The “Twindemic” Has Landed: COVID-19 and Influenza

Joseph R. Anticaglia MD
Medical Advisory Board

Health experts have predicted the next few months of 2020-2021 will be a “dark winter” in the United States. The confluence, the explosive “twindemic” of COVID-19 and the Flu will cause millions of new cases, a surge in hospitalizations and thousands of additional deaths in this country.

People in nursing homes, the elderly, those with comorbidities and those with compromised immune systems are particularly vulnerable to the “double whammy” of this virus.

What’s Just “Around the Corner?”

Credit Getty Stock Photo Mobile Refrigerated Truck

Yes, the vaccine is coming but what’s, in fact, around the corner is the dramatic increase in the number of COVID-19 cases during the months of December, January and February.

Dr. Anthony Fauci and other scientists say coronavirus cases will surge “exponentially” this winter. In addition, some states and medical facilities have ordered refrigerated, mobile trucks to operate as temporary morgues in anticipation to the skyrocketing COVID-19 case load.

Because the coronavirus will be coupled with the flu season, health officials outline a grim picture; hospital workers will burnout, too many of them will die, and there’ll be a shortage of hospital beds, equipment and personnel.

Sick patients will be transferred to health facilities that aren’t filled to capacity. Elective surgery will be postponed because of the swarming COVID-19 bugs. Some hospitals will be forced to close their doors.

People with broken bones or heart attacks will compete with COVID-19 patients for medical care and hospital beds. Agonizing medical decisions may have to be made.

Imagine you’re the doctor who must decide which patient is going to be admitted to your hospital to receive medical treatment and get the last remaining hospital bed.

You’re caring for two patients in the emergency room of your hospital. One is a 38 year old mother of three children who suffered a heart attack, chest pain and difficulty breathing. The other patient is an 83 year old grandmother sickened with COVID-19 experiencing difficulty breathing, cough and fever. Both are close to death. The risk or transporting the patient to another hospital is not an option. Who gets the last remaining bed and medical treatment?

Both of these patients should be admitted to the hospital and their medical needs attended to. However, the healthcare meltdown has placed additional burdens on doctors, nurses and other frontline workers. Are there lessons to be learned?

Pandemic 1918

Credit CDC 1918 Pandemic (H1N1 virus)

The global pandemic of 1918-1919 infected one third of the world’s population, or 500 million people causing 50 million deaths! The Flu started in the spring of 1918 and the virus grew exponentially that fall and winter infecting millions of people in its path.

The United States, military personnel in 1918 initially contracted the disease while serving overseas during WWI. American soldiers came in contact with patients in the influenza ward at a U. S. Army camp. The men who returned home from the war, it’s believed, spread the virus that led to 675,000 American deaths.

Pandemic Redux

Today what’s worrisome is the lack of leadership at the highest levels and the health care system’s failure to persuade Americans to implement preventive measures necessary to blunt this relentless virus. The outbreak in the U. S. is a “self-inflicted” tragedy. Millions of Americans inexplicably, at this time, do not follow public heath guidelines to save their lives and that of others.

  • Wear masks
  • Keep a safe distance (at least 6 feet apart from each other)
  • Wash hands
  • Avoid large indoor gatherings
  • Avoid travelling, especially during the holiday season
  • Get vaccinated
  • Consider getting tested

Some health care experts suggest that non-symptomatic persons be tested with home testing kits to get important information concerning the scope of the pandemic in the U. S.


Pfizer applied for emergency use authorization for its coronavirus vaccine and Moderna will seek E. U. A approval for its version of the COVID-19 vaccine by the end of November of this year. But vaccinations for the average American, if proven to be safe and effective are several months away. In the interim, COVID-19 cases are soaring and physicians are confronted with painful decisions

Mishandling of the COVID-19 crisis has led to a regrettable surge in COVID sickness and deaths. However, the good news — after you feel comfortable that the COVID-19 vaccine is safe and effective, it’s sensible to get vaccinated.

When 70% or more of Americans get vaccinated, herd or population immunity happens and the incidence of coronavirus will decrease significantly. Right now, we need to protect ourselves and prevent others from contracting the disease by implementing the advice of medical experts during the “twindemic.”


  1. Michael Christ et al; Modern Triage in the Emergency Room; Deutsches Arztenbatt International; February 10, 2010
  2. CDC; Center for Disease Contro and Prevention; 1918 Pandemic (H1N1 virus); March 20, 2019
  3. CDC; The Deadliest Flu: The Complete Story of the Discovery and Reconstruction of the 1918 Pandemic Virus; December 17, 2019
  4. Joseph R. Anticaglia, MD; Could the Upcoming Flu Season be a “Double Whammy?” The “Twindemic” of COVID-19 and Influenza? Doctor’s Column, HC Smart. 2020

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.