

Once all the data is submitted, Pfizer will ask the FDA for emergency use authorization. Gottlieb said he believes that will happen “imminently.”

When the FDA does give the green light, the US will be ready to vaccinate younger kids, US Surgeon General Dr. Vivek Murthy said Tuesday.

“The FDA’s top priority is getting COVID vaccines for the population, particularly for our children,” he said.

But whether families will choose to participate in child vaccinations on a wide scale is unclear.

An Axios-Ipsos poll published Tuesday showed parents of 5-to-11-year-olds are split on vaccinating their children, with 44% saying they are likely to do so and 42% saying they are unlikely to.

Boosters likely to expand

There has also discussion over vaccine boosters, but Fauci expects they will likely end up being part of the official vaccine series.

Booster doses of the Pfizer COVID-19 vaccine are now available for people 65 and older and some adults with underlying medical conditions or who are at increased risk for infection.

When asked about people who do not fit the criteria who are already getting booster doses, Fauci told NBC News, “That is correct, and the reason is, we’re dealing with a moving target. There is interpretation by some, ‘Well, let’s just go ahead and get the booster.'”

Health experts are also looking into whether those who originally got the Moderna or Johnson & Johnson vaccine can get Pfizer boosters before the companies release their own.

Data evaluating the safety and efficacy of mixing different brands of COVID-19 vaccines is coming soon and will be submitted to the FDA for review, Fauci said Tuesday.

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CNN’s Lauren Mascarenhas, Virginia Langmaid, Maggie Fox, Jen Christensen, Jamie Gumbrecht and Naomi Thomas contributed to this report.