With the winter season approaching, there are concerns about possible outbreaks of seasonal flu, which could put further pressure on the country’s health care system that is already strained due to the Covid-19 pandemic.

Cases of seasonal flu are already being reported in various hospitals, and with the highly contagious Delta variant of the coronavirus circulating in communities, doctors fear a double whammy of seasonal influenza and Covid-19.

“We are particularly concerned about the patients suffering from chronic obstructive pulmonary disease and chronic lung disease. Their condition could exacerbate if they catch Covid-19,” said Dr Ashesh Dhungana, a pulmonologist and a critical care physician at Bir Hospital.

Of the 65 Covid-19 patients receiving treatment at Bir Hospital on Wednesday, Dhunganga said over two-thirds were patients of COPD and chronic lung disease.

“These patients have been either receiving intensive care or placed on oxygen support,” said Dhungana.

For health experts what is concerning is that most of the symptoms of Covid-19 and seasonal influenza overlap with each other. Similar symptoms mean challenges in distinguishing between the two diseases.

Seasonal influenza and Covid-19 both are respiratory illnesses which affect lungs and spread quickly in communities. Both diseases can cause fever, cough, body aches, sometimes vomiting and diarrhoea, and pneumonia.

“Seasonal flu patients will have to undergo polymerase chain reaction tests,” Dr Raju Pangini, a pulmonologist at Hams Hospital, said. “This increases the financial burden on the patients but we have no other option to rule out Covid-19.”

Although early diagnosis is crucial in both diseases, the outcome of treatment is high in seasonal influenza cases. Patients recover early if they are treated in time, doctors say.

“Both severity of the disease and deaths increase if seasonal influenza cases are not diagnosed in time,” Pangeni said.

Dr Sagar Rajbhandari, a former director of Sukraraj Tropical and Infectious Disease Hospital, meanwhile, warned of the risks of misdiagnosis and negligence, which could lead to delayed treatment and even deaths.

“Seasonal influenza is also highly contagious. It could cause pneumonia and if left untreated, it could lead to the patient’s death,” Rajbhandari said. “We should not ignore the risk factor.”

The infection risks of seasonal influenza as well as Covid-19 have increased as many schools have started in-person classes despite warnings from public health experts.

Authorities in most of the districts, including in Kathmandu Valley, have reopened schools for in-person classes with no monitoring mechanism to ensure the schools are strictly following health and safety measures.

Health experts have warned that children could become vectors of the coronavirus and infect the elderly people in their homes and communities. And now there is also the risk of seasonal flu outbreaks to contend with.

“Those who have breathing difficulties, COPD patients and those suffering from lung diseases should immediately seek medical attention if they have flu-like symptoms,” Dhungana said.