By Dr. Peter J. Plantes

November 12, 2020

Contracting both flu (influenza virus) and COVID-19 (SARS-CoV-2 virus) at the same time will be a tough clinical road for the patient. Similar to how a pre-existing chronic disease like asthma or COPD (chronic obstructive pulmonary disease) complicates COVID-19, an acute case of flu superimposes another respiratory and immunological assault on the body. The death rate is expected to be higher for these patients. While there is no definitive study measuring and demonstrating that point, it is reasonably evident to most physicians.

 The CDC acknowledges the chance to have both virus illnesses at the same time, but it does not quantify this risk. This winter will supply the unfortunate experience of demonstrating the complicated outcomes for those contracting both virus illnesses at the same time.

The two illnesses are caused by different types of viruses. Influenza is in its own class of viruses with type A or type B causing what we term “the flu.”  Several oral medications are available to treat a case of the flu such as Oseltamivir (Tamiflu). These drugs slow the replication of the influenza virus and are more effective if taken at the early stage of the symptoms. There is also an effective preventative immunization for influenza that is modified yearly as the virus mutates. 

COVID-19 is caused by the SARS-CoV-2 virus (coronavirus type). In contrast to influenza, to date, there is no effective oral medication to treat the illness (hydroxychloroquine (HCQ) has not been demonstrated as helpful), and many pharmaceutical companies are still working to produce a vaccine to prevent the illness. 

The chances of catching each virus are not independent. If you are conscientious about protecting yourself from the respiratory spread of COVID-19, then you are also protecting yourself from the respiratory spread of influenza, because COVID-19 and influenza are both spread by hand and face contact. Surface contact spread also can occur for either virus. However, whereas surface contact is known to be prevalent as a pathway for widespread dissemination of influenza, very few documented cases of COVID-19 have been determined to come from surface contact alone.

Some expect the 2020–2021 flu season may not be as intense this year because a reasonable number of people are wearing masks, washing hands, and keeping physically distant. Precautions like this are new this year compared to past years and are likely to impact the prevalence of influenza. 


2017-2018 Flu 2018-2019 Flu COVID-19 
Cases  45 Million 35 Million 10.1 Million
Deaths 61,000 34,157 238,000

Source: CDC data as of November 9, 2020. COVID-19 cases are required to be reported. Flu cases are estimated by CDC given that influenza is not a “required reportable” illness. 



Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD). Frequently Asked Influenza (Flu) Questions: 2020–2021 Season. Updated November 6, 2020.

Rubin, Rita, MA. What Happens When COVID-19 Collides With Flu Season? JAMA. 2020;324(10):923-925. doi:10.1001/jama.2020.15260.

About the Author

Peter J. Plantes, M.D. has three decades of experience creating service and delivery solutions that enhance marketplace success and clinical performance for clinical practice groups, academic faculty group practices, hospitals, health systems, and health care organizations. His success stems from his ability to blend and synergize clinical knowledge, operational expertise, financial performance, and collaborative methodology with his deep commitment to serve patients and improve the health of the community. Dr. Plantes has served in CEO & Physician Executive roles for a number of large healthcare clinical delivery networks including regional community networks, academic practices, national hospital networks, international health systems (Chile, Colombia),  and corporate managed care/HMO networks.

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