Washing hands, using sanitizer, wearing a mask and getting the flu shot take on extra importance as we enter the cold and flu season amid the coronavirus pandemic.
Some strategies for avoiding the flu can also help prevent the spread of COVID-19. Both are contagious respiratory illnesses, but there are key differences, and there is no vaccine yet to protect against COVID-19.
During the flu season spanning from October 2019 until April 2020, it is estimated at least 39 million people got the flu. Of those, at least 410,000 were hospitalized and between 24,000 and 62,000 people died, according to the Centers for Disease Control and Prevention.
"You can't be overly cautious," said Dr. Trish Perl, chief of the Division of Infectious Diseases at UT Southwestern Medical Center in Dallas. "But you have to be smart. A lot of people don't recognize how serious the flu can be.”
The risk may be particularly acute when it comes to the heart. A 2018 study in the New England Journal of Medicine indicated the incidence of heart attack was six times higher within a week of being diagnosed with the flu compared to the year before or after the infection.
Research increasingly indicates the flu vaccine prevents cardiovascular events as well as death, especially for people over 65, Perl said.
The flu can be transmitted through the air and can survive on some surfaces up to 48 hours and on unwashed hands for up to an hour, she said. Those characteristics make hand sanitizers and disinfecting wipes allies during every flu season.
It appears COVID-19 spreads more easily than the flu and causes more serious illnesses in some people, according to the CDC. Older people and those with certain underlying conditions like heart or lung disease or diabetes are at increased risk of severe illness.
Symptoms of the flu and coronavirus can both include fever, chills, cough, shortness of breath, fatigue, a sore throat and body aches. However, unlike the flu, an additional symptom of COVID-19 may be loss of taste and smell.
From Jan. 21, 2020, until Oct. 26, 2020, more than 8.6 million cases of COVID-19 have been reported in the United States. Of those, more than 224,000 people have died of the illness, according to the CDC.
COVID-19 most often spreads through the air, mainly through respiratory droplets from coughing, sneezing, talking or breathing. Transmission through contaminated surfaces is less common. Those at greatest risk are people in close proximity to someone with the virus, so practice physical distancing by staying at least six feet apart.
In some cases of airborne transmission, small droplets linger in the air for minutes to hours and possibly infect people more than six feet away or after the infected person has left the area.
Keep in mind that both the flu virus and coronavirus may be spread by people before they show symptoms or those who have mild or no symptoms. It can take longer for people to show COVID-19 symptoms, and they can be contagious longer. How long someone can spread the virus remains under investigation.
Experts suggest several healthy steps for cold and flu season:
Avoid crowded indoor spaces. Crowded bars and restaurants and even large parties among extended family and friends can become coronavirus superspreaders, meaning the virus can spread quickly and easily to a lot of people. Staying out of crowds can also protect against the common cold and the flu.
Wear a mask. This protects other people in case you are infected with COVID-19. Everyone should wear a mask that covers their nose and mouth in public settings and when around people who don’t live in their household. The exceptions are children under age 2 or those who have trouble breathing. Masks are not a substitute for physical distancing.
Get enough sleep. A 2015 study in the medical journal Sleep found people who slept fewer than six hours at night were more susceptible to catching colds.
Have a cup of tea. In the journal Molecules, a 2018 review of the latest studies suggests catechins, a flavonoid and antioxidant in tea, can inhibit the spread of flu virus in the body.
Eat right and don't forget the vitamin D. Some studies suggest vitamin D can strengthen the immune system and fight flu infection. Sources include fatty fish, dairy products, supplements and sunlight.
Be careful in public and when touching items. Charles Gerba, a microbiologist at the University of Arizona who has tracked germs everywhere from toilet seats to computer touchscreens, notes most common illnesses are spread by your hands. He advocates washing hands or using sanitizer when coming home after a day of touching our germ-ridden world. Disinfect phones and tablets daily with alcohol wipes, Gerba said.
Try not to touch your face. The eyes, nose and mouth are prime entry points for germs. Habits like rubbing your eyes, scratching your nose or biting your nails are especially risky during flu season. "People do it so subconsciously and so often that it's difficult to stop," Gerba said. "You've got to really make an effort."