EVERETT — We’re back to spreading germs again.

Health concerns are swirling as well.

Will the “twindemic” of flu and COVID-19 that was feared two years ago happen this season?

“You can be unlucky and have both at the same time,” said Dr. Yuan-Po Tu, infectious disease specialist for the Everett Clinic.

COVID and flu cases surged in the Southern Hemisphere, where the seasons are opposite of ours, and winter ended a month ago.

“For the last two seasons, there has been very little influenza in the United States,” Tu said. “The amount of natural immunity to influenza in the community is pretty darn low. That’s why getting vaccinated to boost your immunity is a good thing.”

Flu cases went down because of COVID practices: People stayed home, social distanced, wore masks and incessantly sanitized their hands.

Things have loosened up and we’re getting back to partying like it’s 2019 … just in time for flu season.

Flu activity tends to start in October and run through spring, typically peaking between December and February.

Health officials advise everyone 6 months and older to get a flu shot. COVID shot protocols vary by age.

Shots are available at most pharmacies and clinics. Those who qualify can get a COVID booster and flu shot on the same day, in different arms.

In the 2021-22 season, there were 21 flu deaths in Washington state. Of these, 18 were people 65 or older, the demographic traditionally hit hard. Three who died were ages 50 to 64. The state had no reported flu deaths in the 2020-21 season.

The senior population also has the highest rate of COVID deaths.

Vaccines decrease the severity of illness and likelihood of hospitalization, Tu said.

Home tests are widely available for COVID, but not for flu.

Some symptoms are similar, such as cough, sore throat, body ache, fever and fatigue. Flu tends to have a sharper onset. With COVID, the onset can be gradual and people who are asymptomatic can spread the disease longer. Both infections are spread by droplets when people cough, sneeze, talk or sing.

Treatment medications are different as are death rates.

As of this week, there have been nearly 1.1 million COVID deaths in the United States.

“On an average year, we lose 40-, 50-, 60,000 people to influenza,” Tu said.

Influenza is associated with secondary infections such as pneumonia.

Andrea Brown: 425-339-3443; abrown@heraldnet.com; Twitter: @reporterbrown.