How to prepare for flu season during the COVID-19 pandemic

By Maria Sarrouh

Dr. Matthew Muller

(November 13, 2020) – Flu season is here and this year it’s especially important to protect yourself. That’s because COVID-19 and the flu are both contagious respiratory illnesses, and they present with very similar symptoms.

We spoke to Dr. Matthew Muller, medical director of Infection Prevention and Control at St. Michael’s Hospital, about how you can protect yourself and others during this year’s “double-whammy” flu season – and why doing so is an important way to ease the burden on healthcare workers who are working so hard during the pandemic.

Q: What have the preparations for flu season been like this year?

A: We launch a campaign every year to encourage staff to get vaccinated and make the process as easy as possible. That’s been moving forward in the way it normally does, with some extra safety considerations. What’s different is we’re really focusing on vaccinating patients at Unity Health in basically any clinic or area where they could be vaccinated. We’re concerned that public access to vaccination may be lower this year because of the pandemic and we’re recognizing that it’s particularly important that we all get vaccinated this year.

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

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 can make you feel quite sick. This year, it’s particularly important because there’s no way to tell flu symptoms — like fever, headaches and muscle pains — from COVID-19 symptoms. This will cause a huge amount of stress and anxiety for the individual with those symptoms and for the health care workers providing care to that individual. It’s also going to consume health care resources, such as COVID-19 tests and personal protective equipment, that might not have needed to be used if the individual had gotten their flu shot. It’s sort of a double-whammy this year because if you get flu, you will have to make sure it’s not COVID-19.

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.

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

It’s going to depend on two scenarios, but the most important thing is to make sure you don’t have COVID-19. If you’re really sick — which can happen 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.

The second scenario is if you’re starting to feel a bit tired, a bit achy and maybe you have a low grade fever, but you’re not too sick. In that case, 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 may make flu more severe, it is worth asking your doctor about anti-viral treatment for flu, for example with Oseltamivir or Tamiflu.

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: 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. And that 60 per cent is the chance of you not even getting the flu at all. But even if you do, the vaccine will make it less severe in most cases.

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