A Coweta County father was carefully restoring a black-on-black 1964 Ford Falcon convertible to give his daughter as a surprise for her 16th birthday.
Instead, Marino Molina had to sell the car to help pay for her funeral.
He's still stunned that one day in late January, his daughter, Kira, was upbeat and had just passed a physical to play tennis. A few days later, the 10th-grader with a sweet smile and a love of animals was dead from complications from the flu.
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The flu. An illness associated with fevers, chills, staying in bed, sipping chicken soup. Every year, people get the flu. Recovery may take a few days or a week, but most people do get better.
However, this season — which has finally subsided — was particularly harsh. Kira was part of a sobering statistic during a singular flu season — 145 dead in Georgia and 3,037 hospitalizations in metro Atlanta. According to local health officials, this was the worst outbreak in decades.
“I had the flu many times,” said Molina, his voice breaking. “This had to be some kind of mutation. You don’t think anyone will die from the flu.”
His daughter didn’t get the flu shot, but he didn’t press it because neither did he. Many of his friends who got the shot ended up getting sick anyway. One was in the hospital for a week.
The Atlanta Journal-Constitution has been covering the toll on families and the pressure on hospitals throughout the season. Flu activity in Georgia finally dropped to low intensity throughout the state, according to the most recent flu report for the week ending April 14. Only two people were hospitalized in metro Atlanta during that time period.
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"This was the worst season I have ever seen in Georgia, and I have been doing this for 20 years," said Dr. Cherie Drenzek, state epidemiologist with the Georgia Department of Public Health. "From my perspective, this flu season is a really stark and somber reminder the flu is very unpredictable."
Each year, on average, 5 percent to 20 percent of the U.S. population gets the flu, tens of thousands are hospitalized and thousands die from flu-related illness. This costs an estimated $10.4 billion a year in direct medical expenses and an additional $16.3 billion in lost earnings annually, according to the Centers for Disease Control and Prevention.
In Georgia, there were record-breaking hospitalizations for the flu in metro Atlanta this past season. The death toll of 145 people in Georgia included four children ages 5-17; 15 were ages 18-51; 25 were ages 51-64; and 101 were people 65 and over. The number of flu-related deaths is expected to rise over the coming weeks as more reports are sent to the health department.
Last season, there was a total of nine flu-related deaths in the state.
The battle over flu shots
This current flu season started early, in November. Then, by early January, the flu appeared to be pummeling almost every state in the country at the same time — giving the CDC’s flu map a stark, uniform look.
The predominant flu strain is H3N2, a form of influenza A. Doctors dread this strain because although it’s been around for decades, this flu strain is associated with more severe illness, especially among children and the elderly. Flu vaccines also tend to be less effective against H3N2 than other strains.
This season’s vaccine has been only about 36 percent effective against both A and B virus strains, according to the CDC. But experts say even if the vaccine provides just partial protection, the vaccine can still help lessen the severity of the flu and reduce the chance of experiencing severe complications.
Getting Americans to get a flu shot annually is a tough sell. Americans, in general, don’t like getting it, and when vaccines on the market provide limited protection, many people decide it’s not worth it. And then there are myths — some Americans (incorrectly) think you can catch the flu from the vaccine.
Credit: Justin Sullivan
Credit: Justin Sullivan
About half of Americans get flu shots each year, according to the CDC. In recent years, flu vaccination rates have been on the rise, particularly among children, and now stand at about 60 percent for children, up from about 44 percent during the 2009-10 season. For adults, the vaccination rate has remained steady at about 42 percent, up from 40 percent during the same time period.
Calls for a universal flu vaccine rose this past season as the severe season ravaged the nation. (Read more about a universal flu vaccine in the section below story.)
One person who has avoided flu shots is Buckhead retiree G. Morgan Timmis, who has never taken the flu shot — and has never gotten the flu.
Despite the number of hospitalizations and deaths during this flu outbreak, she has no plans on getting a flu shot.
“I hate shots and avoid them at all costs,” she said. “I can, perhaps, foresee changing my mind as I age further and my doctor insists. But, until then … Nope!”
That doesn’t mean she wasn’t careful, though.
“I have to say I was a bit more concerned, so I made sure to wash my hands more frequently and stayed clear of big crowds to some extent,” she said.
Local Catholic churches even encouraged parishioners to stay home if they had the flu. In a letter to churches, Atlanta Archbishop Wilton D. Gregory advised those with flu-like symptoms not “to attend Sunday Mass (or other parish activities), partake from the chalice or participate in the exchange of the Sign of Peace.”
And in Ocilla, Irwin County Elementary School closed for two days because of the large number of teachers who were sick with the flu.
RELATED: Have the flu? Atlanta archbishop advises ill Catholics to skip Mass
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Grappling with a deadly season
At the height of the flu outbreak, waiting rooms were swamped at hospitals here and across the country. For the first time, Grady Memorial Hospital set up a mobile emergency department outside to help handle flu patients.
Some days, the number of patients exceeded 500 in the emergency department, said Dr. Hany Atallah, chief of emergency medicine at Grady.
“When it got over 500, we stopped counting,” he said. “It became a common occurrence. It was really tough.”
For many patients who tested positive for influenza, they also developed pneumonia, particularly older patients.
He said many of the patients did not get the vaccine. “If someone says you can take the shot and have a 30 percent chance of not catching the flu, even though that’s not very effective, it’s better than zero,” he said.
Dr. Brett Cannon, chief of emergency medicine at WellStar Health System in Marietta, said the length and severity of a flu season are difficult to predict. One reason is because flu strains change from year to year.
The volume of flu activity and severity of illness — number of hospitalizations — dwarf any year since Georgia’s current flu surveillance system was started in 2009. Another severe year was during 2009-10 H1N1 “swine flu” epidemic, but the death toll this season doubles that season.
RELATED: Flu hospitalizations in metro Atlanta reach record high
Officials often look to Australia, where the flu season begins during our summer and their winter, for clues on what to expect for flu in the United States. And there were indications the flu vaccine was not highly effective for the predominant strain.
Even so, Cannon and other doctors said getting a flu shot remains on top of the list of what steps to take to protect you and your family.
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‘He had never been sick before’
This past winter, Winston G. Whitlow, 63, a LaGrange businessman, was in perfect health, said his wife of 30 years, Judy.
On Feb. 7 , though, Whitlow, co-owner of JSP Audio and JobShop Productions in LaGrange, complained about a sinus headache that wouldn’t go away. He took over-the-counter medications, but things got worse. Soon he was running a fever and was lethargic.
“It was alarming because he didn’t want to leave the house,” said Judy Whitlow. “He had never been sick before. He had never spent one night in a hospital. He took a vitamin every morning.”
On Feb. 11, he woke his wife and asked her to take him to the emergency room.
He hadn’t taken the flu shot. Never had.
This time was different. His oxygen level was low. A swab came back positive for influenza B. A chest X-ray was clear.
Doctors sent him home with Tamiflu, Motrin and steroids to help him breathe.
He didn’t get better. This time, he had nausea. Maybe the medicine just needed time to work.
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At 2 a.m. Feb. 12, Judy Whitlow felt a tug on her foot. It was her husband. He seemed in “dire straits.” He was breathing so rapidly that he couldn’t really talk. There was pain in his chest and stomach.
He needed to go back to the emergency department. Fast.
Tests showed pneumonia in both lungs and a bacterial infection.
He was in the process of being airlifted from WellStar West Georgia Medical Center in LaGrange to a hospital in Marietta when he went into cardiac arrest.
Meanwhile, Judy Whitlow and her daughters and a few friends sped toward Marietta. They had gotten to Old National Highway when her cellphone rang.
It was the ICU nurse back in LaGrange, who said he had coded on the helicopter. Fear rippled through her body.
Whitlow said she thought the helicopter was continuing to Marietta. The helicopter, instead, had turned around and took him back to the first hospital. His wife later learned his heart stopped four more times in the hospital.
They reached the hospital in Marietta and were standing at the security desk when her phone rang again.
He didn’t make it.
“That moment, one daughter hit the floor, one went off on her own. I just sat down in the chair,” Judy Whitlow said. “We all just kind of lost it at that moment. I just thought how is all of this happening to a healthy person.”
The flu.
Two months later, Whitlow still asks: How did things go so wrong?
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UNIVERSAL FLU VACCINE
The AJC recently interviewed NIH's director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, who has designated a universal flu vaccine to be a top priority. Last summer, he brought together more than 150 leading researchers to map a path. Here, he answers key questions about a universal flu vaccine.
What is a universal flu vaccine?
A universal vaccine would offer robust, long-term protection against influenza.
One approach to designing a universal vaccine is to generate antibody responses to parts of the virus that are common to all influenza strains that don’t readily change during mutation.
Fauci said imagine a head of broccoli with a stalk. The head is the part that mutates each season — and it’s also the part the current flu vaccine targets.
A new universal vaccine would go deeper, aiming at the interior “stalk” of the virus, which doesn’t change season to season.
Why is a universal flu vaccine needed?
Even an ordinary seasonal flu epidemic will kill thousands of people every year in the U.S. alone. That is because seasonal viruses continually evolve and mutate, and although we update our vaccines frequently, they may be only 40 to 60 percent effective. This past season, the flu vaccine was only 36 percent effective, and only 25 percent effective against H3N2 influenza, which is causing most flu cases this year.
The goal of the universal flu vaccine would be to offer protection closer to 90 percent for several years with one flu shot.
Where are we in the development and when might we see a universal flu vaccine hit the market?
Several pharmaceutical companies are working on a universal flu vaccine. Researchers at National Institute of Allergy and Infectious Diseases are also working on a universal flu vaccine.
Research is underway at academia, biotech firms and NIH. A handful of major pharmaceutical companies are supporting universal flu vaccine research, including GlaxoSmithKline; Janssen Vaccines, a division of Johnson & Johnson; and Sanofi.
A universal flu vaccine, but only version 1.0, is still at least five years away. A really effective universal flu vaccine that could provide protection against virtually all strains instead of a select few is at least a decade away.
What do we do while we wait?
About the current effectiveness rate of flu vaccines, Fauci said, “it is absolutely not good enough.”
That said, he said, “some protection is better than no protection. Even 20, 30 or 40 percent protection is better than no protection at all.”
2017-18 FIERCE FLU SEASON BY THE NUMBERS
Number of hospitalizations in metro Atlanta for flu-related illness: 3,037
Number of flu-related deaths in Georgia: 145
Flu vaccine effectiveness: The flu vaccine generally ranges between 40 and 60 percent effective. This past season, however, the flu vaccine was only 36 percent effective, and only 25 percent effective against H3N2 influenza, which is causing most flu cases this year.
