Does getting the flu with COVID double your risk of death?

Health experts are predicting an especially brutal flu season this year, but there are measures you can take to try to avoid contracting these serious illnesses.

[Jawahir Al-Naimi/Al Jazeera]

Globally, an estimated 290,000 to 650,000 people typically die each year from seasonal flu. Last year, however, was different. The northern hemisphere winter of 2020-21 saw some of the lowest recorded flu death rates.

Scientists believe this was mainly due to restrictions put in place at the height of the COVID-19 pandemic, most notably less mixing of people in indoor spaces, social distancing, mask wearing and hand washing.

Many countries, including the United Kingdom, also saw record numbers of people come forward for the flu vaccine during this time – motivated in part by fears of contracting COVID and flu at the same time. The result was fewer flu cases, hospitalisations, and deaths compared with previous flu seasons.

But as most of the developed world is now fully vaccinated against COVID, and governments are focused on reversing some of the economic damage of the pandemic, many social distancing measures have been lifted. In England alone, despite nearly 40,000 new cases of COVID per day, almost all protective measures to reduce the risk of transmission of the disease have been lifted.

As a result, there has been a stark rise in the number of COVID cases which has coincided with the onset of what is usually the flu season. There is a real worry that this year we could see more people than ever become infected with flu – and that many could get flu and COVID at the same time.

Although it was in some ways a good thing that we saw lower levels of flu circulating last year, this could come back to bite us this year.

Usually, flu seasons are easier to handle when some portion of the population has a natural immunity as a result of an infection the previous year. But as fewer people had flu last year, we will likely see less natural population immunity.

In addition to this, the northern hemisphere is usually able to look at the southern hemisphere – to countries like Australia, for example, which have their flu season before the north – to see which flu strains are circulating and to include those in the flu vaccine. But because Australia has had COVID lockdowns and restrictions in place that have limited the circulation of flu there, it is harder to accurately predict which strains will be around this season.

The flu and COVID-19 are serious illnesses – both can kill, and getting them at the same time increases your risk of becoming seriously unwell. Get the vaccines; it is our best line of defence against both.

All of this is likely to lead to an especially brutal flu season this year. To help mitigate this risk, many countries have rolled out an ambitious flu vaccine campaign and many Western countries have combined this with encouraging people to either take up the COVID vaccines if they have not already or to come forward for booster shots if they are eligible.

With all the news around COVID, it is easy to become complacent about flu, but it can be a serious and deadly disease. Flu can affect the lungs, cause pneumonia, cardiac problems and sepsis, which can lead to death. During an acute flu infection, the immune system can become weakened while fighting off the virus; if you were to then get another infection like COVID-19 at the same time, the risk of long-term organ damage and death increases.

Speaking to Sky News on October 10, UK Health Security Agency chief executive, Dr Jenny Harries, said people who catch flu and COVID at the same time this winter are twice as likely to die than those who only have the coronavirus. “I think it’s an uncertain winter ahead,” she warned.

But there are things you can do to reduce your risk of getting flu and COVID at the same time. The most important is to take up the vaccines if you are eligible. Although it is harder to predict this year, generally the flu vaccine can reduce your risk of illness by 40-60 percent.

The World Health Organization (WHO) has forecast the four flu strains likely to cause the most infections this year, and those are what the vaccines will protect you against. The flu vaccine will not give you the flu, only protect you from it, although some mild side effects like a sore arm or headache are normal.

It is also still advisable to wear masks in crowded indoor spaces and on public transport as well as to practise good hand hygiene. In addition to this, ventilating indoor spaces will help to blow away any particles containing the flu virus that have been breathed out by infected people.

The flu and COVID-19 are serious illnesses – both can kill, and getting them at the same time increases your risk of becoming seriously unwell. Get the vaccines; it is our best line of defence against both.

Progress report: Increase in pregnant women hospitalised with COVID-19

The UK National Health Service (NHS) is encouraging pregnant women to get the COVID-19 vaccine as new data shows that nearly 20 percent of the most critically ill COVID patients are pregnant women who have not been vaccinated.

According to the latest data in England, since July one in every five people receiving specialist therapy known as Extracorporeal Membrane Oxygenation (ECMO) is an unvaccinated pregnant woman. People who need ECMO have a severe and life-threatening COVID infection that stops their lungs from working properly.

Pregnant women with COVID-19 have a 76 percent increased risk of pre-eclampsia, a potentially fatal complication of pregnancy; and soberingly, maternal deaths associated with COVID have been noted to be 22 times higher than those in non-infected pregnant women.

[Jawahir Al-Naimi/Al Jazeera]

It is well established now that the mRNA COVID-19 vaccines (Pfizer or Moderna) are indeed safe for pregnant women to take, and the risk of getting the virus outweighs any potential risks from the vaccines. In 827 pregnant women who had completed pregnancies and received one or two doses of mRNA vaccines, a recent study reports no increased rates of miscarriage and stillbirths, compared with pre-COVID rates. There were no increases in preterm labour or negative effects on newborns, including congenital abnormalities.

Still, there remain high levels of hesitation among pregnant women and those planning to get pregnant when it comes to taking up the COVID vaccine. A large part of that is due to misinformation circulating online about the effects of the vaccines on developing babies. But we must also hold our hands up to the fact that there was a delay in approving the vaccines for pregnant women at the start of the rollout, leading to inconsistent messaging and confusion.

Pregnant and breastfeeding women are often excluded from clinical trials on ethical grounds. But the delay in getting this safety data for the COVID vaccines meant the pregnant women or those planning a pregnancy were told they could not have the vaccine. It was not until later that the safety data came in and the advice changed. There is no doubt in my mind this has contributed to vaccine hesitancy in this group and it highlights the need to include this often high-risk group of people in trials so they too can benefit from emerging and new treatments.

The focus now must be on repeatedly reminding unvaccinated pregnant women that the vaccines are safe and effective. Although COVID restrictions are easing worldwide, this virus is still very much out there and vulnerable groups, such as pregnant women, remain at high risk.

Personal account: What the UK’s (mis)handling of the pandemic did to care homes

The Science and Technology Committee and the Health and Social Care Committee have published a damning report which criticised the UK government and its scientific advisers for their handling of the COVID-19 pandemic. The study, put together by a group of cross-party MPs, looked at key decisions by policymakers and their outcomes.

A major criticism was that the planning around the pandemic was based on a flu outbreak rather than viruses such as SARS or MERS that are far more like the virus that causes COVID-19. This meant advice around controlling the outbreak and protecting the vulnerable was based on a virus that is far less infectious and deadly, leading to a catastrophic number of deaths in the early stages of the pandemic.

The report tells of scientists not taking the pandemic seriously enough and the government pursuing “herd immunity” by allowing the virus to spread in what they hoped would be a controlled manner rather than attempting to stop transmission. We now know that controlled spread through an unvaccinated population meant more people died.

It also said the first lockdown did not come early enough, and that an earlier lockdown would have bought time to develop a much needed “test and trace” system; another delay that, in my opinion, caused unnecessary deaths.

The report goes on to talk about the “slow and chaotic” test and trace system; the UK’s lukewarm border control measures; and says more could have been done to slow the spread of the Alpha variant that led to the second waves of deaths in the winter of 2020-21. It also tells of how minority groups were not protected despite them being hit the hardest.

[Jawahir Al-Naimi/Al Jazeera]

But perhaps the most difficult thing for me to read was the part about care homes, and how, despite the then-Health Secretary Matt Hancock saying he had put a “protective ring” around care homes, the truth was that people were sent from hospital back to care homes without being tested for the virus, leading to tragically high numbers of deaths.

As a doctor who worked throughout the pandemic and saw the effects of these failures in real time, I am not surprised by the findings of the report. But to see it listed like this in black and white is heartbreaking. I work in an inner-city area which has a dense minority population. I saw some of my patients from these groups die; I held the hand of dying residents of care homes who were not allowed to have family members around them; I made calls to loved ones informing them that their mother or father had passed away from COVID. These are the real stories from the pandemic.

My one frustration is that there will be no accountability. The families of those lost to the virus continue to suffer and this report will compound that suffering. While I acknowledge this was a novel illness and we were learning along the way, we could have done things better. We could have looked at countries like South Korea which were tackling things more effectively, who did not see the numbers of deaths we saw in the UK and some other nations.

Hindsight is always a valuable thing, but my only hope going forward is that lessons will be learned, and we will not repeat the same mistakes. We need to humbly take forward what we know about dealing with the pandemic, who the most vulnerable groups are, and how sometimes acting early is better than reacting too late.

Good news: Children across Africa to be vaccinated against malaria

A vaccine to help protect against malaria was always going to be historic, so there is much to celebrate with the WHO recommending the rollout of a new RTS,S vaccine.

Malaria is one of the biggest killers of children across Africa, and having done voluntary work in Malawi, I have seen first-hand how it can devastate families. Currently, a child dies every two minutes from malaria in Africa.

Malaria is caused by a parasite that can get into the human body through infected female mosquitoes when they bite. The parasite targets red blood cells, infecting and destroying them. There are several different types of malaria parasites but the most common in Africa is Plasmodium Falciparum.

The trials, which were carried out in Ghana, Kenya and Malawi, found that the vaccine led to a 30 percent reduction in severe malaria, and that it was deemed to be cost-effective.

The downside is that it is given in four doses: at five months, six months, seven months, and a final booster at the age of 18 months. This will take some organisation, but if it can be done, countless lives will be saved.

Reader’s question: Is it safe to get my flu shot and COVID-19 vaccine at the same time?

Yes.

During the initial rollout of the COVID vaccines, we were advised to wait seven to 14 days before getting another type of vaccine, but this has since been revised as more evidence has emerged.

Health authorities across the world have agreed that both vaccines can be given at the same time. This is not a new concept; we often give multiple childhood vaccines at the same time and it is deemed safe to do so.

So, if you are offered both at the same time, my advice is to take them.

Source: Al Jazeera

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