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Health care providers brace for 'twindemic' as flu season looms amid COVID-19 outbreaks

Health officials across the U.S. are bracing for flu season while in the midst of battling the ongoing COVID-19 pandemic, a phenomenon many in the healthcare community have dubbed the "twindemic."

Local doctors, pharmacists and healthcare providers are advocating for as many people in Aiken County to get vaccinated for influenza as soon as possible. They hope that early preparation can help prevent people from being infected by multiple respiratory illnesses like colds, strep throat and coronavirus that will be circulating this fall. 

"This is going to be the season," said Dr. Kenneth Jones, chief medical officer at Rural Health Services. "We've never had anything like this before. It's all new, so we're going to have to figure it out as we go along. We're probably going to end up over-treating some people, but I'd rather over treat than under-treat at this time."

It is possible to become infected with multiple respiratory illnesses, like COVID-19, the flu or colds, at the same time. According to pharmacist Jay Watts, owner of Family Pharmacy, the immune system can be weakened while fighting off multiple infections, increasing the risk of potentially severe – or even fatal – side effects. 

"God help you, yes," Watts said. "It can absolutely make everything worse."

Watts said he's only seen a few isolated flu cases in Aiken throughout the month of August, but the season doesn't end until May 2021. He "absolutely" recommends getting a flu shot early to give the body's immune system its best fighting chance.

The flu vaccine won't work for COVID-19, for which there is currently no cure. But it might keep people from falling seriously ill to the flu this season.

"Getting a flu vaccine will not protect against COVID-19," said Dr. Bhagyashree Shastri, an infectious diseases expert at Internal Medicine Associates of Aiken. "It will however reduce the risk of flu related illness, hospitalization and death. There is a good chance it will keep you out of waiting rooms in urgent care, a doctor’s office and emergency department."

Shastri recommends anyone who begins experiencing symptoms of respiratory illness, such as fever or cough, contact their healthcare providers first to determine their next course of action, including how to get tested. 

A guessing game of symptoms 

One of the complications of having two potentially fatal respiratory illnesses circulating at the same time is that COVID-19 and influenza generally present with very similar symptoms. The viruses can both cause fever, body aches, headaches, fatigue and nausea in infected persons.

Additionally, people with underlying health conditions such as heart disease and diabetes are at elevated risk of developing severe side effects from both COVID-19 and influenza, which is why medical experts claim catching both at the same time could be very dangerous for some patients.   

Jones said loss of taste and smell and low-grade fevers are slightly more common with COVID-19 than the flu, but it's not a surefire way of telling the two apart. It's why he's looking forward to receiving a panel test that will help determine what type of respiratory infections a patient has.

"A lot of it is going to be confusing," Jones said. "A lot of people are going to think it's the flu, but it's COVID. And a lot of people are going to think it's COVID, but it's the flu. That's why it's called a twindemic. It's going to be a conundrum for the medical professionals."

Jones is also worried people will have "COVID tunnel vision" if they start presenting with symptoms of illness. He doesn't want people to panic if they get sick, but pay close attention to their symptoms, as they may not match up with those often caused by COVID-19.

Despite the potential dangers of a "twindemic," health officials are finding a silver lining by looking into data from countries in the southern hemisphere, where flu season is just wrapping up. A close look at flu data from countries like Australia and South Africa revealed that COVID-19 lockdowns and safety measures like social distancing and wearing masks, had an immense impact on lessening the spread of the flu and other coronaviruses like the common cold.

Regardless, health officials at the CDC are advocating for Americans to get vaccinated early, fearing possible overcrowding at hospitals if there is a surge of flu cases. 

"Just be careful, because it's coming," Jones said. "A lot of people are doubting that – even a lot of politicians are saying that. But I'm not political, I'm medical, and my take is it's coming, so be prepared. Stock up in your homes on your cough medicines… Be ready, because it's going to come regardless."

Who should get a flu vaccine?

• People 6 months of age and older should be vaccinated. Vaccinations must be done each year to be maximally effective, as different vaccines are created each year depending on the most common strains of influenza expected to be circulating.

• The CDC recommends getting vaccinated in September or October for optimum protection.

• Getting a flu vaccine does not increase one's chance of catching COVID-19, according to the CDC.

• If someone is confirmed to have or is suspected of having COVID-19, they should not be administered a flu shot until their isolation period is over regardless of whether they have symptoms, according to the CDC. This is to prevent the infected person from potentially spreading the virus to healthcare personnel or other people outside their isolation area.

• People who have life-threatening allergic reactions to flu shot ingredients, children under 6 months of age and people with Guillain-Barre Syndrome should not receive a flu shot.

• People who are currently sick should wait until they are in good health before getting a flu shot to ensure the quickest possible immune response to the vaccine.  

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