Flu and Covid-19 at same time significantly increases risk of death

UK scientists warn co-infection is ‘serious trouble’ and urge those at risk to get flu vaccine

Having flu and Covid-19 together significantly increases your risk of death, say government scientists who are urging all those at risk of getting or transmitting flu to get the vaccine in the coming weeks and months.

The evidence for the double whammy is currently limited and comes mostly from a study with small numbers – 58 people – carried out in the UK during the early phase of the pandemic.

“As I understand it, it’s 43% of those with co-infection died compared with 26.9% of those who tested positive for Covid only,” said England’s deputy chief medical officer, Prof Jonathan Van-Tam. These were people who had been hospitalised and had been tested for both viruses, he said, and so were very ill – but the rate of death from Covid alone in the study between January and April was similar to the known rate of Covid hospital mortality generally of around 25% or 26%.

“I think it is the relative difference in size of those rates that’s rather more important than the absolute rate,” he said. The study may have been small and they would be doing further studies this season, but the findings tallied with other work that has been done, he said.

Flu and other respiratory viruses would be circulating this winter, said Prof Yvonne Doyle, medical director of Public Health England, and flu kills between 4,000 and 22,000 people every year – last year the death toll was 8,000.

“The last thing you really want to have is flu. And if you do think you have either flu or Covid stay at home and self-isolate that’s to protect yourself – you’d be feeling very miserable – but also to protect others,” said Doyle.

There was some evidence that flu and other viruses compete with each other. In the co-infection study, those who had flu were less likely to get Covid. But this is not the year to see which prevails, said Doyle.

“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. So please protect yourself against flu, this year.”

The government has bought 30,000,000 doses of flu vaccine, which is more than ever before. They will arrive in batches, so the elderly – over 65 – and those with medical conditions will be called for immunisation first. Relatives of those who are on the shielding list will also be called up. The letters will begin to go out this week.

Because of the threat of Covid and the risk that people with flu could be infected if admitted to hospital, all those aged 50-64 will be offered flu vaccination, but not straight away. They should wait to be called by their GP.

Children aged two and three, plus all primary school children and those in year seven, the first year of secondary schools, will be offered vaccination to protect the older people in their family. Officials hope that all health and social care workers will be vaccinated this year – last year 74.3% took up the offer. Only 44.9% of “at risk” groups had a flu vaccination last year. It is hoped to get that up to 75% this year.

• This article was amended on 22 September 2020 to correct the number of flu vaccine doses bought by the government from 30,000 to 30,000,000.


Sarah Boseley Health editor

The GuardianTramp

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