Preparing for flu season during a pandemic.

For the past couple of months, we have been doing our best to adapt to the changes brought about by COVID-19. From mandatory workplace adjustments to enforced social distancing, the world has entered a new status quo that is gradually becoming our reality. Even so, the incoming end-of-year flu season will bring with it some additional challenges since its overlap with the pandemic could result in renewed pressures on our healthcare system. Influenza, also commonly referred to as the flu, is known to cause approximately 250,000 to 500,000 deaths worldwide each year, with another three to five million people suffering from severe symtoms of flu¹. singapore's annual flu season from December to February² also adds substantial stress to our healthcare system, with it resulting in more than 520,000 outpatient visits, 1,500 hospitalisations, 600 deaths, and 315,000 workdays lost every year³. Combine with the current difficulties of the COVID-19 pandemic, the industry will need all the help it can get in preparation for this challenging period.

Why is the flu so serious?

In anticipation of this, let us stay ahead by equipping ourselves with the knowledge about flu and steps for prevention. For a start, it is worth noting the main characteristics of influenza. This viral disease affects our health by attacking the respiratory tract and causing inflammation in the areas of our nose, throat and lungs. It is similar to COVID-19 in the way it spreads, but with a shorter incubation period of three days as compared to the latter’s interval of four to five days⁴. While the flu may also be confused with the common cold, it is more severe than the latter, and can even be deadly for those who develop life-threatening complications.

Why is it so contagious?

The main reason why the flu is so contagious is because of the airborne nature of its transmission. Much like COVID-19, flu viruses are transmitted through the air via mostly invisible respiratory droplets that we produce every time we breathe. In colder regions, we can see these droplets in the form of a fine mist, but they are still very much present in warmer regions in Singapore, despite being harder to spot. The virus transmission occurs when we breathe in these virus-carrying droplets. Transmission can also happen indirectly when we touch a surface with flu viruses and subsequently touch our nose or mouth. In enclosed areas like our offices where many people are breathing in recirculated air from the air-conditioning, the risk of exposure is even higher. Once infected, a person can continue spreading the flu viruses a full day before getting sick, and up to a week after experiencing symptoms⁵.

What are the symptoms?

Unlike the common cold, influenza typically occurs with a sudden onset of symptoms, such as:

• General feelings of discomfort (otherwise known as malaise)
• Fever
• Headache
• Fatigue
• Muscle aches
• Dry cough
• Nasal discharge or congestion
• Sore throat
• Appetite loss

Amongst more high-risk individuals, more severe complications such as pneumonia, bronchitis, sinusitis, ear infection and meningitis can also develop. However, with the current pandemic and the upcoming flu season, it is curcial for us to be discerning when it comes to our health, as not every symtom will be indicative of either influenza or COVID-19.

Why is it important to be vaccinated?

We have all heard the adage that prevention is the best medicine, and this is certainly the case when it comes to flu – getting the vaccine every year before flu season is fundamentally the best way to avoid contracting it. The concurrent pandemic season is highlighting the importance for us to stay healthy now more than ever before. Keeping our immune system in tip-top shape can reduce our risk of being badly affected by influenza and COVID-19 viruses if we are infected. Vaccinations can also help the attending doctor to make more informed decisions in giving the appropriate treatment should someone come down with Acute Respiratory Infection (ARI) symptoms. Perhaps most importantly, they also keep our loved ones safe by reducing the transmission of flu within close personal groups, especially if they belong in the following high-risk categories:

• Elderly aged 65 years old and above
• Children aged 5 years old and below
• People with low immunity (e.g. undergoing cancer treatment, those with HIV or diabetes)
• Healthcare workers

Individuals in these categories tend to have immune systems that are more easily compromised. In this regard, consistently opting for annual flu vaccines is one of the best ways for them to stay protected while also reducing their risk of developing more severe complications. If you have any questions about getting you and your family vaccinated, be sure to talk to your healthcare provider to get more specific advice that is catered for you. And with the rapidly approaching flu season, it might be better to do so earlier than later.

What are some general tips for prevention?

Beyond the recommended practice of getting vaccinated, we can also do our part in reducing flu transmission by following some good practices:

• Avoid close contact with people who are sick
• Wash your hands often with soap and water for at least 20 seconds, especially after you cough or sneeze
• If soap and water are unavailable, sanitise with an alcohol-based hand sanitiser
• Cover your nose and mouth with a tissue when coughing or sneezing, before disposing of them properly
• Clean objects and surfaces that may be contaminated
• Drink water to stay hydrated
• Open the windows to let air circulate
• Maintain a healthy lifestyle with regular exercise and a balanced diet

Remember to also continue taking additional precautions during this period when the pandemic and flu season overlaps, including:

• Remaining at home as much as possible
• Avoid visiting crowded places
• Social distancing by maintaining at least a distance of six feet between yourself and other people
• Wear a mask in public places
• Avoid touching your eyes, nose, and mouth

By holding ourselves accountable for our health during this challenging period, we can not only keep our loved ones safe but also provide some much-needed help in reducing the pressures on our healthcare system.

How can I treat the flu?

While there are rare cases in which severe complications can occur, the good news is that most people recover from the flu without needing an in-person medical visit. Opting for teleconsultations via our Cigna Virtual Clinic can therefore come in handy for flu recovery. the typical antihistamines and anti-inflammatory medications can be delivered to your doorstep within three hours, while you make use of the valuable time saved for further rest and recuperation. Other than taking medication and getting ample rest, the following tips can also help with recovery:

• Increase your intake of fluids, especially natural teas and juices
• Avoid strenuous physical activities like running and jogging until you are well
• Use decongestants in the form of medicated or saline nasal sprays to help with congestion
• Stay at home to minimise the risk of further exposure to the virus and prevent transmission to others

Over to you

With the coinciding pandemic and flu season, the most important takeaway seems to point to the enormous role that our public health and personal hygiene measures have in preventing infection and keeping us safe. From having basic hygiene and general etiquette to getting flu vaccinations, these somewhat minute actions can have significant impacts in relieving the excess stress on our healthcare systems. After all, the benefits of these precautions go both ways - preventing flu can make the COVID-19 pandemic more manageable, and preventing coronavirus transmission can reduce the occurrence of flu as well⁶. As we continue through the rest of 2020, there will undoubtedly be new challenges to face and bigger obstacles to overcome. While we cannot necessarily control these developments and changes, what we can control is our actions in keeping ourselves as well as our loved ones healthy and safe.

Cigna offers home-based vaccination services that can help make it easier for you to do so. Getting your flu vaccination shots done at home can not only help save time by cutting down on travelling and waiting, it also minimises your risk of exposure to viruses in crowded areas. To get started, simply follow these four easy steps:

1. Go to Cigna Virtual Clinic’s registration page
2. Schedule an appointment
3. We will contact you within 3 working days to schedule your appointment
4. Our mobile medical team will perform the vaccination at your preferred address, date and time

Our booking hours:

• Monday to Friday: 9am - 5pm
• Saturday: 9am - 12pm

Registration period:

• 1 - 31 Oct 2020

*All flu vaccines must be administered between 15 Oct and 31 Dec 2020

Sources:
1. Gan, E. (2017). When flu turns fatal. TODAYonline.
2. HealthHub. (2019). Influenza.
3. Ng, T. P., Pwee, K. H., Niti, M., & Goh, L. G. (2002). Influenza in Singapore: assessing the burden of illness in the community.
4. World Health Organisation. (2020). Q&A: Influenza and COVID-19 - similarities and differences.
5. Knowles, K. (2019). The Flu is More Contagious Than You Think. DispatchHealth.
6. McKenna, M. (2020). Flu Season and Covid-19 Are About to Collide. Now What?. Wired.