Tip Sheet: COVID-19 and the Seasonal Flu

Dr. Roess is a professor in the College of Health and Human Services, Department of Global and Community Health.

Tip Sheet: COVID-19 and the Seasonal Flu

Dr. Roess is a professor at George Mason University's College of Health and Human Services, Department of Global and Community Health. She is an epidemiologist with expertise in infectious diseases epidemiology, multi-disciplinary and multi-species field research and evaluating interventions to reduce the transmission and impact of infectious diseases. Dr. Roess served as the Science Director for the Pew Commission on Industrial Food Animal Production at Johns Hopkins, and was an Epidemic Intelligence Service (EIS) officer at the Centers for Disease Control and Prevention (CDC). 
When disease outbreaks or other public health threats emerge, CDC EIS officers investigate, identify the cause, rapidly implement control measures, and collect evidence to recommend preventive actions.

health care provider giving a patient a vaccineDo you recommend getting the flu shot this year?

Flu season recently started in many parts of the country and it is a good idea to get the flu vaccine soon to protect yourself from the seasonal flu. 

Remember that vaccines need a little bit of time to allow your body to produce an immune response. It takes about two weeks from the time you receive your flu vaccine for your body to develop enough antibodies to protect you from the flu. It's important that you get the vaccine at the start of the flu season. If you get it too late then your body may not have enough time to develop enough antibodies to protect. In many parts of the country getting the vaccine between the end of September to the end of October is about the right time to maximize the protective effects of the vaccine. 

Older individuals and those with underlying conditions are a higher risk of serious flu complications and should prioritize getting the flu vaccine.

Can someone get the flu and COVID-19 at the same time? If so, how do you know if you have both? What symptoms would a person experience that would let them know they have both? What risks are associated with having both illnesses at the same time?

It may be possible to have both the flu and COVID-19 simultaneously. COVID-19 is a new virus and we do not know much about how it interacts with flu. Flu and COVID-19 have a few symptoms in common, including fever, cough and chills among others. It will be important to contact a health care provider to receive tailored guidance for your individual situation. Your health care provider may try to determine if you have COVID-19 by asking you about your exposures to individuals who have recently be diagnosed with COVID-19 or flu and by asking you to list symptoms. Some symptoms like loss of taste and loss of smell are very specific to COVID-19 and may help your health care provider differentiate between the two.  Rapid tests are available for the flu and for COVID-19 viruses and some health care providers may offer testing to determine what their patients have.

Can a person have flu symptoms and also be asymptomatic for COVID-19? Can a person have COVID symptoms but also be as asymptomatic for the flu?

We know that transmission of both of these viruses can occur from a person who does not have symptoms (asymptomatic or presymptomatic). This makes outbreak response difficult because individuals often don’t know that they have been exposed and asymptomatic individuals don’t know that they are exposing others.  It is very important that if you are diagnosed with either virus that you alert people you have been in contact with, this includes friends, family, coworkers and others and schools if your child is diagnosed.

 Should a person get tested for both the flu and COVID-19 if they are experiencing symptoms? What are the tests like for each or is there one test?

COVID-19 testing is widely available and in most areas you can get one at a testing facility if you are symptomatic or have an exposure.  Flu tests are generally limited to health care providers and you will have to make an appointment to get one. It is possible that some jurisdictions may offer broader flu testing. Your health care provider may collect throat or nasal swabs for COVID-19 and flu testing. Many health care provides have access to rapid flu tests and increasingly to rapid COVID-19 tests. There is a COVID-19 and flu test that some government laboratories have access to. 

If a person can have both the flu and COVID-19 at the same time, what should they do? Should they take any medications? How long can they expect to feel sick, and how long are they contagious?

It is important that you notify a health care provider if you think you have COVID-19 or flu so that they can make the final determination and ensure that you receive adequate care. Older individuals and those with underlying conditions must take this very seriously. The sooner they get care the better. If your health care provider determines that you have flu then they may place you on an antiviral, like Tamiflu, to shorten the duration of the flu. Our treatment protocols for COVID-19 have improved since March and your health care provider will determine what the best course of treatment is based on your unique situation.

We are starting to see reports of co-infection but there is a lot that we don’t know about the long-term impacts of these. Older individuals and those with underlying conditions are at risk for severe complications from either flu or COVID-19. If individuals from these vulnerable groups are infected by both of these at same time complications may be more severe.  For example, both viruses attack the lungs in different ways--if an individual’s lungs are attacked at once in multiple ways the outcome may be grave.  Again, there is still a lot we don’t know about co-infections may play out but we do know that early diagnosis leads to early treatment and better outcomes.  

 Although meant to reduce the spread of COVID-19, can wearing masks and following hand washing and social distancing guidelines also help lower the spread of the flu and colds? 

There are a number of things that you can do to keep your risk of COVID-19, flu, and colds low, including adhering to social distancing guidelines, wearing face masks, and washing your hands often and well, especially after getting home and before eating or handling food. We recommend washing hands with soap and water for twenty seconds. If you are in a situation where you cannot wash your hands, then use hand sanitizer. An alcohol-based hand sanitizer (some say with 60% alcohol content) is recommended to kill most germs.

Coronaviruses, influenza viruses and other respiratory pathogens are generally spread through air-borne droplets so wearing a face mask will lower your exposure to all of these. Remember it is important that everyone wear a face mask to protect us all.

Face masks make it easy to follow other recommendations including avoiding touching your eyes, mouth and nose. We often introduce viruses and bacteria that can make us sick into our bodies through those.