Is the Coronavirus Disease More Severe Than the Flu?

Coronavirus disease (COVID-19) is much worse than the flu because there is no immunity, the death rate and rate of severe respiratory complications is much higher, it's far more infectious and no human population has any significant level of immunity to the virus.

Coronavirus disease (COVID-19) is much worse than the flu because there is no immunity, the death rate and rate of severe respiratory complications is much higher, it's far more infectious and no human population has any significant level of immunity to the virus.

Coronavirus disease (COVID-19) is a novel (new) coronavirus, not previously identified in humans, responsible for an outbreak of respiratory illness that became a global pandemic in 2020. COVID-19 is different from other coronaviruses that cause mild illness, such as the common cold.

The flu (influenza) is a respiratory illness caused by influenza viruses. 

While there are some similarities between the coronavirus disease (COVID-19) and influenza, overall coronavirus disease is a much more serious illness for several reasons:

• Coronavirus disease is more infections than the flu
• Coronavirus disease has a higher death rate than the flu
• Coronavirus disease has a higher rate of serious illness that requires hospitalization than the flu
• There is currently no vaccine for coronavirus disease
• There is currently no significant community immunity to COVID-19

The most common early symptoms of the coronavirus disease (COVID-19) appear about 2 to 14 days after exposure and include:

• Shortness of breath
• Cough
• Loss of small and/or taste
• Headache
• Feeling unwell (malaise)
• Fever or chills

Emergency warning signs that require immediate medical attention (call 9-1-1 or go to a hospital’s emergency department): 

• Difficulty breathing
• Bluish lips or face
• Persistent pain or pressure in the chest
• New confusion or inability to arouse

Less common symptoms of COVID-19 may include: 

• Fatigue
• Severe headache
• Diarrhea
• Body and muscle aches
• Nausea
• Vomiting
• Feeling unwell 
• Loss of appetite
• Sore throat
• Congestion
• Runny nose

Symptoms of the flu tend to come on suddenly, and may include: 

• Fever (not everyone has a fever) 
• Chills
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle or body aches
• Headaches
• Fatigue 
• Vomiting and diarrhea (more common in children)

Both coronavirus disease (COVID-19) and influenza (the flu) are caused by viruses transmitted from person-to-person through respiratory droplets thrust into the air when an infected person coughs or sneezes. 

Less commonly, COVID-19 or the flu is transmitted when a person touches a surface or object that has the virus on it, and then touches their mouth, nose, or eyes.

If coronavirus disease (COVID-19) is suspected, a long swab is used to take a sample from the nose or throat to test for the virus, which is then sent to a lab for testing to diagnose the illness. Some tests are rapid and results are available within a few hours. Other tests may take several days to receive results. 

An antibody test can determine if a person had a past coronavirus disease (COVID-19) infection. This test is not used to diagnose current infections, because it can take up to 3 weeks following infection for the body to produce antibodies to the virus. When a person has antibodies to COVID-19 they may have some protection against re-infection, but scientists do not yet know how much protection antibodies provide or for how long any protections might last. 

Influenza (the flu) is usually diagnosed with rapid influenza diagnostic tests (RIDTs) that can provide results in about 15 minutes. These are less accurate than other flu tests called rapid molecular assays that detect genetic material of the virus and provide results in about 15-20 minutes. Other specialized flu tests that use a long swab to swipe the inside of the nose or the back of the throat may be used in hospitals or state public health laboratories. The samples are sent to a lab for testing and results may take several hours.

There is no specific treatment for coronavirus disease (COVID-19), and supportive care is aimed at relieving symptoms in mild cases. 

Patients with mild illness are usually advised to remain home and self-isolate for 14 days to avoid spreading the virus. Treatments for mild coronavirus disease (COVID-19) symptoms include:

• Pain relievers 
• Cough suppressants
• Rest
• Adequate fluid intake

For more severe coronavirus disease illness, patients may require hospitalization. Treatments may include:

• Antiviral therapy with remdesivir 
• Corticosteroids 
  • Dexamethasone is preferred
  • Prednisone, methylprednisolone, or hydrocortisone may be used if dexamethasone is not available 
• Immunotherapy 
  • Convalescent plasma
  • Immunoglobulin products
  • Interleukin inhibitors
  • Interferons
  • Kinase inhibitors
• Antithrombotic therapy: anticoagulants and antiplatelet therapy 
• High-flow nasal cannula (HFNC) oxygen 
• Ventilation 

Current guidelines neither recommend nor advise against the use of vitamin C, vitamin D, or zinc for coronavirus disease (COVID-19). Zinc should not be taken in doses above the recommended daily allowance (RDA) due to the risk of toxicity. 

Hydroxychloroquine has been touted as a possible treatment for coronavirus disease (COVID-19), but studies to date have shown it to be ineffective with a high risk of fatal heart arrythmias, and it is not recommended. 

Antiviral medications may be used to treat the flu. These medications work best when taken within 48 hours of the onset of flu symptoms. They work to lessen the severity and duration of the illness. Antiviral flu medicines include: 

• Oseltamivir phosphate (Tamiflu)
• Zanamivir (Relenza)
• Peramivir (Rapivab) 
• Baloxavir marboxil (Xofluza)

Many people who have the flu do not require medical treatment. Rest, adequate hydration, and over-the-counter (OTC) pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be used. Do not give aspirin to children, due to the risk of Reye’s disease. 

Doctors and researchers are still learning about the effects of coronavirus disease (COVID-19) on the body. Lingering complications of the illness are being discovered well after patients have recovered. Known coronavirus disease (COVID-19) complications include:

• Acute respiratory failure
• Acute respiratory distress syndrome (ARDS)
• Pneumonia 
• Heart problems
• Liver injury
• Kidney injury
• Abnormal blood clotting
• Severe secondary infections

Complications of the flu include: 

• Pneumonia, which can be life-threatening and result in death
• Sinus and ear infections 
• Inflammation of the heart (myocarditis), brain (encephalitis) or muscle (myositis, rhabdomyolysis) tissues
• Multi-organ failure (for example, respiratory and kidney failure)
• Sepsis, a life-threatening response to infection
• Worsening of chronic medical problems such as asthma or heart disease 

To protect yourself from getting both coronavirus disease (COVID-19) and the flu:

• Wash hands frequently with soap and water for at least 20 seconds. 
• If soap and water are not available, use hand sanitizer with at least 60% alcohol and use a sufficient amount to rub in for 20 seconds.
• Do not touch your mouth, nose, or eyes with unwashed hands.
• Avoid close contact with anyone who has been diagnosed with COVID-19 or the flu. 
• If there is an outbreak in your community, stay at home and limit close contact with others. 

Additional steps to protect yourself from getting coronavirus disease (COVID-19):

• Maintain a distance of at least 6 feet from other people. 
• Wear a face mask when out in public. 

To prevent transmission of viral illness, in general:

• Stay home if you’re sick, unless you need medical care. 
• Wear a face mask around other people if you are sick. 
• Cover your mouth and nose with a tissue or the inside of your elbow when you cough or sneeze. Discard used tissues. Immediately wash hands with soap and water for at least 20 seconds or use a hand sanitizer with at least 60% alcohol if soap and water is not available. 
• Clean and disinfect frequently touched surfaces daily. This includes countertops, doorknobs, handles, tables, light switches, phones, keyboards, toilets, faucets, and sinks. Use EPA-registered household disinfectants.

The main way to prevent influenza (the flu) is to get vaccinated every year.