Research has found that, as with SARS-CoV-2, flu virus is exhaled in small particles by infected people while breathing, talking and coughing; and the flu virus has been found in aerosols in indoor environments, including hospitals, children’s day care centers and airplanes. As with the new coronavirus, people can spread the flu even when they don’t have symptoms, which is further indication that transmission can occur without coughing or sneezing and doesn’t require large, wet droplets.

If recommendations to combat the flu continue to rely heavily on hand washing and surface cleaning, without recognizing the role of aerosols in transmission, we are unlikely to make a dent in the 12,000 to 52,000 deaths in the United States per year caused by the flu. But if we take a page from the Covid-19 playbook, the United States could drive flu cases down and prevent missed days of school and work, as well as death.

People who want to prevent flu infection should get their seasonal flu vaccine. They should also now feel more comfortable using masks. The use of masks, along with washing hands, appears to reduce transmission of flu to others within households. Those concerned about flu infections may also want to consider limiting the time spent during flu season in crowded indoor settings, where transmission can happen more easily.