This winter, flu is in full swing. Let me answer some questions to make our lives easier.
1. “Can you tell if I have COVID or flu based on symptoms?”
No.
Doctors try to guess based on the season, what’s floating around the community and what your niece, who came over for Christmas dinner, just tested positive for. However there is too much overlap among COVID, flu and other common cold bugs to know for sure.
You can, however, test yourself at home using over-the-counter COVID/flu tests (cost $10 to $30 per box—because most boxes contain multiple test strips, each test averages $5).
2. Should I get tested early or wait if I don’t get better?
Good question. Treatments for flu and COVID-19 work better if taken early. So, testing early makes more sense especially if you belong to the high-risk group, for example, you have diabetes, breathing problems, heart problems (see CDC list).
To treat COVID-19, drugs like Paxlovid work well. Data showed Paxlovid reduced COVID hospitalization by 90% in the unvaccinated and 50% in the vaccinated. These are good outcomes.
In 2022, COVID-19 spread through my entire extended family. When my 89-year-old mother, who has frailty, stroke, dementia, and high blood pressure, came down with the first sign of running nose. We tested her immediately. She was COVID-positive—and was started on Paxlovid within the hour. Mother suffered congestion for a day—and woke up the next day like nothing happened. (For full disclosure, she was (and has been) fully vaccinated.) Since then, I’ve been a rabid devotee of Paxlovid.
For flu, we have four drugs—the least expensive, Oseltamivir, (Tamiflu, a dose pack $10 to $30 on GoodRx). All require prescriptions and are best taken within 2 days of symptoms. Drugs can cut your symptoms by a day—and might reduce the incidence of severe complications.
3. Next, about the 2025-26 flu vaccines, some updates.
During the flu season, different types of flu viruses hit at different times. A flu vaccine typically protects against 3 to 4 strains. But this year, the vaccine may not fully protect against the most severe strain of the flu virus—too many mutations. Flu vaccine in general can reduce hospitalization by 50 percent.
For those over 65, CDC recommends high-dose flu vaccines in the hope of providing additional immunity. But how well these high-dose flu vaccine can reduce the most severe complications such as pneumonia, hospitalization, or death? The studies have shown mixed results.
My take-home: Get the vaccines. The 2025-26 flu season is predicted to be the worst in almost 30 years. As of Dec 27, 2025, 5000 has died from flu including 9 children. Last year, 288 children died of flu. Given all the best scientific data and doctors’ best wishes, please get vaccinated.
4. When is a good time to get the flu vaccine?
Yesterday.
October is usually the ideal time to get vaccinated against flu in the US. After vaccination, it takes over 2 weeks for our body to develop combat-ready immunity. That said, if the flu season is ongoing and you’re going, it’s never too late.