Seasonal flu in the times of pandemics – what options do we have? Op-Ed by Ala Tocarciuc

The calendar fall has started and among other things, it brings us lower temperatures and increases the risk of getting sick with seasonal flu. This year we will face for the first time a special situation: seasonal influenza will come in direct collision with the pandemic of COVID-19.

How do we distinguish seasonal flu from COVID-19 infection?

Both infections are caused by viruses and are expressed through a wide range of symptoms. For the 2020/2021 flu season, four influenza viruses have been identified, for which a vaccine has been proposed for development.

If we look at the number of symptoms of these four influenza viruses and try to compare them with the COVID-19 symptoms, we will find that they are absolutely identical and we don't have much major differences to diagnose them correctly. The only difference we can see is between the incubation period, which is shorter for seasonal influenza viruses. But this indicator is also difficult to apply, because for COVID-19 there are specific many cases of asymptomatic disease.

One of the solutions for differentiated diagnosis would be the possibility of carrying out laboratory tests for all influenza viruses and new type coronavirus. Regrettably, given the reduced testing capabilities in our country, these tests are problematic.

In conclusion, in the context of direct collision of infections caused by seasonal influenza viruses and COVID-19, the first task of correctly establishing the diagnosis and applying the correct treatment, will be a very complicated one for family doctors.

What happens when two viruses meet?

In situations, when a person contacts multiple viruses, there is interference between these viruses in his body.

As a result, a serious form of the disease can be triggered, and the person will become a source of infection and spread a cocktail of viruses in the environment if he does not wear the mask.

In some cases, one of the viruses, which is stronger, can inhibit the activity of weaker viruses and dominate the clinical picture.

In the case of COVID-19 there is very little data about the pattern of interference with other viruses.

Which solutions are real and applicable under these conditions?

The prevention of seasonal influenza diseases and protection measures against COVID-19  are practically the only solutions accessible under pandemic conditions in Moldova today.

The prevention of seasonal influenza diseases can be carried out through seasonal vaccination campaigns for all risk groups and here, first of all,  are doctors, teachers in schools, as well as  representatives of other  professions exposed to frequent contacts. Consistent communication at all levels about possible risks in this particular situation is absolutely necessary.

Because for seasonal influenza there are  antiviral medicines with confirmed effectiveness, including for prophylactic purposes, the creation of stocks of these medicines will allow the eradication and isolation of potential outbreaks, in particular, in the closed-type institutions.

Individual protection measures against the COVID-19 virus will also help to control the spread of seasonal influenza. The mask will remain the reliable partner for this period for each responsible citizen.

For these reasons it is recommended to follow the status of health on a daily basis, to isolate ourselves as soon as we have the first symptoms of the cold, not to deal with self-treatment and to call the doctor or pharmacist for qualified help in case of need.

Science is evolving very rapidly, and it is likely that in a year's time combined vaccines for COVID-19 and seasonal influenza will appear. This season, however, they are definitely missing.

It is extremely important to realize that we are each on our own in a unique situation. Humanity has never had a pandemic of highly contagious virus superimposed on seasonal influenza. This year's seasonal influenza viruses, ten years ago, were also pandemic viruses, meaning they are quite virulent and contagious still.

Only through consistent and systematic actions in a consolidated and responsible community, we will be able to survive these unique and highly disruptive times.

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