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This has been reviewed and updated as of October 23, 2020.

Coronavirus Not Same as Flu

As the COVID-19 pandemic continues to dominate our lives for the better part of 2020, many people are growing tired of the restrictions that have changed our normal routines.

While this “pandemic fatigue” is somewhat understandable, now is hardly the time to let down your guard. COVID-19 cases are on the rise again in the U.S. and much of the world. Experts are pointing to signs of yet another spike in the U.S. (after two earlier ones in April and July), with nearly 360,000 new infections reported just last week. For Global Healthy Living Foundation and CreakyJoints readers and others with chronic health problems, continuing to stay vigilant is especially important.

One common refrain issued by those who believe the threat of COVID-19 is overblown is that it’s “just like the flu.” Most visibly, President Trump recently likened coronavirus to the flu while tweeting after his release from Walter Reed National Military Medical Center, where he received treatment for his own COVID-19 infection.

Meanwhile, new research shows that people who are hospitalized with COVID are five times more likely to die compared to those who are hospitalized with the flu. Most infectious disease specialists and public health experts say that COVID-19 is actually quite different than the flu.

Here are some of the main reasons, based on what we know about the novel coronavirus now.

1. You can get vaccinated against the flu, but not yet against COVID-19

Getting the flu vaccine doesn’t guarantee that you’ll dodge the flu, but it dramatically increases the odds in your favor. What’s more, if you do get the flu, having been vaccinated reduces the likelihood of developing severe complications, including pneumonia and death.

At this time, there is no vaccine that will reduce your chances of contracting COVID-19. Many vaccines are in development in the U.S. and around the world, but there’s no definite timeframe for when they will be deemed safe and effective and ready for mass distribution. Even when some vaccines do gain approval from the U.S. Food and Drug Administration (FDA), it will likely take months before they’re widely available. At first they will be rationed to groups who need the vaccine most urgently, such as health care providers.

However, staying current on your flu vaccine (as well as the pneumonia vaccine) can help prevent you from getting sick with other health issues that might require hospitalization. Talk to your health care provider about your vaccination record to make sure you’re up to date.

Here is more information about getting the flu vaccine safely during COVID-19.

2. There is still no herd immunity to COVID-19

Even if you’re someone who can’t get the flu vaccine for medical reasons, the concept of “herd immunity” offers you some degree of protection from flu, provided that you live in the vicinity of many others who have been vaccinated. Large groups of individuals can also become immune to a contagious disease after they’ve had the illness and recovered from it, which similarly decreases its spread in the community going forward.

Herd immunity has been discussed a lot in the context of COVID-19. Most recently, the White House came out in support of a declaration by a small group of dissenting scientists who believe that the majority of people around the world should resume normal life in an effort to build herd immunity more quickly. This plan, however, is controversial and not backed by most scientists and health care professionals.

Herd immunity for COVID-19 is still a long way off. A recent study published in The Lancet found that less than 10 percent of Americans currently have COVID-19 antibodies. Herd immunity won’t be reached until a much greater percentage of the population has antibodies to this virus (thanks to previously being infected with it or getting vaccinated against it), though the exact percentage is still up for debate among medical experts.

“Eventually there will be herd immunity, and [COVID-19] will simmer into the background, but that might take a few years,” says Mark Schleiss, MD, an infectious disease expert at the University of Minnesota Medical School.

3. We have several FDA-approved medications to treat flu and shorten its duration; treatments for COVID-19 require further

They aren’t perfect, but antiviral drugs have been proven to shorten the duration of the flu and lessen its severity. There are currently four of these drugs on the market: oseltamivir (Tamiflu), zanamivir (Relenza), peramivir (Rapivab), and baloxavir (Xofluza).

So far, the only drug officially FDA-approved to treat COVID is remdesivir, which the FDA approved on October 22, 2020. However, this approval comes on the heels of a World Health Organization (WHO) study, published just a week earlier, which found that COVID patients who were treated with it were not any more likely than others to survive. For this reason, many scientists believe that further study of remdesivir is warranted.

Scientists are also continuing to study other possible treatments for COVID-19, including dexamethasone (a corticosteroid that reduces inflammation), but this drug and many others are still considered investigational.

4. The flu may impact more people, but COVID-19 is more deadly 

The numbers are changing constantly, but as of October 14, 2020, more than 38 million people worldwide have been infected with COVID-19. While that sounds like a lot, it actually pales in comparison to the flu. About 1 billion people get the flu each year worldwide.

But so far, COVID is proving much more deadly than the flu. New research from the CDC looked at the health records of nearly 4,000 patients in the Veterans Health Administration who were hospitalized with COVID-19 from March 1 to May 31, 2020 and compared them with a group of nearly 5,500 patients who were hospitalized with flu between October 1, 2018 and February 1, 2020.

COVID-19 patients were five times more likely than flu patients to die in the hospital. People with COVID-19 also had a higher risk for many different kinds of complications (more on this below) compared to people with the flu.

5. COVID-19 is more contagious than the flu

People with COVID-19 may be contagious for a longer period of time than flu. According to the CDC, most people with flu are contagious for about one day before they show symptoms and people appear to be most contagious during the initial three to four days of their illness. Many remain contagious for about seven days.

With COVID-19, people can spread the virus for about two days before experiencing signs or symptoms and they remain contagious for at least 10 days after signs or symptoms first appeared.

What’s more, many COVID-19 carriers are asymptomatic, which means they are apt to spread the virus to others even if they never develop symptoms themselves. That generally doesn’t happen with the flu.

COVID-19 has also been transmitted by “super-spreaders” who are able to infect many others very rapidly.

6. COVID-19 can cause more severe complications than flu

Both flu and COVID-19 can lead to hospitalizations and serious complications, especially in people with underlying health issues. These include:

  • Pneumonia
  • Respiratory failure
  • Acute respiratory distress syndrome
  • Sepsis
  • Heart attacks and stroke
  • Multiple-organ failure (respiratory failure, kidney failure, shock)
  • Worsening of chronic medical conditions (involving the lungs, heart, nervous system or diabetes)
  • Inflammation of the heart, brain or muscle tissues
  • Secondary bacterial infections (infections that occur in people who have already been infected with flu or COVID-19)

COVID-19, however, is linked with additional health issues that don’t seem to occur with flu, such as blood clots in the lungs, heart, legs, or brain. And certain complications seem worse with COVID-19 than with flu. For example, the recent CDC study found that patients were COVID-19 had almost 19 times the risk for acute respiratory distress syndrome (ARDS) than did flu patients and more than twice the risk for myocarditis, pulmonary embolism, bleeding in the brain, liver failure, and other issues.

There’s also a growing group of COVID-19 “long-haulers.” They have recovered from COVID-19 infections but have lingering symptoms — such as chronic fatigue, brain fog, shortness of breath, muscle and body aches, and more — that are wreaking havoc on their ability to return to their usual quality of life and often require ongoing medical care and investigation.

7. Experts know a lot more about how to manage the flu.

With experience comes knowledge, and we’ve only known about COVID-19 for about a year. (The first reports were in November 2019 in China.) While experts are striving to learn everything they can about this disease as quickly as possible, it’s going to take some time to fully understand the disease and figure out how to best manage it.

“This is a virus that’s unique, that’s never been seen in a human population before. Sure, flu changes year to year, but at least we have some immunologic experience with it,” says Dr. Schleiss. “I’ve been doing this long enough that I remember Legionnaires’ disease. I remember the explosion of measles in the 1980s, Zika, Ebola, and SARS. I’ve never seen anything like [COVID-19]. The biology of the virus, its ability to persist in the human population, the high mortality rate — particularly in vulnerable individuals — and the impact it is having on society are all unique.”

“I’ve heard people say, ‘The media is making too much of this; why all the fuss?’” Dr. Schleiss continues. “I push back against that… Young, healthy people will survive, but it’s very sobering and really gives one pause to think about the very high risks for the elderly, debilitated, and disabled. All these lives are important.”

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Anand, S. etc al. Prevalence of SARS-CoV-2 antibodies in a large nationwide sample of patients on dialysis in the USA: a cross-sectional study. The Lancet. September 2020. doi: https://doi.org/10.1016/S0140-6736(20)32009-2.

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Interview with Ashita S. Batavia, MD, infectious disease expert and assistant professor of medicine at Weill Cornell Medicine

Interview with Joshua F. Baker, MD, assistant professor of rheumatology and epidemiology at the University of Pennsylvania and Corporal Michael J. Crescenz VA Medical Center

Interview with Mark Schleiss, MD, an infectious disease expert at the University of Minnesota Medical School

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