A masked nurse gives a patient a flu shot.

The Nurse’s Role in Preparing Patients for Flu Season During a Pandemic


Nurses play a vital role in educating the public about ways to stay healthy. Rarely has the task been more important—or more difficult—than now as the COVID-19 pandemic rages through the annual flu season. As many symptoms of the flu and coronavirus overlap, health care professionals struggle to distinguish between the two illnesses without relying on laboratory test results. Besides, nurses must protect their health while providing their patients with the information and resources required to stay safe.

The prevention strategies that nurses teach their patients to protect them from the flu and coronavirus also overlap. Practicing social distancing, washing hands frequently, and wearing proper masks in public are only a few techniques that help keep people safe from both illnesses. By teaching skills for avoiding the flu and COVID-19, nurses help save patients’ lives.

When Is Flu Season?

Although present in the environment year-round, the influenza virus is most prevalent in the fall and winter, the CDC explains. In the U.S., the incidence of flu usually begins to increase in October, then peaks between December and February, although cases are often reported as late as May.

Nurses must be ready to prepare patients for the flu season at any time of year as the characteristics of the flu vary across different parts of the world. The World Health Organization (WHO) identifies typical geographic patterns of the flu:

  • In the northern temperate zone, the flu occurs primarily from November to April.
  • In the southern temperate zone, the flu peaks from April to September.
  • In tropical zones, the rate of flu cases is steady throughout the year rather than seasonal.

The WHO notes that in a typical flu season, between 5% and 10% of adults and 20% and 30% of children worldwide will contract the virus. However, the CDC reports that flu cases have been lower than average in late 2020. For the week ending November 14, 2020, 1.5% of people visiting their health care providers reported flu-like illness compared to the 2020-2021 national baseline of 2.6%.

The COVID-19 pandemic makes protection against the flu even more important than in past years. The CDC notes that people can be infected with the flu and COVID-19 at the same time, although how often this occurs is uncertain. Both illnesses strike the respiratory system, so a person weakened by the flu may be more susceptible to a serious or deadly case of COVID-19.

Flu vaccinations prevented an estimated 4.4 million cases of the flu and 3,500 deaths in the U.S. in the 2019-2020 season, according to Kaiser Permanente. Annual vaccinations also avoided an estimated 2.3 million medical visits and 58,000 hospitalizations. As treating COVID-19 patients stretches health care resources beyond their limits, flu vaccinations reduce the number of people infected with the flu virus, which allows care providers to focus scarce medical resources on saving pandemic victims’ lives rather than on treating people suffering from the flu.

Why Is There a Flu Season?

The reason why there is a flu season is the temperature variation that defines temperate zones:

  • Airborne infectious diseases, such as the influenza virus, thrive in cool, dry climates that occur in the winter seasons of the Northern and Southern hemispheres, December to March and June to September, respectively.
  • The virus needs to survive long enough in the air to move from one person to another. The news magazine Insider explains that a gel-like lipid coating protects the virus in cold temperatures. This extends the life of the virus and makes it more likely to infect someone.
  • When the temperature rises, the virus’s lipid coating dissolves. If this happens outside the body, the virus is likely to be destroyed before it can find a new host.
  • When the virus’s protective coating dissolves inside the body, the virus begins to replicate to a potentially devastating effect.

Flu seasons differ by region. The WHO notes that in tropical regions, influenza outbreaks occur most often in the rainy season. However, the flu affects people year-round causing infections, hospitalizations, and even death, according to the CDC. Healthline points out that precautions people are taking to prevent the spread of COVID-19, such as practicing social distancing and wearing masks in public, have reduced interseasonal flu activity early in the 2020-2021 season.

Health care professionals remain concerned about the prospects of a “twindemic” of COVID-19 and flu infections once the season progresses. Science magazine reports that a rise in patients presenting with flu-like symptoms would further strain health resources that are already stretched to the breaking point due to COVID-19. Health care providers would have to rule out COVID-19 by testing patients infected with the flu, which would further delay test results for people who may be infected with COVID-19.

Scientists studying the interaction of flu viruses with coronaviruses detected a possibility that having either COVID-19 or a respiratory syncytial virus (RSV), which is a seasonal pathogen similar to influenza, makes a person more susceptible to the other virus. Researchers have not yet collected enough data about COVID-19 and other respiratory infections to understand how they may interact or affect treatment decisions.

Flu Symptoms vs. Coronavirus Symptoms

The flu and COVID-19 are both contagious respiratory illnesses. People infected by either illness present many of the same symptoms, which makes it difficult for health care professionals to distinguish flu symptoms from COVID-19 symptoms. Nurses play a primary role in helping their patients determine the difference between flu and coronavirus symptoms and providing guidance when patients exhibit symptoms that these illnesses share. By educating patients, nurses can prevent people from panicking and thinking they have the coronavirus.

The CDC lists the symptoms that the flu and COVID-19 share:

  • Fever and chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Sore throat
  • Nasal congestion or runny nose
  • Body aches and muscle pain
  • Headaches
  • Vomiting and diarrhea (occur mostly in children)

Among the COVID-19 symptoms that appear much less frequently or not at all in flu patients are:

  • Loss of taste and smell
  • Persistent chest pain or pressure
  • New confusion (distinguished from people who experienced confusion before infected)
  • Insomnia
  • Bluish lips or a blue tint to the face

While the CDC notes that much remains to be learned about COVID-19 and the coronavirus that causes it, the following key differences between COVID-19 and the flu have been identified:

  • The coronavirus that causes COVID-19 appears to spread from person to person much more easily than the seasonal influenza virus.
  • The COVID-19 symptoms take longer to appear in patients than flu symptoms.
  • People infected with the flu are most contagious during the three to four days after symptoms first appear; but, they may spread the virus from the day before symptoms arise up to seven days after becoming symptomatic. Children and people with compromised immune systems may continue to spread the flu virus for more than seven days after falling ill.
  • Most people infected with the coronavirus develop symptoms five days after the initial infection, although symptoms may arise as early as two days after infection. People infected with the COVID-19 may remain contagious for up to 14 days after the initial infection. However, the period when people infected with the COVID-19 appear to be most contagious is from two days before symptoms develop to five days after they occur reports The New York Times.
  • Flu vaccines are readily available, but COVID-19 vaccines are not expected to be widely available in the U.S. until the second quarter of 2021 at the earliest.

Flu Season Safety Tips for Keeping Nurses and Their Patients Healthy

Nurses are remotely connecting with patients through telehealth, electronic health records, and other technologies to communicate effective COVID-19 and flu season safety tips. Many health information resources are available to help nurses and other health professionals work with patients to devise individualized strategies aligned to their age, health status, and potential risk factors.

Nurses must focus first on protecting themselves from infection and potentially becoming a locus for spreading the coronavirus or the flu virus to their patients. The CDC has updated its guidelines for preventing the spread of the flu virus in health care settings in light of the added precautions required to combat the coronavirus:

  • Caregivers and contacts of people with suppressed immune systems should receive any age-appropriate flu vaccination.
  • Health care providers and visitors should avoid caring for severely immunosuppressed people for seven days after receiving certain flu vaccinations.

The health and lifestyle site The Doctor Weighs In offers tips for nurses – and their patients - to reduce the risk of becoming infected by viruses circulating at work and elsewhere:

  • Get plenty of rest. The body’s ability to fight off a potential infection declines when a person is sleep-deprived. Lack of sleep also extends the time required to recover from a viral infection.
  • Eat foods that bolster the immune system. Garlic and peppers that contain high levels of vitamin C have been shown to boost people’s immune response. Chicken soup does indeed help people recover more quickly from illness.
  • Adopt an exercise regimen. Getting at least 30 minutes of moderate exercise each day strengthens the immune system in addition to maintaining the cardiovascular system, muscles, and bones.
  • Get a flu shot. The CDC’s Advisory Committee on Immunization Practices recommends that all health care workers in the U.S. get vaccinated against the flu each year. However, the CDC does not take a stand on whether flu vaccinations should be mandatory for health care workers, as some health care employers require.
  • If you do not feel well, stay home. The risk of spreading either the flu virus or the coronavirus is much greater than any benefit that could result from going to work sick.

The CDC’s advice for preventing the spread of the flu and other germs includes information for preventing the spread of the flu in workplaces and schools, preparing your home and family for flu season, and tending to a family member who has the flu. The agency’s guidelines for going out in public have been updated in response to the COVID-19 pandemic to caution more strongly against engaging in public activities or attending indoor or outdoor gatherings with people outside your immediate household.

How to Stay Healthy in Flu Season During a Pandemic

The presence of the coronavirus has made staying healthy in flu season more important than ever. The CDC’s guidelines for preventing the flu begin with vaccination, which the agency calls “the single best way to prevent seasonal flu.” Other flu prevention measures that the CDC recommends are as follows:

  • Avoid close contact with people who are sick and, when you are sick, isolate yourself as much as possible.
  • Cover your mouth and nose with a tissue when coughing or sneezing; if no tissue is available, block the cough or sneeze with the inside of your elbow.
  • Wash your hands frequently with soap and water; if soap and water are not available, apply an alcohol-based solution to your hands.
  • Avoid touching your face, especially your mouth, nose, and eyes.
  • Clean and disinfect surfaces that are touched frequently, especially those in the vicinity of someone who is ill.
  • Get a good night’s sleep, exercise, drink plenty of water, eat a nutritious diet, and take steps to minimize stress.

Much of the same preventive advice applies to stopping the spread of the coronavirus, according to the CDC:

  • If someone in your home is ill, stay at least six feet from the person and all other household members.
  • When outside your home, stay at least six feet from others (except household members). Social distancing is especially important for people at high risk, including those aged 50 and older (risk of severe illness increases with age) and people with underlying medical conditions, such as cancer, chronic kidney disease, chronic obstructive pulmonary disease (COPD), and heart disease.
  • Use a mask to cover your nose and mouth when around others who are not household members. Masks are especially important to use when in public settings where maintaining six feet from others is difficult. (The exceptions are children under age 2, people who have trouble breathing, and people who are incapacitated or unable to remove the mask themselves.)
  • Wash your hands with soap and water for at least twenty seconds after being in public or after sneezing, coughing, or blowing your nose. Also wash hands before eating or preparing food, handling your mask, changing a diaper, touching a pet, or caring for someone who is ill.
  • At least once a day, clean and disinfect all surfaces regularly touched, including doorknobs, light switches, handles, desktops, countertops, phones, keyboards, and faucets.

In addition to following these guidelines, nurses can share this information with patients to prevent their infection and spread of the disease.  Patients can follow by example at medical visits or receive communications that outline these guidelines.

Resources for Staying Healthy During Flu Season and the Pandemic

These health services provide information about how to avoid becoming infected with the flu virus, and how to prevent the spread of the illness.

  • Stay Healthy During the Coronavirus Pandemic, SF.gov — Find tips for shopping safely, using mass transit, and seeking health care while protecting against the coronavirus.
  • How Not to Spread the Flu, WebMD — Learn the best way to apply alcohol-based hand disinfectant, the proper approach to washing the hands, and the mechanics of how the flu virus spreads from person to person.
  • Cold and Flu Resources, Everyday Health — Read about organizations that provide information relating to flu vaccines and vaccine safety for children and the elderly, and find maps tracking the rate of flu infections in various locations this flu season.

Staying Safe, Healthy, and Informed

Nurse leaders are at the forefront of the effort to keep patients and health care workers safe during the COVID-19 pandemic and the flu season. Norwich University’s online Master of Science in Nursing degree program prepares nursing professionals for the challenges of modern health care. The program features concentrations in Healthcare Systems Leadership, Nursing Education, Nursing Informatics, and Nurse Practitioner. Three track options are available in the Nurse Practitioner concentration: Family Nurse Practitioner, Adult Gerontology Acute Care Nurse Practitioner, and Psychiatric Mental Health Nurse Practitioner.

Earning a master’s degree in nursing provides nursing professionals with the opportunity to develop advanced nursing and leadership skills for keeping patients and their nursing staff safe during the COVID-19 pandemic, the annual flu season, and other crises.

Learn more about how Norwich University’s master’s degree in nursing helps nurses pursue their goals as leaders of the profession.

Recommended Readings

Nurse Leadership Qualities for Your Future Career
Leadership in Health Care: Gain Skills to Advance Your Career
Nurse Educator vs. Nurse Practitioner: Comparing Two Key Health Care Careers


Similarities and Differences Between Flu and COVID-19, U.S. Centers for Disease Control and Prevention
The Flu Season, U.S. Centers for Disease Control and Prevention
Seasonal Influenza, World Health Organization
Weekly U.S. Influenza Surveillance Report, U.S. Centers for Disease Control and Prevention
Frequently Asked Influenza (Flu) Questions: 2020-2021 Season, U.S. Centers for Disease Control and Prevention
Flu Prevention and COVID-19, Kaiser Permanente
When Is Flu Season and Why There Is a Flu Season in the First Place, Insider
What to Know About Flu Season Right Now, Healthline
How Will COVID-19 Affect the Coming Flu Season? Scientists Struggle for Clues, Science
How Flu Spreads, U.S. Centers for Disease Control and Prevention
Should Isolation Periods Be Shorter for People With COVID-19?, The New York Times
Healthy Habits to Help Prevent Flu, U.S. Centers for Disease Control and Prevention
How to Protect Yourself & Others, U.S. Centers for Disease Control and Prevention
People at Increased Risk and Other People Who Need to Take Extra Precautions, U.S. Centers for Disease Control and Prevention
People with Certain Medical Conditions, U.S. Centers for Disease Control and Prevention
Information for Health Care Professionals 2020-2021 Flu Season, U.S. Centers for Disease Control and Prevention
HCP Fight Flu Toolkit, U.S. Centers for Disease Control and Prevention
Influenza Vaccination Information for Health Care Workers, U.S. Centers for Disease Control and Prevention
Summary: ‘Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2020-21,’ U.S. Centers for Disease Control and Prevention
A Nurse’s Guide to Staying Healthy When Viruses Are Circulating, The Doctor Weighs In
Preventive Steps, U.S. Centers for Disease Control and Prevention
Everyday Preventive Actions Can Help Fight Germs, Like Flu, U.S. Centers for Disease Control and Prevention
Deciding to Go Out, U.S. Centers for Disease Control and Prevention

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