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Can We Fight Flu at the Same Time as COVID-19?

This year it is more important than ever to fight flu. Many of the same tactics that stop COVID-19 transmission also work against influenza.
Can We Fight Flu at the Same Time as COVID-19?
Vaccine or flu shot in injection needle. Doctor working with patient’s arm. Physician or nurse giving vaccination and immunity to virus, influenza or HPV with syringe. Appointment with medical expert.

Shortly before flu season, public health experts got worried. Americans were encouraged to get their flu shots right away. The goal was to prevent double trouble: influenza on top of COVID-19. They didn’t want people to have to fight flu and COVID-19 at the same time.

How Can You Fight Flu in a Time of COVID?

We would not discourage anyone from getting a flu vaccination. There was, however, a good chance that if we followed public health guidelines to avoid COVID-19, we might also be able to avoid a bad flu season. What we should have done is avoid crowds, wear face masks, stay home if we get sick and wash our hands. These are simple but effective tactics against any infection.

How Well Did This Strategy Work?

Americans did not do as good a job of staying home and avoiding crowds as we might have over the Thanksgiving holiday. The consequence, sadly, is that now hospitals and ICU units in many parts of the country are full to overflowing. However, enough people did follow through on the anti-infection tactics to reduce the amount of influenza circulating in the population. We suspect that they also may have gotten flu shots, as they were urged to do. So far, the flu seems to be far less common than usual. In addition to immunization, precautions to slow the spread of the coronavirus may be largely responsible for the lower burden of flu. 

A Mild Flu Season in the Southern Hemisphere:

That follows the pattern from the Southern Hemisphere between March and September. Our spring and summer is their fall and winter. That is when influenza strikes hard down under.

This year, though, the flu season was exceptionally mild. Countries like Australia, New Zealand, South Africa, Chile and Argentina were preparing themselves for a challenging time with two nasty respiratory infections at once. To everyone’s surprise, the flu never materialized.

New Zealand screened for influenza starting in June. They found no cases. Normally, more than half of their samples would be positive for the flu.

Australia also experienced record low levels. In 2019, the country had more than 130,000 identified cases of influenza. In 2020, by contrast, there were only 315. Deaths from the flu were dramatically lower—only 4 percent of last year’s total.

How Did Southern Hemisphere Countries Fight Flu in 2020?

What explains this good news? It seems that measures taken to reduce the transmission of COVID-19 also help control the spread of influenza. When people don’t travel, avoid large crowds, wear face masks and wash their hands conscientiously, they may be able to avoid a variety of transmissible viral infections.

Face Masks Can Help:

Although such tactics are new to western societies, people in Japan, China and many other Asian countries have been practicing them for years. It has been suggested that people in Japan adopted face masks during the Spanish flu outbreak of 1918. That pandemic was devastating, killing nearly 400,000 people. During the height of a normal flu season, nearly one in three Japanese people wears a mask, which is considered a signal of respect for others.

Americans have had a hard time embracing face masks. Many don’t believe they work. Others complain that they make breathing more challenging. However, there are data demonstrating that face covering and hand washing reduce viral transmission (Epidemiology and Infection, May, 2014). Hand hygiene alone was not effective to fight flu; people needed to use both.

A review of 12 studies found that face masks can help reduce the spread of influenza as well as the coronavirus (International Journal of Infectious Diseases, Sept. 25, 2020).

The authors conclude:

“We strongly recommend medical facemask use in community settings especially when widespread community transmission may be ongoing and where physical distancing may not be possible, e.g. public transportation, grocery shops, etc. However, facemask use must not be considered as a replacement for physical distancing, hand hygiene, and other essential preventive public health measures.”

The People’s Pharmacy Perspective on Flu Season:

The prospect of suffering two nasty respiratory infections at the same time or within the same season is daunting. That’s why we think it is important to fight flu as well as COVID-19. Masks are important for protecting both the wearer and those within range of a cough or sneeze. Despite our cultural resistance to this practice, the experience from the Southern Hemisphere this past winter points to the benefits of this approach. In addition, flu vaccines, while less than perfect, provide some protection. If we all employ the full range of preventive tactics–immunization, hand hygiene, face coverings in public indoor spaces, staying out of crowds and most importantly, staying home when we are sick, we may be able to reduce transmission of both viruses. However, it will require everyone working together.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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  • Wong VWY et al, "Hand hygiene and risk of influenza virus infections in the community: a systematic review and meta-analysis." Epidemiology and Infection, May, 2014. DOI: 10.1017/S095026881400003X
  • Chaabna K et al, "Facemask use in community settings to prevent respiratory infection transmission: a rapid review and meta-analysis." International Journal of Infectious Diseases, Sept. 25, 2020. DOI: 10.1016/j.ijid.2020.09.1434
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