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4 things to know about the flu in the time of COVID-19

How can you tell which virus is causing your cough or fever? Is it too late to get a flu shot if you haven’t? A Johnson & Johnson expert addresses these questions—and how the company is working to improve the future of flu prevention.

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Since the spring of 2020, there have been many comparisons made between COVID-19 and the flu. And while the novel coronavirus and the influenza virus are not the same, they do have one major thing in common: Both can be deadly. In fact, the World Health Organization estimates that there are around 1 billion cases of influenza globally each year, resulting in 290,000 to 650,000 deaths.

What’s more, experts believe that the flu might be especially deadly this year—because many COVID-prevention strategies that we used last winter, such as masking and social distancing, also protected us from getting the flu, to the point that our immunity to the virus might be lowered this winter.

We sat down with Jonathan Uy, M.D., Global Medical Affairs Leader, Respiratory Infections at the Janssen Pharmaceuticals Company of Johnson & Johnson, to learn how best to protect yourself from the flu as the pandemic continues on—and about new innovations on the horizon that could keep us all safer in the future.


We may be at greater risk of getting the flu this winter.

People wearing masks in a crowded airport

Typically, flu season extends from October to May (or from April to September in countries in the Southern Hemisphere). But last winter, influenza was practically nonexistent around the globe. In the United States, for instance, there were only about 3,000 reported cases of flu for the entire 2020-21 flu season, compared to an estimated 35 million cases the previous year.

“There’s no doubt that all of the protective measures we took last year, like wearing face masks, hand washing and physical distancing, contributed to such low numbers,” says Dr. Uy. “In addition, many more people got the flu vaccine last year than in previous years, which may have translated into a lower infection rate.” In fact, a record number of influenza vaccine doses—193.8 million—were distributed in the U.S. last year, according to the U.S. Centers for Disease Control and Prevention (CDC).

The downside to this good news: Since there was such low incidence of influenza last year, our immunity to the virus is likely lower this year, which may cause a spike in cases, says Dr. Uy.

“We saw that this past summer with a spring and summer surge of common respiratory viruses, including respiratory syncytial virus, or RSV,” after a winter of practically no cases, he explains. While RSV usually targets young infants, there were surprisingly high numbers of older infants and toddlers who developed the disease this year, possibly because they were never exposed to it as babies during the early months of lockdown.

Pair our lowered immunity with newly reopened schools and workplaces, along with the loosening of mask mandates, and “it’s a really unprecedented time,” says Dr. Uy. “No one in the medical community knows what will happen, so we’re watching this closely.”


The best way to protect yourself is to get vaccinated.

A woman in a mask gets vaccinated by a healthcare practitioner in a mask

Experts agree on this fact, but less than 60% of Americans are sure that they’ll get a flu shot this year, according to the CDC. One reason may be the belief that the shot isn’t very effective, since it “only” reduces your risk of infection by 40 to 60%.

But, argues Dr. Uy, “a lot of people don’t realize that the vaccine may be protective against complications from the flu, even if you do get sick.” Case in point: A 2021 study of adults published in the journal Vaccine found that flu vaccination was associated with a 26% lower risk of ICU admission and a 31% lower risk of death from flu compared to those who were unvaccinated.

“One story I love to tell from many years ago during my fellowship when I was much younger: I came down with classic flu symptoms even though I was vaccinated—I felt fine one minute, and five minutes later I felt like I was hit by a bus,” recalls Dr. Uy. “I got tested on a Thursday, but by Saturday I felt good enough to go skiing. When I returned to work on Monday, I learned I’d tested positive for flu. While the vaccine didn’t keep me from getting infected, it likely reduced the severity of my illness.”

In addition to getting vaccinated, frequent hand washing can help prevent contracting the virus. There’s also some evidence to suggest that wearing surgical masks may offer some protection against not just COVID-19, but the flu virus as well.

The best time of year to get the flu shot is early October, but it’s better to get it late in the season rather than never. This advice is particularly true this year, as we just don’t know when the biggest spike in flu cases will be.
Jonathan Uy, M.D., Global Medical Affairs Leader, Respiratory Infections at the Janssen Pharmaceuticals Company of Johnson & Johnson


It’s not too late to get a flu shot.

A woman on a sofa coughs and looks at a thermometer

The ideal time to get the flu vaccine each year is before the start of flu season, since it takes your body a couple weeks afterward to build immunity to the flu virus.

“The best time of year is early October, but it’s better to get it late in the season rather than never,” Dr. Uy advises. “This advice is particularly true this year, as we just don’t know when the biggest spike in flu cases will be.”


Unsure whether you have the flu or COVID-19? Get tested.

A healthcare provider in a mask swabs the nose of a seated patient

Since symptoms of COVID-19 and the flu overlap so much—think headache, fever, muscle aches and cough—the only way to know for certain you have one or the other (or another virus such as RSV) is to see a doctor and get tested for both, says Dr. Uy.

While treatment for both viruses is generally the same (rest, plenty of fluids and an over-the-counter pain and fever reliever such as acetaminophen), knowing you have the flu and being diagnosed right away means you can talk to your doctor about taking an antiviral treatment, particularly if you’re age 65 or older or have a compromised immune system.

The elderly are at particular risk for contracting the flu, even if they’ve been vaccinated, since their immune responses may be lower than in younger people. “There’s still a high unmet need for older patients in whom traditional flu vaccines aren’t as effective as they could be,” says Dr. Uy.

That’s why, earlier this year, Johnson & Johnson announced a partnership with Cidara Therapeutics to develop a new antiviral preventive therapy that could potentially protect against all influenza strains for an entire flu season, even among higher-risk individuals. “We want to make sure that everyone is as protected against the flu as they can possibly be,” stresses Dr. Uy.

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