As we head into our first cold and flu season during the coronavirus pandemic, the convergence of these two illnesses (coined with the term twindemic) may have prompted a scary thought — is it possible to get the flu and COVID-19 at the same time? POPSUGAR asked Amira A. Roess, PhD, MPH, who is a professor of Global Health and Epidemiology at George Mason University's College of Health and Human Services, to weigh in. She is an epidemiologist with expertise in infectious diseases and evaluating interventions to reduce the transmission and impact of infectious diseases.
Can You Have the Flu and COVID-19 at the Same Time?
"It may be possible to have both the flu and COVID-19," Dr. Roess said. COVID-19 is a new illness, and we don't know much about how it interacts with the flu since it hasn't been around that long. The flu and COVID-19 have a few symptoms in common, including fever, cough, headaches, chills, and body aches. She said that it's important to contact your healthcare provider if you suspect that you have both, so they can offer tailored guidance for your individual situation.
Your healthcare provider may try to determine if you have COVID-19 by asking you about your exposures to individuals who have recently been diagnosed with COVID-19 or the flu, and by asking you to list your symptoms, Dr. Roess said. "Some symptoms like loss of taste and loss of smell are very specific to COVID-19 and may help your healthcare provider differentiate between the two," she explained. Rapid tests are available for both the flu and for COVID-19 viruses, and some healthcare providers may offer testing to determine what their patients have.
Can You Have Flu Symptoms and Also Be Asymptomatic For COVID-19?
We know that transmission of both of these viruses can occur from a person who does not have symptoms (asymptomatic or presymptomatic). Which is why Dr. Roess said, "This makes outbreak response difficult because individuals often don't know that they've been exposed, and asymptomatic individuals don't know that they're exposing others." It's very important that if you are diagnosed with either virus that you alert people you have been in contact with, she said. This includes friends, family, coworkers, neighbours, and schools if your child is diagnosed.
Should You Get Tested For Both the Flu and COVID-19 If You're Experiencing Symptoms?
COVID-19 testing is widely available and in most areas you can get one at a testing facility if you are symptomatic or have been exposed, Dr. Roess explained, but added that flu tests are generally limited to healthcare providers and you'll have to make an appointment to get one. It is possible that some facilities may offer broader flu testing.
Your healthcare provider may collect throat or nasal swabs to test for COVID-19 and the flu individually. Many providers have access to rapid flu tests and increasingly more have access to rapid COVID-19 tests. Dr. Roess said that the CDC now has a test under FDA EUA (Emergency Use Authorization) that allows for the differentiation between the COVID-19 virus and several flu viruses, that allows testing for both COVID-19 and flu at the same time. Some government laboratories have access to this test, and hopefully with time we will see more of these tests emerge, said Dr. Roess.
What Should You Do if You Have the Flu and COVID-19 at the Same Time
Although mortality for COVID-19 appears to be higher than for the flu, it's important to notify a healthcare provider if you think you have COVID-19 and the flu so 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, Dr. Roess said.
If your healthcare provider determines that you have the flu then they may place you on an antiviral, like Tamiflu, to shorten the duration of the flu, she said.
"Since March we are better at understanding what supportive treatments are helpful for certain patients," in regards to COVID-19, she said. We also recognise the wide range of symptoms that occur in COVID-19 patients and this helps healthcare providers identify COVID-19 patients earlier and start supportive treatments earlier. "There are medications that are now used to treat COVID-19 patients under FDA EUA, but more work is needed to identify effective medications and treatments for COVID-19,"Dr. Roess said. Your healthcare provider will determine what the best course of treatment is based on your unique situation, she added.
"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," Dr. Roess said. Older individuals and those with underlying conditions are at risk for severe complications from either the 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," she said. Again, there is still a lot we don't know about how co-infections may play out, but we do know that early diagnosis leads to early treatment and better outcomes. So definitely seek care if you're experiencing symptoms for either the flu or COVID-19.
How Can You Lower Your Risk of Getting the Flu and COVID-19?
Although there is not yet a vaccine to prevent COVID-19, there is a flu vaccine. It's a good idea to get your flu shot soon to protect yourself from the flu, Dr. Roess advised. "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," she explained.
"Getting the vaccine between the end of September to the end of October is about the right time to maximise the protective effects of the vaccine," Dr. Roess said. If you're an older individual or live with underlying conditions, you're at higher risk of serious flu complications and should prioritise getting the flu vaccine.
Although meant to reduce the spread of COVID-19, wearing masks and following hand washing and social distancing guidelines can also help lower the spread of the flu and colds. Dr. Roess said it's important to wash your hands well, especially after getting home and before eating or handling food. "We recommend washing hands with soap and water for 20 seconds. If you are in a situation where you cannot wash your hands, then use hand sanitizer," she said. An alcohol-based hand sanitizer, some say with 60 percent alcohol content, is recommended to kill most germs.
In regards to wearing masks, coronaviruses, influenza viruses, and other respiratory pathogens are generally spread through air-borne droplets, Dr. Roess said, "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 not only prevent the spread of infectious droplets, but she said wearing one also makes it easy to follow other recommendations, including avoiding touching your eyes, mouth, and nose, since this is how most of the viruses and bacteria that make us sick get introduced into our bodies.