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Will Flu Season Be Bad This Year?

Q&A With Infectious Disease Specialist Soniya Gandhi, MD

The flu seemed to vanish in 2020 as safety measures meant to stop the spread of COVID-19 also worked against the influenza virus. But with some precautions lifted amid widespread vaccination, what will it mean for this year's flu season?

"We did not see one flu case at Cedars-Sinai last year, which is unheard of. That was because everyone was masking, socially distancing, being very conscious of hand hygiene, and really trying to isolate if they were sick," said infectious disease specialist Soniya Gandhi, MD, vice president of Medical Affairs and associate chief medical officer at Cedars-Sinai.

Now, as more people are mixing again in social situations and many kids are heading back to the classroom, some experts believe that the flu could come roaring back this fall.

"We're in uncharted territory," Gandhi said. "It's possible that due to the relaxing of COVID-19 safety measures and with not enough public immunity to the flu because few people were exposed to it last year, we may be in for a more severe flu season. Because the symptoms of COVID-19 and the flu are so similar, it will be critical to get tested if you become sick."

Gandhi spoke with the Cedars-Sinai Newsroom to explain why it's important to determine which illness you might have and to answer common questions about how to navigate this unprecedented flu season.


Newsroom: Why is it important to get tested for COVID-19 if you have any of the symptoms that look similar to the flu?

Gandhi: A positive COVID-19 diagnosis would help guide you in terms of quarantining and self-isolation and when you'd be able to return to work or school safely. It could also guide your treatment. Monoclonal antibody therapy has been shown to be highly effective at preventing severe COVID-19 illness, hospitalization and death in individuals who are at risk of severe disease. If that were an appropriate option, you would need a positive test result within the last 10 days to qualify for a monoclonal antibody infusion. Lastly, an individual who has COVID-19 would want to understand their risk for developing "long COVID." Many treatment programs for this condition require a previous positive diagnosis to qualify for care.

Newsroom: Is there any reason you'd want to get a confirmed flu diagnosis?

Gandhi: With a confirmed flu diagnosis your medical provider could prescribe antiviral medications, such as Tamiflu, that can reduce the severity of symptoms but must be taken within 48 hours of diagnosis. A positive flu diagnosis also will confirm that you should self-isolate and quarantine to prevent spread to those around you, especially those who are most vulnerable to the illness, such as young children, pregnant individuals and older adults.

Newsroom: Can you have the flu without a fever?

Gandhi: You can if you're immunocompromised, or if you're already taking medications that will blunt a fever, such as ibuprofen, Advil, Motrin or Tylenol.

Newsroom: Is there a way to tell if you have COVID-19 or the flu without getting tested?

Gandhi: There is no reliable way from a symptom standpoint to assess whether or not you have COVID-19 versus the flu. Loss of taste and smell is associated with COVID-19. And symptoms like nausea, vomiting and diarrhea tend to be associated with COVID-19, unless you're a child, in which case the gastrointestinal symptoms are more common with the flu. But because the flu and COVID-19 are both respiratory illnesses and their symptoms really overlap, the only way to distinguish between the two is to get tested.

Newsroom: Could you have both flu and COVID-19 at the same time?

Gandhi: Unfortunately, yes, you can have co-infection with the flu and COVID-19 simultaneously. We don't have enough data at this point in time to know exactly what that would mean, but in general, it's never good for your body to be fighting off two potentially deadly infections at the same time.

Newsroom: What are your first steps if you develop symptoms of COVID-19 or the flu?

Gandhi: Self-isolate to ensure that you're protecting those around you from getting either illness. Then reach out to your medical provider to review your symptoms with them and get tested as quickly as possible so you can get any appropriate treatment.

Newsroom: How can you protect yourself from the flu and COVID-19?

Gandhi: Luckily, it's a lot of the same things. We learned last year that continuing to mask, maintaining physical distance, self-isolating if you're sick, observing good hand hygiene, and covering coughs and sneezes are all important. But most important, get the flu shot and get vaccinated against COVID-19.

Newsroom: Will the flu shot protect you from COVID-19?

Gandhi: No. The flu shot is intended to protect against the flu. Influenza, the virus that causes the flu, is different from the coronavirus that causes COVID-19.

Newsroom: If you don't normally get the flu, should you get a flu shot anyway?

Gandhi: It's incredibly important to get the flu shot to protect yourself from getting the flu, but also from a public health standpoint, to try and prevent severe illness and hospitalization, which we know the flu vaccine protects against. We really need to maintain our hospital capacity this coming winter to be able to take care of those patients who need the hospital.

Read more on the Cedars-Sinai Blog: A Tale of Two Pandemics—A Look Back