Local

Q&A with Dr. Kravec | Differentiating flu, cold and COVID-19 will be ‘very difficult’

By Jess Hardin

September 15, 2020 3:52 AM

YOUNGSTOWN — During last Thursday's state news briefing, Gov. Mike DeWine, First Lady Fran DeWine and Lt. Gov. Jon Husted all pulled up their sleeves and received their annual flu shots.

Medical experts agree: getting the flu shot this year is more important than ever.

"While the flu can be deadly on its own, we also are concerned that Ohioans who get both the flu and COVID-19 at the same time could become severely, if not fatally, ill," said DeWine.

The Centers for Disease Control and Prevention recommend that everyone 6 months and older receive a flu shot annually.

Mahoning Matters caught up with Mercy Health Youngstown's Chief Clinical Officer Dr. Jim Kravec to discuss how best to prepare for the upcoming colder months.

Mahoning Matters: As we head into flu season, how are we going to be able to tell the difference between flu symptoms, cold symptoms, allergy symptoms and COVID-19 symptoms?

Dr. Jim Kravec: I think this year is going to be much more challenging than any in the past. Allergy symptoms, flu symptoms, COVID symptoms, common cold symptoms can overlap tremendously, and it's going to be very difficult to know this year. So I think what we're going to find is that we're going to have to err on the side of caution rather than assume that it might be allergies like it always is this time of year.

I think, at least looking specifically at COVID-19, shortness of breath and fever are very common, but we know there's so many other symptoms. If you look at flu, fever, cough, shortness of breath, there could be some muscle aches, which can be seen in COVID as well. There could be gastrointestinal symptoms, which can be seen in COVID as well. So it's very challenging. In the past, the symptoms were more telling, but now the overlap is so much that it's going to be very difficult to know which virus or allergy symptom it is.

I've seen tables that are published, and I'm sure others are seeing those as well as the list of common cold, flu and coronavirus. Some have more of one type of symptom than the other type of symptom, but the overlap is almost 100 percent. And so it's very challenging to know just by symptoms.

MM: With symptoms being so similar and people being instructed to stay home if they're experiencing COVID-19 symptoms, when should people stay home? When should parents keep their kids home?

JK: There are some practical tips that I would like to share — what I tend to do with my own kids. We know they're getting their temperature checked when they go to school. So buy one of those thermometers that they use at school. You can find them at the drugstore. And take their temperature when they're home because if they're high at home, they're probably going to high at school and they're going to sent the student right home, as they should. So, I would recommend that we do take temperatures at home before going to school.

Now that said, [parents] also need to keep kids home if they have a cough, sore throat, muscle aches and other symptoms as well. Fever is not the only symptom with flu or coronavirus, nor is it present in everybody. You certainly can have flu without fever or have coronavirus without fever.

Symptom check and temperature check is really what I think parents can do in a very practical way prior leaving the house with your children and really for yourself

In the past, I know people would send their kids to school when they ad cough or cold symptoms or go to work if they have cough or cold symptoms. But, I think in this day and age, we can't do that and shouldn't do that, because it could really protect or hurt the entire population.

So I think that's really where my thoughts are. Stay home when you're sick. Take your temperature. Cover your cough if you have one. Wash your hands. Socially distance. Those are really some of the areas that will be most important to not spread common cold, flu or the coronavirus.

MM: What is the threshold for a temperature?

JK: 100.4 degrees is considered a temperature, and schools will probably use that.

MM: How should people socialize when the weather turns and we're no longer able to gather outside?

JK: Many people eat outside on the patio. Many people have gatherings outside. And so, as it gets cold, people want to be more inside. So I think as you are inside with people that are not folks who live in your house, do the best you can if you have to do that if you choose to do that. Meaning, try to socially distance in the house. You can still keep hand sanitizer. Don't go visit someone when you have any symptoms. I think those are really the most common set of things we can do to still be able to go about our lives. It's going to be challenging to not go about our lives.

MM: Why is it important that people get the flu shot this year?

JK: The flu shot is always important. Every fall, the CDC recommends on or about Oct. 1 to get the flu shot. And really the main reason is to protect that person from getting influenza, which for most people is self-limited. But for some people, it's very serious and there are a large number of deaths every year from influenza.

The flu is not as contagious as the coronavirus, and depending on the numbers we see, it may or may not be as high mortality, but there is still a decent mortality rate with influenza, so that's why really we need to get the flu vaccine. It reduces the spread to other people and it reduces the risk of severe infection for the person that gets the shot.

And it is possible to have both [the flu and COVID-19] ... They are two different viruses, and you can have both. We have a vaccine for flu, and we would definitely recommend that everyone get the flu vaccine.

MM: As the seasons start to change, what are your biggest concerns regarding the pandemic?

JK: I think my biggest concern is kind of what you talked about: as people come back indoors, what is going to be the outcome?

Everyone's doing a great job. During the quarantine times, everyone initially buckled down and stayed at home by themselves. Then we were able to get outside. It's really important to do that. It's good for business that could open again. It's really important for people to get their health care. It's really important for people to have good mental health.

So I think the good news is by doing that this summer, we didn't see a big spike up. The hospitals have capacity, mortality numbers have dropped and people are wearing masks and socially distancing when possible. So I think it's got to be both, not one or the other. And so as we go into the fall, I'm concerned about what it will be like when people head back indoors. I still would hope that our businesses can stay open, sporting events for the kids can happen, kids can stay in school and activities can happen, but still maintain the safety that they've been doing during the summer

MM: Is there anything else you're thinking about as we head into flu season?

JK: I'm hopeful of the flu season, meaning as long as people get their flu shots, and we continue to maintain social distancing, mask-wearing, staying home when you're sick, there's a chance that we will have a better flu season than in the past because people are behaving differently. So I think the vast majority of people are doing a great job in the community as far as masks and social distancing. We still can go about our business, business reopening, and school reopening, which is super important as well.

———

To learn more about virus response in Mahoning County and at Mercy Health, check out Mahoning Matters' previous Q&As with Dr. Kravec:

This story was originally published September 15, 2020 at 3:52 AM with the headline "Q&A with Dr. Kravec | Differentiating flu, cold and COVID-19 will be ‘very difficult’."