Surviving flu season amid the COVID pandemic

AMMAN — Generally, flu season starts at the beginning of fall and ends towards the end of spring. The seasonal flu viruses peak around January. A study in Jordan found that influenza infections were responsible for nine percent of hospital admissions with severe acute respiratory infections. Those admitted had a mortality rate of three percent. اضافة اعلان

Although we tend to take the flu lightly, seasonal flu constitutes an $11.2 billion burden on health care in the US alone, and worldwide results in 290,000 to 650,000 respiratory deaths annually. Flu and COVID-19 together can put additional strain on both society and the healthcare system. Prevention is the key.

The types of flu

The seasonal flu is not a single virus, it is a collection of constantly mutating influenza viruses. There are four types of influenza virus, A through D. Influenza C is not commonly detected and only causes mild infections and Influenza D primarily affects cattle and does not infect humans. Influenza B is more severe but does not mutate as rapidly and can be grouped into lineages. Currently, type B influenza viruses belong to either the Yamagata lineage or the Victoria lineage. 

Type A influenza is the most serious type of flu and is the only one responsible for pandemics. It mutates constantly and rapidly making vaccination against it difficult. Type A has two subtypes based on the proteins on the surface of the virus known as hemagglutinin (HA) and the neuraminidase (NA). Currently, the most common influenza type A viruses circulating are H1N1, which was responsible for the 2009 pandemic known as the swine flu, and H3N2.

The severity of the flu ranges from mild to severe based on the individual. Typically, symptoms resolve in three to seven days without the need of medical attention, but severe cases can last up to two weeks or more and may require hospitalization. Symptoms of the flu include rapid and sudden onset of fever (>37.6°C), coughing, usually a dry cough, headache, muscle and joint pain, sore throat, runny nose, and a general feeling of being unwell.

Susceptible groups

All age groups and demographics are susceptible to infection but there are groups that are at greater risk for severe disease or complications. This includes pregnant women, children under the age of five, and the elderly who are over 65. Additionally, those with chronic medical conditions such as chronic cardiac, pulmonary, renal, metabolic, neurodevelopmental, liver, or hematologic diseases are more likely to experience complications. Individuals who are immunocompromised, such as those with HIV/AIDS, receiving chemotherapy or radiation therapy, on steroid regimens, or have a malignancy are at the greatest risk for developing severe complications, and infection can prove fatal.

COVID-19 vs the flu

Both viruses share many similarities but are nevertheless two different viruses entirely. Both are respiratory diseases and include similar symptoms such as cough, runny nose, sore throat, fever, headache, and fatigue. The two viruses also have similar transmission methods and can spread via aerosolized droplets that are formed when coughing, sneezing, or even simply breathing.
 
The infection range is also similar at about one meter and can be spread through contact with contaminated objects. The higher risk demographics share similarities as well. Older adults, those with chronic medical conditions, and those who are immunocompromised are at greater risk for developing severe complications.

As far as differences go, the main difference is the virus itself. COVID-19 is caused by a coronavirus called SARS CoV 2, whereas the flu is caused by the influenza virus, primarily type A but also type B. The onset of symptoms is also slightly different but may be difficult to distinguish. Symptoms of COVID-19 generally appear around two to 14 days after exposure, whereas the flu usually appears around one to four days after exposure. 

Although COVID-19 is still a relatively new virus, it is more contagious and spreads more rapidly than the flu. Instances of severe illness such as lung injury and even mortality are higher in COVID-19, as well as a unique symptoms of anosmia and dysgeusia, loss of smell and taste respectively.
Although the two viruses are very different in terms of severity, it is possible to have both viruses at the same time and both in conjunction can increase the severity and potential mortality dramatically. It is important to take the necessary precautions to avoid either disease but especially having both at the same time. 

Prevention

Prevention of both diseases is similar since they have similar modes of transmission. Handwashing for no less than 20 seconds and sanitizing with alcohol-based sanitizers that is at least 60 percent alcohol content. It is important to note that sanitizing is not a substitute for handwashing and should only be done when washing is not available. 

Wearing a surgical face mask is also important to prevent infection, especially when in a public indoor area and generally avoiding large crowds. When you have to cough or sneeze, do so in the crux of your elbow and never in your hands, and if you do, wash your hands immediately and avoid touching other objects. Similarly, avoid touching your eyes, nose, or mouth and always wash your hands before and after doing so.

Without a doubt, the most important method of prevention is vaccination. Currently, only 35 percent of the Jordanian population is fully vaccinated which is five percent behind the world average of 40 percent. The COVID vaccine generally may only produce mild, short term side effects. 

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