Living Well

How to Make it Through This Year's Flu Season Safely

Doc's note: "Doc, when should I get the flu shot?"

"What's going to happen this flu season thanks to the coronavirus?"

Over the past week, I've gotten dozens of questions from readers who are worried about this year's flu season.

So Health & Wealth Bulletin Managing Editor Laura Bente recently spoke with my friend Dr. Param Dedhia to ask him your questions.

Longtime readers know our guest-writer Param... He's a physician trained at Johns Hopkins who practices both modern and traditional medicine. He serves as the Weight Loss program leader and the director of Sleep Medicine at Canyon Ranch, a wellness retreat in Tucson, Arizona. He's board-certified in sleep medicine, internal medicine, and obesity medicine. He also did a fellowship in geriatrics and is currently in fellowship training in integrative medicine. He's just the sort of common-sense doctor we need to hear from during these trying times.

During their chat, Param talked about how this year's flu season will be different, when you should get your flu shot, and his tip for getting the most out of your flu vaccine. (Edited for length and clarity.)

Laura Bente: Hi Param. Thanks for taking the time to talk to me today.

Dr. Param Dedhia: Thank you, Laura.

Laura: Lots of folks are worried about this year's flu season, especially with the added worry from COVID-19. Do you think this year's flu season will be different from previous years and will COVID have an impact?

Dr. Dedhia: First and foremost, if you were to ask me this three to six months ago, I would have thought, "If we're going to be doing more physical distancing, if we're going to be doing more handwashing, and more people using masks in a public place, this could potentially lead to lower transmission of the flu compared to other seasons." So, if anything, I thought to myself, "Wait. This could actually be a benefit." Then obviously you wonder if people still have the tolerance to do these things because they're fatigued from the distancing... the handwashing... the mask use.

So that's my first thought. These are the best things we can do to decrease transmission of the flu virus. Everything's been focused on COVID, but what's good for COVID could also be very good for the flu.

Laura: So as we go into flu season, you'd recommend people continue social distancing and wearing face masks when in public?

Dr. Dedhia: Absolutely. This is one of the greatest challenges in terms of the transmission of the flu – it's very similar to COVID. There's no need to reinvent the wheel. Fatigue aside, it's one of the better things we can all do.

Laura: One of the questions I've seen a lot of people ask this year is, "When is the best time to get a flu shot?"

Dr. Dedhia: Traditionally, we've told people to get their flu shot during October. This year, I've told people, "Don't worry. Just go get it done now with everything going on." It's going to be really tough to tell flu symptoms from COVID symptoms. To me, COVID is the here and now, and the numbers are still high in terms of transmission. So there's no need to wait... Go ahead and get the flu shot now.

There are going to be some discussions on whether people should get a booster or not, but that aside, the sooner the better. We do not want to have to debate whether a patient has COVID or the flu. It's going to happen anyways. But the sooner you can get the flu shot, do it.

The most typical comment I get on the flu shot is that it doesn't work anymore. But we know that the flu shot decreases the severity of the flu if you catch it.

Laura: So you're saying that even if the flu shot I got doesn't prevent the particular strain of the flu we could see this season, it decreases the severity of the symptoms from other strains?

Dr. Dedhia: Exactly.

And you know, we keep forgetting – and somehow tolerate – the number of deaths per year due to the flu. The flu is no joke. If we go back through history, it was something to be feared. There's no question that the sooner you get your flu shot, the better, knowing that it can reduce the severity of the flu, and it will make it a lot easier if we were to see a patient and had to debate if it's COVID versus the flu.

Laura: You've brought up a couple times this debate on whether someone has the flu or COVID. Will it be difficult to tell the difference between the two?

Dr. Dedhia: It is going to be difficult. If you take a look at the medical journals I get – and I'm not pretending I've read them very carefully – or the e-mails we are getting, and they're saying what to do during this COVID time. There's a lot of discussion among the medical community on how to prepare for the two viruses that are going to be coming this season and the fact that they're going to overlap. It's going to be really difficult for a lot of people to differentiate between COVID and the flu.

And this is the part that's frustrating for a lot of people... Why can't we get clear information up front? We didn't know everything about COVID up front. We've been spoiled with the flu. We've had textbooks written and we've had years to learn about it. We've had to learn about COVID on the fly. And it's been one of the most difficult things... and humbling.

I don't blame people for wanting to know everything up front. But with COVID, we just don't.

Laura: What about travel? Should we consider avoiding travel this year?

Dr. Dedhia: The greatest risk is when somebody has to go through an airport. There are ways in which people can take all of the precautions and really heighten their awareness while going through an airport before they get on a plane. Those are the things that we can take a look at because we need to appreciate that there is a fatigue from all the precautions.

What I can say is to just take the highest number of precautions, especially those who are at higher risk. Higher risk means higher precautions. And think about where you're going. I'm of Asian descent and I'm very connected with my parents. We're under one roof since last year. So I've cut down on my travel. Why? Because I come home to Mom and Dad and I'm part of their caregiving. If I'm going to care for them, I have to do everything I can to take precautions.

It's all a matter of risk to yourself and your loved ones. I have a lot of friends and colleagues who are flying. But for a person like me, it's not the best thing because ultimately, I'm coming back home to my parents who are high-risk, exposing them to that comorbidity.

Laura: So, we should still be taking precautions as we've done for months with COVID... with things you've already mentioned like wearing masks, washing our hands, and socially distancing. What else can we do to prepare for flu season?

Dr. Dedhia: You and your readers already know about the importance of sleep. When you sleep better, you have a better immune system. But here's the other thing... There's research showing that when people get better sleep on the day they get a vaccine, they get a better vaccine response. If you want to get the very best experience out of vaccine, get your sleep that night. Obviously, with not sleeping well or pulling an all-nighter, you get the worst vaccine response.

Now, I don't mean a perfect night of sleep. I just don't want someone burning the midnight oil or getting your shot on a day when you know you're going to have a difficult night. I don't want people to worry about being perfect. Just make sure to wind down earlier than usual, so you can rest well that night.

Editor's note: Look out for part two of my interview with Param next week where he details the three things you need to do to protect yourself this flu season. I've spent years writing about the flu, and I'll admit, they surprised me. And I've personally already started following his advice.

So keep an eye on your inbox for me next week. In the meantime, if you have questions, send them our way at [email protected].

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Here's to our health, wealth, and a great retirement,

Dr. David Eifrig with Laura Bente
October 1, 2020