Twindemic

What happens when the annual flu season coincides with the biggest pandemic to hit the world in a century? One possibility that public health experts worry about is a “twindemic.”

What Is a Twindemic?

Twindemic is a new, non-medical term appearing in pop culture when describing the upcoming annual flu season during the COVID-19 pandemic. It describes a particularly severe flu season that occurs alongside a spike in COVID-19 cases. And the nation’s best shot at preventing a twindemic is getting a flu shot.

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Is It Possible to Have the Flu and COVID-19 at the Same Time?

Yes. Flu and COVID-19 are both respiratory illnesses caused by different viruses. That means it’s possible to have the flu and COVID-19 at the same time. It’s also possible to have trouble telling the difference between the two when you begin to have symptoms.

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“Unfortunately, it is possible to get two viruses and these two viruses at the same time if they’re co-circulating,” says Marian Michaels, MD, of the Division of Pediatric Infectious Diseases at UPMC Children’s Hospital of Pittsburgh.

When Is Flu Season?

The flu is a seasonal illness, which means it’s mostly active in the fall and winter. People can get the flu at other times of the year, but it’s unusual. So far, experts don’t have enough experience to know if COVID-19 is seasonal in nature.

COVID-19 vs. Flu Symptoms

Several symptoms are commonly seen in both the flu and COVID-19 are:

  • Fever
  • Dry cough
  • Tiredness

People with COVID-19 also often lose their sense of taste or smell and can become short of breath or have difficulty breathing.

Other symptoms associated with both the flu and less with COVID-19 include:

  • Body aches or muscle pain
  • Headache
  • Loss of appetite
  • Body chills
  • Sore throat
  • Runny or stuffy nose
  • Vomiting or feeling sick to your stomach

“Unfortunately, both COVID-19 and influenza have a lot of overlapping symptoms, so fever, headaches, myalgias, or achy body and joints,” Dr. Michaels says. “Those kinds of things can really be seen with both influenza and COVID-19, so sometimes it’s very difficult to tell without having an actual test.

“There are a couple of things that are a little bit different. With COVID-19, people have seen a new onset of just not being able to smell or taste, and that’s more common with COVID-19 than with influenza. And influenza, in general, comes on a little bit faster and a little bit harder. But to really be able to know, you would have to test to tell the difference.”

Other Differences Between Flu and COVID-19

Medical experts are still learning about core differences between the flu and COVID-19, including about the exact risk of death from COVID-19.

The lowest estimate is that COVID-19 is 6 times deadlier than flu, but other estimates suggest it’s nearly 30 times higher. The risk of dying from both diseases also depends on other factors, especially age and existing medical conditions.

The flu tends to come on quickly and last a shorter time than COVID-19. People with flu experience symptoms within 1 to 4 days of infection and are contagious a day before symptoms appear. The flu can last from a few days to 2 weeks, and longer with complications.

How to Prevent Flu and COVID-19

The good news is there are several things you can do to reduce your risk of COVID-19 and flu at the same time:

  • Regularly wash your hands, especially before and after touching your face
  • Use a hand sanitizer containing alcohol if you cannot wash your hands
  • Try to avoid touching your eyes, nose, and mouth as much as possible
  • Wear a mask or similar face covering in public places and around other people, especially indoors
  • Avoid close contact with people who are sick
  • Get plenty of sleep, eat a healthy diet, exercise regularly, and drink enough fluids daily

The best way to reduce your risk of flu is to get the flu shot. The flu vaccine usually cuts your risk of catching flu in half each year. And even if you catch the flu, getting the vaccine reduces your chances of serious complications, hospitalization, and death.

Sources

Carol H. Yan, Farhoud Faraji, Divya P. Prajapati, et al. Association of chemosensory dysfunction and COVID19 in patients presenting with influenzalike symptoms. International Forum of Allergy and Rhinology. April 12, 2020. Link

COVID-19 Hospitalization and Death by Age, Coronavirus Disease 2019, National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases, Centers for Disease Control and Prevention. Link

Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths in the United States — 2017–2018 influenza season, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention. Link

Frequently Asked Questions, Coronavirus Disease 2019 (COVID-19), National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases, Centers for Disease Control and Prevention. Link

Handwashing: Clean Hands Save Lives, Centers for Disease Control and Prevention. Link

Healthy Habits to Help Prevent Flu, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention. Link

How to Protect Yourself & Others, Coronavirus Disease 2019 (COVID-19), National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases, Centers for Disease Control and Prevention. Link

Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19), National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases, Centers for Disease Control and Prevention. Link

Jan Hoffman, Fearing a 'Twindemic,' Health Experts Push Urgently for Flu Shots, New York Times, August 16, 2020. Link

Nick Tate, What Changing Death Rates Tell Us About COVID-19, WebMD, September 1, 2020. Link

Mortality Analyses, Coronavirus Resource Center, Johns Hopkins University and Medicine. Link

Robert Pellegrino, Keiland W Cooper, Antonella Di Pizio, et al. Coronaviruses and the Chemical Senses: Past, Present, and Future. Chemical Senses. May 14, 2020. Link

Seasonal Flu Shot, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention. Link

Use of Masks to Help Slow the Spread of COVID-19, Coronavirus Disease 2019 (COVID-19), National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases, Centers for Disease Control and Prevention. Link

Similarities and Differences between Flu and COVID-19, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention. Link

Vaccine Effectiveness: How Well Do the Flu Vaccines Work?, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention. Link

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