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Are we heading for a 'Twindemic'? Person tests positive for both COVID-19 and common flu in California

Health experts have been dreading a 'twindemic' of respiratory diseases this winter, in a scenario where there is a spike in coronavirus cases as well as a severe influenza season
UPDATED OCT 31, 2020
(Getty Images)
(Getty Images)

The US Centers for Disease Control and Prevention (CDC) believes it is likely that flu viruses and the virus that causes Covid-19 will both be spreading in the fall and winter. Health experts have also been dreading a ‘twindemic’ of respiratory diseases this winter, in a scenario where there is a spike in coronavirus cases as well as a severe influenza season. While it is currently uncertain how common a co-infection of the flu and Covid-19 can be, a person has tested positive for both the diseases in Solano County, California. 

No other information was disclosed regarding the patient except for the fact that the person is below 65 years. “The Solano County Department of Health and Social Services, Public Health Division, has confirmed that a Solano County resident under the age of 65 has tested positive for the first case of flu and Covid-19 co-infection,” reads a statement.

According to the CDC, it is possible to have the flu, as well as other respiratory illnesses, and Covid-19 at the same time. Health experts are still studying how common this can be. “With the likelihood of both Covid-19 and seasonal flu activity this winter, contracting either disease may weaken your immune system and make you more susceptible to the other disease,” warns Dr Bela T Matyas, Solano County Health Officer.

Dr Peter Chin-Hong, a professor of medicine and infectious disease specialist at the University of California, San Francisco, told NBC News that how common it will be will depend on what the flu season is going to look like. “There's nothing that would preclude co-infection. It’s not like Covid comes in and takes out all the flu,” explains Chin-Hong. 

An analysis, which was published in April in JAMA, reported co-infection between SARS-Cov-2 (the virus that causes Covid-19) and other respiratory pathogens, including influenza, in Northern California. “These results suggest higher rates of co-infection between SARS-CoV-2 and other respiratory pathogens than previously reported, with no significant difference in rates of SARS-CoV-2 infection in patients with and without other pathogens. The presence of a non-SARS-CoV-2 pathogen may not provide reassurance that a patient does not also have SARS-CoV-2,” the research team concluded.

Contracting either Covid-19 or the flu may weaken the immune system and make a person more susceptible to the other disease, cautions Dr Bela T Matyas, Solano County Health Officer Getty Images)

Flu and Covid-19 can both result in serious illness, including illness resulting in hospitalization or death. Certain groups – such as people 65 years and older, people with chronic medical conditions, young children, and pregnant women among others – are at high risk of complications from the flu.

Some of the symptoms of flu and Covid-19 are similar, making it hard to tell the difference between them based on symptoms alone. Diagnostic testing can help determine if a person is sick with coronavirus or the flu. The CDC has also developed a test that will check for A and B type seasonal flu viruses and SARS CoV-2. The US Food and Drug Administration (FDA) has granted it an Emergency Use Authorization. 

“Symptoms of the flu can be like early symptoms of Covid-19, meaning people with flu symptoms may require a Covid-19 test and need to stay home from work and isolate while awaiting their results. It is also important to note that flu is not Covid-19, which is caused by a different virus, and that the flu is not the same as the common cold, which is also caused by different viruses,” says Matyas.

The start of the flu season is always unpredictable, and the flu vaccine, once administered, takes two weeks to become fully effective. While getting a flu vaccine will not protect against coronavirus, influenza vaccination has many other important benefits. Flu vaccines have been shown to reduce the risk of flu illness, hospitalization, and death. Accordingly, the CDC repeatedly advises Americans to get a flu vaccine by the end of October every year, as the flu virus changes over time. 

“Getting a flu vaccine this year is more important than ever, and flu vaccines are the best way to protect yourself, your family, and the community from becoming seriously ill with the flu. Vaccination not only reduces the risk of catching the flu, it also reduces the chance that you’ll be hospitalized. In other words, the flu vaccine will provide some protection and reduce your chances of needing to be hospitalized if you do get sick,” explains Matyas.

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