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What is a ‘twindemic’ and how should you prepare?

Over the past six months, one virus has been the center of our worlds. COVID-19 has impacted just about every aspect of our lives — how we work, learn, socialize and shop. Facemasks and social distancing have become the new normal. But a second virus is right around the corner — the seasonal influenza and the potential overlap of the two has been dubbed a “twindemic.”

The annual influenza season can begin as early as September or October and extend into April or May. In fact, Welia Health can expect to see its first case of the flu at anytime. Whether the COVID-19 pandemic remains in a prolonged first wave, or sees a second wave this fall or winter, health officials caution about the increased strain on an already overloaded health system. A second, but equally concerning risk, is that having seasonal influenza may make patients more more susceptible to the effects of the illness (COVID-19).

Over the next few months, doctors and researchers will undoubtedly learn more about the interaction of these two viruses. What we do know is this, even though the illnesses are very different, influenza symptoms can closely resemble symptoms seen in COVID-19 patients –things like body aches, fever and chills. In any other year, many experiencing influenza symptoms would simply ride it out, perhaps by staying home or taking Tamiflu until their symptoms subsided. This year, however, those same symptoms are likely to prompt concern and increase the demand for COVID-19 tests. Together with any surges in COVID-19, it’s easy to see the potential for labs becoming overwhelmed and test results being delayed.  

Distinguishing seasonal influenza from COVID-19 takes time. Any delay in diagnosis also means a delay in treatment. An all-out effort to lessen influenza will not only save lives lost, but also give doctors and hospitals  the space needed to manage a potential COVID-19 outbreak.

Preventing influenza and COVID-19

What can you do to prevent getting the flu and COVID-19? The answer may sound familiar: 

  • Wash your hands with soap and water for at least 20 seconds — and wash them often. Watch the video below to learn how to wash or sanitize your hands properly.
  • Clean and disinfect high-touch surfaces daily in household common areas (e.g. tables, hard-backed chairs, doorknobs, light switches, phones, tablets, touch screens, remote controls, keyboards, handles, desks, toilets, sinks).
  • Avoid touching your face, particularly your eyes, nose and mouth.
  • Keep a distance of at least six feet from people who are not in your household.
  • Wear a mask in public. Watch the video below for all the do’s and don’ts for wearing a mask.
  • Stay home when sick and avoid contact with anyone who is known to be sick.

All of these steps will help protect you from both COVID-19 and the flu. But there is one more step you should add to this list to help protect you, your family and your community. 

  • Get your annual influenza shot. This year it’s more important than ever. Not only will you avoid infection and keep healthier this season, you will also save your time, resources and hospital space. 

Who should get a flu shot?

The Center for Disease Control and Prevention recommends everyone 6 months of age and older get an influenza (flu) vaccine every season with rare exception. 

When should I get a flu shot?

Get your flu shot now. One dose will protect you all season long, so it’s best to get it early. If you had a flu shot early in 2020, you’ll need another one. Each year, the vaccine is reformulated to match the flu strains that are predicted for the upcoming season..

Where do I get a flu shot?

Welia Health offers flu shots at our community pharmacies in Mora and Pine City, as well as at our clinics in Mora, Pine City and Hinckley with a quick, nurse-only appointment. 

Welia Health drive-thru flu clinics

Getting a flu shot is easier than ever. Welia Health will hold drive-thru flu clinics at each of our clinics next month. 

While appointments aren’t required, masks are. Safety first. Follow signs to registration tents and stay in your vehicle.  No out-of-pocket cost with most insurance.

For more information about the flu, see the Centers for Disease Control and Prevention website.


Welia Health Physicians Answer Your Common Questions about COVID-19

As you’ve heard many a time in news broadcasts, online and in print, this is an unprecedented time in history. At Welia Health we want to reassure our communities that we are prepared.

Most healthcare systems, including Welia Health, plan for crisis management regularly, with development of theoretical plans and staff drills. However, the novel coronavirus has its own unique challenges, which could not be planned for in advance, and staff at Welia have been diligently working for weeks to prepare for the arrival of the novel coronavirus in our communities. 

These preparations include a broad range of topics, including but not limited to collaboration with community organizations, patient education, staff training, protocol revision and development, workflow and clinical space changes, equipment inventory and acquisition, and new staff teams. All these things are being done to maximize the safety of our communities and patients, as well as our staff. Welia Health is also working with government agencies, like the Minnesota Department of Health, and regional organizations, such as other smaller community hospitals, to deliver the best possible care at this time.

Dr. Niskanen, our Chief Medical Officer, along with all his colleagues, including Dr. Jess Olen, believe common questions should be answered from a local provider’s point of view. Dr. Olen has been tasked to help answer these questions, specifically as the COVID-19 pandemic relates to Welia Health, and how it may affect you and your families. All of us at Welia Health hope that by answering some common questions from our perspective, it can help decipher critical medical information and ease some of the fears associated with COVID-19.

What is the novel coronavirus?

There are many types of existing human coronaviruses, which typically cause mild respiratory illnesses. The novel coronavirus, officially referred to as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new form of the coronavirus, which causes coronavirus disease 2019 or COVID-19.

New human viruses develop through genetic changes in viruses and when viruses jump from animals to humans. The exact origin of the novel coronavirus is unclear, although first cases seem to be linked to a live animal market. Since the novel coronavirus is new to the worldwide human population, we do not have immunity to the virus.

How is the novel coronavirus spread?

How the virus is spread is still being researched, it is generally felt that the novel coronavirus spreads from one person to the next through respiratory droplets. Droplets are produced by talking, coughing, or sneezing, and can spread to hands, or land on surfaces and other people within close range.

If I am exposed to coronavirus, will I feel sick right away? What is the incubation period for the novel coronavirus?

The incubation period for a virus is the time between exposure to the virus and onset of symptoms.

In the case of the novel coronavirus, its exact incubation period is not yet known, but is believed to be 2-14 days based on the incubation periods for other coronaviruses. This means that symptoms; like fever, cough and shortness of breath, often start 2-14 days after a person has been exposed to the virus. However, it should also be noted that the novel coronavirus can vary widely from one person to the next, and it is believed that some infected people may not show any symptoms, referred to as asymptomatic.

What are the symptoms of novel coronavirus infection?

The novel coronavirus has symptoms similar to other common respiratory viruses, which can make it hard to distinguish, especially in mild cases. The most prominent symptoms include fever, cough, shortness of breath. Other reported symptoms have included fatigue, body aches, sore throat, headache, gastrointestinal symptoms, and loss of smell and taste.

How long are you contagious once you have the novel coronavirus?

At this time, it is not known exactly how long a person can be contagious to others once infected with the novel coronavirus.

Welia Health Providers are following guidelines from the CDC and MDH that a person with these symptoms should isolate themselves until they have been fever-free for 72 hours, symptoms like cough and shortness of breath are improving, and it has been at least 7 days since symptoms started.

Are children at risk of becoming infected with novel coronavirus?

Early data suggests that children may have milder symptoms, and in some cases, no symptoms, when infected with the novel coronavirus. Also, early data suggests that fewer children need hospitalization for COVID-19.

Are pets at risk of becoming infected with novel coronavirus?

Some viruses can pass between animals and humans. There have been a few reports of domestic cats and dogs infected with the novel coronavirus. Generally, it seems as though cats may be more susceptible than dogs to the novel coronavirus virus.

Ultimately, if you become infected with the novel coronavirus, you should isolate yourself from people and your pets.

Can I get the novel coronavirus from food?

At this time, transmission patterns do not suggest that the novel coronavirus can be transmitted by eating food with the virus on it. Additionally, the novel coronavirus has poor survivability on food packaging, so the risk of getting the novel coronavirus from takeout containers is felt to be low. Regardless, hand washing is recommended after handling takeout containers and before eating.

Will the flu shot protect me from coronavirus?

Getting an influenza vaccination will not protect you from the novel coronavirus. The influenza vaccination helps your body recognize and fight off strains of influenza A and B, which cause what we typically think of as the seasonal flu.

Should I be tested for COVID-19? Do you have test kits for COVID-19?

Ideally yes, everyone should be tested, because this would provide information about spread of the virus and allow for better informed policy decisions. However, large scale testing is challenging because there are limited swabs and liquid to run the test. Who gets tested and test availability depends partly on where you live in the United States at this time. Currently, testing resources are being largely redirected to “hot spot” locations with high infection rates. Minnesota is restricting testing to only those with various medical risk factors, hospitalized patients, sick healthcare workers, and those living in congregate settings.

It is likely that testing in the state of Minnesota could become broader as testing supplies become more available. Also, a blood-based antibody test may become available in the future. This test would tell you if you had been infected with and cleared the novel coronavirus already, which may be especially useful for those who had mild to no symptoms.

Why aren’t we seeing many novel coronavirus infections in east central Minnesota yet?

The novel coronavirus virus has been slower to hit rural settings, like east central Minnesota, in particular, because social distancing is easier to accomplish than it is in large cities. As a result, peak novel coronavirus infection in east central Minnesota will likely lag weeks behind that of large urban areas, like New York City.

Is there a treatment for COVID-19?

Like other viruses, the best treatments for COVID-19 are what medical providers often refer to as supportive measures, such as maintaining hydration, pain and fever control, rest, and supplemental oxygen or breathing machine (ventilator) support if needed.

In mild cases of COVID-19, supportive measures can be carried out by patients at home. In moderate to severe cases of COVID-19, it is more likely that patients will need supportive measures and monitoring in a hospital setting.

Beyond these supportive measures, there are no well-researched treatments for mild to moderate COVID-19.That being said, there is limited evidence from a small number of cases that some medications typically used for other diseases may be beneficial when given in severe cases of COVID-19. These treatments have yet to be researched on a large scale. Because taking these medications have not been shown to prevent novel coronavirus infection, it is not recommended that they be taken prophylactically. We should also remember these medications are needed by patients with other diseases, so care needs to be taken to ensure that these patients continue to have access as well.

Please understand as we continue to learn new things about the novel coronavirus daily, sometimes hourly, it is possible that some information below may be outdated by the time it is published. Also, refer to the CDC or the MDH for the most up to date information or call your county hotline for COVID-19 questions.

Listen to Dr. Olen’s interview on WCMP, aired 04/29/20 at 9:15 am

Brian Niskanen

Dr. Brian Niskanen is a family medicine physician at Welia Health. He is Welia Health’s Chief Medical Officer and has been practicing since 2004.

Jessica Olen

Dr. Jess Olen is an emergency medicine physician at Welia Health. She is a recent addition to the medical staff and will be supporting public relations by providing the community with accurate and timely information during the COVID-19 pandemic. 


Considering the COVID-19 pandemic, Welia Health is prepared to take care of the communities it serves. We are also working closely with our community partners including public health officials, the local schools, and other healthcare providers to help lessen the impact COVID-19 could have in our communities. According to the Minnesota Department of Health, of of March 17, 2020, there are no confirmed cases of COVID-19 virus in either Kanabec or Pine Counties.

Welia Health leaders review daily new updates from the Minnesota Department of Health and the Centers for Disease Control and Prevention, and are following their recommendations and protocols. These are the best sources for the most accurate and timely information. The Minnesota Department of Health is also staffing a hotline to address questions from the public and is available from 7am until 7pm daily.

Changes to waiting rooms, events and support groups have already occurred. We will provide updates on our website and via our social media channels as they become available.

The health of our community members and staff remains our top priority.

Remember, the best ways to prevent the spread of COVID-19 are to practice.

Healthy hygiene

  • Wash your hands often and well
  • Cover your cough and sneezes
  • Toss the tissue and wash your hands again
  • Avoid touching your eyes, nose and mouth.
  • By staying home when you’re sick

Social distancing

  • Keeping at least 6 feet (2 meters) from others
  • Postpone or cancel gatherings of 10 or more people
  • Be aware of your surroundings

Being a good community member

  • Identify family, friends, and neighbors who may be feeling alone and contact them by phone to provide some companionship or ask if they have their needs met to safely stay in their home
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