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People who get both flu and Covid-19 are in ‘serious trouble’: Co-infection raises risk of death

People who catch Covid-19 and flu at the same time are in ‘serious trouble’, Public Health England has warned amid fears Britain will be hit with a ‘double whammy’ this winter.

Findings from the government agency’s research suggests that co-infection doubles the risk of death. 

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Analysis also showed the handful of hospitalised patients who had both infections simultaneously during the pandemic were around six times more likely to die than those who tested negative for both infections.

Officials have urged the public ‘not to be complacent’ over the flu by declining the offer of a free vaccination this autumn.

This year will see the biggest ever flu vaccination programme for the UK, with health chiefs hoping to reach 30million people against the 15million last year.

Usual groups will be targeted first, including over 65s and pregnant women. And if there is enough doses left over, those over the age of 50 will be next in line.

The great concern is that if people are not protected against the flu, hospitals will be overrun with sick people unsure if they have flu or Covid-19, or both.

But some experts have insisted Britain ‘almost certainly’ will not see two consecutive waves of flu and coronavirus.

Flu infections during the cold long months in the southern hemisphere are a canary in a coalmine for how hard the NHS will be hit by outbreaks, and are used to design the preventative flu vaccine.

But this year Australia and New Zealand have escaped a bad flu season, which top experts say is down to social distancing measures. 

Overall 43 per cent of people with co-infection died compared to 27 per cent of those who tested positive for just Covid-19. For flu it was 4.8 per cent. The risk of death from just Covid-19 or just the flu is much lower than the study implies – around one per cent. But because the testing is skewed towards the sickest people, the death rates in the study were far higher

Professor Tim Spector, of King's College London , moved to reassure parents the symptom, alongside congestion and sneezing, is a 'sure sign' they have a cold and not Covid-19. Pictured are the common symptoms of Covid-19 compared with a cold or bout of flu

Professor Tim Spector, of King’s College London , moved to reassure parents the symptom, alongside congestion and sneezing, is a ‘sure sign’ they have a cold and not Covid-19. Pictured are the common symptoms of Covid-19 compared with a cold or bout of flu

PHE researchers analysed data in almost 20,000 people who were tested for both Covid-19 and flu in the UK between January 20 and April 25.  

The study cohort would have mostly been people very seriously ill with Covid-19, considering testing was limited to just hospitals at the start of the pandemic until about May.

‘Most of the SARS-CoV-2 tests were collected when the government policy was to test individuals on admission to hospital with lower respiratory tract infections and healthcare workers. Therefore, the majority of SARS-CoV-2 cases were individuals with moderate to severe symptoms,’ the report said.

Fifty eight people were identified as having ‘co-infection’ of the two viruses. 

While the numbers of people with both illnesses were small, the risk of death was nearly six times (5.92) greater among those co-infected compared to the general population.

WHAT IS THE DIFFERENCE BETWEEN FLU AND COVID-19? 

Flu is a viral infection that is spread through coughs and sneezes. SARS-CoV-2, the virus that causes Covid-19, spreads in the same way.

Most people recover from the flu with rest in a week. And most people who get Covid-19 also recover within two weeks or show no symptoms at all. 

But  with both illnesses, people with chronic conditions or who are over 65 are at significant risk of severe illness, complications or death. 

The flu is more common during winter. But it is not clear yet if Covid-19 is also a seasonal illnesses. It is suspected that this is the case, considering it is in the coronavirus family, which also includes the common cold.

SYMPTOMS OF FLU

Symptoms can include fever and chills, a cough, sore throat and a runny or stuffy nose.

Muscle aches, joint pains, headaches and fatigue are also common.

Nausea, vomiting and diarrhoea are more common in children than adults.

Some symptoms may last for more than a week. Medical help should be sought if there is a shortness of breath or rapid breathing, chest pain, sudden dizziness or persistent vomiting.

SYMPTOMS OF COVID-19

The main symptoms of coronavirus listed by the NHS are:

  • a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual) 
  • a loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal 

The World Health Organization says Covid-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.

Most common symptoms:

  • fever 
  • dry cough
  • tiredness

Less common symptoms:

  • aches and pains
  • sore throat 
  • diarrhoea
  • conjunctivitis
  • headache
  • loss of taste or smell 
  • a rash on skin, or discolouration of fingers or toes 

Serious symptoms:

  • difficulty breathing or shortness of breath
  • chest pain or pressure
  • loss of speech or movement

The risk of death was also 2.3 times higher for patients who had caught both viruses, compared to being infected with Covid-19 alone. 

Overall, 43 per cent of people with co-infection died compared to 27 per cent of those who tested positive for just Covid-19. For flu it was 4.8 per cent. 

The risk of death from just Covid-19 or just the flu is much lower than the study implies – and is estimated to be below one per cent. But because the testing is skewed towards the sickest people and not the entire population, the death rates in the study were far higher.

Those who died ‘tended’ to be older, PHE said. 

Flu can be particularly serious in older adults, very young children and people with underlying health conditions, such as COPD, diabetes, heart disease, kidney disease and multiple sclerosis.

The same is true for Covid-19 – other than for children, who often escape without showing any symptoms. 

PHE’s medical director Professor Yvonne Doyle, said: ‘If you get both, you are in some serious trouble. 

‘And the people who are most likely to get both of these infections may be the very people who can least afford to in terms of their own immune system or their risk for serious outcomes.

‘Please protect yourself against flu this year.’ 

Flu usually kills around 11,000 people each year in England and many more are hospitalised.  

But it varies depending on the severity of the flu strain. There were almost 4,000 deaths in 2018/19 but over 22,000 deaths in 2017/18.    

The flu jab is the best protection against influenza but statistics show the number of vulnerable people getting free flu jabs in England is at an eight-year low. 

Last winter just 45 per cent of people under 65 with serious health conditions, who are offered the vaccine for free on the NHS, received the jab.

This has tumbled from a peak of 52.3 per cent in the winter of 2013 and is the worst uptake since Public Health England’s records began in 2012. 

The World Health Organization has previously said that countries should aim to vaccinate 75 per cent of their vulnerable population.  

England’s most senior health officials have implored eligible people to get vaccinated when they get their invitation. 

Professor Doyle said: ‘We’re encouraging anybody who is eligible to accept their flu vaccination this year, particularly with the winter we’re going to face.

‘People still think that the flu is just like a cold. It’s not. The flu is an extremely unpleasant condition.

‘If you’re in a risk group, it can be really dangerous, and it can kill you. The vaccine is good, it’s safe, and it does protect people. So it’s worth having it.’

Professor Jonathan Van-Tam, the deputy chief medical officer for England, said: ‘We want to deliver the most extensive flu programme possible. And we will have enough vaccine this year for 30million people in total.

‘And this obviously is very important in a year where we face the possibility that flu and Covid-19 and may at some point this winter, circulate together and at the same time.’

There has been speculation that because the flu and the coronavirus will compete with each other, SARS-CoV-2 will be pushed out of circulation. 

The PHE study showed the risk of testing positive for SARS-CoV-2 was 68 per cent lower among those positive for the flu, ‘suggesting possible pathogenic competition between the two viruses’.

However, Professor Doyle said that the first peak of the pandemic coincided with the end of the flu season last year so the full interaction between the two viruses is not yet fully known. 

Professor Van-Tam said that alongside the PHE data, there have been studies in mice which found ‘bad outcomes’ among those infected with both flu and Covid-19.

‘There are multiple, plausible reasons why it’s a very bad idea to have Covid-19 and flu at the same time. And of course, that possibility is real for this winter,’ he said. 

Australia and New Zealand have given hope that Britain will not inevitably be hit by the flu and Covid-19 at the same time.

So far this year Australia has recorded only 21,000 influenza infections, fourteen times lower than last year’s figure at 313,000. 

After Sydney declared a lockdown on March 23, flu cases dropped from 5,895 for the entire month to 308 in April, and to a low of 121 in August.

Australia, which faces a similar flu outbreak to the UK, saw very few flu infections this winter. This suggests the UK may dodge a ‘double-whammy’ of coronavirus and the flu

WINTER WAVE OF COVID-19 ‘COULD OVERWHELM 87% OF NHS HOSPITALS’ 

A report published earlier this month warned more than a hundred NHS Trusts may be overwhelmed this winter if the coronavirus hospitalisation rate surges to the level seen in April.

A comparison of the average number of beds needed between December 2019 and February 2020, and the number of beds required for Covid-19 patients in April, at the peak of the pandemic, showed the startling figures.

It revealed that out of the 132 surveyed using data published by the NHS, 115 would be over-capacity should demand rise It showed 115 of the 132 studied would be over-capacity should there be a surge in hospitalisations.

Four of the five NHS trusts that could set to suffer the biggest shortage of beds are in the capital, with one, Walsall Healthcare, based near Birmingham. 

The analysis, carried out by Edge Health and The Guardian, did not include extra capacity provided by Nightingale hospitals or the private sector due to a lack of data.

An NHS England spokesman said the health service is using a £3billion funding boost to ensure it has beds available in private hospitals, and maintain Nightingale hospitals until March 2021. 

New Zealand didn’t see one influenza case since screening began in June. Last year about 57 per cent of samples collected by GPs were positive, The Guardian reported. 

Professor Paul Hunter, an infectious disease expert at the University of East Anglia, told MailOnline Britain ‘almost certainly’ will not see two consecutive waves of flu and coronavirus. 

‘There’s been virtually no influenza around in the southern hemisphere during their flu season this year and the reason for that is obvious,’ he said. ‘The things we’re doing to control Covid are even more effective on influenza.’

Dr Ed Hill, a post-doctoral researcher working on modelling the spread of disease at the University of Warwick, told MailOnline measures to inhibit the spread of coronavirus will also ‘disrupt’ influenza transmission.

Dr Nikita Kanani, medical director for primary care for the NHS in England, said ‘about 32million people’ would be contacted and encouraged to take up their flu jab.

Officials have said they are widening the flu vaccination programme for the UK to reach at least 30million people.  

In the last winter season (2019/20), only 15million of the 25million people eligible for a free vaccination took the offer (60 per cent). 

It suggests if everyone in these groups took up their free jab this year, there would not be enough for additional people, or only some. 

This year people eligible for the flu vaccine include primary school children and Year 7 pupils, who will be offered the flu nasal spray in schools. Two and three-year-olds will be offered the vaccine through their GP. 

Those age 65 and over, people with long-term health conditions and pregnant women will be offered the vaccine through their GP or pharmacy.

Household contacts of people who were instructed to ‘shield’ during the first wave of the pandemic will be invited.

And health and social care workers who have direct contact with the people they care for will be offered the jab.

Once the first at risk groups have been contacted, the vaccine programme will also be rolled out to include people over the age of 50.

It is hoped that a new campaign across TV, radio and digital advertising will encourage those who are eligible to accept their invitation when it is sent out.

Read more at DailyMail.co.uk


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