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Coronavirus Not Same as Flu

While many Americans have recently started taking stricter preparation measures to protect against the spread of coronavirus, many CreakyJoints members and people with chronic health problems have been taking such steps for weeks or even longer. For those with suppressed immune systems and underlying health issues, actions such as canceling travel plans, changing RSVPs to “no,” and stocking up on groceries, medication, and household supplies are critically important. The CDC even started advising high-risk patients last week to “stay at home as much as possible.” Some people in our community are venturing out only for doctor’s appointments or very important errands.

Whatever your level of vigilance, health experts agree that people with chronic ailments face a greater threat than healthy people do from COVID-19 (novel coronavirus). Yet at the same time, many members of the CreakyJoints community have been disheartened by the reaction of family and friends who continue to imply that they’re overreacting.

“I can’t even convince my husband and sister that this could be life-threatening for me,” one member lamented on Facebook. Others have said their concerns have been “ignored” or that they’ve been made to feel like “a hypochondriac.”

One common refrain issued by those who believe the threat of COVID-19 is overblown is that it’s “just like the flu.”

While the flu is certainly no minor ailment — every year, more than 12,000 Americans die from the flu — most infectious disease specialists say that COVID-19 is actually quite different than the flu. Here’s why.

1. You can get vaccinated against the flu

 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.

“The flu vaccine is kind of like a seat belt,” says infectious disease expert Ashita S. Batavia, MD, assistant professor of medicine at Weill Cornell Medicine. “It won’t prevent a crash, but if you do get in a crash you will be a little safer.”

At this time, there is no vaccine that will reduce your chances of contracting COVID-19. However, staying current on your flu and pneumonia vaccines 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.

 2. There is no herd immunity to COVID-19

Even if you’re someone who can’t get the flu vaccine for medical reasons, “herd immunity” offers you some degree of protection 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. But the combination of COVID-19 being so new and the lack of a vaccine means that this effect won’t kick in for quite some time.

“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 FDA-approved medications to treat flu and shorten its duration

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).

COVID-19 is a new virus, so scientists haven’t had much time to study it or create treatments for it. That might change, and Gilead Sciences is already conducting a phase I clinical trial on a broad-spectrum antiviral called remdesivir, says Dr. Schleiss. But for now and the immediate future, the only official treatments for COVID-19 are supportive ones, such as fever-reducing drugs and supplemental oxygen.

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

The numbers are changing constantly, but as of March 12, 2020 there have been nearly 130,000 cases of COVID-19 worldwide. That actually pales in comparison to the flu. About 1 billion people get it each year worldwide.

So why are experts so concerned about COVID-19? “While the exact mortality rate of COVID-19 is not yet clear, it is probably 10 times greater than that of the flu,” says Joshua F. Baker, MD, assistant professor of rheumatology and epidemiology at the University of Pennsylvania and Corporal Michael J. Crescenz VA Medical Center. “In addition, the rate of severe illness is higher.”

The World Health Organization currently says that 3.4 percent of people who have been infected with COVID-19 have died from it. That might not sound like a lot, but the mortality rate from the flu is a fraction of that (about 0.1 percent on average).

If you have a rheumatic disease or other chronic condition — especially one that impacts your lung function or your immune system — your odds may be even worse. “There is ample evidence to suggest that people with more medical conditions, lung disease, and of older age are at higher risk,” says Dr. Baker. “It also stands to reason that people who are using immunosuppressive drugs may be at higher risk and should take precautions.”

5. COVID-19 is more contagious than the flu

This coronavirus is also more contagious the flu, although data is still emerging. Scientists use the term basic reproduction number, or R0, to describe how easily a virus is spread from person to person. R0 is the average number of people who will catch the disease from a single infected person. An R0 of one means that a person with infection is likely to infect one other person.

So far, estimates suggest COVID-19 has an R0 of 2 to 3, which means one infected person is likely to infect two to three others. The seasonal flu has an R0 of 1.3.

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

With experience comes knowledge, and we’ve only known about COVID-19 for a few months. (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, it’s 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… Just look at the map of Italy. Every region now has a cluster, and this is what’s going to happen here. 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. It’s a matter of great urgency.”

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Coronavirus Disease 2019 vs. the Flu. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu.

Coronavirus may spread faster than WHO estimate. Medical News Today. https://www.medicalnewstoday.com/articles/coronavirus-may-spread-faster-than-who-estimate#Coronavirus-spreads-faster-than-SARS.

Disease Burden of Influenza. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/burden/index.html.

Fauci AS, et al. Covid-19 — Navigating the Uncharted. New England Journal of Medicine. February 28, 2020. doi: http://dx.doi.org/10.1056/NEJMe2002387

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

Rolfes MA, et al. Effects of Influenza Vaccination in the United States During the 2017–2018 Influenza Season. Clinical Infectious Diseases. December 2019. doi: https://doi.org/10.1093/cid/ciz075.

WHO Director-General’s opening remarks at the media briefing on COVID-19 – 3 March 2020. World Health Organization. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—3-march-2020.