Transcription:
What To Do If You Get The Sniffles

Prakash Chandran (Host): This VCU Health COVID-19 podcast was recorded on October 20th, 2021. You're feverish, tired, aching all over and that sore throat isn't helping either. Normally this would be the worst way to figure out that flu season has come yet again. But during the ongoing COVID-19 pandemic identifying what's wrong, might not be so simple.

Why? Well, several symptoms are shared between COVID-19 and the flu. How can you tell the difference? What should you do in each case? And most importantly, how can you avoid the sickness altogether to stay safe this flu season? Joining us to discuss is Dr. Michael Stevens, Associate Chair of the Division of Infectious Diseases at VCU Health.

Welcome to Healthy with VCU Health, where experts from VCU Health share their knowledge, cutting edge research, and the latest innovations to help you achieve optimal health and wellness. Take control of your health. I'm your host Prakash Chandran. So, Dr. Stevens, really great to have you here today. I'd love to get started by you telling us a little bit about what you do at VCU Health.

Michael Stevens, MD, MPH, FACP, FIDSA, FSHEA (Guest): Thanks Prakash. So, I'm an Infectious Disease Doctor. So, I evaluate and treat patients who have infectious diseases like COVID and influenza. And I'm also an Epidemiologist. So, I work with a team of folks to help prevent people from getting infected in the first place.

Host: So, today we're talking about the flu season during COVID. And I mentioned a lot of symptoms at the top of the episode, but how do you actually know if you have the cold or if it's the flu or COVID-19 itself?

Dr. Stevens: So right now, you really can't tell the difference between COVID and flu and any number of other viruses that are circulating in the community. And so, a lot of people have talked about sort of classic symptoms with COVID, like loss of taste and smell. What we've learned over time is, you know, really any symptoms of a respiratory infection, like a sore throat, a runny nose, cough, a little bit in a shortness of breath, fever. These could be coming from COVID. They could be coming from flu. And again, we're seeing a lot more of those sorts of typical cold viruses come back that we weren't really seeing over the last year or so now that kids are back in school and there's more people around each other. We're seeing those come back too and you just don't know what you have. And so, the bottom line is if you have any symptoms right now, you should isolate and get tested.

Host: Yeah, I was just going to ask about that because it's a tough situation. I think the natural conclusion for people that are experiencing those symptoms is to think that they have COVID-19. So, you know, what is the first thing that they should do if they start experiencing symptoms and how do they know when to seek care?

Dr. Stevens: Yeah, I think right now, as we're still in this Delta surge, things are getting a little bit better. We're recording this October 20th and things are going a little bit better, but there's still really high community activity of COVID and there's concerns that there's going to also be at winter surge like we saw last year.

And so you have to default to you have infection because especially if you're vaccinated and you're one of the rare folks that's having a breakthrough infection. You may not get that sick, but you don't want to minimize your symptoms because you may spread COVID to somebody who could get really sick because they're unvaccinated or they've got an immune compromising condition that couldn't respond to vaccination and you for sure don't want to do that.

So the bottom line is if you have those symptoms, take it seriously. The right thing to do is to isolate and get tested before you're around others again. And you know, again, it could be one of these viruses like rhinovirus, that's the common cold virus. You don't want to spread that either. And so, you want to sort of minimize your interaction with folks and wear masks, that kind of thing.

Host: Okay. Got it. That makes a lot of sense. So, obviously the right thing to do is get tested immediately, but I know that there are Telehealth options and that is kind of meant to triage or minimize the people that are coming in with potential flu like symptoms, but not necessarily COVID-19. So, talk a little bit about the role Tele-health plays in this whole scenario.

Dr. Stevens: So, Prakash, I think that's great question. And if there's a silver lining to the pandemic, this is one of those things that the sort of how robust Telehealth options are now compared to before COVID hit. At VCU, we have really nice virtual clinic that people can access just by Googling VCU Health Telehealth.

And you can sign up and get an almost immediate virtual appointment, anytime between 8:00 AM to 11:00 PM, where somebody can see you for a number of different medical problems, including flu symptoms. And so that's a really nice option that's available to folks, you know, from the comfort of their own home.

Host: And just expanding on that a little bit more. How is it that a provider or a healthcare provider is actually able to diagnose things virtually? You know, we've always thought that this is something where you got to look down the person's throat and maybe take the temperature. Can you talk a little bit about how they're able to do that from a Telehealth perspective?

Dr. Stevens: Well, Prakash, there are limitations to Telehealth in terms of what a physician can do. Obviously they're not doing a direct physical exam, but about 80% of a diagnosis actually comes from history alone. And so that clinician can assess you and will be looking for sort of warning things that would tell her or him, hey, this person needs to get to somewhere where a physician can do an exam or they need lab tests, that sort of thing. But a lot of things can be diagnosed just by that history.

Host: So, I want to move on to vaccines. You know, many people have gotten one of the available COVID-19 vaccines, but do they also need to get the flu vaccine or are they somehow protected?

Dr. Stevens: So, these are completely different viruses. COVID or SARS COV2, which is the virus that causes COVID and influenza or flu. They are two separate viruses. So, you need to get vaccinated for both of them. We don't know how bad the flu season is going to be this year. The flu actually sort of shifts a little bit every year. So you need a new vaccine for that. And the bottom line is you should get vaccinated for both. And I would prioritize, you can get the vaccines on the same day or any point relative to each other that's okay to do but prioritize getting that COVID vaccine. If you're not vaccinated, this is the time to get vaccinated.

There's a lot of activity. Not enough people have been vaccinated to have that herd immunity where, you know, we're not going to see a lot of activity out in the world. There's a ton of activity. We see really sick folks still coming into the hospital, get vaccinated. And if you're eligible for a booster, get the booster.

And everybody right now should also get flu vaccinated. It's the time. We're starting to see a few cases here and there. This is the time to do it. Cause remember, after you get vaccinated, it'll take a couple of weeks for the vaccine to kick in so you have some immunity to flu.

Host: Yeah. Got it. And just to be clear, I know you said this already, you 100% can get the COVID-19 vaccine and the flu vaccine at the same time. Is that correct?

Dr. Stevens: 100%. That's right. And so there are many different vaccines out there and you have to space vaccines apart from each other, depending on the specific vaccines, but for all of the COVID vaccines, for flu vaccine, it really doesn't matter. You can get them on the same day. If you were scheduled to get them on two separate days, that would be fine. The key thing right now is just to get vaccinated as soon as you can.

Host: Now there are a large population or a large demographic of people that have said, you know what? I've never really gotten the flu vaccine before. I don't know why there's this focus on it right now. I'm COVID vaccinated, but I've not gotten the flu vaccine, you know, my entire life. So why start now? What might you say to those people?

Dr. Stevens: Well, I would say number one, COVID is the thing you're at highest risk to encounter now. So COVID vaccination is the most critical thing you can do. And so if you're vaccine hesitant, you know, that's the one that you absolutely should do because it literally may save your life or save the life of somebody you're going to encounter.

Because remember you could spread that COVID to someone who could get severely ill. The flu vaccine, quite honestly, isn't as good as the COVID vaccine. Depending on the year, it might be 50 to 60%, sometimes a little bit higher, good at just preventing flu but similar to the COVID vaccines, it also helps prevent severe illness.

So even if you get influenza, let's say you get the flu vaccine, you develop influenza anyway, it may not be nearly as bad as it would have been if you weren't vaccinated. So, let's say you would have been in the hospital on oxygen if you hadn't been vaccinated, you know, maybe those things don't happen if you get flu vaccinated.

So, i would say, you know, it's very important to get flu vaccinated. Also, I'll say this, anybody who's had influenza, usually they're going to be the first person in line to get the flu vaccine the next week, because the influenza is a bad virus. It's like getting a cold, but like a hyped-up version of the cold and people can just feel terrible. Can't even get out of bed for like a week. It's a nasty infection.

Host: Yeah, absolutely. And the takeaway there really is to stay the most protected, it just makes sense to get both vaccines. You know, I wanted to move on to something that you said earlier, given the fact that we are in this surge, if you are experiencing these symptoms, you kind of have to assume that it is or could potentially be COVID-19. So, if people want to get tested or to find out if they have COVID-19 or not, what should they do or where should they go?

Dr. Stevens: Prakash, that's a great question. And so one of the things that can be really useful and probably one of the primary values of these virtual Telehealth appointments is they can help you figure out where you should go to get tested. And then do you have any other symptoms that are worrisome that you should actually go and be physically seen for evaluation. In terms of where to get tested, people should call their providers. They can call local urgent care clinics and look for testing options that way as well.

Host: So just as we start to close here, I'm curious if you have any other recommendations on how we can stay safe from the flu during this COVID-19 surge.

Dr. Stevens: Well, the primary thing people should do to take care of themselves and to prevent getting infected, is they get vaccinated. They should get vaccinated for influenza, for sure they should get vaccinated against COVID and get the booster vaccinations for COVID and then follow the Virginia Department of Health and the CDC guidance around other strategies to prevent infection.

And right now, because of the high community activity, it's just really there's high activity nationally, that's wearing masks indoors when you're not at home, around your immediate family you want to maintain social distance. You want to avoid crowded areas where there's poor ventilation, even if you're outside, if you're around a bunch of folks that you don't live with, if you can't maintain six feet distancing, you probably should be wearing a mask right now. And then handwashing is important as well.

Host: Well, I really appreciate your time today, Dr. Stevens. This has been really informative. Is there anything you'd like to leave our audience with?

Dr. Stevens: No, except for maybe this Prakash. I think the key is vaccination. I've said it over and over again. It's the truth. The only way we're going to get back to any kind of normal reality, the pre COVID pandemic normal reality does not see these periodic spikes in activity, where we're having to go back to the things like masking indoors and that kind of stuff; is if people get vaccinated. It's the best thing they can do. COVID vaccinated, it's the best thing they can do to protect themselves their loved ones, you know, other people they may encounter. And right now they should get flu vaccinated too.

Host: Well, I think that's really good advice and the perfect place to end. Thank you so much, Dr. Stevens.

Dr. Stevens: Thank you.

Host: That's Dr. Michael Stevens, Associate Chair of the Division of Infectious Diseases at VCU Health. Thank you for listening to Healthy with VCU Health. Just to reiterate flu season is upon us. So, make sure to get your flu shot. And if you haven't been vaccinated against COVID-19, please consider getting vaccinated and visit vcuhealth.org for more information. You can listen to other podcasts from VCU Health at vcuhealth.org/podcast. Thanks again for listening. My name is Prakash Chandran and we'll talk next time.