There is clear reason for concern. As of September 11, there have been more than 6.4 million cases of COVID-19 in the United States and more than 192,000 deaths, according to the Johns Hopkins Coronavirus Resource Center, with numbers continuing to climb. Then add the potential impact of the flu. The Centers for Disease Control and Prevention (CDC) estimates that 35.5 million Americans got sick with influenza in 2018–19, and 34,200 people died of it. Experts agree that individual behaviors can play a big role in reducing the risk of both COVID-19 and the flu, lowering the odds of a public health emergency this fall and winter. If you have questions about how to minimize your chances of getting sick with the flu or COVID-19 — or both — and want to do your part to help reduce the spread of these illnesses, keep reading. “That includes children, teenagers, adults, and older adults,” adds Noreen A. Hynes, MD, MPH, the director of the Geographic Medicine Center of the division of infectious diseases and an associate professor of medicine at Johns Hopkins in Baltimore. Less than 50 percent of the American public typically gets a flu vaccine, according to Robert R. Redfield, MD, the director of the CDC, in an interview conducted by JAMA Network. This year the push is to vaccinate 65 percent of Americans, he said. To help more people have access to the shot, the CDC ordered 9.3 million doses of the flu vaccine to be distributed to people without insurance. In a typical year, the CDC orders and distributes about 500,000 doses, said Dr. Redfield.
Is September Too Early to Get the Flu Shot?
The ideal time to get a flu shot is whenever you can get it. “If you have the opportunity, go for it now,” Dr. Lynch says. In North America, influenza doesn’t tend to appear until December, according to Lynch, so holding off can make sense. The CDC recommends getting a flu vaccine by the end of October. But the longer you wait, the more likely you are to end up standing in an endless line at the pharmacy or needing to fight for a doctor’s appointment. “We don’t want people to have any barriers to getting a flu shot,” Lynch says. RELATED: No Flu Shot and Now You’ve Got the Flu: What to Do? “When you look at the numbers, whether it’s people who become infected with the flu or those who end up in the emergency department, are hospitalized, or even die — all those numbers go down with flu vaccinations,” he says. The more people get vaccinated, the better the vaccine will work, he adds. “There may be people who think, well, I’m not in a high-risk group, I’m a healthy young person and so I don’t need the shot,” says Dr. Hynes. Those individuals need to consider all the people they might come into contact with and infect, she says. Older adults, pregnant women, and people with underlying medical conditions such as COPD, diabetes, obesity, sickle cell disease, heart disease, and kidney disease are among those at higher risk for serious complications from the flu or COVID-19, according to the CDC. The risk of complications for healthy children is higher for the flu compared with COVID-19. Infants and children with underlying medical conditions are more vulnerable to complications from both the flu and COVID-19. RELATED: How Obesity May Increase the Risk for COVID-19 Complications
What Else Can I Do to Reduce My Risk of the Flu or COVID-19?
All the steps you would take to prevent COVID-19 are the same ones you’d take to avoid the flu, says Lynch. “Physically distancing, masking, and hand hygiene can reduce the risk of transmitting or catching the flu and COVID-19,” he says. “It’s also very important to stay home when we’re feeling ill. If you put all those things together it works in layers to help keep us safe,” says Lynch.
Is There Anything People Should Do to Strengthen Their Immune System?
Practicing healthy habits is important, says Hynes. “Getting enough sleep, exercising, and being at a healthy weight can all impact the health of your immune system. Obesity is a risk factor for more severe respiratory virus outcomes in general, which would include the flu and COVID-19,” she says. Unless they’ve been instructed by a doctor to take vitamins, most people don’t need them, says Hynes. “You can get most of the vitamins and nutrients you need in the foods you consume,” she says. The immune system is also affected by a person’s emotional and psychological well-being, so taking steps to reduce stress could also make a difference. RELATED: 7 Ways to Boost Your Immune System for Cold and Flu Season
If I Get Sick, How Will I Know if It’s COVID-19 or the Flu?
“The flu and COVID-19 usually look very, very similar; it’s going to be very hard to distinguish between the two,” says Lynch. Both illnesses have varying degrees of severity — people can have no symptoms at all or very serious ones. Signs of COVID-19 and the flu include the following, according to the CDC:
Fever or feeling feverish/chillsCoughDifficulty breathing or shortness of breathFatigueSore throatRunny or stuffy noseMuscle pain or body achesHeadacheVomiting and diarrhea (more common in children than adults)
One difference in symptoms is that people with COVID-19 can experience a change or loss of taste or smell, which doesn’t happen to people with the flu. RELATED: Coronavirus Fact Sheet: Answers to 7 Common Questions
If I Get Sick, Do I Need to Be Tested?
If you become ill and suspect it may be COVID-19 or the flu, contact your healthcare provider to find out if you should get tested, says Hynes. “As we move toward the influenza season, people will be most likely be tested for both [illnesses].” RELATED: Your COVID-19 Testing Guide: Nasal-Swab Tests, Antibody Tests, Saliva Tests, and More
Can You Have COVID-19 and the Flu at the Same Time?
People can be exposed to both influenza and COVID-19 and may be infected with both simultaneously, says Lynch. “If you get the flu and COVID-19 at the same time, there’s a high probability of having a more severe case of either or both; the outcomes could potentially be much worse,” he says. When the coronavirus was first identified in the United States in February and March it was still flu season in some parts of the country, adds Hynes, so people with COVID-19 symptoms were often tested for influenza. “Looking back, there were people who were coinfected,” she says. Treating people with both illnesses can be “tricky,” Lynch adds, because the approaches used for one condition might impact those used for the other.
Would Having the Flu Increase the Likelihood of a More Severe Form of COVID-19?
“We don’t have enough data to know that yet,” says Hynes. “The data we do have about flu indicates that if you’re at high risk for adverse outcomes from influenza, you are likely to also be at high risk for adverse outcomes from COVID-19.” RELATED: A Coronavirus Checklist: Prepare for the Possibility You May Get Very Sick
Are a Lot of Americans Expected to Get the Flu This Season?
Looking at flu activity in the Southern Hemisphere in places such as Australia and South Africa can give U.S. experts some indication of what may come our way when winter arrives in our part of the world. “In the 12 or so years that I’ve been looking at flu data regularly, I’ve never seen so little influenza activity across the planet, ever,” says Lynch. There could be many factors behind that, but Lynch believes one significant reason is that people are physical distancing, wearing masks, and washing hands like never before. “That’s probably having a big impact. If we can do something similar, that could maybe help us, too,” he says.
