Trying to temper a 'twindemic'

This issue addressed the upcoming flu season amid the COVID-19 pandemic, policies around mammography, and medical tourism.

This fall marks the second influenza season in the U.S. since the advent of COVID-19, with renewed potential for what some have called a "twindemic." Last year, with social distancing measures and masking requirements in place, the high influenza rates feared by many clinicians never materialized. In fact, the 2020-2021 flu season was one of the mildest on record. Predicting whether 2021-2022 will follow suit is close to impossible, but experts in infectious diseases take their best shot, as well as offer advice on vaccinating patients against COVID-19 and the flu and utilizing available tests for both viruses to guide treatment.

October is Breast Cancer Awareness Month, and our story looks at what's new in screening. While most guidelines agree on recommending annual or biennial mammography in average-risk women beginning at age 50 years and screening younger women based on their risk profile and personal preference, the best course of action in some areas isn't cut-and-dried. This is where internists can come in, using their relationships with their patients to help them determine what's best at each stage of their life. Our story offers advice on how to talk about starting, or stopping, screening, how to determine risk, and how to weigh screening pros and cons.

Our conference coverage is from the Association for Professionals in Infection Control's annual meeting, which was held virtually in June. At the meeting, two experts from the CDC offered an overview of medical tourism, discussing what risks are involved, why patients might choose it, and why they should consult with their primary care physicians to learn what to expect and how to prepare before leaving the country. Patients should be up to date on vaccines, as they would be for any trip abroad, and discuss the risks and benefits as they would for any procedure, the experts said.

We take a closer look at ACP's recent Best Practice Advice on prescribing short-course antibiotics for four bacterial infections that are commonly seen among inpatients and outpatients. Also in this issue, ACP's President, George M. Abraham, MD, MPH, FACP, continues his series on inclusivity by focusing on meritocracy, while ACP's Director of Legislative Affairs previews the progress of two large bills that are on the docket this fall in Congress. Finally, a Practice Tips column discusses whether medical practices can provide patients incentives for getting the COVID-19 vaccine.

Are you concerned about a "twindemic" this flu season? What are your tips for discussing mammography with your patients? Let us know at


Jennifer Kearney-Strouse
Executive Editor