Why are some viruses seasonal?
What you need to know about flu
Each year those of us working in healthcare have our work cut out encouraging our patients to protect themselves and their loved ones against flu. With so much misinformation out there, here's what you really need to know about flu - and how we can fight it during the COVID-19 pandemic.
For all of us, winter is a time of coughs and colds. But for general practices, planning for flu season starts during the summer holidays. Every year (until this year), 15 million people in the UK are invited for a free NHS flu vaccination to protect them against flu. They start being invited from late September, before flu rates really start to rise.
This year, there's a real concern that a combination of increased hospital admissions due to flu and a spike in COVID-19 cases could overwhelm the NHS. In addition, recent data from Public Health England shows that in the early stages of the pandemic, before the last flu season finished, people who were infected with both viruses at the same time were more than twice as likely to die as those who had COVID-19 alone.
That's why this year the NHS is dramatically increasing the number of people eligible for NHS vaccination. Public Health England estimates that while death rates vary significantly from year to year, the annual average for deaths is in the region of 11,000. The flu vaccine is one of the best protections - as well as reducing the risk of catching flu, it cuts the chance of complications if you get it. To find out if you're eligible, head to the two-minute Patient Access flu eligibility checker.
But how can you avoid catching it in the first place?
Are you eligible for a free NHS flu vaccination?
You may be entitled to a free NHS flu vaccination from your GP or local pharmacist. Find out if you are eligible today.
Prevention or cure?
Flu is caused by a virus - that means antibiotics are completely useless. Anti-virus tablets do exist, but they're not a 'cure' (they may speed recovery by a couple of days). So apart from the flu vaccine, the other best way of avoiding flu is to avoid the virus in the first place.
The virus is spread in one of two ways droplets you breathe in and direct contact (picking the germ up on your hands and getting it into your system when you touch your nose, mouth or eyes). Of course, these are two of the main modes of spread for COVID-19 as well. Interestingly, unlike with COVID-19, there's little or no evidence people who catch flu are infectious before they get symptoms - which is why face coverings aren't on the list below. But of course we now know that COVID-19 can be spread throught 'aerosol' spread, even before someone develops symptoms - hence the introduction of face covering regulations.
Two for the price of one
But in other respects, the same lifestyle measures will help reduce your risk of becoming infected with either virus:
- Wash your hands regularly with soap and water, especially when you've been in a public place where germs from others might have landed. 20 seconds is enough to destroy 'envelope viruses' including COVID-19, but during flu season there's an extra benefit.
- Get into the habit of wiping down computer keyboards, phones and doorknobs.
- Avoid close contact with others as much as possible if they're poorly - and in particular, try to stay out of reach of people sneezing, which blasts viruses at huge force around the room.
- Try to avoid touching your nose, hands and mouth wherever possible.
- Encourage everyone to 'catch it, bin it, kill it' - cover your mouth and nose with a paper tissue, bin it immediately and then wash your hands (or use at least 60% alcohol hand sanitiser).
- Eat a healthy diet - lots of fruit and veg and not too much processed food are linked to a better immune system, meaning you're more likely to be able to fight the virus off.
- Regular exercise isn't just good for your heart - there's evidence it strengthens your immune system too.
- Consider a 10 mcg daily vitamin D supplement every day - it won't harm you and may boost your immune system, helping reduce the risk of flu as well as COVID-19.
Flu vaccination - what you shouldn't believe
As for the flu vaccine, I've heard all the usual myths:
"I don't need the flu jab - I had it last year."
The flu virus is sneaky - it mutates every year. Think of human evolution, which happens over thousands of generations. The flu virus can replicate every few hours - so a year is up to a thousand generations to them. This year's main strains are different to last year's, so last year's vaccine won't protect you fully.
"The flu jab gave me flu last time."
Physically impossible - the vaccine doesn't contain any live virus, so it can't multiply inside your body. It isn't Lazarus!
"I had flu last year and it was fine - it was just a nasty cough for a few days."
There really is no such thing as a 'touch of flu', as my patients try to tell me. There are hundreds of cold viruses out there, causing variations on the theme of runny nose, tickly cough, sore throat. But flu is different - profound exhaustion, aches in muscles you never knew you had, high fever, body racked by bouts of harsh coughing. And that's before we get on to the complications. If you think you had a 'mild case of flu', you actually just had a cold.
"I'm healthy so I don't need it."
Not necessarily. As you get older, your immune system becomes less efficient even if you feel well. The same applies if you have long-term health conditions like diabetes, lung/liver/kidney problems, Parkinson’s disease etc. Likewise, your body's immune system behaves differently during pregnancy.This makes it easier for the virus to invade deep into your body, causing pneumonia and other potentially fatal complications.
"What's the point? I've heard it doesn't work."
It's true that a few years ago, the flu vaccine was less effective than usual for over-65s in particular. But since then, over-65s have been offered a new version of the vaccine, specially designed to work more effectively to prime your immune system. And the main flu strains seen in Australia earlier this year - which offer a good indication of what's to come in the UK - are all covered with our vaccine.