We’re several months into the novel coronavirus pandemic and on the cusp of flu season, which typically starts in October with a peak between December and February. Infectious disease experts warn we’re about to enter a “twindemic,” with SARS-CoV-2, the virus that causes COVID-19, and Influenza A and B, the viruses that cause the flu, circulating at the same time.
So far, the United States has more than 7 million confirmed cases and upwards of 200,000 deaths from the novel coronavirus. Although overall COVID-19 cases and deaths have been dropping over the past several weeks, we’re still diagnosing about 43,100 new cases per day—an indication that the virus is still actively spreading in many communities across the nation.
Although you might be tempted to brush off the threat of the flu since it comes along every year and we are, in some sense, used to it, the flu is by no means the “weak sister” to COVID-19, says William Schaffner, M.D., medical director for the National Foundation for Infectious Diseases and professor of infectious diseases at the Vanderbilt University School of Medicine. Every year, the flu sickens tens of millions of Americans, hospitalizes 140,000 to 810,000, and kills 12,000 to 61,000, according to estimates by the Centers for Disease Control and Prevention (CDC).
Both COVID-19 and the flu are highly contagious respiratory diseases that can cause mild to severe illness with many symptoms in common, including a fever, cough, sore throat, muscle aches, and fatigue.
So, as you face the possibility of catching one or both of these viruses, it’s understandable if you can’t help but wonder, Which is worse: COVID-19 or the flu? Read on for the answer with insight from infectious disease experts.
Is COVID-19 worse than the flu?
“They’re both terrible, so trying to distinguish between the two is like trying to choose between one bad actor and a worse one. But if I had to say which one is worse, I’d have to say COVID-19,” says Dr. Schaffner.
Why? For starters, the novel coronavirus is entirely new to us. We’re all susceptible to catching it, and besides exploratory drugs, there’s no set treatment or vaccine available yet. The flu virus, on the other hand, is well-studied and can be treated with antiviral drugs. An annual flu shot can reduce your chances of falling ill by 40 to 60% and, even if you do get sick, you’re less likely to need medical care, end up in the hospital, or die from the virus, per the CDC.
Then, there’s just how easily the viruses spread to consider. While both COVID-19 and the flu are primarily passed from person-to-person via respiratory droplets when an infected person speaks, coughs or sneezes, COVID-19 seems to be more contagious and has been linked to more “super-spreading” events as well.
Based on key measures of severity like hospitalization rates and mortality rates, COVID-19 is more severe than the seasonal flu in terms of its overall impact on the population, too, says Yvonne Michael, Sc.D., an associate professor of epidemiology and biostatistics at Drexel University Dornsife School of Public Health in Philadelphia.
Last flu season, 66.4 out of every 100,000 people were hospitalized with the flu in the United States. Compare that to 174.8 out of every 100,000 people who have been hospitalized due to COVID-19 so far, per the CDC.
The case fatality rate (CFR), meaning the proportion of deaths from a disease compared to the total number of people diagnosed with the disease, is about 0.1% for the flu and could be about 0.5% for COVID-19—which is to say its CFR is potentially five times higher than the flu, according to a May 2020 article published in JAMA Internal Medicine.
However, it’s important to note that much of this data is accrued from different sources and preliminary estimations. As such, “it is very difficult to make good comparisons between the flu and COVID-19 right now, and estimates for COVID-19 will continue to evolve as we improve our testing and detection methods,” notes Dr. Michael.
Both COVID-19 and the flu can hit you hard with complications like pneumonia, lung damage, and heart problems, especially if you’re at increased risk due to older age, an underlying medical condition, or pregnancy. Young children are at a higher risk of severe illness from the flu as well as multisystem inflammatory syndrome in children (MIS-C), a rare but severe complication of COVID-19. However, COVID-19 can cause additional complications including blood clots, and “long-haulers” can suffer from a slew of health issues for weeks or months after their initial illness. Again, like many things COVID-19, doctors are only just beginning to understand exactly why this may be and how to treat patients.
Bottom line: While COVID-19 might be worse than the flu in some ways, you don’t want to catch either one.
With flu season looming, it’s essential that everyone six months and older get their flu shot, experts agree. Doing so doesn’t just protect you—it also reduces the chances that you get someone else sick or further burden the healthcare system, which already has COVID-19 to deal with (you can use the Vaccine Finder to find where flu vaccines are available near you).
Since the novel coronavirus and the flu spread in similar ways, you can protect yourself from both by continuing to do what you’ve been doing to prevent the spread of COVID-19:
- Practice social distancing by maintaining six feet or more between you and people outside of your household.
- Wear a face mask in public.
- Wash your hands frequently for at least 20 seconds with soap and water or use hand sanitizer with at least 60% alcohol when you’re out and about.
- Disinfect high-touch surfaces in your home often.
- Cover your mouth when you sneeze or cough.
- Avoid touching your eyes, nose, and mouth the best that you can.
- Postpone unnecessary travel, stay away from large gatherings, and talk to your loved ones about alternate, virtual plans for upcoming holidays.
- Stay home and call a doctor if you develop symptoms of COVID-19 or the flu.
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