Changing Times: What to Expect When the Flu and Novel Coronavirus Disease COVID-19 Collide

The best thing to do as we go into this potentially deadly season is to build our immune system to shield and help us fight no matter what hits us.

My, how things have changed, and changed drastically, in a few short months. The corona outbreak has everyone scrambling from the way we socialize and practice healthcare to how we live day to day and more importantly how we see our future. Scientists and physicians are trying to figure out how to manage the beast called SARS-CoV-2 that causes the COVID-19 disease as it keeps evolving and changing. The problem now is that flu season is right around the corner and we don’t know the impact on human lives once these two viruses collide.

Robert Redfield, the Director of the Centers for Disease Control and Prevention, has expressed his concerns about the COVID-19 infections and influenza cases expected in the fall: “I do think the fall and winter of 2020 and 2021 are going to be probably one of the most difficult times that we’ve experienced in American public health.”

Many are wondering whether to get the flu shot this season and according to Jennifer Lighter, MD, a pediatric infectious disease specialist at NYU, “everyone should get their [sic] flu shot.” The best time to schedule a flu shot is the end of September or first part of October, for the flu season peaks between December and February. The CDC specifically points out that “getting vaccinated in July or August is too early, especially for older people, because of the likelihood of reduced protection against flu infection later in the flu season. The antibodies wane and this could be a critical factor in combating the two-pronged wave of disease.”

In fact, it’s even more important to get the flu vaccine this year for multiple reasons. First, it’s definitely possible to have the flu and COVID-19 at the same time, and while we still don’t have a large body of research on the effects of the new coronavirus, it’s a pretty safe bet that having both at once decreases the chances of survival, says Waleed Javaid, MD, director of infection prevention and control at Mount Sinai Downtown in New York. “We have seen people who had both COVID and influenza — and were critically ill,” Dr. Javaid says. It’s also worth noting that the flu can weaken your body to the point that it’s more susceptible to the coronavirus, Dr. Lighter says. After you’ve had the flu, your immune system isn’t as strong as it was before your body contracted the virus, which means it may not fight off COVID-19 as easily as it would otherwise.

According to Dr. Paul Biddinger, director of emergency preparedness for Mass General Hospital and head of the emergency preparedness program at Harvard’s T. H. Chan School of public health, “it’s basically impossible to tell the difference between COVID and flu without a test.”He cast the problem as one of managing finite resources in an emergency. For hospitals seeking to treat as many patients as possible while preventing the spread of both the flu and COVID-19 within their walls, having an onslaught of patients with both illnesses could throw a wrench into how quickly doctors can diagnose a patient and assign them to a bed for treatment. Biddinger said that hospitals would likely have to prepare to test for both the flu and COVID-19. “The problem is once you’re testing both, you have to rule out both from an infection control perspective, and it slows down the bed placement process,” he said. There’s no easy way to quantify the impact a flu season will have on hospital capacity.”

The flu is caused by an influenza virus, while COVID-19 is caused by a coronavirus called SARS-CoV-2. The flu can prepare your immune system for future encounters with influenza but not for SARS-CoV-2. But, notably, the two viruses cause a lot of the same symptoms. Both attack airways and lungs and cause fevers, sore throats, and even vomiting and diarrhea. The only symptoms that don’t commonly overlap are the loss of smell and taste and toe lesions associated with COVID-19, but that doesn’t mean they can’t also happen to individuals with the flu. There’s danger enough in either one of these infections — global estimates suggest that the flu kills 389,000 people annually, and COVID-19 has killed over 742,000 people thus far — but the fear in the coming months is that a person could develop both of these infections either simultaneously or one right after the other. Getting your flu vaccine this year can lower the odds of that happening.

The flu changes every year in its severity, depending in part on subtle shifts in how the virus mutates as well as on the success of mitigation strategies like annual vaccination campaigns. Some vaccines end up working better than others — this is why it’s a challenge to determine how hard we’ll be hit this year in the United States when the temperature drops. Research has shown that we’re not at a point where we can predict which flu virus will dominate. If this flu season happens to be a really bad one, this will increase the severity of the COVID-19 season and our health care system will be strained.

What can we look for in symptoms? Unfortunately the two viruses cause a lot of the same symptoms. However, research seems to suggest that the sequence of symptoms may help identify the condition. With COVID-19, fever comes first, then a cough, leading to nausea and vomiting, and then diarrhea. So, upper GI symptoms before lower GI symptoms, and fever before cough. In contrast, the first symptom in influenza would most likely be cough, then fever, followed by nausea and vomiting and diarrhea.

The best thing to do as we go into this potentially deadly season is to build our immune system to shield and help us fight no matter what hits us. There are several key nutrients needed in this fight. Zinc, quercetin, vitamin D, N-acetyl cysteine (NAC), melatonin, vitamin C, glutathione, curcumin, pyrroloquinoline quinone (PQQ), and resveratrol are all anti-inflammatory agents that help build and strengthen your immune system. Not all nutritional supplements are created equal, and they are only as good as their absorbability. Use only pharmaceutical grade supplements from reputable companies with good manufacturing practices. Appropriate dosing depends on gut health, tolerance, current medications, medical conditions, and lifestyle.

Don’t take a chance this season — come by TLC Medical Centre pharmacy for your nutritional and health guidance. Micronutrient testing can also help to determine your nutritional status and identify your deficiencies and imbalances. Your health depends on you! Be proactive to stay healthy, especially you caregivers out there. So many are depending on you.

Picture of Zoom H. Heaton

Zoom H. Heaton

TLC Medical Centre pharmacy is a traditional pharmacy offering specialized services such as medical equipment, compression stocking fittings, diabetic shoes fitting with shoe selection on site, vaccinations throughout the year and medical compounding (our compounding lab is located inside TLC called Custom Prescription Compounders, LLC). Our compounding pharmacist Zoom H. Heaton is also board certified in Anti-aging, Metabolic and Functional medicine. She works with patients needing help with various medical needs such as bio-identical hormone management, adrenal and thyroid issues, autoimmune conditions, weight management, pain management compounding, nutritional guidance using specialized testing and much much more. If you feel that your health needs a change for the better, call us at 803.648.7800 extension 200 and make an appointment. The first 15 minutes of your consultation with Zoom is free.
Picture of Zoom H. Heaton

Zoom H. Heaton

TLC Medical Centre pharmacy is a traditional pharmacy offering specialized services such as medical equipment, compression stocking fittings, diabetic shoes fitting with shoe selection on site, vaccinations throughout the year and medical compounding (our compounding lab is located inside TLC called Custom Prescription Compounders, LLC). Our compounding pharmacist Zoom H. Heaton is also board certified in Anti-aging, Metabolic and Functional medicine. She works with patients needing help with various medical needs such as bio-identical hormone management, adrenal and thyroid issues, autoimmune conditions, weight management, pain management compounding, nutritional guidance using specialized testing and much much more. If you feel that your health needs a change for the better, call us at 803.648.7800 extension 200 and make an appointment. The first 15 minutes of your consultation with Zoom is free.

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