COVID and the Flu: Could We Face a ‘Twindemic'? NYC Experts Weigh In

Battling flu season amid the COVID pandemic poses a threat of a 'twindemic,' particularly as certain mandates have relaxed in comparison to last year's prevention efforts.

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Flu season is in full swing, and as New York City is combating the COVID delta variant, some medical professionals warn of a potential "twindemic."

"A 'twindemic' is a term that's being increasingly used to explain the potential of having both pandemics of the influenza virus, the flu, and the coronavirus at the same time," said Dr. Tobias Barker, Chief Medical Officer of Everside Health, to NBC New York.

To Barker, the main concern is relaxing certain COVID restrictions, such as masking and social distancing. Having these COVID rules in place last year during the height of the pandemic assisted in alleviating flu virus cases.

To give perspective, last year's flu season came at a historic low. During the 2020-2021 season, the least number of influenza-associated hospitalizations were recorded since CDC data collection began in 2005.

Across the U.S. there was a record high distribution of flu vaccine doses - over 193 million. This 2021-2022 season, the CDC projects to supply 188 to 200 million doses nationwide.

Because the flu season was so reduced last year, Dr. Syra Madad, Senior Director of the System-wide Special Pathogens Program at NYC Health + Hospitals, believes the potential risk for a 'twindemic' could be high.

The probability is very high for a few different reasons. First, as we look at general population immunity, because we almost had a nonexistant flu season last year, I think we still have a lot of vulnerable, susceptible individuals this year if we have a more severe flu season.

Dr. Syra Madad
Senior Director, NYC Health + Hospitals

On top of that, Madad agrees that general relaxation of COVID prevention measures, such as less masking and physical distancing, are behavioral factors that could help spread respiratory illness.

Among all doctors who spoke with NBC New York, the best way to evade the flu is by getting the annual shot. However, misinformation and disinformation surrounding both the flu and COVID vaccines continue to hold back individuals from receiving their vaccination doses, according to a recent survey.

More than one-third of Americans are not planning on getting the flu shot this year, based on a national study conducted this September by Everside Health and The Harris Poll.

When asked why, these were the most popular responses among over 2,000 adults surveyed:

  • "I didn’t get the flu last year": 30%
  • "I don’t think I’d get that sick if I got the flu, so I’m not worried about it": 21%
  • "I wear a mask and social distance, so those things will protect me from the flu": 17%
  • "The flu shot will give me the flu": 16%
  • "I work remotely, so my exposure to the flu will be relatively low": 9%

Healthcare professionals try to combat false narratives by reinforcing how and why vaccines cannot give you the tested illness.

"It's unfortunate that vaccines have become a political agenda item. We've been administering vaccines since the early 1900's and the results speak for themselves," said Dr. Ian Leber, Chief Medical Officer of Sollis Health.

In the same study, of those who do not plan on getting a flu vaccine, 1 in 12 believe the COVID vaccine will protect them from the influenza virus. This is not true.

The composition of this year's U.S. flu vaccine is formulated to protect against the four influenza viruses that research suggests will be most common. The COVID vaccine protects you from coronavirus, which has separate virology from influenza with genomes differing in polarity and segmentation.

Meanwhile, over the last four weeks, the delta variant remains the dominant COVID strain in New York City, according to NYC Health data.

With city and federal mandates, more residents are required to get COVID vaccinated. As of data available Friday, 92% of city workers have received at least one dose since the vaccine mandate for municipal employees went into effect. In total, just over 67% of New York City residents are fully vaccinated.

"There is a risk of not just influenza and COVID alone, but when both of these viruses come together - that's what can really increase hospitalization risks and illness in members of the community," said Dr. J.D. Zipkin, Chief Medical Officer at GoHealth Urgent Care.

According to the CDC, the flu vaccine, COVID vaccine, and/or booster can be administered at the same time - and to get both doses as soon as possible.

"Anybody can get both the vaccines together - there is no decrease in the effectiveness of either of the vaccines when given together at one point of time," said Siddhartha Datta, WHO Europe's regional adviser, during news briefing this week.

The WHO recently warned that Europe is facing a worrying resurgence of COVID-19 cases becoming once again the region "at the epicenter of the pandemic," with new daily case numbers reaching record levels.

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