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Influenza in the COVID-19 Era

Educational Objective
To understand the risks of a concurrent influenza and COVID-19 epidemic
1 Credit CME

The annual influenza epidemic substantially affects health care systems worldwide and has resulted in an estimated 12 000 to 61 000 deaths annually since 2010 just in the US.1 The extent of the morbidity and mortality in any given year reflects the degree of genetic drift or shift in the dominant strain of the influenza virus and the efficacy and coverage of vaccination. With the coronavirus disease 2019 (COVID-19) pandemic, clinicians face a second respiratory virus associated with morbidity and mortality several-fold higher than that of influenza, in part due to its spread in an immunologically naive population. A looming threat of concurrent influenza and COVID-19 epidemics is a major concern for public health officials and clinicians.

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Article Information

Corresponding Author: Daniel A. Solomon, MD, Division of Infectious Diseases, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115 (dasolomon@bwh.harvard.edu).

Published Online: August 14, 2020. doi:10.1001/jama.2020.14661

Conflict of Interest Disclosures: None reported.

References
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Wilson  N , Kvalsvig  A , Barnard  LT , Baker  MG .  Case-fatality risk estimates for COVID-19 calculated by using a lag time for fatality.   Emerg Infect Dis. 2020;26(6):1339-1441. doi:10.3201/eid2606.200320 PubMedGoogle ScholarCrossref
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Cowling  BJ , Ali  ST , Ng  TWY ,  et al.  Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong.   Lancet Public Health. 2020;5(5):e279-e288. doi:10.1016/S2468-2667(20)30090-6 PubMedGoogle ScholarCrossref
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Sakamoto  H , Ishikane  M , Ueda  P .  Seasonal influenza activity during the SARS-CoV-2 outbreak in Japan.   JAMA. 2020;323(19):1969-1971. PubMedGoogle ScholarCrossref
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Kim  D , Quinn  J , Pinsky  B ,  et al.  Rates of co-infection between SARS-CoV-2 and other respiratory pathogens.   JAMA. 2020;323(20):2085-2086. PubMedGoogle ScholarCrossref
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Worby  CJ , Chaves  SS , Wallinga  J ,  et al.  On the relative role of different age groups in influenza epidemics.   Epidemics. 2015;13:10-16. PubMedGoogle ScholarCrossref
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Li  X , Xu  W , Dozier  M ,  et al.  The role of children in transmission of SARS-CoV-2.   J Glob Health. 2020;10(1):011101. doi:10.7189/jogh.10.011101 PubMedGoogle Scholar
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