The ongoing wave of the Omicron COVID-19 variant, relaxed quarantine guidelines, and flu season are combining to create a perfect storm for a new public health concern. Flurona, a co-infection of COVID-19 and influenza, has been reported in the U.S., Israel, and Asia. According to COVID-19 and Influenza Co-Infection: A Systematic Review and Meta-Analysis, the frequency of co-infection among COVID-positive patients in the U.S. is 0.4% and expected to rise.
Flurona is a combination of the two viruses and affects both upper and lower respiratory tracts and their functions, such as breathing. After the Centers for Disease Control and Prevention (CDC) shortened isolation guidelines to five days after experiencing symptoms or being asymptomatic, a growing concern has risen regarding the negative impact this may have on the already scarce workforce.
Schools are taking an especially hard hit as more students, teachers, and substitute teachers demonstrate symptoms of or test positive for COVID-19 or the flu. As a result, Missouri schools are seeing administrative staff, such as principals and counselors filling in, to ensure an adult is in every classroom. As schools and businesses remain open, winter temperatures drop, and peak flu season continues, Flurona is a growing concern for community members of all ages.
Co-infections occur when someone is infected with two or more disease-causing organisms at once. This includes the combination of two viruses or a virus and a bacterial infection. Bacterial co-infections with the influenza virus were responsible for a quarter of severe or fatal cases during the 2009 flu pandemic. Flurona, seen today, is the combination of two viruses: COVID-19 and influenza.
Co-infections are common during pandemics due to shared methods of travel, among other factors. The possibility of Flurona was identified early on in the pandemic by doctors treating patients in Wuhan, China, where more than half of 307 patients hospitalized for COVID-19 also tested positive for the flu. This was determined to be the result of factors including the time of year, a localized flu outbreak, and social determinants of health affecting patients.
Flurona and similar co-infections are expected to become more common in the northern hemisphere during winter and flu season due to the ongoing COVID-19 pandemic and increased frequency of “social mixing” as public mandates remain relaxed and varied. Because COVID-19 and the flu present similarly, travel similarly, and both affect breathing and other respiratory functions, it’s important to get tested for and treat both viruses as soon as symptoms occur – it may not be just the flu.
- Fever and chills.
- Body aches.
- Persistent cough.
- Shortness of breath.
- Sore throat.
- Congestion or runny nose.
Symptoms specific to COVID-19 include a new loss of taste or smell, while eye pain may be a sign of influenza.
Both viruses are spread via droplets from breathing, coughing, and sneezing, as well as surfaces contaminated with these droplets. To best prevent Flurona, it’s important to continue following COVID-19 and flu season safety guidelines, such as sanitizing hands and surfaces frequently, wearing a fitted mask around others, and socially distancing when possible.
Though there is not currently enough data available to determine if co-infection increases the risk for severe illness and death, the damage by both viruses to the respiratory tracks can make it easier for COVID-19 to gain traction in the body. Both viruses and the co-infection of the two are a public health concern, but especially so for vulnerable populations.
Although COVID-19 is currently hitting unvaccinated populations the hardest, they are not the only people at high risk of Flurona. The long-term effects of COVID-19 on breathing are still unknown, but because the Flurona co-infection hits both respiratory tracts twice as hard, it’s expected that people with underlying conditions will be among the most affected.
Vaccines are proven to be effective in reducing the risk of infection and severe illness and are the most effective tool in protecting yourself and others from Flurona. Vaccines for both viruses are safe and can be administered at the same time, including in children. It is recommended to get fully vaccinated for both viruses as soon as possible, rather than space out doses.
Although mask mandates vary throughout the U.S., they are proven to help reduce the spread of illness and are a valuable tool in combating Flurona. Estimated deaths from the flu reported by the CDC between 2018 (52,000) and 2020 (20,000) consistently decreased, with the sharpest decline occurring throughout the initial U.S. outbreak of the COVID-19 pandemic, when mask mandates and lockdowns were in place.
Will COVID-19 Become Endemic Like the Flu?
Although the future of COVID-19 largely depends on how the virus evolves, scientists believe the possibility of eradicating the virus is unrealistic, especially as the vaccination gap remains and mutations continue to develop. COVID-19 will likely become endemic like influenza, where the virus remains a present and expected occurrence, though death rates, illness, and social isolation will likely not continue at the current scale.
Similar to the flu, however, the combination of tools to prevent and manage the spread of COVID-19 means that seasonal deaths and illnesses due to the virus are tolerated. Tens of thousands of lives are lost to influenza each year. Because it is endemic, these deaths are expected and therefore tolerated as the norm. For example, preventive measures like required lockdowns, masks, or distancing mandates aren’t put into effect to lessen the expected death toll of the annual flu as they may be during pandemic outbreaks.
The U.S. is already witnessing enormous numbers of preventable losses in people with underlying conditions. Rochelle Walensky, director of the CDC, recently reported that more than 75% of those dying of COVID-19 occurred in people with at least four comorbidities. Her reference to this being “encouraging news” on Good Morning America not only led to severe backlash, but was also used out of context to fuel anti-mask and anti-vaccine outcries on social media.
Though she meant the “encouraging news” is the tools we have – vaccines and masks – are working, the message was lost among the overwhelming and unnecessary loss of lives. Dialysis patients, dubbed COVID-19’s perfect victims, are just one population seeing catastrophic death tolls that could have been prevented. If COVID-19 becomes endemic, it’s possible that more and more deaths among vulnerable populations will be accredited to their underlying conditions or regarded as an expected outcome, rather than be acknowledged as preventable and needless.
Allowing COVID-19 to move into endemic status, without more immediate action as surges of the virus, flu, and co-infection continue, perpetuates preventable deaths. Masks, vaccines, and recommended safety guidelines are proven to protect individuals from hospitalization, severe illness, and death. As members of our community, we have a responsibility to do our part to protect those who are most vulnerable and not allow them to die needlessly.
Protect yourself, your family, and your community by getting vaccinated for both flu and COVID-19 as soon as possible. Children 6 months and older are eligible for the flu vaccine. Children ages 5 to 17 years old are eligible for the Pfizer COVID-19 vaccine. Individuals 18 and older may choose between the three authorized COVID-19 vaccines available.