Although 'twindemic' may sound like a sudden increase in multiple births, it actually refers to an outbreak of two illnesses at once.

The twindemic is currently theoretical: a severe flu season, which runs from October through May in the United States, combining with a surge in COVID-19 cases. Several COVID-19 variants have emerged since the start of the pandemic. Some variants, such as Delta and Omicron, are extremely contagious. The prospect of a twindemic was first raised in 2020, but the 2020-2021 flu season was surprisingly mild. However, several factors contributed to renewed concerns of a twindemic in the 2021-2022 flu season.

Virus Transmission

SARS-CoV-2 (which causes COVID) and influenza viruses spread in similar ways. People with respiratory illnesses may expel aerosol droplets after coughing or sneezing. Other people inhale droplets hovering in the air.

These viruses can also survive from 15 to 48 hours on surfaces. People touch a contaminated surface, such as a doorknob or a pen, then transfer the virus by touching their mouth or eyes. People with COVID-19 or the flu may be contagious and unknowingly spread the virus for days before showing symptoms.

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Impact of COVID-19 Precautions on the Flu

According to the CDC, approximately 750 flu-related deaths occurred in the 2020-2021 season. Around 35 million cases of flu-related illness and 20,000 deaths were recorded just one year earlier.

Schools, universities, restaurants, and other public places were on lockdown throughout most of 2020. Lockdowns and other measures to combat COVID-19, such as mask regulations, increased attention to hand hygiene, and physical distancing, also limited transmission of influenza viruses.

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Acquired Immunity

Flu season refers to the time of year when most flu-related illnesses occur, but influenza viruses are always circulating. These viruses also change over time. People are exposed to many influenza viruses throughout their lives and develop varying levels of immunity.

Exposure to influenza viruses was limited during 2020-2021, which means the opportunity to acquire some degree of immunity was also limited. Flu viruses in the coming year may cause more severe symptoms due to reduced immunity among the general population, although the potential impact is hard to predict.

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Similar Symptoms

The viruses that cause the flu and COVID-19 have similar symptoms, including fever and chills, cough, sore throat, headaches, muscle and body aches, fatigue, and congestion with a runny or stuffy nose.

Vomiting, nausea, and diarrhea are other possible symptoms, most common in children. Some people experience loss of taste and smell after catching COVID-19, while this symptom isn't usually associated with the flu.

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Flurona is a new term for infection of COVID-19 and the flu at the same time. Although it's possible to catch both viruses simultaneously, it isn't very common.

A person with COVID-19 isn't likely to catch the flu because the immune system is already actively fighting off the coronavirus. In this case, exposure to a flu virus probably won't result in illness because the immune system mounts an immediate response.

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Who Is at Risk?

A "flurona" infection is more likely to cause severe symptoms and complications in high-risk populations, including the elderly, pregnant women, and people with compromised immune systems or underlying conditions. These are the same populations that are most at risk of severe symptoms from COVID-19 or the flu as separate illnesses.

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Treatments for COVID-19 and the flu are mainly focused on symptoms. Most people recover at home after a short period of rest and plenty of fluids. Over-the-counter medications may help reduce fever or relieve congestion.

Doctors may prescribe oral antiviral medications for some flu cases, and antibiotics can prevent or treat secondary infections.

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Potential Concerns

Severe cases of COIVD-19 and the flu may require hospitalization. People with critical symptoms may need ventilators to help them breathe. COVID-19 is more likely to cause severe illness than most influenza viruses, but over 200,000 people are hospitalized for influenza-related illness during a typical flu season in the United States.

A potential twindemic is concerning because simultaneous outbreaks of COVID-19 and the flu could overwhelm hospitals and other medical care providers.

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Will a Twindemic Occur?

As of spring 2022, most schools and businesses are open across the country. There's less adherence to precautions such as masks, social distancing, and quarantine after a positive COVID test.

All this means COVID-19 and the flu can spread more easily now. Approximately 3,500,000 to 5,800,000 flu cases, including 34,000 to 69,000 hospitalizations, have already been recorded this year. A twindemic could occur if a contagious COVID-19 variant circulates throughout the country while the number of flu cases increases at the same time.

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Vaccines are the best protection against COVID-19 and the flu. Vaccinated people may catch COVID-19, but vaccines significantly reduce the risk of severe illness. The CDC provides guidelines for staying up to date on COVID-19 vaccines and boosters. Flu vaccines can also reduce the risk of severe illness. Research shows that it is safe to be vaccinated for the flu and COVID-19 at the same time.

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