Prepping for Flurona: When COVID-19 and the Flu Strike at the Same Time

Respiratory season is upon us. And with it, illnesses will continue to be more severe and overlap with one another when the following viruses hit higher numbers during cold weather months:

• Influenza (the flu).
• Respiratory syncytial virus (RSV).
• COVID-19 (coronavirus).

COVID-19, in particular, is the latest of these to peak seasonally, and it continues to be dangerous. Together, these respiratory viruses make up an infectious disease combination — one healthcare providers refer to as “flurona.”

Microbiologist and pathologist Daniel Rhoads, MD, explains why, even now, the threat of multiple infections should be a concern for everyone, especially the most vulnerable populations. He also offers some helpful advice for managing flurona if it happens to you.

What is flurona?

Flurona isn’t a proper medical diagnosis, but it has become an increasingly popular term for what happens when you get infected by both the flu and COVID-19 at the same time. That said, the term flurona, though catchy, is kind of misleading. The experience of getting more than one infection at the same time is not isolated to just COVID-19 and the flu. You can get co-infections of multiple respiratory viruses at the same time — meaning you can get infected with any combination of COVID-19, the flu, RSV, rhinovirus, adenovirus and other viruses.

“Even before COVID-19 emerged, people would get multiple viruses that cause common colds or common coronaviruses,” explains Dr. Rhoads. “People can get more than one or, sometimes, more than two of these viruses at the same time.”

Part of the reason co-infections are even possible is because viruses are always changing in an effort to break through our body’s defenses and cause ongoing infection.

Influenza, for example, rears its ugly head every flu season. As new variants of the virus become ever more potent and infectious, the medical community has to meet those demands by creating an annual flu vaccine that targets current strains of influenza.

Still, from 2010 to 2020, the flu hospitalized between 140,000 and 710,000 people in the United States each year, according to estimates by the U.S. Centers for Disease Control and Prevention (CDC). Annual deaths tied to the flu ranged from 12,000 to 52,000 in the U.S. over the same period.

Fast forward, and we’re now experiencing even earlier increases in the flu among kids under the age of 18. At the same time, we’re seeing higher surges of RSV in both kids and adults. These surges have led to a new RSV vaccine for older adults and an RSV immunization for babies to provide further protection.

And while there may be differences between these viruses and COVID-19, co-infection is not only possible, but also particularly common in children and people who are immunocompromised.

“COVID-19 first emerged in the middle of flu season. All of these were circulating for a short period and then COVID-19 kind of crowded out influenza and RSV,” says Dr. Rhoads. “Now that they’re all circulating at the same time, there will be some overlap and co-infections between viruses.”

What you can do

As we’ve seen in previous years, healthcare providers are confident that winter surges in COVID-19 cases will continue to happen. Because of this, a new annual COVID-19 vaccine is now seasonally available to target the most current variant of the virus making its rounds.

All together, you can decrease your chances of getting more than one infection at the same time if you continue to protect yourself from these viruses with currently available vaccines, and if you take proper precautions when sick or when coming into contact with others who’ve had an illness.

“Preventing disease is ideal, and one of the best tools that we as individuals and as a population have to prevent severe disease due to flu or COVID-19 is the memory of our immune system,” stresses Dr. Rhoads.

“Vaccines help to teach our immune system the specific shape of these viruses, so that our antibodies and immune cells can quickly recognize these viruses if we are unfortunate enough to encounter them in the future.”

What does flurona feel like?

It’s hard to tell on your own which set of viruses you have without a clinical diagnosis from a healthcare provider. Most respiratory viruses have similar symptoms, including:

• Fever or chills.
• Cough.
• Shortness of breath or difficulty breathing.
• Fatigue.
• Muscle or body aches.
• Headaches.
• Sore throat.
• Congestion or runny nose.
• Nausea or vomiting.
• Diarrhea.

How is flurona treated?

In the case of co-infections, it’s possible for some of these symptoms to be more severe. For example, you could experience a higher fever or prolonged fatigue. But knowing exactly how co-infections will affect you is difficult because everybody reacts to multiple viruses in different ways.

For severe infections, Dr. Rhoads says there are oral therapies available to help treat both COVID-19 and the flu. These therapies fall along the lines of oseltamivir (Tamiflu®) and antiviral pills.

Milder symptoms can be managed at home with over-the-counter medications and fever reducers. And should you find yourself with this combo of respiratory illness, you should seek treatment and stay home until you’re no longer contagious.

In many cases, healthcare providers suggest treating any respiratory illness as if it’s COVID-19 because you just never know what you have until you’re tested. So, if you experience any of these symptoms, again, you should stay home until you’re no longer contagious and/or seek medical treatment as you would if you thought you had COVID-19.

“If you’re at risk for getting respiratory viruses, there’s a chance that you’ll get more than one,” warns Dr. Rhoads. “Also, respiratory viruses are passed from person to person. So, the more people you’re around, the more chances you have to be exposed to different viruses.”