Last year’s flu season was the worst in the US since the 1970s—49 million people got sick…960,000 were hospitalized…and nearly 80,000 died. It was a perfect storm—a particularly nasty influenza virus…a vaccine that was less effective than usual…and a growing population of older people, who are most susceptible to the flu and related complications. About 70% of flu hospitalizations and 90% of deaths were among people age 65 and older.

We don’t know yet how bad this season will be, but it sure makes sense to protect yourself. So we interviewed an infectious-diseases expert and an integrative physician to bring you a powerful toolkit to help you avoid the flu—and if you do get sick, to help you get ­better fast.

Flu Shots, Booze and Shut-Eye 

Infectious-diseases specialist William Schaffner, MD, advises everyone to…

Get an annual flu shot even if you’re skeptical. If you’ve already gotten one, bravo. But fewer and fewer Americans are doing so. Now new research from the Centers for Disease Control and Prevention (CDC) shows that skipping the shot was a significant contributor to last year’s record-high hospitalizations and deaths. According to the CDC, only 37% of US adults got vaccinated last year—down significantly from more than 43% the year before. If you’re skeptical about the flu shot based on what happened last season—the vaccine was less effective than usual—keep in mind that things would have been even worse without it. If you are vaccinated and still get the flu, you’re likely to have a milder infection. It also will be shorter in duration, and you’ll be less likely to get pneumonia, to be ­hospitalized—or to die.

If you’re age 65 or older, make sure that you get one of the vaccines licensed for use in older adults. There are two—the high-dose flu vaccine and the adjuvanted flu vaccine. Either one is fine and will give you a bigger immune response than the standard shot. I don’t recommend the nasal vaccine for older people. And it’s not too late in the season to get vaccinated, because flu season often lasts through March.

Get extra protection if you think you’ve been exposed to the flu. If flu is rampant in your community or a family member brought it home, your doctor can prescribe an antiviral medication (see below). These not only help reduce flu symptoms, especially if taken within 48 hours of the start of symptoms but, according to the FDA, also may help prevent flu if you are exposed. It’s still important to get a flu shot, of course, but an antiviral medication can provide additional protection if needed. Tip: If you’re planning a trip between now and spring, ask your doctor about prescribing an antiviral for you to have on hand in case you find yourself surrounded by people with the flu. Cruise ships, in particular, are hotbeds for the flu.

Cut back on or avoid alcohol during flu season. Alcohol negatively affects the body’s immune response and can increase the likelihood of getting an infection as well as the severity of an infection. Do stay hydrated, though—that helps your immune system function at its best.

Stay active. Regular exercise boosts immunity, so keep up your fitness routine throughout the winter even when you feel like hibernating.

Keep a solid sleep schedule. Healthy men and women who average less than seven hours of sleep per night are three times more likely to catch a cold, compared with those who get eight hours or more of sleep, and good sleep likely helps ward off the flu, too.

Be smarter about hygiene. Besides frequently washing your hands and using an alcohol-based hand sanitizer, regularly sanitize shared surfaces such as those in bathrooms and kitchens…and doorknobs throughout the house. Don’t get too close to sick people if you can help it—viruses can be spread not only by sneezes but also by simply breathing. And stay home if you’re sick so that you don’t become a dreaded spreader of germs.

William Schaffner, MD, professor of preventive medicine in the department of health policy and professor of medicine in the division of infectious diseases at Vanderbilt University School of Medicine, Nashville.

Natural Ways to Prevent Flu

Integrative medicine practitioner Fred Pescatore, MD, often prescribes dietary supplements for the fall and winter to help his patients prevent colds and flu. It’s fine to take one, two or all three of the following…

N-acetyl cysteine (NAC). This ­antioxidant can help prevent the flu, and clinical studies have found that it helps ward off flu symptoms even in people who already are infected with the virus. Typical dose: 500 milligrams (mg) per day.

Olive leaf extract. This supplement contains a bitter compound called ­oleuropein that has strong antiviral properties. Typical dose: 500 mg per day.

Monolaurin. This antiviral is derived from lauric acid, one of the main fats in coconuts. It destroys viruses by breaking down their outer membranes. Typical dose: 300 mg per day.

Other natural preventives…

See the light. Sunlight helps your body produce vitamin D, a potent immune booster. Some scientists think that the lack of sunlight and reduced vitamin-D production in the darker months help explain why flu is so common then.For extra protection, give yourself some full-spectrum light inside your home, too. Light therapy has been shown to enhance the immune system in the winter, and a full-spectrum light box is well worth the investment for this purpose.

Fred Pescatore, MD, a practitioner of natural and integrative medicine in New York City, author of several books including The A-List Diet and former associate medical director of the Atkins Center for Complementary Medicine.

If You Do Get the Flu…

From Dr. Schaffner…

Antiviral drugs can make your illness milder…shorten the duration of the time you are sick…and may prevent serious flu-related complications that can lead to hospitalization. It’s best to take an antiviral within 48 hours of symptom onset, so call your doctor the minute you start to feel sick. Classic flu symptoms include sudden onset of fever, aches, chills and tiredness.

Even if you’ve had the flu for more than a few days, an antiviral drug still may lessen symptoms. That’s especially important for people at high risk for flu-related complications, which includes people who are age 65 or older and people with medical conditions such as heart disease, diabetes or asthma.

Oseltamivir (Tamiflu) is the standby, and it’s still effective, but now there’s a new option—baloxavir marboxil (Xofluza), which was approved by the FDA in October 2018. Unlike Tamiflu, which is taken over the course of five days, it’s a single dose. It also dramatically cuts “viral shedding,” so you’re less infectious (Tamiflu hasn’t been shown to do this). Overall, Xofluza and Tamiflu are about equally effective, and their costs are very similar.

From Dr. Pescatore…

The following remedies can help reduce the severity and duration of the flu. It’s fine to use one or any combination of these remedies…

Oregano oil gargle. Put two drops of oregano oil in one-quarter cup of water, gargle and spit. It is fine to gargle up to four times a day. Keep in mind—it has an intense flavor, and you’ll smell like pizza!

Active hexose correlated compound (AHCC). This mushroom extract has been shown to shorten the duration of flu and ease symptoms. It also improved the immune response in people who took it right after getting a flu shot. Typical dose: 500 mg three times a day.

Elderberry tea is an antiviral that’s effective for treating flu symptoms and shortening the duration of the illness. Drink one cup a day. You also can take it as an extract or a syrup.

Robuvit, an antioxidant supplement derived from French oak wood, helps people recover more fully after flu symptoms have passed. In a study, people who took the supplement daily for three weeks after their flu symptoms subsided had better post-flu strength, sleep quality and attention span, compared with people who didn’t take it. Typical dose: 200 mg three times a day.