Physician Q&A: Separating Fact from Fiction with ‘Flurona’

If you keep up with the news, you’ve probably seen reports that isolated cases of “Flurona” have been reported around the globe – some of them right here in South Florida – with a small number of patients testing positive for both influenza and COVID-19. Is “Flurona” really a thing, however? And should you be worried? Andrew James Forster, M.D., an internal medicine physician with Baptist Health Primary Care, offered his clinical perspective in a recent interview with Resource editors.

Resource: How has the current surge caused by the coronavirus Omicron variant affected your practice over the past couple of months?

Dr. Forster: It seems like everybody I’ve seen recently caught COVID-19 over the holidays. These are people who were vaccinated and were being careful, but this variant seems to be so much more transmissible. While it may not be as lethal as the Delta variant, we still have a lot of people in our hospitals with COVID-19.

Resource: Flu season is now underway and it, too, can be dangerous. How do you know if a patient actually has the flu?

Dr. Forster: Flu season tends to peak in late February here in South Florida. Nationwide, influenza kills roughly 30,000 to 60,000 people a year so it’s definitely a concern, especially for people who are older or have other health conditions. But because of protective measures still in place against COVID-19, this year hopefully won’t be so bad. How do we know if someone has influenza? Clinical observation is usually sufficient but a nasal rapid flu test can quickly confirm a diagnosis.

Resource: What is “Flurona,” exactly, and is it really a thing?

Dr. Forster: The first time I heard of “Flurona” was on The Late Show with Steven Colbert, to be honest. But there is no such virus or disease – it’s just a name the media is having some fun with, I think. Can someone be diagnosed with both influenza and COVID-19 at the same time, however? Yes, it’s possible.

Resource: How would someone know if they have “Flurona”? Aren’t there many overlapping symptoms?

Dr. Forster: Yes, there’s a lot of symptom overlap with influenza and COVID-19. Both can cause fever, body aches, headache, sore throat, malaise, cough and so on. Losing your sense of taste and smell temporarily is more specific to COVID-19, though – you don’t usually see that with influenza. As a physician, I think it’s prudent to test for both. That’s the only way to really know.

Resource: How likely is it that one could be infected with COVID-19 and the flu at the same time?

Dr. Forster: We’ve known for some time that people can be infected with two different viruses at the same time. With COVID-19 and influenza, they’re both spread the same way and tend to run in the same circles, so to speak, so it’s certainly possible for someone to have both at the same time. Both are respiratory viruses that are transmitted through droplets and aerosols that can be passed on by coughing, sneezing, speaking, singing or breathing — which is why wearing a mask around others is so important.

Resource: Is it possible for one virus to exacerbate the symptoms of the other?

Dr. Forster: If you were to get both influenza and COVID-19, either one of them would ramp up your body’s immune system into a heightened state of alert, so my guess is you probably wouldn’t get any sicker from both viruses than you would from just one or the other. Your body definitely has the ability to fight off two infections at once. However, if I was over 65 and had co-existing conditions like diabetes or cardiovascular disease, I’d be very worried about contracting both. The risk of developing serious complications from either virus is high – particularly for those who are unvaccinated.

Resource: What treatments are available for “Flurona” patients?

Dr. Forster: There is a five-day, oral antiviral treatment for influenza – Tamiflu – which helps prevent hospitalization and death and is commonly prescribed for high-risk patients. It won’t make your symptoms go away overnight but it has been shown to shorten duration and keep people out of the hospital. Unfortunately, oral treatments for COVID-19 are still being developed. We need them now but we’ll just have to be patient a little while longer.

Resource: Last year, there was talk of a “twindemic” of flu and COVID-19. Do you think that’s possible this year?

Dr. Forster: If the current Omicron variant surge dissipates – and it seems as if we’ve passed the peak now – we may not see many co-infections. Last year’s flu season was comparatively mild because everyone was masking and social distancing to avoid COVID-19, which translated into far fewer flu cases. Perhaps this year will be the same, but we just don’t know. Unlike the influenza virus, which mutates once a year or so, the COVID-19 virus seems to mutate very quickly. We went from the Delta variant to the Omicron variant in just a few months. So we’ll have to wait and see.

Resource: Do you have patients in your practice who are hesitant to be vaccinated against COVID-19?

Dr. Forster: People are prey to a lot of misinformation – and disinformation – online, and a good part of my day is spent dispelling myths about the COVID-19 vaccines. Many times, unfortunately, the discussion about whether or not to get vaccinated seems to revolve around opinion, not science. Ironically, some of those who are the most reluctant to get the vaccine are the ones who would stand to benefit the most from getting it. They’re overweight, they may smoke or they have other existing health issues and are therefore at greater risk of developing serious illness if they were to get COVID-19. If I can convince even just one person to get vaccinated, that’s a good day for me because that’s one person who hopefully won’t end up in the hospital.

Resource: What would you say to someone who’s hesitant to get the COVID-19 vaccine?

Dr. Forster: I recommend to my patients who are having doubts that they do a risk-benefit analysis. I often tell people the chances of them getting COVID-19 and possibly winding up in the hospital are far greater than any perceived risk of the vaccine. The vaccines have been out for a year now and have been remarkably effective at keeping people out of hospitals, and there have been very few issues. But on the other hand, if you have other chronic health conditions that might predispose you to hospitalization if you were to get COVID-19, I can tell you that you’re at far higher risk of developing serious problems from the disease itself than you are from the vaccine.

Resource: We’ve been dealing with COVID-19 for two years now. Will it ever burn itself out eventually and just disappear?

Dr. Forster: Unfortunately, most experts are predicting COVID-19 will be around permanently, with outbreaks flaring up in certain areas at certain times of year. Like influenza, it will continue mutating and we may need to get a booster vaccine every once in a while. But, to me, that is better that than winding up in the hospital on a ventilator. And even if you’ve had all your vaccines and you’ve had the Omicron variant, it’s still too early to let your guard down. Your antibodies may be defenseless against a future variant, which could be even more transmissible than Omicron and more lethal than Delta.

Resource: Any other thoughts you’d like to share with our readers?

Dr. Forster: If you haven’t gotten your COVID-19 vaccination, go ahead and do it. We know the vaccines are safe and effective. Also, please get a flu shot if you haven’t already – why run the risk of getting both viruses at once? Keep masking, especially when indoors with a large number of people. Personally, it’s very hard for me to imagine traveling or flying without a mask anytime soon. Don’t put off your preventive care and annual screenings. We’re still trying to catch up with patients who couldn’t or wouldn’t come see us during the early days of the pandemic. And, lastly, don’t rely on social media for important health information. The U.S. Centers for Disease Control & Prevention (CDC) has all the latest data and recommendations on COVID-19, and Baptist Health’s website has a lot of good information as well.

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If you have any questions or concerns about COVID-19 or the flu but prefer a virtual visit with a Baptist Health physician, you can use the Baptist Health Care On Demand app and see a doctor any time, from the comfort and safety of your own home. Use code CARE19 for a free online urgent care visit.