The Twindemic

It is almost automatic to think “COVID!” when you hear the word “virus” nowadays. Understandably so, as the coronavirus pandemic has been at the forefront of news and impacted our way of life for the majority of the last 2 years. But if you can think back to a time before COVID, a common virus you may have thought of as the culprit of a fever and stuffy nose was the flu. Especially during “flu season”, which is considered to be October-May, with flu activity usually peaking in December. So now we find ourselves combating coronavirus and influenza: two respiratory viruses with many overlapping symptoms and potential for high activity at the same time. This “Twindemic” that many healthcare experts have feared since the spread of COVID-19, may likely come to fruition during this flu season.


You may have heard about the record low numbers of influenza cases during the 2020-2021 flu season. In fact, the CDC reported the lowest levels of flu activity since they began monitoring it back in 2005. There are many possible reasons for the low flu activity last season, but it is not a coincidence. On top of masks, social distancing protocols, and frequent symptom screenings, there was also a record high number of influenza vaccines distributed in the U.S. This year, things are looking a lot different. Social distancing protocols have relaxed significantly – schools are open, big events are back, travel is picking up, and even mask requirements are less common. The number of flu vaccines distributed is also currently lower than this same time last year.

Consequently, there have been signs over the last couple of months that the 2021-2022 flu season has the potential to be pretty brutal. More positive influenza tests have been reported to the CDC during just October and November of this year than there were throughout the entirety of last flu season. Over 90% of these cases have been in children and young adults, with college campuses often being hot spots. The second week of November, an outbreak at the University of Michigan was alarming enough to prompt the CDC to send a team of investigators to campus. With many college students traveling to go home for the holidays, this demographic is especially concerning. Additionally, the influenza cases reported so far this season have been overwhelmingly made up of influenza A(H3N2). This is significant because flu vaccines, which usually cover 4 sub-types of the flu, are usually less effective in covering H3N2 specifically. The main reason for this reduced coverage is H3N2’s tendency to have much more frequent genetic changes, so it evolves faster than the other 3 sub-types. Producing and distributing vaccines before the virus changes is extremely challenging.


• Get vaccinated for both viruses

Influenza: Even when these vaccines have low effectiveness against circulating viruses, vaccination still prevents flu-related deaths, hospitalizations, and medical visits. In the case that you still get the flu after vaccination, it is much more likely to be a mild case and prevent severe disease. Everyone over 6 months old should be getting a flu shot, with very rare exceptions.

Coronavirus: The available vaccines for COVID-19 are proven to be extremely effective. If you haven’t gotten vaccinated yet, it is not too late! Kids can now get vaccinated too – Pfizer’s COVID-19 vaccine is now authorized for everyone 5 years and older. If you have gotten your vaccine and you are 18 years and older, but it has been 6 months since your last dose, you can now get a booster dose. This is the best way to maintain immunity.

• Continue to use masks and social distancing

These kinds of protocols are intended for COVID-19, as it spreads much more easily than the flu. However, they can also prevent the spread of the flu. Despite loosening COVID-19 protocols, it is still recommended for everyone 2 years and older to wear a mask in indoor public spaces, and at outdoor large gatherings. It is important to keep in mind that going to crowded places like restaurants, bars, or movie theaters puts you at higher risk. If you do, it is still best to maintain 6 feet distance from others when possible.

• Keep your immune system strong

Your immune system is your main line of defense against any infection, so keeping it strong is essential to staying healthy. The best way to arm your immune system against this possible twindemic is vaccination. To enhance your immunity, you should also make sure you are getting proper nutrition, exercise, and sleep. Zinc, Vitamin C, and Vitamin D supplements may be beneficial if you don’t get enough in your regular diet, as they play notable roles in immune function.


Both COVID-19 and the flu can be asymptomatic, and have similar symptoms that include:
• fever • cough • muscle pain or body aches
• chills • sore throat • vomiting
• headache • shortness of breath • diarrhea
• fatigue • runny or stuffy nose • change in taste or smell

If you do find yourself with any combination of these symptoms, it is best to go to the doctor and as soon as possible to get tested for both viruses. If it is the flu, early detection is ideal because antiviral medications are most effective within 24-48 hours of illness onset. If it is COVID-19, early detection is vital in limiting the spread to those around you.

During these times when the healthcare system is overwhelmed and can be frustrating for patients, we will continue to provide all your medical needs with an unmatched customer service experience. Whether you need testing, medication, or answers to your twindemic questions, you can always call and speak to one of our providers at ZüpMed at 901-701-7010.

Resources Used
2020-2021 Flu Season Summary | CDC
Influenza Vaccine Doses Distributed, United States | FluVaxView | Seasonal Influenza (Flu) | CDC
National, Regional, and State Level Outpatient Illness and Viral Surveillance (
CDC Tracking Flu in Young Adults | CDC
Flu rips through University of Michigan campus, brings CDC to campus (
Vaccine Effectiveness: How Well Do Flu Vaccines Work? | CDC
CDC COVID Data Tracker
How to Protect Yourself & Others | CDC
Six Tips to Enhance Immunity | DNPAO | CDC
Use of Antivirals | CDC