EDITORIAL

 

COVID-19 and influenza: implications in the public health context

 

 

Andrés Ricardo Pérez-Riera^{I, II}; Raimundo Barbosa Barros^III; Kjell Nikus^IV; Khalifa Elmusharaf^{II, V}

^ILaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, 09060-870 Santo André, SP, Brazil;
^IIBrazil and Ireland COVID-19 Observatory;
^IIICoronary Center of the Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil;
^IVHeart Center, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Finland;
^VSchool of Medicine, University of Limerick, V94 T9PX Limerick, Ireland

Correspondence

 

 

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ABSTRACT

The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 continues to have a major impact on health and social systems around the world. The COVID-19 and influenza manifest themselves in a similar way, causing respiratory diseases that can present asymptomatically, as well as from the cold to severe respiratory problems until death. The form of transmission is similar, through contact with droplets or particles of saliva and secretions, which implies preventive actions that involve the same hygiene measures, use of masks and the need to cough using the elbow or disposable tissues. This characterizes a syndemic. It becomes necessary to monitor these diseases so that there are parameters for better decision-making on the appropriate clinical management of these respective diseases.

Keywords: COVID-19, lethality, mortality, Haemophilus influenzae

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The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 continues to have a major impact on health and social systems around the world. As the clinical and epidemiological features of COVID-19 have many parallels with influenza, it is important to ensure optimal management of both respiratory diseases¹.

In this context, it is necessary to monitor these diseases in order to have parameters for better decision-making on the appropriate clinical management of these respective diseases. In addition, that the population continues with the prevention and health promotion measures that greatly contribute to the reduction of cases, as these are actions that must be carried out by the population in the long term that will provide an effective simultaneous control of respiratory infections and their complications.

Thus, when considering the two diseases, comparisons have been made between the SARS-CoV-2 virus, which causes COVID-19, with the Influenza virus, which causes influenza, as both cause respiratory diseases, however, the spread and existing differences deserve to be discussed and analyzed in order to provide prevention and promotion measures based on health decision-making.

The two viruses manifest themselves in a similar way, causing respiratory diseases that can present asymptomatically, as well as from the cold to severe respiratory problems until death. Also, the form of transmission is similar, since they are transmitted by contact with droplets or particles of saliva and secretions, which implies in preventive actions that go through the same measures, such as the importance of hygiene, use of masks and the need to cough using the elbow or disposable tissues².

On the other hand, how do these viruses differ? One of the main differences between the two viruses is in the speed of transmission. It is known that Influenza virus has a shorter incubation period and a shorter serial interval when compared to the virus that causes COVID-19, the serial interval of COVID-19 is 5 to 6 days, while that of the Influenza virus is 3 days. This difference indicates that the Influenza virus can spread faster than SARS-CoV-2. It still stands out that the transmission in the first 3 to 5 days of the disease or the potentially pre-symptomatic transmission, is one of the main factors of Influenza transmission. On the other hand, although still under review, there are indications that people can be contagious with COVID-19 24 to 48 hours before symptoms start. Currently, this does not seem to be the main transmission factor².

For Chotpitayasunandh et al.¹, this difference in the transmission potential probably reflects years of previous exposure to influenza, as well as the implementation of public influenza vaccination policies that provide the population with a level of immunity, when compared to the lack of pre-existing immunity to SARS-CoV-2¹.

Another point of discussion would be the evolution of diseases, since statistics show that this evolution seems to be different, although presenting similar symptoms. Most cases of COVID-19 present as asymptomatic or mild symptoms, with around 15% severe infections and 5% critical infections; different evolution of Influenza that serious and critical infection numbers would be lower than those observed for COVID-19³ infection.

Finally, in relation to risk groups, in Influenza, the group with the highest risk are children, pregnant women, the elderly, people with chronic diseases and immunosuppressed. For COVID-19, the current understanding is that advanced age and pre-existing conditions increase the risk of serious infections³.

Understanding the differences in epidemiology in high-risk groups between COVID-19 and influenza is critical to ensure optimal clinical management of each of these diseases. Children are known to have significant morbidity due to influenza and are considered the main contributors to the transmission of the virus, while children infected with SARS-CoV-2 appear to be asymptomatic or have only mild symptoms^4,5.

Thus, considering the evolution of diseases, it is clear that COVID-19 presents an evolution that stands out for more severe symptoms, which implies a potential higher mortality rate when compared to the mortality rate from Influenza, especially seasonal influenza.

Information technologies stand out in the context of health. For Chotpitayasunandh et al.¹, public involvement in the notification of symptoms through mobile devices that can help to anticipate local or regional outbreaks, as well as surveillance data on the circulation of influenza viruses and/or SARS-CoV-2 and associated diseases, help in the decision-making process of diagnosis and treatment of these diseases.

As for medicines for COVID-19 and Influenza, although there are discussions regarding the treatment of COVID-19, with clinical trials, there are currently no licensed medicines for COVID-19 in Brazil. Drugs that fight the replication of the virus, such as Molnupiravir (from MSD) and Paxlovid (from Pfizer) can guarantee effectiveness against COVID.

On the other hand, there is a vaccine and antivirals for influenza, which despite not being effective for COVID-19, vaccination is highly recommended every year to prevent Influenza⁶.

Seasonal flu and the current COVID-19 pandemic are perceived to pose imminent global health challenges. Effective and safe vaccines remain front-line tools for mitigating illness induced by the influenza virus and SARS-CoV-2⁷ severe acute respiratory syndrome.

Thus, it is observed that we are faced with two viral diseases with similarities, especially in symptomatology, but which differ in terms of transmissibility and evolution, which implies the need for actions that can empower the population in terms of prevention, promotion and and control so that serious cases that can arise from COVID-19 are avoided. Such measures must increasingly be disseminated and necessary these days, as the world is currently experiencing two epidemics of respiratory viruses, COVID-19 and influenza.

Proper planning is essential to ensure that sufficient resources and strategies are available to meet peak capacity needs and meet additional demand.

It is everyone's responsibility not to let the current COVID-19 pandemic prevent them from properly dealing with the possibility of overlapping epidemics (seasonal flu and COVID-19). It will be more important than ever to reduce mortality rates with vaccination, antivirals, and implementing mitigation measures⁸.

In this approach, the Journal of Human Growth and development (JHGD) stands out, which brings to each edition discussions focusing on technologies, innovation and health, giving visibility to research that deals with the life cycle and health, epidemiology, law and health, public policies and other areas of knowledge ^9-25.

In addition, the JHGD has been providing a broad debate on the different areas of knowledge, enabling the development of critical thinking for the community, contributing to scientific dissemination at national and international levels.

The COVID-19 pandemic is not over. It remains for us to make efforts to ensure that we do not miss opportunities to fill the inequality gap. The use of face masking²⁶, social distancing and mass vaccination of children and adults is the scientific evidence we have for reducing the transmission of the SARS-Cov2 virus and its implications for global public health.

 

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Correspondence:
Andrés Ricardo Pérez-Riera
riera@uol.com.br