New Wave Nightingale

COVID may be on the run, but old fashioned flu is back

New Wave NightingaleCONTRA COSTA COUNTY, CA (Dec. 8, 2022) — The flu, more formally known as influenza, has been notably absent these past couple of years – taking a back seat to COVID-19. This year, however, it’s back and already making its presence felt.

Influenza is a seasonal virus, generally October-May, and is divided into four main categories.

Influenza A is generally the most common. With a large array of subtypes, it has the potential to be quite destructive. It is the only category associated with flu pandemics. Wild aquatic birds can carry it, and the flu can spread across species.

Subtypes are named for the combinations and configurations of the two proteins on the surface of the virus: Hemagglutinin (HA) and Neuraminidase (NA). The two strains in current circulation are A(H1N1) and A(H3N2).

Influenza B strains are not categorized by subtypes but by lineages. Influenza B was identified in 1940 and is known to have split in the early 1980s into the two discrete lineages in circulation to this day: B/Yamagata and B/Victoria. While fierce, it is often less so than Influenza A. It is also found only in humans.

Influenza C is detected quite infrequently. It causes very mild symptoms and is not regarded as a threat to public health. Influenza D is found in cattle and has not been shown to infect people.

The flu can be deadly

Influenza generally presents with sudden onset fever, dry cough, headache, muscle aches, joint pain, sore throat, runny nose and a general feeling of malaise. Most people recover quickly and completely in about a week and don’t need medical attention. Severe illness requiring hospitalization can occur in people at high risk. Under the direst circumstances, it can result in death. High-risk individuals include the very young, the very elderly and those with co-morbidities lowering the body’s ability to ward off and fight infection. This group also includes pregnant women and health-care workers.

Influenza spreads from person to person via contact with infectious droplets emanating from the sneezes or coughs of an infected person. Droplets tend to remain in the air for a short time, then drop to the ground – making one’s proximity to the infected individual of prime importance.

The habit of social distancing adopted during the COVID pandemic is an excellent practice to continue during flu season. Covering one’s mouth or coughing/sneezing into an elbow are also helpful in controlling the spread of droplets. Strict adherence to good hand hygiene remains one of the most important means to control the transmission of flu and other infections.

Influenza is generally diagnosed clinically, but if you feel as though you have it, chances are you do. Lab tests are available that can distinguish between types, which can be epidemiologically significant but generally not helpful in guiding treatment.

Individuals who present with worrisome symptoms – including marked shortness of breath, high fever or other systemic symptoms – should be started quickly on antiviral medications and even hospitalized if the presentation is severe enough.

Flu shot is just the first step

Prevention is, of course, the best strategy and for this the lessons of the COVID pandemic are worth reviewing. In 2020 and 2021, the incidence of influenza in the United States reached an historic low – so much so that the Centers for Disease Control (CDC) has no preliminary statistics. This is attributed to the extended period of quarantine, social distancing in public spaces and a very high degree of mask use. These measures, though often challenging and uncomfortable, proved remarkably effective in controlling the spread of both COVID and flu.

The flu vaccination is recognized to have been safe and effective for more than 60 years and is updated annually to promote effectiveness against current circulating viruses. Maintaining a healthy lifestyle with regular exercise, decent nutrition and effective stress relieving techniques is also of paramount importance.

According to the CDC, 3% to 8% of the population will contract flu before the season finishes. In October and November alone, the CDC estimates as many as 9.8 million cases, 77,000 hospitalizations and more than 6,000 deaths.

Since March of 2020, we know what to do and how to do it. Thankfully, we don’t need to practice strict quarantine, but it is worth leaning in for a few more months and making sure we are vaccinated, masked and practicing responsible social distancing.

Together, we have the power to slow down the flu season. Let’s do all we can to minimize further tragic loss.

Please send your comments and question to Nathalie at

Nathalie Montijo
Nathalie Montijo

Nathalie Raven Archangel-Montijo holds a rather interesting array of degrees and certifications, including master’s in nursing and traditional Chinese medicine (TCM). She has post-master certification as an adult geriatric primary care nurse practitioner (AGPCNP) and a license to practice acupuncture in California (L.Ac). To round all that out, she is certified in infection prevention and control (CIC) and as an advanced certified Hospice and palliative care nurse (ACHPN).

She also performs in the outlaw country band, Nineteen Hand Horse.