science of us

So Hey, How Worried Should I Be About the Flu?

Photo: D. Corson/ClassicStock/Getty Images

Flu season is well underway, and this one is bad — the CDC has rated this year’s flu as “widespread” in 49 states, the most prevalent the virus has been in that many states at once in ten years. Chances are, your own workplace has suffered at least one major breakout by now, because every office has (at least) that one guy who has flu symptoms but refuses to stay home, and instead comes into work to sniffle loudly and cough on people all day. If you haven’t caught the flu yet, you have one of two choices: figure out when it’s all over and stay home until then, or wash your hands and hope for the best. (Obviously, you’ve gotten your flu shot by now … right?)

To address whether or not this year’s flu season is any worse from flu seasons past (and if so, why), or if it just seems that way because everything else is getting worse, too, we consulted some experts.

Why is the flu season so bad this year?

Basically, this season’s flu is worse than usual because human beings, sadly, don’t know everything, and trying to combat the flu involves a fair amount of (educated) guesswork. “The flu virus is one of the most changeable viruses we know, and it’s subtly different every single year,” says Dr. Paul Biddinger, director of the Center for Disaster Medicine and vice-chairman for emergency preparedness at Massachusetts General Hospital in Boston. “We have to change the vaccine every year to try and match the strains we’re guessing will be dominant. The more closely the vaccine matches the dominant strain that’s out there, the less severe the season, because fewer people get the flu.” In other words, this season’s vaccine creators (who did as best they could!) might not have been able to match the most dangerous or contagious strains currently active. That doesn’t mean you should skip the vaccine — more on that in a minute.

How worried should I be about this?

If you’re an otherwise healthy person, you’re less likely to be severely affected by the flu than those who are more at risk, like children, the elderly, and those with other medical conditions. But Biddinger warns that the flu can make even healthy people very ill. “For most healthy people the illness is not life-threatening,” says Biddinger. “But even if you’re young and healthy, you should watch out for severe symptoms such as confusion, difficulty breathing, or inability to keep hydrated.” And, again, if you’re worried — get the flu shot.

How do I know whether I have the flu or just a really bad cold?

If you feel as though you’ve Googled this question every year, once a year, since the internet was invented, you are not alone. It’s often tough to tell the difference between a standard-issue cold and the flu, both of which can make you tired, achy, and generally miserable. Biddinger says a cold is more likely accompanied by a cough and the flu by a fever, but that it’s not always important (or even possible) to make the distinction based on symptoms alone.
In most cases, you’ll get through either illness just fine on your own (along with a few over-the-counter pharmaceuticals). What matters most is knowing which symptoms call for a doctor visit: “If you’re having difficulty breathing, if you’re becoming very dizzy, or can’t stand up or eat or drink effectively, if you feel confused or as if your mental status is changing, those are some of the indicators that should prompt you to seek evaluation by a doctor,” he said.

How exactly does the flu kill an ostensibly healthy person?

If you would like to contemplate the worst possible outcome, then yes: It is possible for the flu to kill someone who is otherwise healthy and doesn’t fall into any of the at-risk categories. Biddinger says there are two ways this can happen: (1) your lungs become inflamed as part of the infection, which makes it hard for you to breathe or hard to effectively get oxygen into your body. Or, (2), in some cases, the flu can make people vulnerable to a bacterial pneumonia that can follow the flu.

Hypothetically speaking … if you forgot to get a flu shot, is it still worth getting one now?

YES. For the love of god, yes. Do it now. “Even though the flu shot is not 100 percent effective — in many years it’s perhaps 60 percent effective or so at preventing the flu — the flu shot still can lessen the severity of your illness or shorten the course of illness,” says Biddinger. “It’s good for everybody.” It’s also usually free, so you really have no excuse.

Why are people getting the flu even if they got the vaccine?

Again: The flu vaccine is a very good and helpful too, but it isn’t perfect. “For the most part there are three strains in every flu vaccine, and there can be more than three viruses that are circulating,” Biddinger says. Because the flu changes so fast, it can be hard for the vaccine to keep up. But the reason you can still get the flu even if you got the vaccine also has a lot to do with your individual immune system and the exact vaccine you got, says Biddinger. Still, he adds, if you get the vaccine and still get the flu, it is very likely that your symptoms will be milder (and your illness shorter in duration) than it would have been had you not gotten the vaccine. You’re also much less likely to die from it! Always a good thing!

How long is flu season?

Kind of sort of almost half the year, unfortunately. “Flu season is typically from midwinter through early spring in most parts of the United States,” says Biddinger. “This year the flu season started earlier than usual, and is peaking sooner than usual, but we don’t know for sure that we’ve hit the peak of flu season. We only know that once we’re well past it. Certainly we can expect at least six to eight weeks more.” That means we’re looking at a late February or early March end date at the earliest.

How are the start and end of flu season determined, anyway?

If you, like me, are picturing some sort of ribbon-cutting or flag-raising ceremony, I have bad news: The real answer has a lot more to do with statistics collected after the fact. “The CDC and individual state health departments have influenza monitoring systems, and they look at a variety of different variables, including the laboratory-confirmed cases in hospitals and doctors’ offices,” says Biddinger. But most people who get the flu don’t get it confirmed by a lab or a doctor’s office, so agencies have to do some background sleuthing to get closer to the real number of cases. For instance, these agencies also collect data from patients who go to the doctor complaining of common flu-like symptoms, like fever and a cough.

There is only so much that can be done to hasten the end of a given flu season, but what you can do is vastly shorten your own, by washing your hands, eating healthily, and, say it with me, getting the flu vaccine.

So Hey, How Worried Should I Be About the Flu?