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Coronavirus Not Same as Flu

As the COVID-19 pandemic continues to dominate our lives, 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. For members of the Global Healthy Living Foundation and CreakyJoints and others with chronic health problems who may be at increased risk of complications and severe COVID-19, 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.”

While we now have a safe and effective COVID-19 vaccine — as we do a flu vaccine — there are still important differences between COVID-19 and the flu in terms of herd immunity, contagiousness, long-term symptoms, and more.

Like the flu shot, the COVID-19 vaccine dramatically decreases your odds of getting infected and/or having a serious bout. Now that more data is emerging, we know that people who are fully vaccinated are protected from severe disease and death from COVID-19.

However, research shows that people who are hospitalized with COVID have a higher mortality risk compared to those who are hospitalized with the flu. In addition, patients with COVID were more likely to end up in the ICU and have longer hospital stays. 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 coronavirus now.

1. 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 for COVID-19 is still a long way off. Researchers and medical experts are continuing to study how many people have to be vaccinated against or infected with COVID-19 before the population can be considered protected.

“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.

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

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, and should only be administered in a hospital or doctor’s office. Other treatments have been approved for emergency use, and scientists are continuing to study other possible therapies for treating COVID-19.

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

The numbers are changing constantly, but COVID-19 has infected tens of millions of people worldwide. While that sounds like a lot, about 1 billion people get the flu each year worldwide.

But so far, COVID is proving much more deadly than the flu. 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.

4. COVID-19 is more contagious than the flu.

People with COVID-19 may be contagious for a longer period of time than the flu. According to the CDC, most people with the 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.

5. 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 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.

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 short time. (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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Amol A, et. al. Characteristics and Outcomes of Hospital Admissions for COVID-19 and Influenza in the Toronto Area. Canadian Medical Association Journal. March 22, 2021. doi: https://doi.org/10.1503/cmaj.202795.

Cates J, et al. Risk for In-Hospital Complications Associated with COVID-19 and Influenza — Veterans Health Administration, United States, October 1, 2018–May 31, 2020. Morbidity & Mortality Weekly Report (MMWR). October 23, 2020. doi: http://doi.org/10.15585/mmwr.mm6942e3.

Cave E. COVID-19 Super-spreaders: Definitional Quandaries and Implications. Asian Bioethics Review. June 2020. doi: https://doi.org/10.1007/s41649-020-00118-2.

CDC COVID Data Tracker. Coronavirus Disease 2021 (COVID-19). U.S. Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#cases_casesinlast7days.

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

COVID-19 Treatment Guidelines. U.S. National Institutes of Health. What’s New in the Guidelines. https://www.covid19treatmentguidelines.nih.gov/whats-new.

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