COVID-19 or the Flu?

Angelina Bambina

On Feb. 26, before the world turned upside down, President Donald Trump said of COVID-19: "This is a flu. This is like a flu."

He was not totally wrong.  In many aspects, COVID-19 does indeed resemble the flu. However, it is most definitely not the flu. 

For one thing, the novel coronavirus (SARS-CoV2) has proven much, much deadlier. The Centers for Disease Control (CDC) estimated somewhere between 39 and 56 million flu illnesses for the 2019-20 flu season in the U.S., resulting in between 410,000 and 740,000 hospitalizations and 24,000 to 62,000 deaths. As of Nov. 3, 9.3 million American COVID-19 cases have been documented — but those have culminated in over 230,000 deaths. 

That's a mortality rate of about 2.5 percent, versus an estimated 0.04 to 0.16 percent for last year's flu viruses (2 to 3 deaths per 100 people versus 4 to 16 deaths per 10,000 people). 

Why does the seasonal flu claim so much fewer victims?  There are three good reasons — immunological memory (our body's ability to better respond to new infections based on past infections), more effective antiviral treatments, and vaccines. Flu shot distribution has always been a priority for hospitals and pharmacies, but this year it has become paramount as healthcare systems prepare to handle another surge of coronavirus hospitalizations. 

Getting vaccinated for the 2020-21 flu season can help more effectively rule out influenza when symptoms present, enabling healthcare providers to more swiftly diagnose COVID-19 cases and free up resources. Vaccine manufacturers should be well-provisioned, with a projected 194 to 198 million doses available. In recent years, though, only about half of Americans six months or older received a flu shot, far below the 70 percent target set by the Department of Health and Human Services in 2010. 

There is not yet a vaccine for COVID-19. The only FDA-approved treatment to date is the broad-spectrum antiviral remdesivir, which works to terminate the RNA chains that viruses use to replicate themselves. Nonetheless, it comes at a high cost and may not have that much of an immediate impact on mitigating symptoms or reducing the length of a hospital stay once the disease has progressed. For now, then, the focus remains on prevention.

If you do happen to feel under the weather, however, how can you tell whether it's the seasonal flu or COVID-19? The only certain way is to be tested, but based on what we know so far, there are a few cues. 

Symptoms

According to the CDC, both COVID-19 and the seasonal flu may present the following symptoms:

• Fever and chills
• Cough
• Shortness of breath 
• Fatigue
• Sore throat
• Runny or stuffy nose
• Muscle pain or body aches
• Headaches
• Vomiting or diarrhea, more commonly in children

COVID-19 has also been associated with a change in or loss of taste and/or smell. 

Complications

Both COVID-19 and seasonal flu may cause the following secondary complications.

• Pneumonia
• Respiratory failure
• Fluid in the lungs
• Sepsis
• Cardiac injury through heart attack or stroke
• Multiple organ failure (respiratory, kidney, or shock)
• Worsening of underlying chronic medical condition, specifically those involving the lungs, heart, or nervous systems
• Inflammation of heart, brain, or muscle tissues
• Secondary bacterial infection

COVID-19 can also produce clotting in the veins and arteries of the lungs, heart, legs, and brain. Youngsters infected with the novel coronavirus are at risk of developing Multisystem Inflammatory Syndrome in Children (MIS-C).

Incubation and transmission

Both COVID-19 and seasonal flu are transmitted through respiratory droplets, especially in crowded indoor or close contact situations. However, COVID-19 has been shown to be more contagious among certain populations and groups.  

The seasonal flu has an incubation period (i.e, time between the initial infection and when symptoms first present) of 1 to 4 days, whereas COVID-19's can be anywhere from 2 to 14 days (the average is five). 

Those infected with the seasonal flu are most contagious within the first 3 or 4 days of symptom onset; those with COVID-19 are most contagious for 10 days after symptom onset or their most recent positive test. Those stricken with either illness can still transmit viruses prior to actually feeling sick (one day before for the flu, two days before for coronavirus).

If you're feeling at all under the weather or have been around someone who has, getting tested and self-quarantining or isolating remains highly advised. For more a complete breakdown of the COVID-19 vs. the flu, click here. 

Matt Swanseger can be reached at mswanseger@eriereader.com