Flu Season & COVID

There’s a virus that infected up to 56,000,000 people between October and April, hospitalized almost 740,000, and killed up to 62,000 people. It wasn’t COVID. It was the Flu.

Flu season is almost here, and it may not be not slowing down just because there’s a new virus in town. Generally stretching from October to April, with the highest number of cases between December and February, Flu season is bound to overlap with the Coronavirus outbreak this year. 

Symptoms

Unfortunately, you actually can get COVID and the Flu at the same time. It’s extremely dangerous, and very often requires hospitalization. 

COVID and Flu symptoms are frustratingly similar. With the exception of some unique COVID symptoms, like shortness of breath and loss of taste and/or smell, all of the most common Flu symptoms are also COVID symptoms. 

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The CDC recommends that someone with the Flu stay home until they are 24-hours fever free without taking fever-reducing medication, like Tylenol. The same is true for COVID, but only after you’ve been self-isolated for at least 10 days from your symptom onset. 

Testing for Flu vs. COVID

Because symptoms are similar, testing for Flu and COVID will be key. But unfortunately, COVID testing simply isn’t accurate enough for a negative test to rule out infection yet. 

A negative COVID test may mean you were tested too early while the virus is still incubating, or it may simply be a false negative. Different kinds of COVID tests have false negative rates ranging from 2-50% false negative. 

Add on to that the fact that someone can have BOTH Flu and COVID at the same time, and testing to eliminate COVID becomes much harder.

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There may be a new combined Flu and COVID test available soon, and providers may begin routinely testing for both if they don’t have the combo test. But operationally, there’s still a high likelihood that someone with Flu- or COVID-like symptoms will still need to self-isolate in case they do have COVID. The CDC’s guidance for a positive flu test and negative COVID test is to treat it as Flu unless the person has had close contact with someone who is COVID positive, or is in a state with rising COVID numbers.  In those cases, treat it as Flu and COVID and require a full 10 day self-isolation period. 

Unfortunately, the reality of this means that there will be people who get the Flu who will need to be excluded for a full 10 days because there’s just no good way to tell for certain that they don’t have COVID, but regular testing and keeping a close eye on local case counts can help us differentiate.

Overwhelming the Healthcare System

Another very real risk for when Flu and COVID overlap is overwhelming our healthcare system.

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Flu and COVID patients will compete for the already thinly stretched resources of PPE, ventilators, beds, and staff. Our healthcare system is already strained, with COVID hotspots regularly running out of ICU beds and other critical infrastructure for treating patients. The scary part is that Flu season regularly maxes out hospital beds in a normal year.

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It’s hard to predict what this year might look like, but experts agree that it could get dire. 

Prevention

So, what can we do about it? 

First, Flu shots. This year more than ever, it’s crucial that as many people as possible get Flu shots, so that they don’t get the Flu and don’t have to stay home from work, strain the medical system, and/or go to the hospital. 

In a normal year, less than half of the adult US population gets Flu shots. That’s not enough to really make a dent in the millions of Flu cases and hundreds of thousands of hospitalizations that happen each year for the Flu alone. 

Experts are hoping that this year, many more will get their Flu shots. But that’s a challenge too - many folks who get Flu shots do so at their offices, college campuses, or community clinics which aren’t doing in-person vaccination drives this year. 

Employers should consider how they can offer Flu shots for their employees, and individuals should ensure that they’re getting their own Flu shots early (don’t wait until January when Flu season starts in October!).

Second, the same preventative measures that work for COVID - social distancing, wearing masks, and washing hands - work for preventing transmission of the Flu, too. It’s crucial that we continue to maintain vigilance - even as pandemic fatigue sets in and the weather turns cold and makes an indoor get-together that much more appealing. 

The Takeaway

If you’re an employer, prepare for a tough Fall and Winter season with a lot of absences. Encourage people to stay home when they’re sick, even if they get sick more than once in the season, even if they’re managers, even if it requires last minute coverage. And talk with your team about arranging Flu shots for your employees. View it as an investment in reducing future sick leave, absences, and publicity nightmares.

This year, many businesses will also have the added complication of managing sick coverage for remote employees.  Remote employees who have the Flu will not be able to work and may need coverage.  Just because someone is working remotely doesn’t mean they can work with Flu.

As individuals, stay home when you’re sick, even if it’s just a mild sore throat or a slight cough. Assume it could be COVID. Get a Flu shot early. And don’t let up on social distancing, handwashing, and wearing your mask - even if it seems like it’s gone on forever. The more you keep your guard up and take preventative precautions, the quicker this thing will be over.... Even if that’s just not quick enough.