Flu season is now fully underground in Quebec, but it has arrived months behind schedule.

Public health experts say it’s rare for the virus to circulate in April, and they warn it’s an extra burden for hospitals already dealing with rising COVID-19 cases.

The flu largely fizzled out during the pandemic as public health measures like face masks and physical distancing kept infections at bay.

But as most of those restrictions are now lifted in the province, influenza is making a comeback, hitting in spring instead of winter and coinciding with the pandemic’s sixth wave.

“The current season is really late compared to what we see normally. We never see a season starting in April under normal circumstances,” said Dr. Gaston De Serres, an epidemiologist with Quebec’s public health institute, the INSPQ.

The institute said flu cases have doubled in the last three weeks.

Epidemiologists warn the delayed start to flu season will only add pressure to the health-care system.

The number of people in hospital with COVID-19 rose to 2,381 on Wednesday.

“We anticipate that the number of influenza cases in hospital will increase over the next few weeks and these patients will add to the burden already high in hospitals due to COVID-19 or influenza,” said Dr. Serres.

Pediatricians are also seeing a rise in flu cases and in rare cases hospitalizations among children.

“Our emergency departments are quite busy. Our wards are quite busy. We haven’t seen a lot of influenza yet but it’s quite unusual that in April we’ve already seen seven children admitted to hospital for influenza,” said Dr. Jesse Papenburg , a pediatric infectious disease specialist.

For both children and adults, it’s hard to spot the difference between COVID-19 and the flu.

“Covid-19 can have such a wide range of symptoms: runny nose, strong fever, a lot of fatigue and the exact same thing is true for influenza,” said Papenburg.

Public health officials say one difference in symptoms is that the coronavirus can cause a loss of sense of smell and that testing is the only way to know for sure.

Whether it’s COVID-19 or the flu, the advice from doctors is the same: stay home if you’re sick.

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