As challenging as the pandemic made spring and summer, it promises to make flu season significantly more difficult than usual, some in the medical community are saying.

Fighting a double threat

When the pandemic appeared earlier this year, the annual flu season was mostly gone. But should another surge of novel coronavirus cases occur in November and December, it will happen when influenza cases are most likely on the rise. Medical experts say that’s quite concerning because hospitals could see a simultaneous influx of COVID-19 patients and flu patients.

“Hospitals in many parts of the U.S. already have been strained and sometimes overwhelmed in the last few months by COVID-19,” says Dr. Lisa Doggett. She serves as senior medical director at AxisPoint Health in Westminster, Colo. “To layer a bad flu season on top of the pandemic, which many experts expect could worsen this winter, would be catastrophic in some communities. I don’t think we have a precedent for anything like what we could face if we have a bad flu season, while COVID-19 continues to pose a real and significant threat.”

For people who become sick with influenza, the coronavirus poses a greater risk, Doggett says. Influenza is likely to make them more vulnerable and susceptible to complications from a co-existing infection with COVID-19, she says.

“To reduce these risks, we all have to double down on the measures we know will lower the risk of spreading both COVID-19 and the flu. Fortunately, social distancing, face masks and hand hygiene will help with both,” she adds.

Getting a flu shot is another important way to stay healthy and lower the burden on hospitals, Doggett says.

“One small silver lining to the pandemic is that if we follow recommendations to reduce the spread of COVID-19 in our communities, we will also reduce influenza,” she says.

Numerous medical experts, including Doggett, stress that the flu shot will not prevent a person from contracting COVID-19.

“It is, in a good year, only about 60 percent effective at preventing the flu,” she says. “But it is one relatively easy, inexpensive way we can stop influenza from becoming more widespread, causing more people to get sick and fill up our hospitals. We know the flu vaccine reduces lost work/school days, hospitalizations and deaths. This year, more than ever, while we wait for a vaccine against COVID-19, we need to do all we can to keep from overburdening our health care system.”

September and October are usually the best months to get the flu shot, Doggett says. Ideally, people should be vaccinated before flu season, which usually peaks between December and February. She cautions that getting vaccinated before September may lead to reduced immunity later in the season, especially among older adults.

“But even if immunization occurs earlier or later than the recommended time frame, it can still be beneficial and protective,” she adds.

Flu shots should be given to virtually everyone older than age 6 months, every year, she says. Although mild side effects can occur, flu shots do not and cannot cause the flu.

“Only rarely are they contraindicated,” she says. “Flu shots are safe, and they save lives and prevent hospitalizations. ... Even if you think you don’t need the shot, you should get vaccinated to reduce your risk of spreading flu to others, especially during the COVID-19 pandemic. With very rare exceptions, everyone should get the flu shot every year. It’s one of the most important things you can do for your own health and that of your loved ones.”

Doggett says it’s not the easiest feat to distinguish flu symptoms from COVID-19 symptoms because it’s often not possible without viral testing.

“Both can cause fever, cough, body aches, fatigue, headaches and other symptoms,” she says. “Early in the pandemic, many test sites actually tested for both because influenza was still circulating, and the symptoms of each viral illness overlap too much to reliably differentiate the two. Right now, influenza is not circulating in the U.S., so if someone presents with classic flu symptoms, COVID-19 is far more likely. Once flu season starts, though, we will need testing, in most cases, to know which virus we are dealing with.”

Boosting immunity

For those who might want to refrain from getting a flu shot, boosting the immune system now in preparation for cold and flu season may help stave off the common symptoms. Dr. Michael Roizen, chief wellness officer emeritus at the Cleveland Clinic in Ohio, offers some best practices and tips.

“Get or keep as healthy as possible by getting adequate sleep; avoiding toxins, like vape or tobacco, and unforced errors, like texting while driving; managing stress and keeping in contact with friends; eating well and taking appropriate vitamins and supplements; and doing moderate physical activity,” Roizen says.

He adds that eating foods with tryptophan and magnesium may also help.

“It is hard to get enough magnesium from food, so if you do not love pumpkin seeds, try a magnesium supplement about an hour before bedtime,” he says.

He suggests roasted almonds, boiled black beans, cooked edamame, cooked lima beans, cooked quinoa, shredded wheat, cooked spinach, dark chocolate and water.

Also, avoid sleep-incompatible behaviors in the bed, including reading, watching TV or worrying, he adds.

“If you’re unable to sleep within 15 to 20 minutes of getting in bed, get up and go into another room. Return to bed only when sleepy again. Repeat if necessary,” Roizen says. “Maintain a regular wake time regardless of the amount of sleep that night, but plan for eight hours asleep, plus 15 minutes to fall asleep and 30 minutes for hygiene and meditation beforehand in a red-light-only environment. Avoid naps during the day. Watch caffeine and alcohol before bedtime. Distance, masks, hand and cough hygiene will do a lot, but push yourself to get healthy.”