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Your patients may soon be asking, “Do I have the flu or COVID-19?”


With COVID-19 cases resurging and the flu season fast approaching, we may see new concerns pop up, most especially with unvaccinated populations.

After more than a year of coping under the strain of the COVID-19 pandemic, many Americans are exhausted from worrying about their health and the health of their loved ones. And while the vaccination push has helped provide a means to return to a more normal lifestyle, there are still a number of Americans who are reluctant to get vaccinated.

As a result, we are starting to see surges of the disease across the country. In fact, the average number of daily new COVID-19 cases in the U.S. has tripled in the past 30 days, according to an analysis of Reuters data. The average number of people hospitalized with COVID-19 has also risen 21% over the past 30 days to more than 19,000, according to the same Reuters analysis. Deaths, which can lag behind other indicators, also rose 25% last week. Globally, the numbers are staggering as well, and even Olympic athletes –close to 200 so far – have been infected with COVID-19.

With COVID-19 cases resurging and the flu season fast approaching, we may see new concerns pop up, most especially with unvaccinated populations such as children and those who are unable or chose not to be vaccinated.

Last year, according to data from the Centers for Disease Control and Prevention (CDC), the U.S. barely had more than 2,000 documented cases of the flu. During most years, the nation experiences millions of cases. But with lockdowns, hand washing, mask wearing and social distancing, very few of us caught the flu in 2020. In fact, the steps we took to limit our exposure to people and germs during last year’s flu season resulted in the lowest reported hospitalization rates on record for the flu virus, noted the CDC.

While this was good news, scientists now have very little data to serve as the basis for creating flu vaccines as they seek to anticipate this year’s flu variant. In preparation for each flu season, scientists work to identify and characterize the full extent of the viruses’ genetic and antigenic makeup. In a light prior-year flu season, fewer virus specimens make it more difficult to do that. As a result, it can be more difficult to develop a targeted flu vaccine.

This is one of the drivers that leads medical experts to believe that the U.S. will experience a more difficult flu season this year. Another driver is the fact that state and local governments have relaxed restrictions because of the wide availability of vaccines in the U.S. With fewer people wearing masks and foregoing social distancing as they return to group gatherings, the primary protections of the 2020 flu season won’t be present this year.

Pre-pandemic, people would typically wonder, "Do I have a cold or the flu?" While this year they are likely to ask, “Do I have the flu or COVID-19?” since the symptoms of COVID-19 mimic the symptoms of the flu or cold initially, like a runny nose or fatigue. Prior to the pandemic, people who wondered “is it a cold or the flu?” may have been comfortable in riding out the illness without the need to test and have a definitive answer. However, in anticipation of the COVID-19 and flu viruses co-circulating this flu season, current guidelines from the CDC state that people with symptoms should be tested for both.

Leading into the 2021 flu season, health care professionals must have the tools they need to rapidly diagnose COVID-19 and the flu during this overlap. Rapid, point-of-care combination tests are likely to be the preferred choice due to the efficiency of only having to collect one sample to run three tests simultaneously (SARS-CoV-2, Influenza A, and Influenza B).

In addition, co-infection ─ the possibility of both infections occurring simultaneously in the same individual ─ is also possible during this time, which means that using a test that detects just the flu or COVID-19 to “rule out” the other infection is not a sound clinical strategy.

As we enter this critical flu season, health care professionals need to create plans on how to manage the potential for increasing cases of flu and COVID-19. Having access to a low-cost, easy-to-use rapid antigen combination tests will help them distinguish these viral infections during the initial appointment, helping them save time and resources. Most importantly it will enable the right care and can help prevent the viruses from spreading, especially among people within the same household or social circles.

Dave Hickey is Executive Vice President at Becton Dickinson and President of its Life Sciences Segment. Becton Dickinson a leading global medical technology company headquartered in Franklin Lakes, New Jersey.

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