RVU Fights the Flu (and COVID-19)

As part of RVU’s Fight the Flu Campaign, University faculty address myths and answer common questions about the flu vaccine, as well as emerging questions about the COVID-19 vaccine.

True or False: The flu won’t be as widespread this season because of social distancing and mask guidelines already in place.

Dr. Jean Bouquet, Assistant Professor of Family Medicine: “The answer, according to most experts, is true. Both the virus that causes the flu (influenza A and B) and the virus that causes COVID-19 (SARS-CoV 2) are transmitted primarily through aerosolized droplets from coughing, sneezing, spitting, or even speaking loudly. A mask is the primary way to prevent inhalation of these microdroplets. Keeping your distance and wearing a barrier (i.e. a mask) will cut down on and may even prevent the spread of both viruses. If we social distance, wear masks, and properly wash our hands, we should expect the number of influenza cases to be reduced this year. May be a good idea during flu season in the future!”

Could a COVID-19 vaccine make the flu vaccine less effective or vice versa?

Dr. David Crimin, Director of Medical Education at the Southern Utah Veterans Home: “We are actually concerned this season with a ‘Twindemic’—people infected with both viruses. The studies that I read and experts in the field [that] I listen to cite evidence that other recent vaccines may actually boost our body’s immune response to mount a defense to other viral infections, e.g. COVID-19.

“So keeping up to date with the recommended childhood and adult vaccination schedules, such as the seasonal influenza vaccine, may boost our body’s immune defense.

“When a safe and effective COVID-19 vaccine becomes available, I believe it will be a key part of our defense against a Twindemic season. Of course, being vigilant with proper rest, nutrition, exercise, and using PPE (like masks), hand washing, and social distancing are always the first line of defense for you, your loved ones, and our RVU community. These are simple and important measures we can all do.”

Should pregnant women get the flu and/or COVID-19 vaccines?

Dr. Mark Wardle, Co-Director of the Global Medicine Track: “Being pregnant raises the risk for suffering severe illness in both COVID-19 and Influenza infections. These illnesses may also be harmful for the developing baby and can increase the risk of having preterm birth and other pregnancy complications. Because of these increased risks, preventing these illnesses during pregnancy is a high priority.

“The influenza vaccine has long been found to be safe and effective in preventing serious influenza disease in pregnancy and is recommended for all pregnant patients during the flu season. Flu shots help protect the mom and, through maternal antibodies passed through the placenta, they protect their newborns, as well.

“Preventing COVID-19 in pregnant persons is equally important; however, there is not yet an approved vaccine available, though several are in development. Once available, vaccines are likely to be in limited supply, but because of their increased risk of more serious disease, pregnant patients are one of the groups considered by the CDC for early vaccination. However, only after a vaccine is properly tested and proven safe in pregnancy will it be recommended. For now, continue prudent practices to lower your risk of getting the virus: wearing a mask; physical distancing; washing your hands; and avoiding activities and interactions that increase your potential for being exposed.”

References and additional information:

https://www.cdc.gov/flu/highrisk/pregnant.htm

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Is this an accurate statement: “I’ve never had the flu, so I must be immune to it?”

Dr. Ben Wilde, Associate Professor of Osteopathic Principles & Practice: “The flu virus changes over time. This makes it difficult for our immune system to consistently recognize and fight off the virus. Even if you have not had the flu previously, there is no guarantee that you won’t in the future when exposed to a ‘newer’ flu virus. The best approach to preventing that first infection is to get the flu shot each year.”

True or False: The flu vaccine itself can help fight off COVID-19.

Dr. Camille Bentley, Chair of the Department of Tracks and Special Programs: “The flu vaccine will not prevent you from getting COVID-19. The viruses are different for each of these infections, despite the fact that they both affect the respiratory system. There is some thought in the science community that by getting the flu vaccine you may have a stronger non-specific immune response to other viruses—this is called ‘bystander immunity’. The flu vaccine will protect you from getting the flu, which will prevent you from getting a double infection which could have a very poor prognosis.”

Other facts: Influenza A and B viruses are negative-strand RNA viruses that cause the ‘Flu’. Strains of the SARS-COV-2 virus causes COVID-19.

What are the main differences between COVID-19 and the flu (i.e. onset of symptoms, types of symptoms, etc.)?

Sarah Neguse, Assistant Professor of Physician Assistant Studies: “Influenza and COVID-19 are both contagious respiratory illnesses that share many symptoms but also have some notable differences. COVID-19 appears to spread easier than the flu and cause more serious illness, particularly in older adults and those with underlying medical issues. Children tend to be at higher risk of serious illness from influenza rather than COVID-19. In addition, COVID-19 has been linked to serious vascular complications, primarily blood clots of the lung, heart, brain, and leg. Children can experience MIS-C (multisystem inflammatory syndrome) as a complication.

“Both influenza and COVID-19 can cause fatigue, fever, cough, shortness of breath, sore throat, muscle aches, and headache. However, COVID-19 has a unique symptom of loss of taste or smell that is not seen in influenza. Typically, those with influenza will experience symptoms 1-4 days after exposure, whereas those with COVID-19 experience symptoms about 5 days after exposure (though it can range from 2-14 days). A person infected with influenza can be contagious a day before symptoms appear and are usually contagious for 3-4 days after symptom onset (but can be contagious up to 7 days after). Conversely, COVID-19 patients can be contagious 2 days prior to feeling sick and this can remain for 10 days after symptom onset. While there is a vaccine to protect against influenza, there is not at this time a vaccine to protect against COVID-19. Though as we are all aware, researchers are getting close to developing one!”

Are Vitamin C or Zinc supplements (or a “good” diet) enough to stave off the flu or COVID-19?

Dr. Dennis Kinder, Associate Professor of Internal Medicine: When taken within 24 hours after onset of symptoms, Zinc taken by mouth may help to reduce the length of a cold. There is no evidence that it is effective against influenza. Intranasal zinc has a severe side effect of irreversible loss of the sense of smell. This is not something any of us want to experience during this COVID-19 pandemic. As for Vitamin C, it does not prevent cold or influenza, but may slightly improve cold symptoms.

When taken within 24 hours after onset of symptoms, Zinc taken by mouth may help to reduce the length of a cold. There is no evidence that it is effective against influenza. Intranasal zinc has a severe side effect of irreversible loss of the sense of smell. This is not something any of us want to experience during this COVID-19 pandemic. As for Vitamin C, it does not prevent cold or influenza, but may slightly improve cold symptoms.

A good diet and regular exercise are important for your general health and have many long-term benefits, but are not enough to prevent influenza or COVID-19.

The bottom line is there is no evidence that zinc, vitamin C, diet, or exercise is enough to stave off influenza or COVID-19. What I can recommend for influenza prevention is:

The influenza vaccination: During the 2018-2019 influenza season it is estimated that the vaccine prevented 4.4 million influenza illnesses, 58,000 hospitalizations, and 3,500 deaths
Wear your mask
Practice Physical Distancing
Frequently wash your hands with soap and water
Avoid touching your nose, eyes, and mouth