What Health Experts Want You to Know As We Enter Flu Season Amid COVID

Flu season overlapping with COVID is sure to present a public health challenge this fall and winter. Photograph by Geber86/Getty Images

We’ve officially entered flu season, the time of year when cooler weather brings increased outbreaks of the viral infection, influenza. Flu season is always deadly. The Centers for Disease Control (CDC) estimates between 12,000 and 61,000 people die from the flu each year. This year, flu season poses an even bigger threat because we’re also in the middle of a global pandemic that has claimed the lives of more than 210,000 people in the United States since the virus began spreading in January. We’re also in a space where people are highly skeptical of vaccines, meaning it’s possible that fewer people will be willing to get their annual flu shot this year. To make matters worse, several symptoms of influenza and coronavirus overlap, making it difficult for people to know when they may be experiencing which illness.

So, what’s a Philadelphian to do to stay safe from coronavirus and the flu this winter? We gathered advice from local health experts about how to distinguish between coronavirus and other illnesses with similar symptoms, and what residents can do to prevent getting infected. Here’s what they recommend.

Know which symptoms are most common in each virus

It can be difficult to tell the difference between the symptoms of coronavirus and the flu, or even the common cold. That’s why the Einstein Healthcare Network put together this helpful infographic, which indicates which symptoms are most likely to occur in which illness. While symptoms like coughing are common in all three viral infections, things like shortness of breath, diarrhea and loss of taste or smell are more likely indicators of COVID-19.

Graphic courtesy Einstein Healthcare

Margot Savoy, chair of Family and Community Medicine at the Lewis Katz School of Medicine at Temple University says COVID-19 and the flu also differ in how they make you feel over time.

“COVID-19 and influenza have a lot of overlapping symptoms — fever, muscle aches, fatigue. Influenza tends to start more abruptly. Whereas with COVID-19, people get infected and it can be a week before they have any symptoms and they gradually get worse and worse,” she said. “Influenza does not cause the loss of smell that we are seeing with COVID-19. So, while you could have a cough, that isn’t the typical early symptom for influenza, but it is for COVID-19.”

If you are experiencing symptoms, contact your doctor and get tested

Even with a helpful guide, it still may be difficult to tell the difference between the two viral infections. That’s why associate professor at the Dornsife School of Public Health at Drexel University, Thersa Sweet says the best thing to do is to contact your provider and get tested for COVID-19 or the flu.

“Many viral infections start out the same way; you have a fever, you have a headache, you have body aches,” she explained. “So, the only real way to be able to tell the difference is to go in and get a test.”

Get a flu shot

Savoy says it is important for everyone six months and older to get the flu shot every year (we’ve mapped all the places you can get your flu shot in Philly here). But this year it’s of critical importance to potentially avoid the risk of catching the flu and COVID-19 simultaneously.

“This year,” Savoy said, “the major fear is that people will catch COVID-19 and influenza either at the same time or close together. Either is deadly. Together is a disaster.”

The efficacy of the flu vaccine, from year to year, varies. On average, the flu vaccine is only 40 to 60 percent effective. This might make some wonder whether a flu shot is still worth getting. Sweet says yes.

“When we look at efficacy, we often don’t look at the severity of disease in that statistic. So, if you have influenza and you’ve had the vaccine, you’re likely to have much milder symptoms,” Sweet explained. “Somebody who’s not vaccinated who gets flu, even a young, healthy person, can be knocked out for a week or two by the virus. Getting the vaccine, not only reduces your chances of coming down with flu but if you still end up with flu, the vaccine will hopefully reduce the severity of your illness.”

In September, the American Nurses Association launched “The Race to 200M,” a national program to encourage Americans to get their flu vaccination this season, especially the 200 million Americans who are above the age of 50 or have chronic health conditions that put them at most risk for flu complications.

“Depending on the person, if they’re of elderly age or if they have chronic health conditions like heart or lung disease, diabetes, or cancer, any of those things can put them at a higher risk for complications from the flu or COVID,” said Kristina Rosario, a nurse, member of the Pennsylvania State Nurses Association and advocate for the Race to 200M campaign.

“This year has been extraordinarily hard,” Savoy added. “There just hasn’t been enough time to process the trauma before the next one shows up. I really hope we can all just agree to get the influenza vaccine and take one preventable disaster off the 2020 disaster bingo card.”

No matter which virus you contract, take precautions to keep others safe from getting infected

“It’s very important to continue to do those personal things that we already should have been doing: washing your hands, staying away from large crowds of people and maintaining that social distance,” Rosario said.

“Both [COVID-19 and the flu] are infectious, so if you think you are sick, try and limit who you are around, wear your mask when you have to go around others, cover your cough, and wash your hands,” Savoy advised. “Don’t try to go to work or school sick. Stay home, get better, and protect those around you.”

The experts also shared their best and worst predictions for how this flu season might play out. Much of it, they say, will depend on human behavior and individual choices.

“All the mechanisms we’re told to use to reduce COVID transmission also work for the flu. So, hopefully, we have a mild flu season because people are doing these preventive things,” said Sweet. “The worst-case scenario is that people get infected with both [COVID and the flu], not necessarily at the same time, but throughout the winter, and that having one might make the second infection that much worse.”

“My nightmare is that we have a continued loss of lives that multiplies because, on top of the on-going COVID-19 losses, we add influenza, suicide, overdoses, exposure, and uncontrolled chronic illnesses,” said Savoy.

“The best-case scenario,” Sweet added, “is that people continue to socially distance, wear masks and wash their hands all the time and that, because of these interventions, perhaps the flu season won’t be so severe.”