How Will the Pandemic Affect This Year’s Flu Season?

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Flu season is almost here — and we’re still in the midst of a pandemic. While experts can’t predict exactly what will happen over the next several months, how people handle the COVID-19 pandemic could directly impact the spread and severity of influenza.

Cassandra M. Pierre, a physician specializing in infectious diseases and the medical director of public health programs at Boston Medical Center, says this year’s flu season could be milder and less deadly than previous years — but only if people practice protective measures like mask-wearing, physical distancing, and of course, getting a flu shot, and getting it early.

“We were expecting to have a very bad flu season last year, but it actually terminated in March and April because everyone was quarantining and physically distancing,” she says. “That would be the hope for this year: That people continue to wear a mask and be physically distant when they’re out, since we know it can be protective for others and for ourselves.”

Here’s what experts know so far about this year’s pandemic flu season — and what they recommend for curbing the spread of both COVID-19 and influenza.

When does flu season start and how long does it last?

Generally, flu season starts in the fall and peaks in early winter, with cases dwindling in the later spring months. Neha Vyas, a family medicine physician at Cleveland Clinic, says cases can start as early as September and sometimes last even through May. The exact time frame for when flu cases begin to spread, peak, and dwindle can vary by region.

According to the Centers for Disease Control and Prevention, older people, young children, those who are pregnant, and people with long-term health conditions are at greater risk for flu complications.

How dangerous will the flu be in 2020-2021?

The first thing to know: No matter how “dangerous” a given flu season is, it’s important to protect yourself — and, as with the COVID-19 pandemic, to prevent the spread to people who are at higher risk. The flu is common — the CDC estimates that millions of people get it every year — but it still can land you in the hospital and even kill you. Yes, older people and young children are examples of those who are more likely to experience severe cases but generally healthy, 20-somethings get sick as well.

Dana Hawkinson, medical director of infection prevention at The University of Kansas Medical Center, says researchers look at flu activity in the southern hemisphere to understand more about flu season here. Some countries, like Australia and South Africa, he says, had lower rates of flu in 2020 than in previous years, which doctors hope translates to the United States.

But the lower influenza rates may be due to public health measures related to COVID-19, making it even more crucial we follow public guidelines that help prevent its spread.

“We are hoping that the public health guidance and adherence to principles such as physical distancing, not meeting in large groups, and hand hygiene will have a positive impact on flu rates — that we’d have lower amounts of influenza compared to previous flu seasons,” he says.

Experts still aren’t sure which strains will dominate this year’s flu season, but Hawkinson says the vaccine usually offers some degree of protection against four different flu viruses (a.k.a. quadrivalent): influenza A(H1N1) virus, influenza A(H3N2) virus, and two influenza B viruses. “Typically we do see both A and B somewhat, but it depends on the time of year. Most of the time we have A circulating earlier, and then later on in the season they’re a B strain,” he says.

What symptoms should I watch out for?

Even if your case doesn't require a doctor's visit, having the flu is no picnic. According to the CDC, flu symptoms include:

  • Fever or feeling feverish/chills (though not everyone who gets the flu has a fever)

  • cough

  • sore throat

  • runny or stuffy nose

  • headaches

  • fatigue

  • body or muscle aches

Pierre says many of these symptoms overlap with COVID-19 symptoms, so it’s important to seek medical advice if you’re ill with any of them. One symptom distinct to COVID-19, Pierre says, is the loss of taste and/or smell, which usually doesn’t occur with influenza.

You can't know for sure that you have the flu or COVID-19 unless you take a lab test. Vyas says many health care providers, including Cleveland Clinic offer telehealth appointments to screen patients before in-person testing, so check with your clinic about available options.

Won't the flu shot prevent me from getting it?

Each year researchers in the U.S. formulate a vaccine meant to protect against the four different flu virus strains they think will be the most common during the upcoming season. But getting the vaccine doesn't guarantee you won't get the flu. After researchers identify the strains most likely to cause trouble each year, viruses can mutate, meaning strains that researchers didn't anticipate can become prevalent. Before you ask, yes: You should still get a flu shot. In addition to preventing the flu, Pierre says the vaccine can also shorten the duration of the sickness.

<h1 class="title">Swine Influenza virus injection / flu shot needle - 2019 Flu Season</h1><cite class="credit">Getty Images</cite>

Swine Influenza virus injection / flu shot needle - 2019 Flu Season

Getty Images

“We absolutely recommend getting the flu vaccine,” says Pierre. “The flu vaccine process is a well-vetted process — we know flu vaccines are both safe and effective.”

A nasal spray vaccine is available as an alternative to the flu shot, and this flu season, the CDC says one option is just as good as the other. The spray is safe for anyone between the ages of 2 and 49 who is not pregnant, although you should speak with your doctor to learn which vaccine is best for you.

What else can I do to avoid the flu and COVID-19 this year?

During this unique flu season, Vyas says like people with chronic illnesses, pregnant people, the elderly, and the very young need to take special precautions against getting sick. But it’s important for anyone to reduce their risk.

Getting proper sleep, adequate nutrition, and regular exercise can help keep your immune system strong. Darria Long Gillespie, a clinical assistant professor at the University of Tennessee School of Medicine, says healthy habits like these have been shown to ward off respiratory viruses like the flu. But they don’t replace the need for a flu vaccine or mitigate the importance of other preventative measures.

For example, you should also be handwashing religiously (and don't shy away from the Purell). "This is the season where you can be a complete germophobe and it's entirely fine," says Long Gillespie. "Wash your hands frequently, carry hand sanitizer, and either wash or sanitize after touching shared surfaces [and] before you eat or touch your face."

Again, it's important to know that you should still be getting the flu shot even if you're practicing frequent handwashing and physical distancing to prevent the spread of influenza to more vulnerable people (and, of course, to decrease the odds you’ll get sick yourself).

Continuing to follow COVID-19 precautions is another important way to prevent the spread of both illnesses. “Influenza and COVID-19 are [both] spread primarily due to transmission of respiratory droplets,” says Pierre. “So it makes sense that COVID-19 protective measures would be just as effective in protecting against flu.”

Experts also agree that even if you don’t normally get a flu shot, you should definitely get one this year — and possibly earlier than normal. “Some people like to postpone their flu shots until October or November, but with the added burden of COVID-19, it’s not a bad idea to get immunized right away,” says Vyas.

If I get the flu, how long will it last and what are my treatment options?

"The vast majority of people who get the flu will feel miserable, but you will likely get better on your own," Long Gillespie says. If you feel like crap, don't try to push through it by going to work or yoga — rest and hydration are your new best friends until you're feeling better. Even if you feel horrible, use it as an excuse to catch up on your favorite TV shows.

<h1 class="title">Cough syrup medicine bottle and spoon - 2019 Flu Season</h1><cite class="credit">Getty Images</cite>

Cough syrup medicine bottle and spoon - 2019 Flu Season

Getty Images

There are prescription antiviral drugs that can help treat the flu, but doctors usually don’t prescribe them for otherwise-healthy adults. While these drugs can shorten the time you’re sick, it's usually only by a day or half a day. Long Gillespie says. "You do need to take them within 48 hours of your symptoms starting. The sooner you take them, the better," she says.

As with any drug, there are potential side effects to antivirals including nausea and vomiting. If you have flu symptoms and “you have a chronic condition such as asthma, diabetes, or autoimmune conditions (among many other chronic conditions), you may be a candidate” for an antiviral drug, Long Gillespie says, so check with your doctor.

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