Flu Season During the COVID-19 Pandemic
Overview
Influenza is a recurring sickness in the human population due to its ability to mutate rapidly, which can play a role in how infectious and deadly the virus is. In any given year, the CDC projects that between 9 and 45 million people fall ill to the flu in the United States. 140,000 to 810,000 of those cases require hospitalization, resulting in 12,000 to 61,000 deaths.
It is well known in the Northern Hemisphere that flu season starts as early as October and ends in April or May. As most of the world enters flu season amid a pandemic, there’s worry and confusion on how to identify influenza apart from COVID-19. This article will outline the basics of flu season, the general differences and similarities, responses to illness, importance of preventative habits, and current trends of the 2020 flu season.
What is Flu Season?
Flu season is easily associated with colder temperatures. Yet, for most, it would be harder to explain why this is true. Well, the winter season correlates with the flu season mainly due to human behavior. Colder weather encourages people to stay indoors and congregate closer together. It’s in these close contacts with limited ventilation where viruses spread more easily. Therefore, it is possible to get the flu in warm weather and during the months of June to September.
Beyond human behavior, other factors that contribute towards flu season are shorter days and influenza’s ability to survive in colder, drier climates. In the winter, days are cut shorter, causing a lack of sunlight. Many humans begin to develop low levels of Vitamin D and melatonin, weakening the immune system. Furthermore, influenza has been proven to better survive in cold, dry climates. Low humidity allows the virus to stay suspended in the air for longer periods of time, extending its lifetime and allowing the virus to infect more people.
It’s important to note the annual flu vaccine, or at least the reason for the need of a flu vaccine every year. Influenza is known to mutate rapidly, where the genetic make-up of influenza in 2020 is different from influenza in 2019. Flu vaccines are created based on precise research of how the virus will mutate over time. Overall though, the rapid evolution contributes to the seasonality of influenza.
Symptoms
Similarities
Unfortunately, COVID-19 and Influenza have similar presentations for infection as they both cause respiratory illnesses. This large overlap makes it very difficult to clinically diagnose either disease, indicating the necessity of antigen tests. Here are similar symptoms:
Fever
Chills
Cough
Sore throat
Muscle/body aches
Headache
Runny Nose/Congestion
Fatigue
Nausea, Vomiting, and/or Diarrhea
Differences
The largest difference in symptoms is that COVID-19 often presents with a loss of smell and taste. Moreover, COVID-19 seems to cause more respiratory distress, or difficulty breathing. Although these symptoms may not always be present in an individual’s illness, when present they can be a good indicator that the illness is most likely COVID-19. However, symptom presentation is not a diagnosis. In order to confirm whether or not an individual has COVID-19 or the flu, they should receive an antigen test.
Furthermore, symptoms after infection typically appear at different times. For the flu, infected individuals develop symptoms from 1 to 4 days after exposure. And COVID-19 infected individuals can develop symptoms anywhere from 2 days to 14 days, typical 5 days, after exposure.
When Someone is Sick?
When you or another person has influenza, the CDC recommends for the ill individual to stay at home and rest. Moreover, sick persons should avoid close contact with others and wash hands often to prevent spreading the disease. Make sure to regularly drink water or clear fluids to prevent dehydration.
SARS-CoV-2 and Influenza are both respiratory viruses. Therefore, the steps that can be taken when someone is sick to prevent spread are the same.
Furthermore, hospital treatments for influenza and COVID-19 will look a little different. Generally, for both, there might be difficulty breathing, so patients can receive supplemental oxygen to the extent of a mechanical ventilator. On the other hand, drug treatments will be different as hospitals and physicians have established treatment protocols for influenza, but not for COVID-19. Patients with COVID-19 will most likely receive experimental drug treatments under approval for Emergency Use by the FDA.
Preventative Habits
In addition to steps taken when someone is sick, SARS-CoV-2 and Influenza can be prevented by similar behaviors. Both viruses spread through respiratory droplets released into the air and surrounding environments when infected individuals exhale. Facial masks can reduce the momentum at which these particles are released, making the virus less likely to reach a healthy person. Facial masks also reduce the number of particles entering the surrounding environment. Additionally, practicing physical distancing can limit the amount of particle exposure as the respiratory droplets have more space to settle to the ground.
*Read Applied OC’s article on Why are Masks and Physical Distancing Effective?
Even with facial masks and physical distancing, viral particles are still released into the environment. These particles eventually settle and can be transported from surface to surface before infecting an individual. Hand washing is an important practice that should be completed regularly in order to remove viral particles on the hands before touching surfaces or the face. Furthermore, highly touched surfaces should be cleaned and disinfected regularly to minimize the number of particles on these surfaces and limiting the transfer to other individuals.
*Read Applied OC’s article on Kiosk Maintenance.
Current Trends
Currently, the CDC is reporting a decrease in the number of influenza cases this season. Influenza is a recurring sickness in the human population due to its ability to mutate rapidly, which can play a role in how infectious and deadly the virus is. In any given year, the CDC projects that between 9 and 45 million people fall ill to the flu in the United States. 140,000 to 810,000 of those cases require hospitalization, resulting in 12,000 to 61,000 deaths. However, during the COVID-19 pandemic and a great majority of people following preventative habits, such as facial masks and physical distancing, the world is inadvertently fighting influenza while trying to slow the spread of SARS-CoV-2.
Initially, researchers attributed the lower case rate to decreased testing as symptomatic individuals were more likely to be given SARS-CoV-2 testing rather than influenza. But as testing became more adequate, health officials and clinicians still had little detection of positive flu cases. Specifically, in Australia, where the flu season is from April to October, health officials saw historically low levels of influenza. Evidence suggests that facial masks have a direct role in lowering the transmission of influenza and most respiratory viruses. Additionally, partial shutdowns (schools, international travel, etc.) might have also played a role.
Similar trends of the flu season seen in countries all over the world offers compelling evidence that influenza transmission is lowered due to the COVID-19 pandemic and preventative habits. However, there are some limitations to the research. First, there could be ecological effects, where the US was entering Spring/Summer when the COVID-19 pandemic started. Second, school and international travel shutdowns do not show any causality, only correlation. Further research for causality would be hard as it is on such a large scale. Lastly, there could be viral interference between influenza and SARS-CoV-2, where those infected with SARS-CoV-2 are unable to be infected by influenza.
Based on anecdotal evidence from Australia, it seems likely that the flu will be historically low. However, scientific data cannot make that claim due to limitations of the results, only estimation and prediction. Overall, this is not indicative of a non-existent flu season in the US. In fact, it can be counter-productive to lowering flu rates as it could influence less precaution and awareness for the presence of influenza. As the US and the rest of the Northern Hemisphere enters into the winter, data and trends will become more apparent as time continues. Health officials and clinicians will be preparing for flu season. In order to continue prediction and hope of a minuscule flu season, continue to practice preventative habits and limit interaction with new individuals. Continue to play your part in protecting others by preparing to get a flu shot, but plan in advance with healthcare professionals in order to minimize exposure risk.
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