Winter is coming, which means snow, mitts and the annual return of colds and the flu. And this year, with the added layer of COVID-19, that means it’s especially important to protect yourself and others.

Dr. Matthew Muller is the medical director of Infection Prevention and Control at St. Michael’s Hospital. The Infection Prevention and Control team is a dedicated group of infection control professionals and hospital epidemiologists committed to helping Unity Health staff, physicians and learners protect themselves and our patients and residents from infection.

Dr. Muller spoke to us about why this flu season may be especially severe, the best way to protect yourself and others – and why this can help ease the burden on healthcare workers who are working so hard during the pandemic.

Q: Why is it so important for people to get their flu vaccines this year?

Every year we talk about why it’s important for people, families and especially health care workers to get vaccinated for flu. Not only does it protect them and their families, it also protects their patients from flu. And while we are all worried about COVID-19, it is important to remember that flu can be a serious disease in those with underlying health conditions, and even in healthy adults. Like last year, it’s particularly important to get your flu vaccine because it’s hard to tell flu symptoms — like fever, headaches and muscle pains — from COVID-19 symptoms.

Last year we didn’t see that much flu because of all the public health measures that were in place. But as most kids are back at in person school and other public health measures relax allowing people to go to restaurants, bars and gyms, we anticipate we may see far more flu than we saw last winter. In fact, it is possible it may be particularly bad because some of our population level immunity to flu may have decreased due to such a mild flu season last year.

Q: In addition to getting the flu shot, what else can people do this year to stay healthy during flu season?

We already know that good and regular hand washing at home can protect us from the flu, so a lot of what we are doing for COVID-19 should help. The normal advice has also always been to stay home if you’re sick so you don’t infect other people and stay away from people that are sick to protect yourself. Because of COVID-19, these routines are much more strictly enforced. Common sense and taking care of yourself over the winter is also a good idea – getting regular exercise, enough sleep and eating well is good for everyone!

Q: What would you say to those who argue that the flu vaccine isn’t as necessary this year because we’re already doing things like washing our hands and wearing a mask more often, so that will decrease our chance of getting the flu?

A: There is some evidence that suggests the chance of getting the flu has decreased in some other countries that had their flu season earlier. But practices keep changing, and what the general public is doing to combat COVID-19 keeps evolving as the pandemic waves come and go. Some people are masking more carefully than others. Some people are physically distancing more carefully than others. We also don’t know how long flu can be contained, so it may be that we can only delay it up to a certain point. We’ve never done this before, so we don’t know with certainty that we won’t have a flu outbreak. There’s a lot of uncertainty and the safe thing to do is make sure we’re all vaccinated this year, along with practicing the basics, like handwashing, wearing masks and physical distancing.

For those thinking about getting both the flu and the COVID-19 vaccine, either their first COVID-19 vaccine doses or a booster, new evidence and Canadian guidance indicate that it is safe to get both at the same time. You don’t need to delay either shot just because you got the other – and I strongly advise getting both!

Q: What should people do if they develop flu-like symptoms?

If you’re really sick — which can happen with COVID-19 or with flu for people that have underlying conditions or are immunocompromised — the right thing to do is always come to the emergency department. If you’re feeling chest pain or other severe symptoms, seek medical attention immediately. Make sure you let the health care providers know right away that you have flu-like symptoms and that will trigger them to take precautions, both for flu and for COVID-19.

If it is not an emergency, but you’re starting to feel a bit tired, a bit achy and maybe you have a low grade fever, you may want to talk to your own health care provider virtually or by phone, or call Telehealth to get instructions on what to do. In many cases, you don’t need medical attention and you may want to isolate at home. It’s a good idea to go to an assessment centre and get tested for COVID-19. Once you know you don’t have COVID-19, and you’re not at risk of severe flu, then drinking orange juice and warm tea, resting and taking care of yourself is the right thing to do. For some people, especially those with conditions that could make flu more severe, it is worth asking your doctor about anti-viral treatment for flu. The decision to treat with an anti-viral medication for flu will depend on your symptoms, your risk-level for severe flu and how much flu is circulating at the time you get sick.

Q: Is there anything else people should know about the importance of getting their flu vaccine during the pandemic?

The flu vaccine is safe – it has been used year after year and we don’t see a lot of side effects from the flu vaccine. Some people get a little bit of a sore arm and that’s about it in almost all cases. The consequences of the flu vaccine clearly outweigh any downside that may happen.

You have to take the flu vaccine every year and it’s not perfectly effective. It’s often estimated at between 50 to 70 per cent effective. Sometimes that discourages people, but it’s zero per cent effective if you don’t take it, so going from zero to 60 is really a fabulous thing.

Check out these resources for more information about the flu vaccine:

By: Danielle Pereira