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The latest news about the novel coronavirus and COVID-19 in Montana.

‘Twindemic’: Health workers warn of the combined threats of flu and COVID

An illustration of an influenza virus
Centers for Disease Control and Prevention
An illustration of an influenza virus

Flu season is here, and health officials say it could be one marked by both influenza and COVID-19, further stressing Montana's already strained health care system. A word has already been coined for that potential viral convergence: “Twindemic

Holly Sienkiewicz is one of two school nurses serving the Livingston, Montana School District.

“We’re pretty overwhelmed. We’ve had roughly 15 new cases of COVID in the past week and at the high school about 19 in the past week and we just couldn’t keep up,” she says.

Along with their other duties, school nurses conduct various screening services and treat all kinds of playground bumps and bruises.

Sienkiewicz says the schools have been overwhelmed with COVID cases entering the fall flu season. Kids are already starting to come down with other viruses.

“At the beginning of this year, some viral bug went rapidly through our kids. We have never actually seen that many sick kids at the start of a school year. This year was incredible. We did a lot of COVID testing. It wasn’t COVID, so it was something else.”

Livingston middle and high schools recently shifted to remote learning due to the mounting number of local COVID-19 cases.

“Yes, you absolutely could get them [COVID and influenza] at the same time,” says Susan Reeser, a nurse consultant for the state health department’s immunization program. “It would be really hard on a body.”

The district has also diagnosed a handful of RSV, or Respiratory Syncytial Virus, in some of the younger kids. RSV is a common childhood illness which can also infect adults.

But Sinkiewicz says RSV combined with COVID could be particularly dangerous. She also worries about this emerging flu season’s impact on hospitals already stressed with COVID cases.

Health officials anticipate the United States will see both COVID-19 and influenza cases this winter, sometimes simultaneously infecting patients.

“Yes, you absolutely could get them at the same time,” says Susan Reeser, a nurse consultant for the state health department’s immunization program. “It would be really hard on a body.”

The Centers for Disease Control and Prevention says last year’s flu season was unusually quiet.

So quiet in Montana that “we did not have any documented cases of influenza last year in Montana,” Reeser says “And it wasn’t that we weren’t testing for them – we were testing – we just did not have any.”

Montana health officials attribute influenza’s no-show last year to the public health policies implemented during the early days of the COVID pandemic: masking mandates, widespread social distancing as well as limited traveling and working from home.

Earlier this year Gov. Greg Gianforte rescinded Montana’s mask mandate, distancing is not as common as it was and people are gathering in ever-larger crowds.

"You can receive your flu shot either on the same day with your COVID booster or with your first or second COVID shot or at any time in between,” says Susan Reeser, a nurse consultant for the state health department’s immunization program.

How this bodes for this flu season isn’t yet known, but Kallie Kujawa of Bozeman Health Deaconess says that hospital is already seeing an uptick in respiratory-related illness compared to this time last year.

“We’re finding other types of illness in the community besides COVID-19 that is causing respiratory illness: para-influenza and other types of viruses, earlier – much earlier this year — than we typically see and from what we saw last year.”

Influenza testing is underway in Montana, and as of the time this story was published, there are no confirmed flu cases.

According to the CDC, COVID-19 and the flu have similar, but varying degrees of symptoms. They range from no symptoms, to fever, fatigue, sore throat and body aches. Testing is required to confirm a diagnosis.

The state health department’s Susan Reeser says 48 percent of adult Montanas got vaccinated against the flu last year. She says the flu shot, like COVID vaccines, prevent or lessen the impact of the virus.

“Yes, you can receive your flu shot either on the same day with your COVID booster or with your first or second COVID shot or at any time in between. They have determined that you do not need to wait any amount of time.”

The same guidelines to help protect against COVID apply to influenza: avoid close contacts, stay home when sick, wash your hands and avoid touching your eyes, nose and mouth.

Influenza season typically runs its course through early spring.

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