It is unclear if there will be an increase in influenza cases this year, but we should be prepared if influenza is more prominent than expected and a so-called ‘twindemic’ ensues.

Dr. Paul Skolnik, Chairman of the Department of Internal Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine and an infectious diseases specialist, says that the decreased use of masks in many areas of the U.S. could result in more cases of influenza. If this happens in the setting of ongoing transmission of SARS-CoV‑2, the virus that causes COVID‑19, our hospitals could see additional surges in admissions.

“The low level of influenza transmission rates last year is thought to have mostly been due to the high level of mask usage, distancing, and hand-washing,” says Skolnik.  

Dr. Skolnik explains that many symptoms of influenza and COVID‑19 are similar—cough, fever, muscle aches, joint pains, and headache. In severe cases there may be shortness of breath. Loss of taste and smell are unique to COVID‑19, but do not occur in every case.

“The best way to differentiate between the two infections is to be tested for each. It’s also important that individuals get the influenza vaccine in addition to COVID‑19 vaccination, which may be either the initial series or boosters for COVID‑19, to protect them against both infections. These vaccinations can be administered simultaneously or in any order.”

Wear masks, practice distancing, and practice good handwashing—the same mitigation strategies that protect against COVID‑19 will protect against influenza,” says Skolnik.

Dr. Skolnik says that people with influenza will generally have symptoms; people with COVID‑19 may be symptomatic or asymptomatic. If there is concern for either infection, he encourages individuals to see their doctor and get tested for COVID‑19 throughout the year and for influenza during the fall and winter months.

“You want to be in contact with your doctor if you have any symptoms consistent with either COVID-19 or influenza since there are effective treatments for both infections if you are treated early after symptom onset,” says Skolnik. “For COVID‑19, monoclonal antibodies are helpful, especially if given within 5 days of symptom onset, and for influenza, oseltamivir or zanamivir are helpful, especially if given within 48 hours of symptom onset.”

About Skolnik
Paul Skolnik, M.D., is the chairman of the Department of Internal Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine and an infectious diseases specialist. Skolnik has more than 30 years of experience in medicine across all fields of patient care, education, and research. His expertise in infectious diseases makes him uniquely qualified to serve as one of Virginia Tech and Carilion’s voices of facts, not fear, in speaking to patients, communities and the greater public since the beginning of the COVID-19 pandemic and during the current rollout of vaccines.

To schedule an interview, please contact Shannon Andrea in the media relations office at or 703-399-9494. 

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