Stay Well This Winter

Expert advice to help you avoid COVID-19, colds, and flu this season

multi-generational family with dog walking on trail in cold weather Photo: Getty Images

Last year, as Americans facing the threat of COVID-19 hunkered down and masked up, the flu seemed to go into hibernation.

At the height of a typical flu season, up to one visit in every 20 to emergency departments is for the illness. But during the most recent flu season, it accounted for less than one of every 1,000 ER visits.

Experts expect that the flu will make a comeback this winter, circulating along with other seasonal respiratory viruses as well as the coronavirus. Here’s what you need to know to protect yourself and your family.

What to Expect

Influenza is a notoriously difficult virus to predict. The past year with fewer cases means there may be a lower level of immunity in the general population, says Lynnette Brammer, an epidemiologist in the influenza division at the Centers for Disease Control and Prevention. This may affect children more than adults, because adult immune systems have had decades of exposure to different flu viruses.

On top of that, COVID-19 will still be with us, especially because new and more contagious variants of SARS-CoV-2 (the virus that causes COVID-19) are continually emerging. So it’s possible we may see both the flu and COVID-19 spreading at the same time, a situation feared by some scientists last year.

“It really comes down again to behavior” and whether people continue taking the steps to avoid respiratory diseases that so effectively limited the spread of flu last season, says Sarah Cobey, PhD, an associate professor of ecology and evolution at the University of Chicago.

Your Vaccine Checklist

Consider vaccines as your first line of defense. They’re not available for all seasonal respiratory viruses, including many that cause the common cold. But you can be vaccinated against two of the riskiest viruses that will be circulating, influenza and SARS-CoV-2.

More on flu season

In a May 2021 study published by the Centers for Disease Control and Prevention, researchers found that the Pfizer and Moderna COVID-19 vaccines were 94 percent effective at preventing hospitalizations for the disease among people 65 and older. In comparison, the flu vaccine’s strength may seem low: The shot was 39 percent effective at keeping people from needing to see a doctor for a case of the flu during the 2019-2020 flu season, the last year for which CDC data is available. But just as with the COVID-19 vaccines, flu shots also reduce your risk of serious illness or hospitalization if you do get sick. For example, the CDC estimates that in the 2019-2020 flu season, vaccinations averted about 61,000 hospitalizations among people ages 65 and older and 105,000 hospitalizations overall. So take these steps now:

Get a COVID-19 vaccine. If you haven’t had a shot yet, get one as soon as you can. The CDC says you can even get a COVID-19 shot and a flu vaccine during the same visit.

65 or older? Seek out the best flu vaccines. Two have been shown to provide better protection for older adults compared with the standard vaccine, and they’re available only for people 65 and older. The Fluzone High-Dose contains four times the amount of viral antigen (the molecule that stimulates an immune response) as the standard shot. The other vaccine, Fluad, is made with an additive that’s designed to prompt a stronger response from the immune system. If you can’t get one of those shots, a standard flu vaccine is still better than none at all.

Time your flu jab right. Flu vaccine effectiveness wanes over the course of the season, especially for older adults. So you don’t want to get it too early. But don’t wait too long, either. Getting vaccinated in September or October should provide good protection for the season.

Go for a pneumococcal vaccine if you haven’t yet. The bacteria Streptococcus pneumoniae is one of the most common causes of bacterial pneumonia. Vaccines are available against this bacteria, which can also cause sinus infections and meningitis. The CDC recommends that everyone 65 and older receive a dose of PPSV23 (Pneumovax 23).

Other Important Steps

With COVID-19, the flu, and colds likely to circulate together this winter, you’ll need to practice some additional virus-fighting habits.

Hang onto your mask. Whatever the current rules are where you live, remember that wearing a mask can help protect you from COVID-19—including breakthrough infections—and may shield you from other respiratory viruses. (Even with a mask, keep a distance from anyone coughing or sniffling.)

While the flu can spread through surfaces and large droplets (as from a sneeze), it can also be transmitted via small particles in the air, just like COVID-19. The CDC doesn’t actively recommend mask use for preventing the flu, but if you have any respiratory symptoms or are headed into a crowded environment—an airplane, a busy store, a big event—wearing a mask is a reasonable precaution to take, says Seema Lakdawala, PhD, an assistant professor in the department of microbiology and molecular genetics at the University of Pittsburgh School of Medicine, who studies flu transmission. That’s especially true if you’re at higher risk for severe disease because of your age or an underlying condition.

Wash your hands. Cleaning your hands regularly with soap and water for at least 20 seconds helps prevent a wide range of diseases, not only those caused by respiratory viruses. When you don’t have access to a sink, use hand sanitizer with at least 60 percent alcohol.

Stay home when you’re sick. Many people developed at least one very good habit during the pandemic: staying home the minute they had any respiratory symptoms, Lakdawala says. That meant not going to work, visiting friends, or even stopping in a store. This probably helped limit the transmission of many viruses in addition to SARS-CoV-2, she adds.

If You Get Sick

If you start to notice symptoms of any viral illness—fever, cough, chills, runny nose, congestion—see a doctor right away, either in person or via a telehealth service. The flu, COVID-19, and colds can cause similar symptoms, and a prompt diagnosis is important.

If you have the flu, antiviral medications can help reduce the severity of symptoms, but meds are most effective if you start taking them within two days of noticing the first signs. Early treatment with monoclonal antibodies and other medication may improve your prognosis if you have COVID-19. Early testing is also important so that you can isolate yourself if you have the disease.

Editor’s Note: A version of this article also appeared in the October 2021 issue of Consumer Reports On Health.

Catherine Roberts

As a science journalist, my goal is to empower consumers to make informed decisions about health products, practices, and treatments. I aim to investigate what works, what doesn't, and what may be causing actual harm when it comes to people's health. As a civilian, my passions include science fiction, running, Queens, and my cat. Follow me on Twitter: @catharob