Flu Season Is Coming. Here’s How to Prepare.

Flu Season Is Coming. Here’s How to Prepare.

| Sunday 18 September 2022

NYT- Melinda Wenner Moyer

We may be more susceptible to the virus than we have been in recent years, but doctors have tips to stay healthy.
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With the recent headlines about Covid-19, polio and monkeypox, I have been in denial about the fact that yet another virus — influenza — will soon be upon us. Flu activity tends to ramp up starting in October, although the virus has already been circulating this month in Texas, New Mexico, Delaware and Georgia.

The Southern Hemisphere, which is finishing up its flu season, has seen a lot of flu this year — and that may not bode well for us up north. “I do think it’s going to be a worse year than we’ve seen in the last few years,” said Dr. Bessey Geevarghese, a pediatric infectious disease physician at Northwestern Medicine Central DuPage Hospital.

This year may be worse in part because Covid restrictions — which can also prevent the spread of the flu — have loosened and because people may travel more this fall and winter than they did over the past two years. Dr. Geevarghese also added that because flu seasons have been so mild over the past few years, many people in the United States may be more susceptible this year because their immune systems haven’t been exposed to the flu virus in a while.
Here’s what you can do to stay healthy.

Get a flu vaccine.
It’s too early to tell how effective the flu vaccine will be this year, said Dr. Jeff Kwong, an infectious disease physician with the University of Toronto’s Centre for Vaccine Preventable Diseases. But Dr. Geevarghese pointed out that even when the vaccine does not match well against circulating flu viruses, it still protects people against serious illness and complications.
A 2017 study found that the flu vaccine reduced the risk of hospitalization in people between the ages of 18 and 64 by 51 percent and in adults 65 and older by 37 percent across five flu seasons. A 2020 study also found that, among children, flu vaccination reduced the chance of flu-related hospitalization by 41 percent and reduced the risk of flu-related emergency room visits by 51 percent during the 2018-2019 flu season.

If you have children, keep in mind that many who are 2 or older are eligible for the nasal spray flu vaccine, which doesn’t require a needle stick and should work just as well as the shot, Dr. Geevarghese said. Children between 6 months and 8 years old who are getting the flu vaccine for the first time, or who have only ever received one flu vaccine dose, should get two doses of the flu vaccine this year, she added.

Even if you aren’t very worried about flu complications for yourself or your child, remember that vaccination “will also protect the people around you,” Dr. Geevarghese said.

Consider getting a Covid booster and flu shot at the same time.
Last week, Dr. Ashish Jha, the White House Covid-19 response coordinator, urged those who are eligible to get the new Covid-19 booster immediately, along with their flu shot. “You can get both your flu shot and Covid shot at the same time,” he said. “It’s actually a good idea.”

Experts agree that it is safe to get your Covid booster and flu shot simultaneously — and that the convenience of getting them together may help to get more shots in arms, which will keep the population healthier, said Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at the Brown University School of Public Health. But she noted that people who get the vaccines at the same time could experience more side effects, such as sore arms, headache and fatigue, which tend to be mild.
Dr. Kwong said that people at higher risk for flu complications, including those who are pregnant, 65 or older or who have conditions like asthma, heart disease or diabetes, may want to get their flu vaccine as soon as possible. People living in parts of the United States that already have moderate or high flu activity, such as Texas, New Mexico, Delaware and Georgia, should get vaccinated as soon as possible, too. 

For optimal protection, though, some people may want to wait.
If you aren’t at high risk for complications and flu activity is low where you live, and if you are the type of person who likes to optimize your flu protection, waiting another month or two could be a wise choice, the experts I spoke with said. Dr. Nuzzo said she usually gets her flu shot in October, while Dr. Kwong said he often waits until November.

Waiting can make sense because people are more likely to encounter the flu virus in the winter rather than in the early fall — and the protection afforded by the flu vaccine wanes over time, said Emily Martin, an infectious disease epidemiologist at the University of Michigan School of Public Health.

Dr. Martin and her colleagues published a study in 2021 that found the ability of the flu shot to protect against flu-induced hospitalization dropped by 8 to 9 percent each month after vaccination across four flu seasons. A 2019 study reported that the odds of catching the flu went up by 16 percent every 28 days after vaccination. This is relevant considering that last flu season, the flu was still spreading in March, April and even June in some U.S. regions, perhaps because people were ramping up travel and loosening Covid restrictions. If you got your flu vaccine in August, or if you get it in September, you may not be protected against flu during the spring and early summer months, Dr. Kwong said.

That said, the vaccine may still partially protect you after seven or eight months, Dr. Martin said. So don’t fret if you got your vaccine already. Getting the flu vaccine early is better than not getting it at all, she added.

Wear a mask in crowded indoor spaces and wash your hands regularly.
Even if the flu isn’t yet spreading where you live, experts recommend wearing a mask in crowded indoor spaces. “Masking helps reduce the spread of a lot of respiratory viruses, not just flu,” Dr. Martin explained, and in the early fall there can be 20 or more viruses circulating because of back-to-school spread, she said. Dr. Kwong recommended wearing high-quality, well-fitting masks, such as N95s, KN95s or KF94s. If that’s not possible, surgical masks are more protective than cloth masks, but cloth is better than nothing at all, he said.
Regular hand washing will also reduce your risk of getting sick, Dr. Kwong said, because many viruses — including influenza — are spread through contact with contaminated surfaces. Sick people can leave viruses behind on doorknobs, handles and other commonly touched surfaces, which can transfer to your hands — and then to your nose and mouth.

Understand what to do if you feel sick.
Because symptoms of flu and Covid-19 are similar — both can include runny nose, cough, fever, fatigue, body aches or headache — Dr. Nuzzo recommended stocking up on rapid Covid-19 tests so you can follow Covid-19 isolation guidelines if you’re positive and ask your doctor if you’re eligible for treatments like Paxlovid. It may be worthwhile to get a flu test at the doctor, too, she said, because if you’re diagnosed within the first few days of symptoms, antiviral drugs may help to minimize your symptoms and even shorten the course of illness.

While rapid tests that can distinguish between Covid-19, flu and other viral infections aren’t yet available for home use, Labcorp sells a testing kit that they will mail to you for home collection. Once you send it back to their lab, they can test for Covid-19, flu and respiratory syncytial virus (R.S.V.), an infection that can cause complications in babies and young children. According to Labcorp, results come back in one to two days.

No matter what virus you have, if you feel sick, it’s important to stay home if possible, Dr. Martin said. “If your nose is running, and you’re coughing, and you’re all congested, try to limit your activities and your exposures to others,” she said.

Although it’s stressful to think about yet another virus to avoid this fall and winter, the upside is that the same steps we’ve taken to prevent Covid-19 also prevent the spread of the flu. You can reduce your risk of the flu by getting vaccinated, wearing a mask and washing your hands — and none of these strategies, thankfully, are difficult to do.

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